Warning – this will sound like an off-topic rant. It is, but it’s a cathartic one.

My mother had a fall last year during which she fractured her pelvis. This, and a historical neck-of-femur fracture sustained in a fall 15 years ago have led her surgeon to determine that a total hip replacement is needed. She’s rather frail, and losing mobility by the day, so I’ve undertaken to advocate on her behalf. Here’s a run down of the couple of hours I spent on the phone today. (for non New Zealanders here is a run down on the New Zealand Accident Compensation System)

Specialist – I spoke with the PA of her specialist who advised that the referral letter to ACC had not been written. This despite it being some 12 days since my mother saw the specialist and he dictated the letter. Two thoughts here;

  1. Voice to text works rather well these days
  2. If a typist cannot type a one page letter in 12 days perhaps they want to look at the skill level of their staff

Finally I was told that the referral would be finished in the next 24 hours and faxed to ACC

ACC – ACC would not divulge any information to me until I had authority to act on my Mother’s behalf (bleedin’ Privacy Act). This was duly obtained and I re-contacted them. A very process driven ACC call centre staffer read me the claims process description at least three times. After explaining to him twice that a lengthy claims process, coupled with my mother’s frailty, could likely result in a far more serious ACC claim and that expediting the process would be beneficial for all, he finally reverted to someone else. The someone else explained to him the claims process description which he then (helpfully, just in case my Alzheimers was kicking in) proceeded to relay to me yet again.

The one glimmer of information I got from him was that full medical notes would be required before ACC could even begin the approval process (which takes around four weeks once information is complete).

Specialist – I re-called the specialist to ask for all the case notes to be sent directly to ACC along with the application for treatment. The specialist’s offsider informed me that was impossible as the case notes resided at the public hospital while they were a private hospital. She also told me that the PA had requested the case notes from the public hospital who had entirely ignored her request.

Public hospital – I contacted the records department at the public hospital who told me that everyone had gone home for the day and that they’d try and contact me in the morning. Whether I’ll be able to facilitate them faxing the records to either the specialist or ACC is anyone’s guess.

So… our system is broken. Globally we can look at the US and the UK at either end of the spectrum – in one country you can be dying but without insurance you’ll not be treated, while in the other the public system provides for all. At least one knows where one stands! Here in New Zealand we have this bizarre combination which slows down treatment, bottlenecks communication and results in bad situations for the people we’re meant to be looking after: the patients.

So there’s my rant – let’s see what tomorrow brings…

Ben Kepes

Ben Kepes is a technology evangelist, an investor, a commentator and a business adviser. Ben covers the convergence of technology, mobile, ubiquity and agility, all enabled by the Cloud. His areas of interest extend to enterprise software, software integration, financial/accounting software, platforms and infrastructure as well as articulating technology simply for everyday users.

  • My commiserations! My dealings with the health system have shown that it is set up for nobody to win. Of course no one means it to be that way, but currently the people working in the system are overworked, and the people relying on it for help are having their experience worsened, which is probably making their original conditions worse. NZ needs some Mayo Clinic treatment!

  • What a rigmarole for you to navigate, feel for you and more importantly your mum.

    BTW: Been a VERY long since th UK had a “public system provides for all.”, if ever – bit of a myth really.

  • @Simon @Mike – thanks for the words and thoughts. It’s nice to vent, kind of cathartic. Just imagine how many people out their are experiencing the same situations but don’t have someone advocating for them….

  • Jessica Griffin |

    The trouble is that the information in our healthcare system is trapped, disconnected. X-rays aren’t talking to medical records…patient histories aren’t talking to insurance forms…The list goes on. All these components, processes and participants that comprise our health system aren’t connected. We need to move away from paper records and apply technology to connect all this information so doctors, patients and insurers can all share information efficiently. We need to put the focus back where it belongs – on the patient. We should be able to as individuals manage our own patient heath records and determine our own rights of access, eg family members. While I’m no expert in this area, I’m passionate about improving our healthcare system. The reality is our health system isn’t, in fact, a system – it’s chaotic.

  • Jessica – totally agree, keen to hear ideas on what that “system” could look like…

  • We need an IT Sans Frontier working in major public hospitals to try out these type of projects, on the ocndition that the technology created isn’t owned but will be given away freely.

