GOOD MEDICAL PRACTICE
The Medical Council of New Zealand is reviewing its standards of clinical competence, cultural competence and ethical conduct for doctors.
Have your say about ‘good medical practice’ in Aotearoa.
To find out more go to http://consumercollaboration.org.nz/news/good-medical-practice
Under section 118 of the Health Practitioners Competence Assurance Act 2003 the Medical Council of New Zealand (the Council) is responsible for setting “standards of clinical competence, cultural competence and ethical conduct” for doctors. In 1998 the Medical Council developed Good Medical Practice to be the foundation document for the standards they set…
Good Medical Practice aims to outline the duties of a good doctor in a simple and direct manner. It is intended to help doctors to monitor their own conduct and the conduct of their colleagues. It is also intended to serve as a source of education and reflection for medical students. The Council are also aware that it is often referred to by patients who are uncertain about the quality of care they have received. They have tried to make the resource accessible to all of these groups, and endeavoured to ensure that the standards outlined are clear and easy to follow.
Good Medical Practice also has another important function. It is often used as a standard against which professional conduct is measured. It is used by the Health Practitioners’ Disciplinary Tribunal, the Council’s Professional Conduct Committees and the Health and Disability Commissioner in determining whether a doctor has acted appropriately or not. The advice it contains therefore needs to establish a clear line in the sand against which conduct can be measured.
Good Medical Practice was last reviewed in 2006. The Council is seeking feedback from doctors, patients and other agencies engaged in the regulation and practise of medicine on this resource, and on changes that they are proposing to make.
While the Council believes that Good Medical Practice remains useful and relevant, they also think that it could be improved in a number of ways. They are seeking your comments on the proposed changes, and also your responses to a number of specific questions.
Quite a few of these changes they propose are minor, but a number outline new or different standards. The Council appreciates that your time is precious, so have tried to summarise the most important changes in a consultation paper. However, if you do have the time they would also encourage you to review both the consultation paper and a complete copy of the draft Good Medical Practice that includes details of all of the suggested changes.
Download Good Medical Practice Consultation paper
Download draft Good Medical Practice
Please send your comments to Michael Thorn, the Council’s senior policy adviser and researcher by 12 October 2012. You can either complete the questions in the consultation paper or in the complete copy of the draft Good Medical Practice and send your responses to Michael at mthorn@mcnz.org.nz or post it to:
Michael Thorn
Senior Policy Adviser and Researcher
Medical Council of New Zealand
PO Box 11-649
Willis Street
Wellington 6011
Please also feel free to send Michael any other comments or suggestions you have about Good Medical Practice.
Blueprint II was launched on the 13th of June and the mental-health sector has been largely silent in response. This is likely because Blueprint II is an epic 52-page document.
An Executive Summary on pages 6 and 7 of Blueprint II provides a summary of what goals need to be achieved, but does not outline how to achieve them. This leaves the reader with a lofty set of ideals and little practical perspective of what implementation involves.
In order to get the full picture of Blueprint II, one must read the entire document and it’s 102 page companion document. Notably, the assertions likely to make the most significant impact on service delivery are saved for the final chapter and the appendices of the companion document.
While Blueprint I set out to clearly define what was needed in the mental-health service sector and how to get there, Blueprint II makes calls for better, more effective services while supporting a drive for reduced funding and greater efficiency.
Oddly, the Blueprint II Companion Document makes the assertion that problems of inaccessible and under-resourced services have been resolved and that the future strategy should be focused on efficiency and productivity.
The document provides no evidence to back up this assertion that services have improved and can now focus on efficiency and cost-cutting. Presumably the authors have simply believed the marketing material of mental-health services without establishing whether their rhetoric is realised in action.
Blueprint II is a missed opportunity for the Mental Health Commission to influence government to increase the resources available to the mental-health sector and prevent further cuts to a sector that can ill afford them.
Staff at Engage Aotearoa have been supporting individuals currently residing in Auckland’s acute psychiatric wards across the previous two weeks and can confirm that although the Blueprint II authors state that services are now accessible, family-focused and person centred, this is not the case. Family members are currently left without information, nursing staff do not have time to talk to service-users, service-users are given extended periods of unsupervised leave without a single member of their family being informed, service-users have no access to the clinical psychologist on staff, even when specifically requested. There is clearly no room at the acute service for any form of budget cuts or loss of FTEs. Anecdotes from service users in the community suggest waiting times for a funded therapist can extend upwards of six months. In our community mental-health centres, only those in the top 3% of severity can be seen. At Engage Aotearoa we have heard stories about suicidal people seeking access to a key worker to keep themselves safe and being turned away. We have heard stories about service-users being discharged from their community mental-health centre over the phone without being reviewed due to demands on the service. Access to unfunded therapy is limited to those who can afford the fees.
A number of NZ newspapers recently ran a story about an unwell man who murdered his flatmate: while many people were worried about him in the days leading up to the incident, no one knew to call the Crisis Team or police to get him help. Everyone knows where they can buy an iPhone, but no one knows where to go when someone is a risk to themselves or others.
It seems clear that mental-health services in NZ continue to be under-resourced and difficult to access. Some of the most crucial services are so under-resourced that they cannot even make the public aware that they exist, let alone actually provide their service to all who need it.
Despite its push for better, more effective services, Blueprint II advocates reducing the number of services and making those services do more with less. An environment of competition for scarce resources pits services against each other at the same time that they are asked to work together in collaboration.
This is unlikely to result in positive changes for New Zealanders seeking improved wellbeing, the people they live with or the professionals who work to help them.
