Dalziel mulls over ACC and medical misadventure

The Government is exploring extending Accident Compensation Corporation's coverage of medical misadventure injuries, but final policy decisions won't be taken until after the next election.

The area has been highly contentious in recent times because of a number of cases where injured patients have found it difficult to get ACC compensation and had problems trying to take doctors to court.

ACC Minister Lianne Dalziel said the existing cover for those injured due to medical misadventure was "messy" and ran against the founding principles of ACC.

"It is the only area of the scheme where a claimant has to prove fault or prove what happened to them was so rare and so severe that it doesn't generally happen," Ms Dalziel said.

Ms Dalziel said this set the threshold too high and those injured in any other way received assistance from ACC no matter what the nature of the accident or who was to blame.

One of the reasons for the tighter rules is to ensure ACC isn't swamped by claims for medical work where an injury is expected or likely to happen. For instance, where an operation involves surgery and painful recovery, this is an injury, but an expected one.

Officials are still working on the options, but Ms Dalziel envisaged ACC widening its coverage by not making the injured person prove negligence to have a claim accepted. Instead minor injuries would be excluded and the claimant would have to show the injury was not a likely outcome of the medical intervention.

The minister acknowledged if implemented this would lead to an increase in ACC's expenses and this would have to be met somewhere. Currently any claims are funded by other levy-payers.

"The question at that point is do we then look at whether registered medical professionals ... contributed to a fund?"

Doctors have argued that this would lead to defensive medicine being practised and people being harmed because doctors were scared to intervene in case something went wrong. This is based on ACC charging higher levies for those parts of the profession with higher medical misadventure rates.

"I argue if it was a flat low levy across the professionals that wouldn't be the case," the minister said.

Ms Dalziel said the alternative of a return to the right to sue doctors -- which she does not support -- would create even more defensive medicine and a huge increase in medical insurance premiums.

ACC statistics show under current rules the number of medical mishap and medical error claims it accepted rose by more than 100 to 721 in the year ended June 30, 2001, costing ACC $22 million. The term misadventure covers both mishap and error. A medical error is where the professional was at fault.

Over a seven year period ACC accepted 4847 medical mishap and 763 medical error claims.

The most claims accepted by ACC in the seven-year period for medical mishap was 629 from general surgery. Gynaecology supplied 516 and orthopaedics 439.

The highest number of medical error claims related to general practitioners, with 159.

Doctors reacted angrily last year when it was suggested that health professionals pay an ACC levy to cover the sector. The power to levy the profession has been in law since 1992, but never used.

A major patient safety study released last year found more than one in eight public hospital patients would suffer some kind of medical mishap.

Of the 3000 deaths caused by medical failure, about half were preventable, according to the study.

Preventable errors can be the result of individual negligence or system problems, such as misread drug prescriptions.

Unavoidable incidents included known complications of operations and drugs.

- NZPA