  • copy of email I sent to min of health .
    How Long is long enough?
    I’m a functional tetra plegic funded by MOH I have been waiting for aids promised in 2000 and others promised in 2003 , I have to cover most of my disability costs and my parents and myself have had to sell our properties that were free hold to fund my needs .
    A lot of the problems stem from 1 OT who just never got round to things , for 6 1/2 of 9 years I was unable to eat properly because I was unable to prepare meals and didn’t have home help to do it .
    All the money and effort that my family and myself went into getting me working was just a waste of time because the assistance we were offered never happened .
    I got married earlier this year and my wife gets totally exhausted from caring for me with no assistance and has injured her back & is starting to suffer from depression , she also helps care for my parents as my father is very ill and my mother has health problems , they are now living with us as they need the support as there is not sufficient support required .
    I had to supply my own access ramp as enable considered that our garage was a level access , it is not !! it is also full of my excercise equipment my fathers mobility scooter and other belongings (as well as being the laundry as well )
    Enables answer was I had choices and if I chose to put things in the garage instead of using it for access it was my choice , well I have no where else to keep these things and I’m not leaving them on the front lawn , Would you?
    I am sick of people in the disability sector treating me like an idiot , yes like an idiot to be perfectly honest most disabled people are treated that way , especially the ones not on ACC & funded by MOH .
    Another point I want to make is , That people with similar disabilities to those on acc get very little assistance under MOH funding , isn’t that discrimination ?? many legal experts say yes .
    I am disabled due to a motor vechile accident , but acc who accepted that , then changed their tune and gave me to the MOH , as I am 0ver 18 & under 65 I don’t fit most of the funding criteria , I have been assessed for Aids etc that my specialist said I required and Ruth Dyson at that time directed I be funded for them , but with all the delays a new minister was in office by the time the applications went through , and his medical advisor told him I didn’t require such aids ( I think that particular adviser has a degree in French literature , he may have been an expert on the health of asthmatic old French manuscripts , but I’m not one of them )
    There seem to be no communication between health provider and it can be confusing and extremely stressful .
    I was informed by the ministers office (when ruth dyson was around ) that my funding was going to be shared between ACC & MOH , and my doctors & specialists were under that impression , but Acc never came back on board .
    Acc won’t even pay to get my artificial eye replaced and I am 10 years overdue for a replacement , my eyesocket has now shrunk considerably and I get infections in it regularly .
    My funded wheelchair was unsuitable from day one as an OT decided to change the prescription and it was made the wrong size for me , It has caused me severe permenant shoulder and Bowel problems because of this , and although I complained for 5 years the wheelchair problem was never rectified even though I got broken bones on several occaisions when the wheelchair tipped me on my face due to it being made to the wrong specifications .
    I am still waiting on eating utensils that I can hold properly , I have been waiting on them for 9 years , everytime something broke on my wheelchair I often had to wait months for it to be repaired so had to purchase another one for a back up .
    I purchased a huge amount of aids prior to may 2003 as I couldn’t cope at all without them , but unfortunately they were all destroyed when my house burned down in may 2003 I was almost destroyed to as I was trapped inside it for almost 20 min and if I didn’t have the aids I purchased myself I would have not been able to get out .
    I have paid for all my own rehabilitation etc as I want to work in a field I am very good at again , but not having the aids for daily living that I require to enable me to work has put me several years behind and at my age(45) I cannot afford to waste my life waiting on others I depend upon to get their act together I have no choice but to find a way of generating an income as there is no way we can survive much longer on what we get which goes nowhere near covering disability and living costs .
    I am the only one in the house hold that can drive so everyone is reliant on me , I have had to pay for all the vehicle modifications myself as I don’t fit into the funding criteria , as much as I would love to be working right now I am unable to until I get the aids to be able to cope in daily life , the OT’s knew I was trying to enable myself to work again , but although I did my part in getting most of my work equipment etc myself they delayed supplying the aids I required
    On the grounds it wasn’t that urgent , I could have been working 4 or 5 years ago if it wasn’t for that attitude and been financial independant of the system by now .
    I have lost many opportunities I was offered by not having aids I required , many people who don’t understand disability and how limited it can make people , gave up on me and blamed me for not getting ahead when I was doing all in my power to make things happen only to be let down by the system time after time .
    Not Only has this continual battle with inefficient and lazy health providers caused me great heartache , stress, and financial hardship it has also done much emotional damage to my family , an to my way of thinking that is just not on , my disability is disabling for them too and where is their support !!
    Are nt disabled people supposed to have the same opportunities as able bodied people ?well in this country most of them don’t , I have looked at the results of surveys and studies done by the govt on disability , I know almost no disabled people who don’t think the results are total bullshit , ask the disabled what there needs are ! don’t just survey a few ask all of them , I think you’ll get a huge shock and find yourself up to your neck in crap if you research things properly .
    A huge amount the figures from heath providers are fabricated to make it look like they are doing their jobs and so they can get extra funding (which often gets channelled elseware )I have this information directly from people working in the health industry .
    Also , Health equipment providers here greatly inflate the prices on equipment as the Govt pays for most of it , in other words we are all getting ripped of millions & millions each year also NZ is the Dumping ground for much disability equipment that no one else wants and you pay a fortune for it , there are backhanders and cash incentives given to OT’s and other health care professionals all the time , to recommend that the is great and just what is required when in fact it is crap which is not much better than useless .
    Not mentioning names , I know someone with several business that deal in disability aids etc that supply DHB’s and MOH , he was bragging about the gullibility of the system , as most products he sells are not up to NZ or AUS standards and infact he pays virtually nothing for them as its all stock no one else will take he makes several 1000% profit after he pays tax and hundreds of thousands a year in backhanders , lucky he has a creative accountant , who infact is employed by the IRD in wellington as a tax fraud investigator , yes corruption is rife in all sectors of govt employment .
    It should really get looked into , would save NZ 100’s of millions a years .
    Anyhow , I really would appreciate some assistance with disability needs , notice I say needs not wants , I’m not a greedy Kripple I just need enough to enable me to work and become a productive member of the community .
    OH yeah, I also design disability aids that would enable thousands of NZers to doe much more and be a lot more independant , best of all they could be manufactured here with about 80% local content and be well enough made to export if the market demand was sufficient .
    Disability costs big money it’s time that was realised and people got what they require to enable themselves .
    Have A nice day .
    Cheers Andrew A

  • my reply to pansy wong ass min Acc , in refference to the replys from her office that I will here from her in due course , and I keep replying with the question , “when is Due Course ?” is it to hard for them to understand ? is minimal IQ a prerequisite for govt empoyment ? It appears so .

    Thank you for your reply but I am still waiting for the answer to my question as when , DUE COURSE might be , I generally find it’s between several months and never usually never , but after 9 years of due course’s I would like some action not excuses and due courses , I am sick of being treated like a mushroom !!!! (being kept in the dark & fed on shit )
    This is simply not good enough !!!.
    Have a nice day , Cheers , Andrew

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