NEW ZEALAND: MISADVENTURE COSTS CLIMB
By Glen Scanlon

MEDICAL misadventure has cost ACC $91 million in seven years, with the annual cost climbing to more than $20 million for the first time in the past year.

ACC Healthwise general manager David Rankin said yesterday that medical misadventure continued to have a "very high" under-reporting rate with just 20 per cent of cases reported. The cost of claims was expected to be $280 million during the next five years.

A patient safety study issued last week by Professor Peter Davis, of the Christchurch School of Medicine, found that more than one in eight public hospital patients would suffer a medical mishap.

ACC statistics show the number of medical mishap and medical error claims it accepted rose to 721 in the year ended June 30, 154 more than in the previous June year. Last year, it received 615 new medical error and mishap claims, one more than in 1999-2000 and 182 more than in 1998-1999.

Medical mishaps and errors cost ACC $22.09 million in the June year, an increase of $15 million in seven years. Costs in the June year were $6 million higher than the previous year.
In the seven years, ACC has accepted 4847 medical mishap and 763 medical error claims.
The most claims accepted by ACC in the seven years was 629 from general surgery. Gynaecology supplied 516 and orthopaedics 439.

The highest number of medical error claims related to general practitioners, with 159.
The number of ongoing claims handled by ACC has grown from 66 in the 1995 June year, to 1515 in the past June year.

Dr Rankin said the number of new claims had levelled off with the end of the inquiry into Gisborne pathologist Michael Bottrill, but many people were still not aware of their rights to claim.

The reasons for under-reporting were not clear but New Zealanders had a high respect for doctors and were reticent about sending their doctor to the "cleaners". Many were also caught up in the devastating consequences of misadventure. By the time they were ready to complain it was too much for them to find everyone involved.

Dr Rankin said ACC was using publicity to try to make people more aware of their entitlements. The cost would continue to grow because people were living longer and the cost of health technology was increasing.

Medical Association chairman John Adams believed ACC's figures were fairly representative of the extent of medical misadventure. Most people were aware of the scheme.
Dr Adams said the facts spoke for themselves - "12.9 per cent of hospital admissions in New Zealand will be associated with adverse effects of some description, of which 6.3 per cent are preventable".

A lot of effort was being put into the issue of quality medical care and trying to reduce errors by targeting medical systems, Dr Adams said.

New Zealand's rate of medical error was comparable to those in Australia and Britain.

Medical errors and mishaps CLAIMS for medical misadventure arise from personal injury resulting from medical error or mishap. Medical error is the failure of a registered health professional to observe the standard of care and skill reasonably expected in the circumstances. It includes situations when the health professional is negligent about a diagnosis. Medical mishap is an adverse result of treatment by, or at the direction, of a registered health professional. This occurs if the adverse result would not occur in more than 1 per cent of cases where that treatment was given, and hospitalisation, significant disability, or death resulted.

ACC does not pay lump sums for medical misadventure though that is to change from April 1. Victims receive weekly payments. In the case of accidental death, ACC will pay a funeral grant of up to $3186. The victim's partner can also receive $4563 and children and other dependants $2881 each.
Independent Newspapers, quoting The Dominion, 8th December 2001

Phillip Day's Comment: After recently touring that fine country New Zealand, and meeting some of its people in December, the medical establishment predictably reacted to my message of the extent of iatrogenic death in New Zealand with disbelief, feigned outrage and cries of "Nonsense!"

I think it's high time these authorities were brought to account. The answer is not higher compensation claims, but a complete reorganising of how disease is treated from the outset. Nutrition should blaze the way forward, with somatic treatments applied strictly where needed. As usual, this is not the message the pharma-complex wishes to hear, but hear it they shall, if the people of that great country organise and cry loudly enough for a end to 'medical misadventure'.