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BMJ 2006; 332 doi: (Published 13 April 2006) Cite this as: BMJ 2006;332:904

Compensation and complaints in New Zealand

Dear Editor,

In New Zealand, complaints regarding 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.

For thirty years, New Zealand has essentially barred medical
malpractice litigation. All patients who suffer a treatment injury are
eligible to receive government-funded compensation through the Accident
Compensation Corporation. Following 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.1

Separate and independent processes are available for responding to
patients’ non-monetary interests (such as the desire for an apology,
explanation, or corrective action to prevent harm to future patients).2 In
particular, the Health and Disability Commissioner resolves complaints by
advocacy, investigation, or mediation.3

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 anonymized form so that lessons can be learned from the
adverse event.

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

Yours faithfully

Marie Bismark

1. Bismark MM, Paterson RJ. No-fault compensation in New Zealand:
Harmonizing Injury Compensation, Provider Accountability, And Patient
Safety. Health Affairs 2006;25(1):278-283.
2. Bismark MM, Dauer EA. Motivations for medico-legal action: lessons from
New Zealand. Journal of Legal Medicine 2006;27, Number(1):55-70.
3. Paterson RJ. The Patients' Complaints System in New Zealand. Health
Affairs 2002;21(3).

Competing interests:
None declared

Competing interests: No competing interests

17 April 2006
Marie M Bismark
Senior Solicitor
Buddle Findlay