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  • Consultation on health and safety plans for Managed Isolation Facility

    Case notes
    Complaint about level of consultation with residents before Stamford Plaza Hotel became a Managed Isolation Facility—Chief Ombudsman found that the Department did not consult appropriately with the residents before this occurred—the Department also did
  • Administrative error resulting in lost opportunity for ACC claim

    Case notes
    A patient who was unaware he had asbestosis underwent a CT scan while being treated at a DHB Hospital. On the scan’s accompanying notes a radiologist noted previous asbestos exposure. This CT scan with accompanying notes was misfiled, for unknown reasons, and the patient’s diagnosis of asbestosis was not confirmed until autopsy.
  • Ministry of Health unreasonably disallowed visiting Australian resident access to publicly funded health services

    Case notes
    Whether the Ministry of Health was unreasonable to determine that medical treatment obtained by a visitor to New Zealand was not ‘immediately necessary’ and therefore not covered by reciprocal health agreement with Australia – Ombudsman considered the Ministry of Health erred – complaint sustained
  • Ministry of Health policy on reimbursement of expenses for house modification unreasonable

    Case notes
    Whether the Ministry of Health’s policy to require prior approval for funding for house modification was reasonable—Ombudsman concluded it was not
  • Decisions of PHARMAC to fund Opdivo and Keytruda

    Case notes
    A complaint was made to the Ombudsman that PHARMAC took too long to approve the May 2015 application to fund the metastatic melanoma cancer drug Keytruda.[1]
  • Health and Disability Commissioner not unreasonable to refer matter to Medical Council without advising complainant

    Case notes
    Whether the Health and Disability Commissioner legally or otherwise required to inform complainant of a referral made to the Medical Council of New Zealand—Ombudsman concluded HDC not bound to divulge this information
  • Ministry of Health agrees to increase what was an unreasonably low offer of ex gratia payment

    Case notes
    Ministry of Health’s decision in December 2016 to offer complainant $8000 by way of an ex gratia payment for mistakes made by the Ministry and lengths complainant had to go to in having the Funded Family Care hours reinstated unreasonable—Ministry of Health agreed to increase the amount following the complaint.
  • Ministry of Health’s decision following audit of aged care facility not unreasonable

    Case notes
    Ministry of Health’s HealthCERT not unreasonable to issue an aged care facility with ‘partial attainment’ in its August 2016 surveillance audit
  • Patient eligibility for publicly funded healthcare

    Case notes
    This case note concerns an investigation under the Ombudsmen Act 1975, resulting from a complaint to the Ombudsman about the failure of a district health board (DHB) to identify that a patient was ineligible to receive publicly funded health care before
  • Adequacy of ex gratia payment to remedy mistake by Customs

    Case notes
    NZ Customs officer rejected passenger on flight because water damage on passport—Ombudsman found officers failed to process the passport adequately and caused considerable cost to passenger because of this failure—complainant upheld and complainant received full payment to cover financial losses
  • Department of Internal Affairs provides reasonable service and advice to traveller on temporary passport

    Case notes
    Whether the Department of Internal Affairs (DIA) reasonably handled revalidation of a passport for New Zealand citizen travelling on temporary passport—Ombudsman concluded DIA had made every effort to inform the complainant of the steps needed to have his passport validated
  • District Health Board decision not to consult on provision of abortion services at a Hospital was unreasonable

    Case notes
    Whether the District Health Board was unreasonable to offer abortion services at a hospital without consultation with the local community
  • Pharmac decision not to fund drug was not unreasonable or contrary to law

    Case notes
    Whether PHARMAC decision not to fund a drug was unreasonable or contrary to law—Ombudsman concluded that this case did not reach the threshold of being unreasonable or contrary to law but made suggestions to PHARMAC about the matter
  • Accident Compensation Corporation failed to explain reasons for decision made on independent review

