Revamping ACC's Medical Misadventure Provisions
A revamp of ACC's medical misadventure provisions is proposed. The aim is to make them simpler and fairer, and improve patient safety. Legislation for the changes is likely to be introduced to Parliament by the middle of this year, with the new law coming into effect on 1 February 2005.
Under the proposed changes, medical misadventure - the term used to cover injuries caused by medical treatment - will be replaced by a new category called treatment injury. Treatment injury will remove the requirement to find fault (medical error), or prove that a medical injury is rare or severe (medical mishap), before a patient is entitled to ACC cover (see box). This means that treatment injury will cover injuries whether they are serious or not (making it more consistent with the rest of the ACC scheme).
NB: Current ACC rules for medical misadventure require a finding of either:
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Medical misadventure claims currently cost around $47 million (incl GST) annually. The new treatment injury provisions are estimated to cost an additional $8.69 million a year.
Getting Health Professionals on Board
It's claimed the current provisions made health professionals reluctant to be involved in the claims process because of the emphasis on finding fault and reporting medical errors. The new approach removes fault, making it consistent with the rest of the ACC scheme. This, it is said, should mean that health professionals will be more willing to co-operate in the claims process, discuss medical injuries that occur, and learn from them.
It should be noted, however, that claimants who are concerned that their provider was negligent would still be able to make a complaint to the Health and Disability Commissioner.
Changes would also be made to ACC's reporting provisions. Under the new provisions, ACC will no longer be required to report all medical errors to the relevant professional body and the Health and Disability Commissioner. Instead, ACC must report information to the relevant professional body if it considers there would be a risk of harm to the public. In all cases, it must also inform claimants of the Health and Disability Commissioner's role in investigating complaints about the standard of care provided.
Exceptions to Cover
Treatment injury would not cover all medical injuries. Injuries that are a necessary part of treatment, such as a surgical incision, and those that result from a patient's underlying condition would not be covered. Nor would there be cover just because the desired results were not achieved or the treatment was not 100 percent successful. However, in common with the rest of the ACC scheme, cover would be available for minor injuries, when they met other criteria.
Other Points
Many people who have already been injured in adverse medical events will only show symptoms after the new law comes into affect. The Government is working on transitional provisions that ensure that these people are treated fairly. The details will be made public in the new bill.
Those people that have already been considered under existing legislation and declined cover because they do not have an injury cannot be reconsidered under the new legislation unless they can show they now have a personal injury.
Contact for Enquiries
The Ministry of Agriculture and Forestry
Pastoral House
25 The Terrace
PO Box 2526, Wellington
Tel: 0800 00 83 33
Fax: +64 4 894 0720
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