Dave Macpherson: Why Being Part of the Health Sector Means Never Having to Say You’re Sorry, and why the Government won’t step in…..
Late last week the NZ Herald covered a story about a young boy who nearly died while in Starship Hospital due to a staff member’s treatment error.
The error was suspected by the boy’s mother, who demanded the treatment be checked; when the error was confirmed, the boy was rushed to the intensive care unit where he, very fortunately, survived.
The point of mentioning this is not to talk about the treatment error – as with the best will in the world, mistakes can be made, but about how it was handled, how the boy’s family was responded to, and how the Auckland DHB medical fraternity tried every which way to avoid taking responsibility, or even saying ‘sorry’.
The health sector’s inability to say that little word has also been very evident in my own family’s case, involving the death of my son Nicky Stevens, which has been profiled in mainstream and social media recently.
When Auckland DHB issued a comment about little Stephen Eletise, they said ‘patient safety was the top priority for the Starship team’.
And “we take concerns expressed by patients and whanau very seriously and have a robust review process,”
But not once did they use the word ‘sorry’, and Stephen’s mother also said the DHB tried to talk her and her husband out of filing a complaint against the nurse who made the error. When the parents met the doctors involved “they said there was no point in blaming anyone as they needed to focus on saving our son’s life.”
Fair enough, you might say; let’s focus on the most urgent things. I recall Waikato DHB staff saying to my partner Jane, immediately after Nicky disappeared when let out of the Henry Bennett Centre’s acute care unit unescorted, against our wishes; ‘let’s not argue about whose fault it is, let’s concentrate on finding him’.
As we found out later, not only did they not do a complete (or any) search of the area they had been told he was likely to go to, they did not complete the required report to the police for nearly 12 hours, and the cops themselves didn’t start a search for nearly 3 days.
But the understandable reaction by our family, and Stephen’s family, to the ‘now is not the time to argue’ message from the DHBs got the health authorities off the immediate hook and gave them time to shore up their defences.
And their defences were, and are, ‘don’t say you’re sorry, or in any way accept any blame’, as that will be tantamount to admitting liability, which may cost the DHB in the long run.
DHBs are all covered by liability insurance policies, not to the extent of American ones, when you see the relatively small premiums they pay, and when you factor in the ‘no fault’ ACC scheme are not meant to cover huge sums. However the insurance companies (QBE in Waikato DHB’s case) fiercely work to ensure even the limited level of liability is minimised.
When withdrawing from direct discussions with our family, Waikato DHB’s Board Chair and CEO openly stated that they had been “instructed” by QBE to try and get a re-opening of the Coroner’s Inquest into Nicky’s death, along with a new Coroner. The unequivocal apology that our whanau sought, was never given.
That this happened after the Coroner had said my son’s death was “avoidable” and that the DHB had made a series of mistakes in his care, showed the key driver for the DHBs actions was the potential cost to their insurers, as it will be in Stephen’s case.
The Government, from the Prime Minister, through the Health Minister to the local MP, have all moved to distance themselves from comment on Nicky’s case, as they do on many other contentious health issues.
They say ‘the matter is in the hands of the DHB’, omitting to mention that they appoint the Chairs and Deputy Chairs of the DHB Boards, plus at least 2 other members and, through the Health Ministry, have a powerful say in the actions of each DHB, giving those bodies 99% of their revenue, and approving pretty much 100% of their budgets.
Successive Governments have encouraged the pretence of ‘local control’, while ensuring the control strings are firmly kept in the hands of both Wellington and their private sector health partners, such as the drug and medical equipment supply companies and, in many cases, the insurance companies.
So our fight, and the fight of Stephen’s family, will be by proxy against the DHBs, but will be also need to be against those in underlying control; the health sector bureaucracies acting on behalf of the Crown, and their private sector partners.
Dave Macpherson is TDB’s mental health blogger. He became a Waikato DHB member after his son died from mental health incompetence.
