CHANGES TO ACC MEDICAL MISADVENTURE

Treatment injury to replace ACC medical misadventure

In March 2004 ACC Minister Ruth Dyson announced a sweeping revamp of ACC's medical misadventure provisions to make them simpler and fairer, and improve patient safety.

Medical misadventure - the term used to cover injuries caused by medical treatment - will be replaced by a new category called 'treatment injury'.

The new category of treatment injury will remove the requirement to find fault (medical error), or prove that a medical injury is rare or severe (medical mishap), before a patient is entitled to ACC cover. More people will be eligible for cover, and ACC hopes the claims process will be fairer, simpler and quicker.

Treatment injury will not cover all medical injuries. For example, injuries that are a necessary part of treatment, such as a surgical incision, and those that result from a patient's underlying condition, will not be covered. Nor will there be cover just because the desired results were not achieved or the treatment was not 100 per cent successful.

However, in common with the rest of the ACC scheme, cover will be available for minor injuries, when they meet other criteria.

Ruth Dyson said current provisions made health professionals reluctant to be involved in the claims process because of the emphasis on finding fault and reporting medical errors. ACC believes the new approach removes fault, making it consistent with the rest of the ACC scheme, and that health professionals will be more willing to co-operate in the claims process, discuss medical injuries that occur, and learn from them. This in turn will improve overall patient safety and help prevent injuries in the future.

Changes would also be made to ACC's reporting provisions. Under the new provisions, ACC will no longer be required to report all medical error to the relevant professional body and the Health and Disability Commissioner. Instead, ACC must report information to the relevant professional body if it considers there would be a risk of harm to the public. In all cases, it must also inform claimants of the Health and Disability Commissioner's role in investigating complaints about the standard of care provided.

Medical misadventure claims currently cost around $47 million (incl GST) annually. The new treatment injury provisions are estimated to cost an additional $8.69 million a year.

Legislation is likely to be introduced to Parliament by the middle of this year, with the new law coming into effect on 1 February 2005.

The information contained in this article was sourced from ACC's website. For more information about the changes to Medical Misadventure refer to www.acc.govt.nz.