KEY POINTS:
The Government is under pressure from its leading health watchdog to protect patients better during health-worker strikes after a near-miss at Dunedin Hospital.
And the health board at the centre of two investigations warns that health strikes will inevitably lead to patient deaths.
Health and Disability Commissioner Ron Paterson has taken the unusual step of publicly urging Health Minister David Cunliffe to read his report on the near-miss.
"I recommend that the minister ... review this report and consider what action could be taken to ensure better protection of patients during strikes," Mr Paterson says in the report.
It is one of two commissioner reports, made public today, on episodes of care at Dunedin Hospital affected by radiographers' strikes in September and November 2006.
One involved a 50-year-old man who had a near-miss but later recovered. No one was found in breach of the code of patients' rights.
The other case involved a 67-year-old woman with a brain aneurism who died while waiting for a scan.
Mr Paterson's call for better patient protection during strikes follows his plea, during a national strike by junior doctors in April, for new ways to solve health pay disputes.
He told the Herald then: "It's entirely unsatisfactory to have what are becoming rolling strikes.
"It's a totally unacceptable situation for the public and for all the people working in hospitals who are left to pick up the pieces."
An Apex union representative, Robyn Slater, said the legislation did not need to be changed, although it appeared health boards needed to improve their internal communication.
Otago board chief executive Brian Rousseau said there was a conflict between the right to strike and boards' obligations in patient safety, but this was for Parliament to address.
"These cases have left us with the incontrovertible belief it is just a matter of time before an error of judgment is made during a strike and a patient is either harmed, or worse, dies ... "
However, the Government will be unwilling to remove the right of health workers to strike provided they agree to provide cover to avoid death and, since late 2006, permanent disability.
"I would not make it illegal to strike, but I would want to have confidence that the LPS [life-preserving services] process is rigorous ... ," said Mr Cunliffe. "I am pleased that there is now an understanding between the unions and DHBs that if an LPS request is made it will be met, and any disputes about interpretation will be dealt with after the fact."
His office says DHBs' responses to strikes have become more co-ordinated.
DIED WAITING FOR CT SCAN
* Myra Corbishley, 67, died of a brain aneurism while waiting for a semi-urgent CT scan that was delayed by the September strike.
A neuro-surgeon-adviser to commissioner Ron Paterson considered her death was probably not caused by the aneurism, contrary to the death certificate. An autopsy was not done.
Mr Paterson found her rights were breached by a hospital neurosurgeon by not assigning sufficient urgency to the scan referral; and by the Otago District Health Board by not communicating with her promptly about the appointment. She had waited nearly six weeks when the strike led to a three-week delay.
* In November 2006, during a strike by radiographers in the Apex union, a 50-year-old man was admitted to Dunedin Hospital with slurred speech and poor balance.
A neurologist considered he should have an MRI (magnetic resonance imaging) head scan. His condition was serious, but not life-threatening, so he did not meet the criteria for calling on striking staff to provide life-preserving services. The next day, after the man's condition deteriorated, the neurologist wrote that his care was now "critically dependent on obtaining a life-sustaining scan".
The scan was done. It indicated a "hyperacute haemorrhage" in the brain. Surgery was performed in which a large brain abscess was drained and he was given antibiotics until the following February. He slowly recovered.
Mr Paterson said that if not for the strike, the man would have had the scan on the day of his admission to hospital "rather than allowing him to deteriorate to a perilous state".
