Consumers Rights & Physicians Obligations - Referrals and Inter-District Flow

Amy S Van Wey Lovatt made this Official Information request to Ministry of Health

Response to this request is delayed. By law, Ministry of Health should normally have responded promptly and by (details and exceptions)

From: Amy S Van Wey Lovatt

Dear Ministry of Health,

According to the Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996, Right 6 clause 3 (c), "Every consumer has the right to honest and accurate answers to questions relating to services, including questions about...(c) how to obtain an opinion from another provider;". Further, Right 7 clause 8 states: "Every consumer has the right to express a preference as to who will provide services and have that preference met where practicable."

According to the MoH Operational Policy Framework 2019/20, available through Nationwide Service Framework Library <https://nsfl.health.govt.nz>,
section 7.5.2 "Regions should ensure that clear referral pathways are in place and known to all clinicians."

Request 1:
I respectfully request a copy of each referral pathway for each region in New Zealand.

Background:
I am a New Zealand citizen. Waikato DHB, my DHB of Domicile (DoD), has insisted that my GP provide a referral to services outside my DoD; however, when my GP referred me to the Southern DHB, the only DHB we could find which had a protocol consistent with the Endocrine Societies Guidelines for testing for hyper aldosteronism, the Southern DHB rejected the referral on the grounds that the referral was from my GP and not my specialist, Dr Wu, at my DoD.

Clearly, Waikato DHB and Southern DHB cannot both be correct, as they contradict each other. [The statement, referrals must be from GPs AND referrals cannot be from GPs, is logically false.]

Request 2:
Please provide me with the specific policy, guideline, rules or legislation (including page or section number) which specifies who is responsible for the submission of patient referrals to specialists, where the specialist is located in a DHB that is not the DoD, especially in the case of where two DHB's have contradicting policies.

Request 3:
Please provide me with the specific policy, guideline, rules or legislation (including page or section number) which specifies the avenues that patients may take to seek care out of the DoD, when the patient has lost all trust and confidence with the DoD.

Request 4:
Please explain how these policies are consistent with the Code of Health and Disability Services Consumers' Rights, specifically:
- Right 3, which states "Every consumer has the right to have services provided in a manner that respects the dignity and independence of the individual"; and
- Right 4 clause 3, which states "Every consumer has the right to have services provided in a manner consistent with his or her needs"; and
- Right 7 clause 8, which states: "Every consumer has the right to express a preference as to who will provide services and have that preference met where practicable".

Respectfully yours,

Amy S Van Wey Lovatt

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Dear Amy

Please find attached a letter regarding your request for official
information.

Nga mihi

OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]

From:        "Amy S Van Wey Lovatt"
<[FOI #12108 email]>
To:        "OIA/LGOIMA requests at Ministry of Health"
<[Ministry of Health request email]>,
Date:        29/01/2020 09:43 a.m.
Subject:        Official Information request - Consumers Rights &
Physicians Obligations - Referrals and Inter-District Flow

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Dear Ministry of Health,

According to the Health and Disability Commissioner (Code of Health and
Disability Services Consumers' Rights) Regulations 1996, Right 6 clause 3
(c), "Every consumer has the right to honest and accurate answers to
questions relating to services, including questions about...(c) how to
obtain an opinion from another provider;". Further, Right 7 clause 8
states: "Every consumer has the right to express a preference as to who
will provide services and have that preference met where practicable."

According to the MoH Operational Policy Framework 2019/20, available
through Nationwide Service Framework Library
<[1]https://nsfl.health.govt.nz>,
section 7.5.2 "Regions should ensure that clear referral pathways are in
place and known to all clinicians."

Request 1:
I respectfully request a copy of each referral pathway for each region in
New Zealand.

Background:
I am a New Zealand citizen. Waikato DHB, my DHB of Domicile (DoD), has
insisted that my GP provide a referral to services outside my DoD;
however, when my GP referred me to the Southern DHB, the only DHB we could
find which had a protocol consistent with the Endocrine Societies
Guidelines for testing for hyper aldosteronism, the Southern DHB rejected
the referral on the grounds that the referral was from my GP and not my
specialist, Dr Wu, at my DoD.

Clearly, Waikato DHB and Southern DHB cannot both be correct, as they
contradict each other. [The statement, referrals must be from GPs AND
referrals cannot be from GPs, is logically false.]

Request 2:
Please provide me with the specific policy, guideline, rules or
legislation (including page or section number) which specifies who is
responsible for the submission of patient referrals to specialists, where
the specialist is located in a DHB that is not the DoD, especially in the
case of where two DHB's have contradicting policies.

Request 3:
Please provide me with the specific policy, guideline, rules or
legislation (including page or section number) which specifies the avenues
that patients may take to seek care out of the DoD, when the patient has
lost all trust and confidence with the DoD.

Request 4:
Please explain how these policies are consistent with the Code of Health
and Disability Services Consumers' Rights, specifically:
- Right 3, which states "Every consumer has the right to have services
provided in a manner that respects the dignity and independence of the
individual"; and
- Right 4 clause 3, which states "Every consumer has the right to have
services provided in a manner consistent with his or her needs"; and
- Right 7 clause 8, which states: "Every consumer has the right to express
a preference as to who will provide services and have that preference met
where practicable".

Respectfully yours,

Amy S Van Wey Lovatt

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