29 October 2021
Michael Vaughan
Email:
[FYI request #16802 email]
Dear Michael,
Thanks for your request for information. I have added some comments below
to the questions you are asking. I would point out a couple of considerations
first –
- COVID is a rapidly changing environment with information coming available daily
(currently there are over 180,000 per review scientific articles ono the American
Pubmed web site related to COVID)
- We are amid a global pandemic equal in intensity to the Influenza pandemic of 1918
and the HIV pandemic of 1980’s. The way scientific information is actioned may occur
of that reflective of the global emergency that we are in (even if we are in relative
isolation in New Zealand).
1) What is the Covid-19 treatment protocol for hospitalised cases?
Each case is assessed on a case by case basis but fol owing the general
guidelines provided by the fol owing site –
interim_guidance_-_clinical_management_of_covid-
19_in_hospitalised_adults_2 (health.govt.nz)
2) Are some DHB's following different treatment protocols from others?
Most DHB’s will be following the nationally set guidelines. Some hospitals can
manage different levels of complexities than others and so variations between
the hospitals can be expected. Some hospitals for example don’t have ICU
facilities and hence patients might be expected to be transferred into facilities
that do.
3) Are DHB's free to make decisions about treatments for individuals with
Covid-19?
Yes, as each case is managed on a case to case basis. Individual patients have
their own level of complexities and have to be managed accordingly. The
overall general principles wil be consistent throughout.
4) To what extent are patients able to participate in decision-making about
their treatment programmes?
This is strongly encouraged and partnership between patient / whanau and
clinician demonstrates the best outcomes.
_____________________________________________________________________________________________________________________________________
MidCentral District Health Board, PO Box 2056, Palmerston North.
5) If a patient requests a blood test for Vitamin D and/or the administration of
high dosage Vitamin C, are hospital staff able to provide these?
Where this is evidenced base through the peer reviewed literature, most
clinicians would be supportive. I would think that an open two way
conversation between both parties occur from a position of mutual respect and
sharing of information and knowledge.
However not all medications, procedures and processes that are available in
other countries have passed through the regulatory process that exists in New
Zealand.
6) Do hospital staff have the right to refuse a patient's request and, if so, is
there a process for a patient to appeal the decision?
Clinicians fol ow the best available evidenced based practice in their respective
professions. Usually, the first point of discussion when a major “disagreement”
between patient and treating clinician occurs is to get a second opinion. This
may occur on treatment modalities, prognosis estimates and planning around
discharge.
I trust these answer your issues or concerns.
Please note that this response, or an edited version may be published on the
MDHB website ten working days after your receipt of this letter. Please let me
know if you have any objections to this as soon as possible.
Yours sincerely
Dr Kelvin Billinghurst
Chief Medical Officer, Primary Public & Community Health Executive
MidCentral District Health Board
_____________________________________________________________________________________________________________________________________
MidCentral District Health Board, PO Box 2056, Palmerston North.