Bill Garden: Safe health system depends on close scrutiny, openness

COMMENT

Who would disagree with the need for responsible journalism? And, yes, when something goes wrong it is not always the result of a failure by medical practitioners. As Health and Disability Commissioner Ron Paterson indicates, they, too, have feelings, and they, too, have to live with the outcomes of investigations.

But what caught my attention in Mr Paterson's Perspectives article was his reference to this country facing a medical workforce shortage, and "hostile media publicity" being a factor cited by doctors giving up practice.

He followed this up, however, by saying that most media reporting of health was positive. What, then, was his purpose in putting the statement out there other than, perhaps, seeking to manipulate?

Precisely how many doctors have given up practising medicine because of hostile media publicity? It is just so easy to pull statements out of a hat and then let them hang there, waiting to do damage.

When members of the public go to the Health and Disability Commissioner or to the media, something has gone terribly wrong. For them, finding the support, the resources, the energy and the will to take on such a well-oiled and well-resourced machine as hospital management, or a doctor armed with lawyers, is no simple task. The media are often the only place to go.

For myself, approaching the media was a last resort. I had spent months trying to get the hospital to talk to me directly, and was still awaiting an acknowledgment from the Health and Disability Commissioner that my claim would be investigated. That claim, which related to the death of my daughter Amanda at Middlemore Hospital in 1998, had been sitting with the commissioner for a number of months.

The media raised the issue in a responsible manner. They double and triple-checked with the hospital for its view of what I was claiming, all of which was printed.

New Zealand is not alone in the way health professionals are demanding that the media not go into print, or that they limit what they say about medical mishaps. The reason is always the same: that raising health issues in public scares off much-sought health professionals. In recent weeks, I have seen articles in British and Australian newspapers saying much the same thing.

Why is this? I have yet to hear of anyone who was dragged into the profession against his or her will. They became doctors for a variety of reasons, but surely none expected indemnity for getting it wrong when the errors were blatant thoughtlessness or carelessness.

I am sure the the medical codes of ethics caution them against working where the environment is deemed unsafe because of inadequate resources, where people are knowingly practising in an unprofessional manner, where systems are not in place, or where there are no defined processes. In other words, the safety of the patient is deemed paramount.

That does not include doctors having done their absolute best, and the result being different from what they had set out to achieve. In most circumstances they would have informed all those concerned of the various likelihoods.

Most of us are pretty reasoned, and where the medical profession is dealing with unreasonable people, safety barriers appear to be in place to ensure that doctors are protected. Where they are not, there is no body of people better placed to demand change.

The fact is that the medical profession does not like coming under the scrutiny of the media. Why not? Because when something goes wrong, it is usually about body parts and shortened lifespans, and that is emotional stuff.

And I can understand why doctors are sensitive. But where do you draw the line about what to report and what not to report, and how long is it before the medical profession is completely fenced off from accountability because it works in isolation from the rest of the community?

And how does a political ideology fare in this environment? Do the media ignore that element because often the failure is not that of the practitioners but the ideology under which they have to work? Often claimants are aware of this and the only way they can get to the root of the problem is through the media.

And, of course, should car salesmen, politicians, lawyers or whoever not also be given the same protection?

Perhaps there is another option: that health professionals pause to check out the nature of the profession they are entering, and acknowledge that they will come under a good deal of scrutiny. And maybe consider whether they have the stamina to deal with it.

We have come a long way towards providing quality healthcare, and the media must get some of the credit. The day we have to wait for the Health and Disability Commissioner to issue a report before the media can have access to the details is the day healthcare takes a giant leap backwards.

* Bill Garden, of Takinini, complained about the care of his 21-year-old daughter, Amanda, at Middlemore Hospital in 1998. The Health and Disability Commissioner criticised South Auckland Health for being "lax and insensitive". While Ms Garden's death could not have been avoided, she had not been treated with appropriate care and skill.