    Case notes
    ACC failed to provide a full and detailed explanation as to why it declined to make an ex gratia payment as recommended by an independent reviewer
  • District Health Board’s processes regarding informed consent for assisted reproductive procedure not unreasonable

    Case notes
    Whether a District Health Board (DHB) failed to ensure the complainant received adequate professional advice before being required to sign a legal document surrendering substantial legal rights—whether that document was ‘informed consent’—Ombudsman concluded DHB had not acted unreasonably in this matter
  • Canterbury District Health Board received inadequate advice about historic place

    Case notes
    District Health Board’s decision to sell land around disused hospital in Hanmer Springs—requirements for consultation discussed—requirement for keeping open mind referred to—an inadequate summary of submissions provided to Board—Department of Conservation asked to reassess site
  • Ministry of Agriculture’s aerial spray programme had unreasonable impact on population

    Case notes
    Ministry of Agriculture and Fisheries—Ministry of Health—actions in relation to the aerial spraying of Foray 48B (to eliminate the Painted Apple Moth) in West Auckland and Hamilton—inadequate advice to ministers about impact of spray operations
  • Department of Internal Affairs not unreasonable to cancel passport

    Case notes
    Department of Internal Affairs—decision to recall and cancel complainant’s NZ passport – position determined by terms of legislation
  • Agreement by ACC to stop regular rehabilitation assessments in light of information it already holds

    Case notes
    Whether the Accident Compensation Corporation (ACC) was reasonable to carry out regular assessments of a claimant for vocational rehabilitation despite already holding medical and occupational assessments confirming the claimant’s limitations—Ombudsman concluded this was not reasonable in the circumstances
  • ACC required to contribute towards client’s travel costs to attend hearing

    Case notes
    ACC client had difficulties with Individual Rehabilitation Plan and case manager—weekly earnings stopped—client sought review and later appealed decision to District Court but before hearing took place client moved to another town and had new IRP and case manager, and the earnings were reinstated—the client chose to continue with appeal in District Court but the appeal was unsuccessful—ACC refused to reimburse client for travel expenses but Ombudsman held this decision unreasonable
  • ACC delay to obtain opinion from Crown Solicitor unreasonable

    Case notes
    A 17 month delay by ACC in deciding whether to prosecute claimant for fraud but this delay due to 16 month delay by Crown Solicitor in providing ACC with written legal opinion — Ombudsman unable to investigate actions of Crown Solicitor but could consider how ACC dealt with the delay—three emails by ACC sent in 13 month period, then a formal request sent in writing for legal opinion—no agreed timeframes for when advice could be expected and Ombudsman of view that it was unreasonable for ACC to wait 14 months before formally raising concerns about the delay with the Crown Solicitor—ACC apologised to complainant and agreement reached between ACC and Crown Solicitor that legal opinions will be provided within 21 days of receipt of request
  • Ministry of Health reconsiders decision to charge for collation of information

    Case notes
    Requester sought draft and final copies of public health contracts for four financial years between Ministry of Health and 42 providers—Ministry agreed to release but subject to charge of $24,000—Ombudsman sought basis for charge—request for vast amount of information requiring substantial collation—charge applied in accordance with Ministry of Justice Charging Guidelines—however, Ministry had previously released part of requested information to an MP free of charge—Ombudsman did not consider it reasonable now to charge member of public for same information—Ministry agreed to review decision and release that particular information again free of charge and assist requester to refine request for outstanding information
  • ACC has responsibility to meet statutory obligations despite uncooperative claimant

    Case notes
    Refusal to compensate for alleged ‘wrongful action’ – independent review of case incomplete because of complainant’s behaviour—treatment and rehabilitation compromised by stand-off between claimant and Corporation—complaints sustained and recommendations made but rejected by Corporation—Accident Insurance Act 1998
  • Accident Compensation payment backdated but delay to repay

