Consumers' Code of Rights
If you are like me, you will be vaguely aware of the Code of Rights for consumers using the health system. You will have seen the tomato-coloured posters on waiting room walls entitled “Your Rights” or “Ou Tika”. You'll largely ignore them although you have been known to fire off an emotive email to a hospital department at times.
Now that I’ve looked at them closely, I realise that they are very simple and sensible and if you think the Code of Rights has been breached, you can take one of four actions of increasing seriousness:
Talk to the people who treated you or your family member
Write a letter or email to the DHB
Contact a local Health and Disability Commission advocate (more about this later)
Write to the Health and Disability Commissioner
There are ten rights, that’s all and we should all be aware of them, especially those of us dealing with cancer or other serious illnesses. “Cancer isn’t a third person disease,” as e-Patient Dave would say. Anyone could get cancer and have to deal with the health system. These rights are precious, and unique to New Zealand.
Here’s a brief summary of the rights stipulated on the poster above - not the full details but easy to get your head around.
Respect and privacy
Dignity and independence
Choice and consent
Rights during teaching and research
Your complaints taken seriously
History: the Cartwright Report
The Code was written after the Cartwright Report in 1988 and became law in 1996.
The Rights were designed to improve the power imbalance between patients and doctors and were later extended to include all health and disability consumers and providers.
Judge Sylvia Cartwright’s report was based on one of the biggest scandals in New Zealand health history, the “unfortunate experiment” conducted by a gynecologist at National Women’s Hospital in the 60s and 70s (pictured). Numerous women had pre-cancerous lesions on their cervixes observed but not removed so that the doctor could prove his theory true - that not all carcinoma in situ turns into full blown cancer. The women were not informed, did not give consent, were not encouraged to ask questions, were not treated with respect and a number died avoidable deaths from cervical cancer.
How the service works
The formal name for the Code is “The Code of Health & Disability Services Consumers’ Rights”.
The 1994 Health and Disability Commissioner's Act set up a Commissioner to craft and oversee the legally enforceable Code of Rights - as well as advocates to be on the side of patients/consumers.
A nationwide advocacy service was established to assist consumers who feel their rights have not been respected. There are 48 advocates around the country in 25 community based offices from Kaitaia to Invercargill.
HDC = Health and Disability Commissioner. As well as the 48 patient advocates there is a Health and Disability Commissioner who looks at more serious breaches. Their website has three branches: the Commissioner, the local advocates and the Director of Proceedings who is in charge of the legal side of complaints, http://www.hdc.org.nz/
Complaints made to the HDC, once resolved, are posted on the website (without names or any identifying details) and make for some interesting reading.
Lodging a complaint via your DHB
if you don't feel comfortable talking to the people directly concerned, you can complain to the DHB. You can ring and ask for the complaints or feedback section or find the information online. Some DHBs have an online form to fill in; others ask you for an email or letter. Below is the appropriate section from the ADHB.
Compliments and complaints, ADHB
If you have a compliment or a concern about a service or care that you or a family member received at Auckland DHB, please let us know. We welcome all constructive feedback because without it we cannot continually improve our services or share positive stories with staff. You can either speak to those providing your care, or the charge nurse or midwife on the ward or clinic where you are being treated.
If you feel uncomfortable talking to these people, or you have a concern and aren’t satisfied with their response, please contact our Consumer Liaison Team:
Phone: 09 375 7048
Mail to: Consumer Liaison Team, Auckland DHB, Private Bag 92024, Auckland Mail Centre, Auckland 1142
If you prefer you can also contact the Health and Disability Commissioner (HDC) on: 0800 112 233 or complete the HDC's online form: http://www.hdc.org.nz/
Wherever you are, you need to provide your contact details, hospital number, identify yourself and your treatment, tell what happened, when and where. Follow this up with what you would like to be done about it. Ask for an acknowledgement/apology. (Most people want to ensure that the same breaches of patients' rights don't happen to someone else.) Try to keep to the facts but provide a context for them. Look at the Code of Rights to see where you treatment did not meet those criteria.
Below is a sample complaint letter in PDF form.
Asking an HDC advocate to help
This is the next option up in terms of intensity but it is not scary. It really isn't. The independent advocates are there to help you. They can even advise you on how to advocate for yourself. They can help you sort issues out with the provider. As you can see there is a group of advocates in all parts of New Zealand.
An Auckland advocate spoke to the Auckland Support Group in 2015. You can see a summary of her talk in the PDF of the newsletter below the map.
Keliie Dore, HDC advocate, spoke to us in 2015: Newsletter%20with%20Advocacy%20Story.pdf
Next time, you peer at the notices in the waiting room, be grateful that New Zealand has a Health and Disability Commissioner and a unique Code of Rights. This year, on 1 July, very soon, these Rights will be celebrating their 21st birthday. On this date 1996, our Code of Rights came into effect. Worth thinking about.
And remember that you can do the opposite of complaining if you feel that a health provider has gone above or beyond the call of duty. All DHBs like positive feedback too and have places on their sites for you to say thank you.
It's all about making our health system serve all of us. It's about people as you can see from the logo below. Maureen