Doctors: hospitals hide slips

By FRANCESCA MOLD

Almost two-thirds of New Zealand doctors who took part in an international survey feel hospital staff are discouraged from reporting medical errors.

The 2000 International Health Policy Survey of Physicians interviewed 493 New Zealand doctors and specialists, comparing their views with those of colleagues in Canada, Australia, Britain and the United States.

The study's findings are being discussed at a Commonwealth Fund forum in Washington, attended by Health Minister Annette King and Director-General of Health Dr Karen Poutasi.

The study found that 64 per cent of general hospital doctors in New Zealand and 46 per cent of specialists felt hospital staff were encouraged not to report errors.

Health and Disability Commissioner Ron Paterson said he was concerned at the findings.

"I'm also a bit surprised, given the legal protections that are available in New Zealand that are not available in those other countries," he said.

These protections included the accident compensation scheme, which prevented doctors being sued by their patients, and the emphasis of the commissioner's office on resolving disputes.

"But the survey highlights that we have got a problem and I'm concerned by the clear perception I have observed - and this survey has confirmed - that people may think it is better to keep their mouth shut about errors."

Hospitals needed a culture change as well as a system to deal with mistakes that was balanced by public accountability for serious lapses.

The executive director of the Association of Salaried Medical Specialists, Ian Powell, said the results reflected years of under-resourcing and a lack of reporting systems.

"The whole question of reporting medical errors has not been part of the central ethos of hospitals," he said.

"Hospitals have been preoccupied with survival."

The survey also showed that about 82 per cent of New Zealand doctors were concerned about limitations on specialist referrals and the time patients had to wait for treatment.

New Zealand rated worst among the five countries for treatment waiting times.

About 9 per cent of doctors reported that a 50-year-old woman needing a biopsy for an ill-defined mass in her breast would wait more than a month for treatment.

In the US and Britain about 1 per cent of doctors reported a similar waiting time, in Australia 5 per cent and in Canada 7 per cent.

Most doctors in New Zealand thought the woman would be treated in one to two weeks.

For a 65-year-old man needing a hip replacement, 92 per cent of the New Zealand doctors interviewed said he would wait more than six months.

That compared with 93 per cent in Britain, 71 per cent in Australia, 60 per cent in Canada and 1 per cent in the United States.