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New Zealand has evolved a just, sensible and balanced system for addressing adverse medical events. This article considers potential changes to enhance justice for health consumers after an adverse event. Patient motivations for claiming are described. Changes to the complaints regime are considered with the aim of opening up access to the Human Rights Review Tribunal. Modest change only is advocated, to avoid the potential for the tribunal to become a de facto appeal mechanism. The preferable solution is greater access to Health and Disability Commissioner investigations. The second part of the article considers changes, some implemented already, to the compensation regime to make it more affordable. These will compromise the ability of the scheme to address the remedial interest of injured patients in compensation. Undesirable consequences are likely to occur across the system. Policy-makers need to consider the ramifications of change for the system as a whole.  相似文献   

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The development and reorganization of mental health services in New Zealand is underpinned by a national strategy, with increased funding from the government, and is occurring on a background of radical change in health service policy and delivery. The major challenge will be to sustain the developments to date, and increase the quality and quantity of services in a climate of ongoing change. A more integrated form of service delivery and funding would potentially enhance the development of population-based mental health services, which will allow the alignment of targeting specialty service to the 3% of the population with the highest need, with a more comprehensive approach to overall mental health service through the primary sector.  相似文献   

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