Health and Disability Commissioner Annual Report 2006

The Health and Disability Commissioner Ron Paterson says there is growing evidence that complaints do improve the quality of health care.

In his 2005/06 Annual Report, Mr Paterson gives examples of improvements that have resulted from recommendations made after his investigations into complaints. For example, the Palmerston North Hospital case in November 2005 highlighted the issue of medication safety in public hospitals and has prompted audits and changes in hospitals across the country.

Mr Paterson cites research he co-authored with New Zealand lawyer and doctor, Marie Bismark, and others, that was recently published in the international journal Quality and Safety in Health Care. It concludes that “complaints offer a valuable portal for observing serious threats to patient safety and may facilitate efforts to improve quality”.

Mr Paterson says greater transparency and accountability in the publicly funded health system is being promoted by his practice of now naming public hospitals and district health boards found in breach of the Code of Health and Disability Services Consumers’ Rights for systemic issues.

Despite the gains, Mr Paterson also cautions that progress in tackling the safety and quality of health care in New Zealand has been “slow, patchy and uncoordinated” in comparison with countries such as Australia, the United Kingdom and the United States.

He comments in the report that there continue to be “significant challenges to improve patient safety and the quality of care in hospitals and the community”. He notes that although a range of activities are being undertaken at a national level and by individual district health boards, there is no national body equivalent to the newly established Australian Commission on Safety and Quality in Health Care to lead quality improvement efforts.

The Commissioner says the National Health Epidemiology and Quality Assurance Advisory Committee (EpiQual) “has had very little visibility in the sector to date, and is not yet a body that clinicians or consumer groups look to as leading safety and quality efforts nationally”.

In 2001 the New Zealand Quality of Healthcare Study reported that 12.9% of public hospital admissions were associated with an adverse event, and 30% of adverse events were judged to be preventable. More recently, Parliament’s Health Select Committee highlighted the problem of adverse events and called for national action.

“There is an opportunity for New Zealand to make patient safety and quality improvement a key priority for government and the health sector in the year ahead” says the Commissioner.

Key statistics in the annual report

•    88% of 4,550 complaints received by Nationwide Advocacy Service partly or fully resolved with advocacy support, 91% within three months
•    Slight drop in complaints to HDC: 1,076 in 2005/06 compared with 1,124 in 2004/05
•    89% of all complaints to HDC are concluded using approaches other than formal investigation
•    79% of all complaints to HDC concluded within six months
•    116 complaints were resolved after or during a formal investigation / 51% of completed investigations resulting in a finding of breach of the Code
•    Most breaches of the Code related to deficiencies in assessment and treatment, lack of care co-ordination, poor communication and inadequate record-keeping
•    32% of breach findings (19 providers) were referred to the Director of Proceedings / 11 out of the 12 substantive hearings resulted in the Director of Proceeding’s charges being upheld
•    High levels of satisfaction reported by parties surveyed following experience of the Office’s investigations – 78% of complainants and 82% of individual providers who responded to HDC’s survey were satisfied that their view was heard in a fair and unbiased way.

Background Information

The Code of Health and Disability Services Consumers’ Rights 1996 is a regulation under the Health and Disability Commissioner Act 1994. It confers a number of rights on all consumers of health and disability services in New Zealand, and places corresponding obligations on the providers of those services, including hospitals.

The Commissioner is required to facilitate the resolution of complaints relating to alleged breaches of the Code of Health and Disability Services Consumers’ Rights, and to educate the public and health and disability providers about consumers’ rights.

The Annual Report 2005/06 is available on the Health and Disability Commissioner website at www.hdc.org.nz.

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