BMJ  2006;332:1095 (6 May), doi:10.1136/bmj.332.7549.1095

Letter

Compensation and complaints in New Zealand

EDITOR—In New Zealand complaints about quality of care are resolved independently from claims for compensation. The New Zealand Health and Disability Commissioner does not serve as a "gateway" to the no-fault compensation system.¹

For 30 years New Zealand has essentially barred medical malpractice litigation. All patients who have a treatment injury are eligible to receive government funded compensation through the Accident Compensation Corporation. After reforms in 2005 the scheme is truly no-fault with no requirement to establish any error or negligence on the part of the healthcare provider.²

Separate and independent processes are available for responding to patients' non-monetary interests (such as the desire for an apology, an explanation, or corrective action to prevent harm to future patients).³ In particular, the Health and Disability Commissioner resolves complaints by advocacy, investigation, or mediation.⁴

The commissioner's focus is on opening channels of communication between the doctor and patient, understanding what went wrong and why, and supporting doctors and healthcare organisations back into safe practice. The process is confidential, though the commissioner's findings are widely disseminated in an anonymised form so that lessons can be learnt from the adverse event.

Of course, some injured patients seek monetary and non-monetary remedies and may choose both to lodge a complaint and to file a no-fault compensation claim.

Buddle Findlay, 1 Willis Street, PO Box 2694, Wellington 6001, New Zealand mariebismark{at}gmail.com

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Competing interests: None declared.

References

1. Marcovitch H. Patents' complaints are "tip of an iceberg" in New Zealand. BMJ 2006;332: 904. (15 April.)[Free Full Text]
2. Bismark MM, Paterson RJ. No-fault compensation in New Zealand: harmonizing injury compensation, provider accountability, and patient safety. Health Affairs 2006;25: 278-83.[Abstract/Free Full Text]
3. Bismark MM, Dauer EA. Motivations for medico-legal action: lessons from New Zealand. Journal of Legal Medicine 2006;27: 55-70.
4. Paterson RJ. The patients' complaints system in New Zealand. Health Affairs 2002;21(3).

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