    Case notes
    ACC claimant originally declined attendant care payment and review of decision found that claimant was entitled to payments and they should be backdated to 1983—ACC accepted review decision but payments not forthcoming. Claimant’s family complained to Ombudsman and ACC explained it was in the process of calculating amount owed and expected negotiations to begin shortly—Ombudsman kept informed on progress—meetings between ACC and claimant’s family occurred with final amount calculated and preparations made for payment to be forwarded upon appointment of claimant’s property manager—Ombudsman discontinued enquiries
  • Failure by health funding body to honour undertaking by predecessor funding body to fund gender reassignment surgery unreasonable

    Case notes
    The Health Funding Authority (disestablished in 2001) was required to consider a complaint against its predecessor (Regional Health Authority) about an agreement by RHA to fund gender reassignment surgery—the RHA had initially agreed to fund this surgery but then changed its policy—the Ombudsman concluded that it was unreasonable for the RHA not to honour this undertaking on the basis of a subsequent change in policy and that its successor, the HFA should remedy the unreasonable actions of its predecessor—the HFA agreed with the Ombudsman’s recommendations to fund the gender reassignment surgery in the manner originally approved—as the HFA was by this time disestablished the matter was passed to the Ministry of Health for completion
  • Medical Practitioners’ Disciplinary Tribunal outside Ombudsman’s jurisdiction

    Case notes
    Complaint about Medical Practitioners’ Disciplinary Tribunal decision to strike off a doctor and media coverage of the hearing—no jurisdiction to investigate—Ombudsman has discretion to investigate matters of administration with respect to the Health and Disability Commissioner’s investigation into the doctor’s medical practices but only if complainant has sufficient interest in the subject-matter of complaint and consent from the doctor
  • ACC’s Advisory Committee Members cannot provide independent opinions on cases they then later consider

    Case notes
    Lack of independence alleged on part of medical expert—provider of independent advice also had deliberative role—perception of possible predetermination—complaint sustained and recommendation made—Accident Insurance Act 1998
  • ACC withheld document favourable to complainant’s case for review and accepted Ombudsman’s view that its service was inadequate

    Case notes
    Incomplete copy of file supplied—document favourable to claimant not revealed until after successful review—inadequate explanation offered—apology and remedial action instituted—Accident Insurance Act 1998
  • Health and Disability Commissioner unreasonably applied ‘gold standard’ when deciding on dental practitioner’s professional clinical standards

    Case notes
    Whether breach of professional clinical standards had been established—Health & Disability Commissioner (Code of Health & Disability Services Consumers’ Rights) Regulations 1996— whether Commissioner acted unreasonably in informing practitioner’s employer of alleged breach without first providing practitioner with adequate opportunity to respond—whether Commissioner unreasonable in failing to compensate practitioner
  • Ministry of Health decision not to respond to ‘open letter’ on baby food not unreasonable in circumstances

    Case notes
    Complainant wrote open letter to Ministry of Health expressing concerns about potential soy toxicity in baby food—no reply received—Ombudsman’s assistance sought—Ombudsman considered wording of letter—no specific information requested—Official Information Act did not apply—Ombudsman noted considerable correspondence on issue had already been exchanged between Ministry and complainant—open letter appeared to be a continuation of debate with Ministry—Ministry’s failure to respond unlikely to be unreasonable in the circumstances—Ombudsman exercised discretion under s.17(1)(b) Ombudsmen Act not to continue enquiries
  • Accident Compensation Corporation exercise of discretion found to be misleading and deficient

    Case notes
    Exercise of ministerial discretion—effect of advice to Minister fettered exercise of discretion—matter resubmitted to Minister for reconsideration—complaint deemed resolved—Accident Rehabilitation and Compensation Insurance (Experience Rating) Regulations 1993, regulation 7
  • ACC overpaid compensation in error but agreed to write-off debt

    Case notes
    Accident Compensation Corporation overpaid compensation in error and then tried to recover the overpayment debt from young debtor in poor financial position—Ombudsman found for the complainant and ACC agreed to write off debt and revise debt recovery policy