And do not forget our so often overworked, understaffed and in some cases also biased ‘watch dogs’, delivering nothing more than wet bus ticket slaps on the wrists of wrongdoers:
https://nzsocialjusticeblog2013.wordpress.com/2016/03/28/how-the-hdc-throws-out-valid-complaints-and-protects-code-breaching-health-professionals-a-true-story/
https://nzsocialjusticeblog2013.wordpress.com/2015/10/04/how-the-n-z-health-and-disability-commissioner-let-off-a-biased-designated-doctor/
http://nzsocialjusticeblog2013.wordpress.com/2014/05/27/health-and-disability-commissioner-can-we-trust-in-hdc-independence/
https://nzsocialjusticeblog2013.files.wordpress.com/2017/11/how-the-n-z-ombudsman-effectively-provides-cover-for-the-hdc-report-post-28-11-17.pdf
https://nzsocialjusticeblog2013.wordpress.com/2017/11/21/how-the-new-zealand-ombudsman-effectively-provides-cover-for-the-hdc-an-information-request-complaint-case/
https://nzsocialjusticeblog2013.wordpress.com/2016/09/05/the-new-zealand-ombudsman-underfunded-and-compromised-the-auditor-general-sees-no-need-for-action/
is it a case of the government wont step in or the government can’t step in cause our sate services systems may be set up in such a way so our government cant intervene sometimes this is actually detrimental to who they are suppose to be helping
Correct, Michelle. Most of these systems are structured so that the govt cannot step in. This is done because govt’s primary concern is to help itself.
The Starship Hospital little boy’s life being saved was due 100% to the wisdom and pluck of his mother disagreeing with the health professionals and requesting an xray. I say ‘pluck” because Mama was in a systemically intimidating situation where many people would hesitate to disagree or speak up, but she didn’t.
The hospital’s craven self-serving response is an absolute disgrace, and hopefully they will be called to account.
underfunding and lots of undermining was done on purpose by national so was holding up the OIAs all intended and all part of a poorly thought out economic plan that created more inequalities and social deviseness in our communities
Not really, Michelle. Under-funding was part of a cunningly-thought out plan by the National Govt as part of an agenda to privatise and/or flog off various health services to the private sector.
Don’t forget that if Bill English had had his way, a night’s stay in a hospital could have had public hospital patients paying $50 per night for such hospital stays. And these are the patients who can least afford it, because others have work, or private health insurance schemes.These are non-rich people – aka poor, because that’s how capitalism works.
At least three previous health dept/public hospital services have been flogged off to PHO’s, or totally terminated. I never kept track, but one was The Quit Line, and the service which stopped altogether was the physiotherapy clinic for MS patients at Hutt Hospital.
Payment for public hospital services was implemented some time ago but met with strong resistance.
I was billed $75 for attending an eye consultation that I tried to cancel but was told I had to attend the clinic to cancel it or I would be charged a not attending fee.
I attended to cancel , had no consultation and was still charge $75 which I did not pay.
Bay Corp chased me for months and I invited then to take me to court and warned of action and damages claims if I was harassed by any action by them to alter my credit ratings.
A change of Govt saw the scheme dropped
DHBs are a move to effectively corporatise Health and divide the sector. Both well known neo liberal moves on the path to full privatisation by stealth.
The investor state extracts billions out of NZ each year which becomes unavailable for circulation in NZ so no further tax is harvested from that money.
yes I know all about acc under the instructions of the national governments were told to get people of their books and many were denied their entitlements by paid acc health professionals who told them their injury was degenerative so what is the point of us paying acc levies when they are doing this and how many poor people did they kick in the guts with this mean policy. Paula rebstock was employed primarily to do this nasty piece of work and paid handsomely she ended up in big trouble withal her bullshert but she was doing the national parties dirty work
Do not understand why we have all the District Health Boards, we are only 5 million people what a waste of resources, won’t even mention the clowns they employ ?
I hear so many stories of professional negligence in NZ hospitals, it is not funny.
I have experienced it myself having to have two major operations in 2 days, plus 2 x blood transfusions due to hopeless doctors and nurses not following standard procedures.
Before ever I want to hear “Sorry” I want the problem fixed at core. For me “Sorry” is worthless.
I get it that the word has value for others. They give it significance.
Remorse and regret seem to work better on a person to person base. Not between a person and an agency, though. The person saying the word may have had no part of the harming.
If many people were involved in the harming – whose “Sorry” carries most weight? How is it delivered? Where’s the sincerity and change of heart, ways, delivery?
“Sorry” as a word is trite. Where’s the action? The remedy? The evidence of contrition?
Forcing people to say sorry is a waste of time. If it doesn’t come with sincere contrition, empathy with the distress caused, the recognition of abuse of authority and power – then the situation will repeat.
You need something else when it comes to institutions. “Sorry” is the wrong word – until it’s followed by, “I have the power and will to fix this. I pledge to get it sorted within the next few months and I’ll invite you to see what we’ve done for you and any others we’ve hurt through the ways we’ve been. I will not move on until this wrong has been righted.”
Otherwise it’s as sincere as a curt passing ‘sorry’ from someone who jostled you in a crowd.
Is that all you’re wanting?