Welcome to this week's edition of Health Alert. The Health Alert is transmitted on Monday of each week (unless there is a public holiday on Monday).

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Nigel Preston

JUDGMENTS

New Zealand

Health And Disability Commissioner

Case 09HDC00816 A Report by the Health and Disability Commissioner

This case concerned an investigation by the Health and Disability Commissioner (HDC) about the services provided by gynaecologist, Dr B, to Mrs A, a patient at a private hospital.

Mrs A had consulted Dr B at her private practice to discuss treatment options for prolonged heavy menstruation. After investigation and consideration of various options, Mrs A decided to have a laparoscopic hysterectomy which was performed by Dr B at a private hospital on 24 November 2008. Following the surgery, Mrs A experienced pain and distension of her abdomen which Dr B attributed to a paralytic ileus that would settle in time. Mrs A was subsequently admitted to a public hospital on 4 December for repair of a perforated bowel and underwent further surgery for perforation of her left ureter.

The HDC identified a number of issues for investigation, including whether Dr B provided Mrs A with reasonable treatment and care, whether Dr B provided adequate information to Mrs A about laparoscopic hysterectomy and postoperative care and whether the private hospital provided Mrs A with reasonable treatment and care.

The HDC concluded that Dr B should have recognised that Mrs A's recovery was not progressing as expected and investigated the delay. In the HDC's opinion, by failing to do so, Dr B breached Right 4(1) of the Code of Health and Disability Services Consumers' Rights. However, the HDC found that Dr B provided an appropriate standard of surgical care to Mrs A on 24 November 2008, had provided appropriate postoperative information and had complied with her professional duty of open disclosure following an adverse event. In considering the role played by the private hospital, the HDC concluded that the hospital provided appropriate care and information to Mrs A and did not breach the Code.

LEGISLATION

Commonwealth

Health Insurance (Extended Medicare Safety Net) Determination 2009 - F2009L03861 - Health This Determination provides which items of the Medicare Benefits Schedule subsections 10ACA(7A) and 10ADA(8A) will apply, and the maximum increase in Medicare benefit payable for those items under the Extended Medicare Safety Net.

Health Insurance (Positron Emission Tomography) Facilities Determination 2009 (No. 2) - F2009L03702 - Health - This Determination revokes the Health Insurance (Positron Emission Tomography) Facilities Determination 2009 and provides that new rule 28 of the Diagnostic Imaging Services Table will apply to positron emission tomography services specified in the Determination and will allow a Medicare rebate increase for relevant diagnostic imaging services that are provided out of hospital and are bulk-billed.

National Health Act 1953 - Amendment special arrangements under subsection 100(1) - Highly Specialised Drugs Program (No. PB 101 of 2009) - F2009L03885 - Health - This instrument amends the National Health Act 1953 - Special Arrangements under subsection 100(1) - highly specialised drugs program (No. PB 54 of 2009).

Therapeutic Goods (Listing) Notice 2009 (No. 6) - F2009L03872 - Health - This Notice permits the use of Chlorella vulgaris as an active ingredient in Listed medicines for oral use.

Health Insurance (Diagnostic Imaging Services Table) Regulations 2009 - F2009L03137 - Health - These Regulations repeal the Health Insurance (Diagnostic Imaging Services Table) Regulations 2008 and prescribe a new diagnostic imaging services table for the 12 month period commencing on 1 November 2009.

Health Insurance (General Medical Services Table) Regulations 2009 - F2009L03329 - Health - These Regulations repeal the Health Insurance (General Medical Services Table) Regulations 2008 and prescribe a new table of general medical services for the 12 month period commencing on 1 November 2009.

Health Insurance Act 1973 - Declaration of Quality Assurance Activity under section 124X (QAA No. 3/2009) - F2009L03735 - Health - This Declaration re-defines benchmarks and standards set for surgical care in a rural setting through surgical audit and peer review activities.

Health Insurance (Allied Health Services) Determination 2009 (No. 2) - F2009L03704 - Health - This Determination revokes and replaces the Health Insurance (Allied Health Services) Determination 2009 made on 15 June 2009 to amend the fees that apply from 1 November 2009, remove obsolete terminology and make minor grammatical changes to clarify the context of referral forms.

National Health Act 1953 - Amendment determination under section 84AF - responsible persons (No. PB 98 of 2009) - F2009L03798 - Health - This Determination amends the National Health Act 1953 - Determination under section 84AF - responsible persons (No. PB 115 of 2008) to determine the responsible persons for the brands of pharmaceutical items set out in Schedule 1 to the instrument.

National Health Act 1953 - Amendment determination under section 85B - price determinations and special patient contributions (No. PB 100 of 2009) - F2009L03820 - Health - This Determination amends the National Health Act 1953 - Determination under section 85B - price determinations and special patient contributions (No. PB 118 of 2008).

National Health Act 1953 - Amendment determination under subsection 85AB(1) - drugs on F1 (No. PB 99 of 2009) - F2009L03802 - Health - This Determination amends the National Health Act 1953 - Determination under subsection 85AB(1) - drugs on F1 (No. PB 87 of 2007) by adding the listed drug "Lenalidomide".

Private Health Insurance (Prostheses) Amendment Rules 2009 (No. 3) - F2009L03777 - Health - These Rules amend the Private Health Insurance (Prostheses) Rules 2009 (No. 2) by editing billing code information and correcting typographical errors in the Schedule.

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