Injuries at 'epidemic levels'

Dunedin ACC campaigner Dr Denise Powell is urging the country's medical system and ACC to improve their handling of traumatic brain injuries after a major report warned they were at "epidemic levels".

The report, published last week in The Lancet medical journal, found New Zealanders suffered about 36,000 traumatic brain injuries (TBIs) each year, and the extent of TBIs had previously been "grossly underestimated".

The study noted such injuries were "the leading cause of long-term disability in children and adults younger than 35" and had "serious effects on the lives of patients, their families and friends, and society".

TBIs result from falls, assaults, road accidents and other causes.

Dr Powell, who is the president of Acclaim Otago, an ACC claimant support group, said the report posed a "real challenge" to ACC and the New Zealand health system.

The report found many TBIs were not recorded by medical staff close to the time they occurred, partly because symptoms were often subtle and could be overlooked, as medical staff focused "on more obvious conditions, such as bleeding and fractures".

Dr Powell said ACC often declined claims for TBIs that were made some time after the accident which caused them, because there was no "contemporaneous evidence" that the claimant suffered TBI at all.

ACC was declining these claims for want of "bureaucratic paperwork" which it expected to have been compiled when patients were admitted to the health system.

When claimants later tried to challenge these decisions, through statutory reviews and appeals, they often failed, for the same reason, as decision-makers "ignore the fact" that characteristic TBI symptoms had been shown.

This resulted in the costs of personal injury being "shifted on to the victims and their immediate families", which was a "grossly unjust" outcome.

Labour's ACC spokesman, Andrew Little, is urging a "major review" within ACC taking into account the implications of the report and for "appropriate changes" to be made to ACC programmes and approaches.

The report showed New Zealand had one of the largest incidences of brain injury in the developed world, and that such injuries often resulted in "significant and long-standing" effects, including memory problems and depression", he said.

Approached for comment, an ACC spokesman said ACC was "working to improve the service" provided to patients with a TBI.

"For example, we're in the final stages of developing a TBI strategy focusing on adults with moderate to severe TBIs, aimed at providing a clearer direction for their treatment and rehabilitation and ensuring the right systems and services are in place to support this.

"We're also currently working to improve assistance for adults and children with mild TBIs," the spokesman said.

-john.gibb@odt.co.nz