Health Minister Simeon Brown is open to ways of providing confidence in the health system. Photo: RNZ / REECE BAKER
Health Minister Simeon Brown has not ruled out introducing a Patient Safety Commissioner to boost public confidence in the health system.
The Health Consumer Advocacy Alliance petitioned Parliament last year, asking it to establish a commissioner to reduce medical injury and harm, heading off problems before people get hurt.
New Zealand already has checks and balances in the health system, including the Health and Disability Commissioner, the Health Quality and Safety Commission and the Health Practitioners Disciplinary Tribunal.
Health advocates have renewed calls for another agency, like the one currently in place in the UK, arguing the existing checks and balances are overworked and underfunded.
"A Patient Safety Commissioner would have the mandate to be able to make the effective change for the systems, and bring all of the respective agencies around the table and get them to really break down the issues of why things aren't getting done," Health Consumer Advocacy Alliance member Denise Astill said.
Astill has been a health advocate for more than a decade, since her twin daughters were diagnosed with foetal anti-convulsant syndrome that left them with chronic eyesight and hearing problems.
Cameron and Denise Astill with their twin daughters Natasha and Jazmyn, who have foetal anticonvulsant syndrome. Photo: Supplied
Neither daughter will ever be able to live independently and Astill said she initially blamed herself, after two specialists advised her the risks around an anti-seizure medication she was taking for epilepsy could be mitigated by taking folic acid.
"I grieved for a long time and it took me a long time to figure out it wasn't my fault. It was the medication, not me, and I'd been failed by the system."
Astill believed a Patient Safety Commissioner could have helped her years ago and should be in place now for those who needed help.
"It would benefit New Zealand on whole different level, because the agencies we currently have are overworked and underfunded, and they're not tackling the systemic issues of the retrospective issues properly."
Patient Voice Aotearoa chair Malcolm Mulholland has been on a nationwide roadshow, hearing all sorts of stories, from long wait times at emergency departments to doctor-less hospitals.
"It's been pretty exhausting," he said. "Hearing some of the stories that are coming from patients and communities is pretty harrowing, but somebody has to do it."
He supported the proposal for a Patient Safety Commissioner, who could act as "an ombudsman" for the health system.
"The Health and Disability Commissioner is probably well equipped to deal with doctors, where patients have issues over the treatment that they received, but I don't think they're well equipped to look at system issues and I can see a number happening throughout our health system.
"We need a forum, an entity, a body whereby those issues are identified, and solutions are found and basically tabled in front of politicians, who can deliver on those recommendations."
'Hold the system to account'
Health and Disability Commissioner Morag McDowell said her work was independent and "certainly" identified systemic issues through the complaints she received.
"I would say that we hold the system to account far more often than we do individual providers," she said. "Obviously, from time to time, individuals will be held to account for breaches of the code, but we will look at the system and the way it supported the provision of care.
"It's really important to understand that this is always done with a view to quality improvement, because the vast majority of complainants who come to us say, 'We don't want what happened to us to happen to anyone else'."
Health and Disability Commissioner Morag McDowell Photo: Supplied
The HDC has received a significant increase in complaints since the start of the Covid-19 pandemic, up 52 percent since 2019/2020. Its funding in that same time has risen by 32 percent.
McDowell said delay and access were key themes in these complaints, and while the numbers were up, the commission was closing 70 percent of them within six months.
"At the moment, we're closing more cases than we're receiving, which puts us in a really good position to look at the cases on hand, and to try and manage that volume of complaints, which will directly impact on our ability to be a bit more timely.
"I do accept that timeliness is an issue for us, and we are working very hard to make sure that we become more timely and efficient, more timely in the way we manage things."
McDowell agreed with some parts of the Health Consumer Advocacy Alliance's petition to Parliament, but did not think a Patient Safety Commissioner was necessary.
"There can be improvements in information sharing and the monitoring of patient harm," she said. "I'm not yet persuaded that we need another agency.
"I think that we need to look to the agencies that exist to see whether they're maximising their powers within their legislation."
McDowell said the recommendations and suggestions she made after looking into complaints had a high compliance rate of more than 90 percent.
She added her jurisdiction was flexible and she had the ability to investigate concerns in the health system, without receiving a complaint.
Minister 'open' to looking at what other jurisdictions are doing
When asked about his position on a Patient Safety Commissioner, Brown did not rule it out.
"I am open to looking at other models used in other jurisdictions to provide more confidence to the public that all parts of our healthcare system are putting patients first."
He noted avenues already existed for patients to raise safety concerns and for these concerns to be investigated by the appropriate authorities.
"Patient safety is critical to ensure Kiwis have confidence in our healthcare systems. All of our health professionals undertake extensive training to ensure they are providing patients with high-quality, safe care."
The Health Quality and Safety Commission was approached for an interview.
