The country’s health sector watchdog is apologising and reopening a woman’s complaint after her case received public attention and the Government lauded her advocacy work.
It comes after the Herald exclusively reported the details of Charlotte’s allegations of grooming and sexual abuse at 16 years old by a nurse while seeking help for anorexia at an eating disorder unit run by Hutt Valley District Health Board (DHB).
The Health and Disability Commissioner (HDC) now says it was wrong not to reopen Charlotte’s case when she presented fresh information last year.
Charlotte (the Herald agreed to withhold her surname) first complained to the HDC in 2019 – but investigations were halted due to the time lapsed – that few staff present during Charlotte’s admission in 2007 would still be employed by the DHB and that there was no mention of the alleged abuse on her clinical notes.
Last year, she sent the HDC more information and requested her case be reopened, but this was denied.
“I have spent seven years of feeling completely unvalidated and angry that they never bothered to speak to staff and they took the DHB at their word,” Charlotte told the Herald.
Correspondence from Hutt Valley DHB to the HDC in 2019, and later obtained by Charlotte, said other staff at the unit had raised concerns about the nurse’s “maintenance of professional boundaries” in respect to patients.
In that document, the DHB says it acted on these concerns and information from another patient’s father contributed to a disciplinary process that the DHB undertook in the late 2000s. The letter is heavily redacted but notes the nurse was ultimately dismissed that same year.
“On top of the trauma of what happened, the denial from the HDC affected my mental health for years,” Charlotte said.
In a statement, the HDC acknowledged Charlotte’s experience with the healthcare system would have caused “significant distress”. The watchdog confirmed the case had been reopened due to new information that had not previously been considered.
“In line with our usual processes, we cannot comment further on this case while our assessment is ongoing.
“We acknowledge that (Charlotte) was initially advised we would not be re-opening her complaint, however during a quality assurance process it was identified this decision was made in error. We have apologised directly to (Charlotte) for any distress this caused her.”
Charlotte previously told her story of abuse within the eating disorder unit exclusively to the Herald.
“From the beginning, the very beginning, there was one nurse who took a special interest. And when you are in that physically vulnerable [space], away from home, that feels, I don’t know, good?
“It feels warm. That slowly but surely escalated ... I would leave [the residence] and stay over at her house, and it slowly, almost without me noticing, it turned sexual.”
She said she was told by the nurse that visits to the nurse’s house were to be kept secret.
The abuse and manipulation by the nurse continued after she was discharged from the unit and went on until the nurse died suddenly some years later, Charlotte said.
“I remember her saying, ‘We have such a special bond’. She slowly isolated my supporters. [She played] this supportive role but also slightly maternal at the beginning, which added to the mindf*** of when it turned sexual because it was just a weird dynamic.
“At the time, I felt confused but also supported, which kept me going back.”
Charlotte needed to complain via the HDC, an independent but broad watchdog for the health and disability system, because the Ministry of Health’s formal redress system only applied to cases up to June 30, 1993.
She emailed several ministers trying to raise attention to this system shortfall. When she saw one of the ministers with oversight of that scheme, Erica Stanford, would be at a local event, Charlotte printed one of the many emails she had sent officials and walked up to Stanford and handed it to her.
“It was scary but at that point I was desperate,” Charlotte told the Herald.
“It got to the point where I thought ‘this is never going to get through’, so I printed off my email and personally handed it to her.”
That email explained how the country’s core and formal redress scheme did not cover abuse in state-run mental health facilities after July 1993 and “excludes an entire generation of survivors like me”.
This gap in the system is because of major health reforms in the 1990s. Liability for abuse that happened in health settings was the responsibility of the Ministry of Health, which had a formal redress system, until 1993, when major reforms dispersed liabilities across a number of organisations, such as the Crown Health Enterprises, which did not have formal redress schemes.
In 2001, liabilities were again dispersed with the establishment of district health boards and further reforms in 2022 led to DHBs being absorbed into the entity known today as Health NZ.
None of the organisations formed after 1993 had formal redress schemes to respond to claims of abuse in care and survivors’ only options were to pursue an ad hoc complaint or litigation. Health NZ is liable for claims after 2022. It says there have been 11 claims of alleged abuse in mental health settings since that time.
Stanford said when Charlotte walked up to her at the event, she was “visibly shaking and trying to hold it together”. The pair talked and organised a further meeting at Stanford’s office.
“It took an enormous amount of courage for her to come and talk to me about her case. She told me what had happened to her and what she had tried to do to get redress, and the terrible time that she had had and the brick walls that she just kept hitting at every turn to try and get some help and get some redress,” Stanford said.
A few months later, Stanford announced the state redress scheme for abuse in mental health inpatient settings would be expanded to include claims from July 1, 1993, to June 30, 2022, when Health NZ was established. Claims after 2022 would be the responsibility of Health NZ.
This amendment would be called “Charlotte’s Change”.
Phil Grady, Health New Zealand’s national director for mental health and addictions, said claims of abuse in its care, including care provided by its predecessor organisations such as DHBs, were taken extremely seriously.
“Health New Zealand recognises the distress, and impact abuse has on survivors and acknowledge Charlotte’s advocacy for the extension of the state redress system,” Grady said.
“If any person wishes to make a complaint to the Health and Disability Commissioner, we will actively participate and respond as per our normal processes as part of HDC investigations.”
Work is underway to incorporate “Charlotte’s Change” into law. It has not yet been implemented. For now, survivors with claims of abuse in mental health contexts from July 1, 1993, can register their interest with the Ministry of Health. The Government will announce when this scheme is open for claims.
Survivors with questions or potential claims can contact:
Survivors can also contact the Survivor Experiences Service, where they can share their experiences or get help accessing their records.
Julia Gabel is a Wellington-based political reporter. She joined the Herald in 2020 and has most recently focused on data journalism.