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Health Council Examines No-Fault Insurance for Medical Errors

Posted on: Wednesday, 27 September 2006, 15:01 CDT

By KEVIN BISSETT

FREDERICTON (CP) - Canadian health officials were urged Wednesday to adopt New Zealand's system of no-fault insurance for medical malpractice.

Marie Bismark, a doctor and lawyer from the South Pacific country, told a meeting of the Health Council of Canada that Canadians would benefit from the system her country uses.

"No-fault compensation benefits the patients because they can receive compensation for the harm they've suffered very quickly," she said.

"It is needs-based and it also benefits the doctors because we don't have a system of individual blame or punishment. Compensation is provided regardless of whether the care was negligent or not."

Canadian patients who suffer problems as the result of the health care they receive currently must file a malpractice lawsuit to seek compensation.

The health council assembled experts to hear the pros and cons of the New Zealand no-fault model, which has been in place for 30 years.

Bismark said no-fault insurance "supports a culture of openness and learning rather than a culture of blame."

"Most health professionals certainly don't go to work to make a mistake," she said. "Many of those mistakes are happening because of broader systems errors, and our system lets us understand those."

Dr. John Gray of the Canadian Medical Protective Association, which insures most doctors in Canada, said patient safety can be improved without going to a no-fault system.

"We can achieve those patient safety reforms and improvements without a major overhaul of the present system," he told reporters.

According to a 2004 study, one in 13 patients who entered an acute-care hospital in Canada suffered some form of adverse effect.

"The adverse events resulted in everything from increased length of stay to re-admission to death. That cost the system 1.1 million days, which is a huge economic cost and burden to the system," said John Wade of the Canadian Patient Safety Institute.

In most cases, he said, individuals get blamed for such incidents when it is usually the system that fails.

Wade said a campaign called Safer Health Care Now has been successful in hospitals across Canada in promoting better practices, including such things as proper hand-washing.

He said they are looking at other measures such as bar codes as a way to help prevent medication mixups.

Jean-Guy Finn, a former deputy minister of health in New Brunswick, sees pros and cons to the New Zealand model, but thinks it would be difficult to implement in Canada because of the different health systems in various provinces.

Bismark said the majority of patients who suffer negligence-caused injuries never file a lawsuit, and of those who do, most get nothing.

She said the New Zealand system usually provides compensation within 15 to 20 working days and is more cost-efficient than litigation.

"In New Zealand about 90 cents of every dollar actually goes into the pocket of the patient whereas in a malpractice litigation system over 50 per cent of the money goes to administrative expenses, including lawyers' fees," Bismark said.

Jeanne Besner, the council's interim chairwoman, said the body would examine the Bismark's suggestion.

Michael Decter, the council's former chair, said in May that Canada needs to consider no-fault insurance for medical errors.

"It may be one way of moving the safety agenda forward," he said.

Source: Canadian Press

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