Complaints and Rights

The following information has been drawn from the book "The Baby Business: What's Happened to Maternity Care in New Zealand" and is used with permission from the author, Dr. Lynda Exton and the publisher.

Every era of maternity care in New Zealand has produced tens of thousands of satisfied women with happy families.  The current system is no different.  But every era has also had room for improvement.

What do you do if you're not one of the large number of satisfied women?  If you have been disappointed with your care or with the outcome, what can you do?  These are some suggestions to consider:

‣Write everything down.  Note down as much as you can remember in as much detail as possible and add to the details from time to time as you recall other aspects of the situation, like a kind of diary.  Sometimes the very act of noting concerns down on paper (or on your computer) helps to clarify thinking and bring some sense of control.  Try to add dates and times to the account, if relevant.  Note particularly the areas or events which concern you the most.

‣Ask your support person/people to write their own accounts of events, again with as much detail as possible.

‣Request a complete copy of your medical records.  You can access a copy from your health professional or from the Medical Records Department of whatever institution you were cared for.  Request a copy of your baby's medical records as these may be stored separately from yours.  You can obtain these by contacting the patient advocate or the medical records department of the larger hospitals.

‣Keep a copy of everything, including any letters you send and the dates you sent them, any phone calls you make, the dates and the names of the person and the institution who you spoke to.

‣Keep everything related to your concerns in one place.

‣Catch your breath!  Wait a while.  You don't have to do anything else right now.  You can come back to this anytime in the future, when your personal or family situation may allow you more time or space to deal with the problem.  Sometimes the passage of time helps to get things in perspective too.

‣When you are ready, if you are able to, write to the health professional involved.  Explain your concerns and what you think should have happened.  Most conscientious health professionals should be eager to respond within around 10-14 working days, in order to clear up any misunderstandings.  Sometimes a little more information or explanation can clear up a straightforward misunderstanding.  If your health professional works for a Centre or group practice of some kind, they are required by law to have a complaints resolution process - this may be helpful to use.  You can have the free support of an independent Health and Disability Advocate to help you make this approach to the individual concerned.  Phone 0800 112233

Important note: The regional Complaints Resolution Committees set up throughout the country by the College of Midwives have some reported drawbacks.  These are:

The College of Midwives describes these committees as 'neutral', but in fact the consumer representation on them is sympathetic to the midwifery model of care.

Women and their partners can feel 'ganged up on' by the numerical representation and united point of view of the committee

There are no other professional viewpoints represented, for example those of paediatricians or obstetricians.

Women may find that their concerns are minimized or that 'there is no case to answer' to the dissatisfaction of the woman and her family and/or whanau.

Ms Guilliland, CEO of the College of Midwives stated in an interview:

'People's understanding of the role of the College of Midwives and their expectations of the College at times amaze me.  The College is expected to solve and fix everything.  What we really are is an education agent and a professional practice agent for the midwives themselves.'

You may like to consider not using the services of your local complaints resolution committee unless you want to.  If you have already used them and been dissatisfied with the outcome, you are not bound by the findings and you can pursue your complaint further if you wish to.  If however your concerns have been considered in the past by the Midwifery Council or the Nursing Council then, as I understand the situation, whatever the outcome, you may not be able to have your concerns reviewed by the Health and Disability Commissioner.  You may like to phone them on 0800 112233 to check on this.

If you are still dissatisfied and your concerns relate to a hospital employee, phone the Patient Advocate on 0800 2787 7678 and/or the Health and Disability Commissioner 0800 112233 to talk over your situation.

If the health professional concerned is self–employed then you can phone the Health and Disability Commissioner (HDC) to discuss your concerns: 0800 112233.  Serious concerns about the actions of a Health Professional which have breached your or your baby's rights will be referred to the Health Practitioners Disciplinary Tribunal - a kind of medical court.

Less serious complaints found to have breached your or your baby's rights will be referred to the appropriate professional council for, for example, censure, retraining or closer supervision of the professional involved.

Coroner's Courts are subject to a new Act as of 1st July 2007 allowing closer working together with other entities such as the Health and Disability Commissioner and a more uniform nationwide approach to issues.

The Health and Disability Commissioner

This is a user-friendly service which Mr Ron Paterson, the Health and Disability Commissioner, describes as a 'one-stop-shop' for those concerned with their health care.  You can access the services on 0800 112233 or else visit www.hdc.org.nz.  The commission must investigate any claims and report back to the complainants in a fair and timely manner.  78 percent of complainants recently surveyed described the process as fair and satisfactory.

How far back can complaints be considered?  The following advice is from the Office of the Health and Disability Commissioner:

The Health and Disability Commissioner Act (HDC Act) was enacted in 1994 with the first Commissioner being appointed in December that year. The Code of Health and Disability Services Consumer's Rights (Code) came into effect on 1 July 1996 and from that date onwards people could complain if they thought that their rights under the Code had been breached.

Previously, if people had complaints about events prior to this date then they had to pursue them under the legislation relevant to that profession - eg complaints about doctors went to the Medical Council.  However the HDC Act was amended in 2003 so that as of 18 September 2004 the Commissioner had jurisdiction to consider complaints about events prior to 1 July 1996 if:

The complaint relates to a health practitioner - ie jurisdiction does not extend to institutional providers or unregistered providers;

The action affected a health consumer

The action was a ground for bringing disciplinary action; and

The matter has not already been referred to the body that previously had jurisdiction to consider it.

Therefore people with complaints about events prior to 1 July 1996 can now complain to HDC.

Please note that the full code of rights is available on the website of the Health and Disability Commissioner www.hdc.org.nz

Birth or Treatment Injuries

In addition to the above processes, you may be eligible for injury-related financial compensation through ACC (the Accident Compensation Corporation).

For injuries to mothers, unborn babies or children, telephone ACC on 0800 101 996 to check on eligibility.

For injuries from treatment received during birth to mothers or babies, phone the Treatment Injury Unit 0800 735 566 to check on eligibility.

Mental injury such as Post Traumatic Stress Disorder is only covered by ACC if it is the result of physical injury or the threat of death or serious injury to the mother or her baby.  Your circumstances and eligibility can be clarified with a claim to ACC.  You will need a referral to a registered psychiatrist to confirm the diagnosis

See also:

Booklet ACC589 'Injury caused by treatment: How ACC can help.'

Booklet ACC586 'Getting help after someone dies from an injury'

Booklet ACC2399 'How you can get help after an injury'

Once a claim is accepted, assistance can be tailored to the particular needs which may include, for example, counselling for PTSD, a funeral grant, a lump sum entitlement for certain injuries or ongoing weekly compensation.  If your complaint has already been considered by the old Medical Misadventure section of ACC then you cannot revisit the issue under the newer Treatment Injury System.