Any ACC restrictions to the cover of treatment injuries could result in more people seeking personal accountability from health professionals when things go wrong, Auckland University associate professor of law Jo Manning says.
In an address to about 200 people at the Health and Disability Commissioner medico-legal conference in Wellington this week, she speculated this could be the result of an even "leaner and meaner" compensation scheme.
The criteria of cover for treatment injury had escaped change so far, but were vulnerable as this area of spending was increasing.
Treatment injury had been described a year ago as a problem area by the ACC Minister, because instead of costing an extra $8.7 million a year as budgeted, costs for such injuries had almost doubled from $42 million to an expected $82 million.
The more injured patients perceived themselves as dealt with unjustly by ACC, the more this exacerbated their sense of grievance, fuelling their quest for personal accountability from those considered responsible for harming them, she said.
Conversely, if people felt society had honoured an obligation to compensate them fairly for injury, the less they would be motivated to seek such action.
"Reductions in cover and compensation raise the spectre of injured patients and their families being left to bear the loss themselves or receiving only partial compensation."
Changes to shrink coverage and entitlements could impact adversely on the overall complaints regime in health care, Prof Manning said.
This could mean more demands for accountability in complaints to the Health and Disability Commissioner and the director of proceedings, accompanied by media coverage.
There might be more concerted political pressure for a return to the ability to sue for personal injury and a return of patients' legal attempts to bring civil actions for damages for personal injury.
• In her address to the conference, clinical director of Counties Manukau DHB quality improvement unit Dr Mary Seddon questioned the emphasis the Government placed on district health board finances.
More attention was paid to whether boards were over budget than quality of care issues.
It was hard to engage on issues about quality if boards were always worried about their financial situation.
University of Otago law professor Peter Skegg , speaking on the evolution of the HDC over the last decade, said the code of patient rights had proved remarkably enduring.
He had been sceptical about it in many ways, but it had worked vastly better than he ever thought possible.
He was one of several speakers to pay tribute to the work of commissioner Ron Paterson, who leaves the office at the end of this month.
