“This increase has undoubtedly placed us as an organisation under significant pressure,” McDowell said.
“The reality is that currently we cannot close as many complaints as we receive.
“Regrettably that means delays are happening within our system.”
Annual reports show the rise in complaints has been driven by the pandemic, an under-pressure health and disability system, health reforms and “novel issues” which require more time and resources.
About 11 per cent of unresolved complaints to the commission were more than two years old.
Labour’s health spokeswoman Dr Ayesha Verrall, a Health Committee member, said those delays were “unnacceptable” - a comment the commissioner agreed with.
Complaints that are assessed by the HDC as serious or highlighting systemic problems proceed to a formal investigation. Data obtained under the Official Information Act showed the average time to complete an investigation was 893 days in 2022/23 - up from 762 days in 2018/19.
McDowell said the organisation was focusing on the most serious and urgent complaints and had improved its triage system to quickly identity complaints needing investigation.
It was also taking measures to address the backlog, including early resolution initiatives and improving cultural resources to tackle a rise in complaints by Māori.
These initiatives alone would not address the backlog, McDowell said: “Our delays are increasing and there is only so much you can do with process redesign to limit the delays.”
She added: “I’m confident that if we had increased resources we could do better.”
The commission has been told by the Government to show fiscal restraint and cut back on spending where possible. It has not been asked to make any job cuts, but was asked by the Finance Minister Nicola Willis in her letter of expectation to reduce spending on contractors and consultants.
A spokeswoman said the commission had tightened its rules around discretionary spending, which included cutting back on non-essential travel and contractor costs. While the commission used independent clinic experts for some of its work, it was not heavily dependents on contractors, the spokeswoman said.
McDowell told MPs a significant factor in addressing the large number of complaints was the commission’s creaking IT system. McDowell sheepishly said their case management was still run by the outdated Lotus Notes programme.
The estimated cost of an upgrade was $1.6 million. A business model for a new IT system was rejected in 2022, though a new proposal was being developed.
Health Minister Shane Reti said he was in discussions with the HDC and the ministry about how to best manage its funding. He said the commission did “critical work” in promoting the rights of New Zealanders using health and disability services.
Reti said he expected to receive a proposal on an IT upgrade in the next few weeks, which he would consider.
HDC is the only independent agency for healthcare complaints. It also plays a quality and safety role and can initiate its own investigations - including a major inquiry into failing cancer services in the former Southland District Health Board which was concluded last year.
The commission also contributed to the decision to “pause” surgical mesh services last year after raising concerns about informed consent and treatment injuries.
A SON’S LONG WAIT
Gareth Lowndes laid a complaint with the commission a week after his mother died suddenly in January 2022.
His mother, who was 69, had an endoscopy procedure at Middlemore Hospital after being admitted for abdominal pains.
The initial procedure went smoothly but a complication led to her pancreas becoming inflamed, and after being admitted to intensive care she died.
An initial report by Middlemore found that two straightforward steps - anti-inflammatory medication and a stent - might have reduced her risk of pancreatitis.
Lowndes, who lives in Tuakau, said a formal investigation by the commission was still necessary because he felt the changes made at Middlemore as a result of his mother’s death should be applied nationally.
Two and half years later, the investigation is ongoing. Lowndes claimed it took the commission roughly 18 months to find an independent consultant to assist with the case.
Lowndes made a formal complaint to the commission about the delay last year, and was told by a team leader that they were under severe pressure which was unlikely to be resolved quickly.
In a draft report by the commission received in May, an independent expert found his mother’s operation went ahead partly on the basis of an eight-year-old ultrasound, Lowndes said. If up-to-date imaging was at hand, his mother might not have needed the procedure at all.
A final report is now being written.
The commission cannot discuss cases under investigation.
After Lowndes’ mother died, his father’s health deteriorated and he died four months later.
“One of the main reasons I’m pushing for answers is because he wanted them,” Lowndes said.
“My sister and I are trying our best to get them, but staffing issues and general bureaucracy are getting in the way.”
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics, and social issues.
