A Southland doctor has been found to have exploited an 82 year-old cataract patient by charging her for post-operative services which should have been free.
Health and Disability Commissioner Ron Paterson did not disclose the name of the doctor, an ophthalmologist, or that of the patient, in aruling released today.
Mr Paterson said the ophthalmologist worked in the private system, as well as the public hospital system, and performed the cataract surgery under the public system, but charged for follow-up appointments as private care.
This was done without the woman having made an informed choice, so was unethical.
"I found that the conduct was a breach of informed consent ... that it was exploitative, that it had, in effect, exploited this patient and that it had breached ethical standards," he said.
The ophthalmologist should re-imburse the woman the money she was charged for her appointments.
The commissioner said in the decision that "with some slight misgivings", he found that the Southland District Health Board reasonably relied on the doctor to make proper disclosures and was not directly liable for his failure to do so.
Southland Hospital ophthalmology department staff were obviously generally aware that the doctor was seeing public patients at his private rooms.
The doctor's lawyer claimed an undated letter indicated that the health board had condoned the arrangement of charging public patients directly for pre-operative and postoperative appointments, but Mr Paterson said he did not accept that.
The board took disciplinary action in November 1997 against the doctor in relation to the charging of public cataract patients seen by him under a "waiting times fund" contract - regarded as a serious breach of trust.
The doctor has now altered his practice and no longer sees public patients for postoperative follow up in private.
Mr Paterson recommended the doctor apologise to his patient in addition to refunding her payments.
He also called for the National Ethics Advisory Committee to advise Health Minister Pete Hodgson on the ethical issues raised by the mix of public and private treatment options in elective services and whether any guidelines are needed to clarify the limits of ethically acceptable practice.
