Dear Accident Compensation Corporation,

On 24 July 2014, I sought an independent surgical review with orthopaedic surgeon Mr Gordon Howie ( who was recommended by my GP), of the lumbar fusion preformed on 7 August 2013, in which post-op I had new and existing sciatica symptoms, and new pain,nerviness and numbness in the right anterolateral thigh, which after a number of additional injuries and putting my fusion under load through strength training the preoperative and new postoperative symptoms remained and had increased markedly when I met with Mr Howie.

Towards the end of the consultation Dr Howie made the statement to me that I should avoid repetitive bending, especially doing such work as skirting work which requires repetitive bending as this is the worst movement for my type of injury. When I pointed out that to secure building work (since I am a carpenter), I am in no position to be able to say that I am unable to do tasks that involve repetitive bending, Dr Howie suggested that I give building a go anyway.

Building work requires constant repetitive bending in constructing subfloors, placing and finishing concrete, tying off, placing reinforcing mesh and steel, placing steel in footings...and the list goes on. In light of Dr Howie's recommendation that I should avoid repetitive bending tasks whilst building, I was surprised then to receive a copy of Dr Howie's report from ACC that commented as follows;

"General recommendation is that patients with fusion do not return to heavy manual work but I have numerous builders and plumbers who have done so so I would not regard this as a contraindication to resuming building with minor concerns regarding the change in L4/5. "

Not only was this advice contraindicated to his advice that I should avoid repetitive lifting tasks which is very prominent in building in many tasks, Dr Howie made comment outside of his area of expertise.

Mr Howie to my knowledge at the time he consulted me was an orthopaedic spinal surgeon, and Mr Howie had not advised me from the notes that his secretary returned to me that he was also renumerated by ACC for medical assessment work, or that he was a trained occupational, and or vocational specialist and therefore appropriately specialised to make commentary on matters of occupational and vocational assessment/suitabilty with regard to the injuries that I sustained.

When I asked Dr Howie to amend his report to my GP and ACC to accurately reflect that he had recommended that I avoid repetitive bending work, Dr Howie replied by email commenting;

"Sorry, I don’t amend reports"

From a review of my selected ACC file notes that ACC have not held back, I noted that Mr Vasu Pai an ACC medical assessor, had recommended Dr Gordon Howie as an alternative to conduct a medical assessment as noted in Mr Pai's email to ACC's Leanne MacDonnell quoted below;

Party: Mr David Lawson Contact date/time: 19-12-2014 8.30
Reason: Contact With Provider Last update date/time: 19-12-2014 8.30
Discussion with: Leanne MacDonnell
Description: From: vasudevaspai . [mailto:[email address]]
Sent: Thursday, 18 December 2014 8:33 p.m.
To: Leanne MacDonnell
Subject: Re:
Hi Leanne
Contact date/time: Last update date/time:
19-12-2014 08:30 19-12-2014 08:30.

I would be grateful if you could cancel this appointment from my list on 23 December as it is far too complex and this should be assessed by Mr Howie or Mr Duthie Mills.

Kind Regards
Vasu Pai

E-mail Direction: INCOMING

I therefore requested clarification from ACC's Mr David Wheeler on 7 August 2015 about the nature of orthopaedic surgeon Mr Gordon Howie's association with ACC requesting under question 4. the following official information;

4. Has Dr Gordon Howie ever contracted to ACC for the purposes of conducting medical case reviews or other assessments on behalf of the Corporation?

To which ACC's Mr David Wheeler provided this reply on 11 August 2015 by email;

4. Mr Howie has a contract to provide clinical services including assessments for ACC clients.

I have reviewed all of the information supplied to me by Dr Howie's office in respect to a privacy act request and have been unable to locate in the information provided to me Dr Howie's secretary, Dr Howie's disclosure to me in his introductory appointment letter or the files sent back to me by his office that Dr Howie provides services to the Accident Compensation Corporation, and which if I had have been advised of Dr Gordon Howie's contractual association with ACC, I would have cancelled my appointment and sought a second opinion from an orthopaedic surgeon who did not have such contractual commitments to ACC.

I have checked Dr Howie's appointment confirmation letter dated 16.07.2014 and if anything Dr Howie's following comments which I quote;

"Please note, Dr Howie does not do Medico-legal, Insurance or Disability reports of any sort. Any reports issued by Dr Howie are not to be used for legal purposes."

gave the impression that Dr Howie was independent of both his clients and also ACC. Finding out that Dr Gordon Howie does actually contract to ACC as a medical assessor, who was recommended by Mr Vasu Pai, and as subsequently confirmed by ACC's Mr David Wheeler conducts assessments on behalf of ACC has raised concern for me.

It appears through comments in Dr Howie's website that he may be transitioning away from actually preforming surgery into a consultancy role having publicly commented on the front page of his website that;

"If surgery is really required I will refer you to the most appropriate surgeon for your condition."

For the above reasons I am respectfully requesting that ACC Government Services return to me the following Official Information for the past 8 calendar reporting years in respect of Dr Gordon Howie and ACC's contractual arrangements, and level of annual renumeration that Dr Gordon Howie has recieved for the following services;

1. The annual renumeration in bands of $25,000 that Dr Gordon Howie has received from ACC in terms of;

a) contracted ACC work that involves ACC clients being referred to Dr Howie for any and all medical assessment,

b) representing ACC at either ACC review and or ACC District Court appeals,

c) any and all other (please specify) contracted work for ACC.

2)
Please specify the scope of all assessments and contracted work that Dr Gordon Howie had contracted arrangements with ACC, either in place and or pending as at 1 July 2014.
It would be welcomed if you could also provide to me copies of these contracts, that include Dr Howie's contractual obligation's to his client's/patient's to have to inform them prior to assessment that Dr Howie may have perceived conflicting interests in assessing on behalf of ACC, persons with disability, injury and illness.

3)
It would also be appreciated if you could specify the scope of all assessments and contracted work that Dr Gordon Howie has contracted arrangements with ACC to currently preform, or has pending as at today's date. It would be welcomed if you could also provide to me copies of these contracts, that include Dr Howie's contractual obligation's to his client's/patient's to have to inform them prior to assessment that Dr Howie may have perceived conflicting interests in assessing on behalf of ACC, persons with disability, injury and illness.

I thank you for your time and assistance and confirm that under s16(2) of the Official Information Act, my preferred way of receiving a response is by email to the address from which ACC received the original request, not by post.

Regards,
David Lawson

Dear Government Services,

Thank you for your extension advice dated 9 June 2016.

I am writing to request that the official information that I have sought in this instance is forwarded to my email address being [email address].

Thank you for your time and assistance.

Yours sincerely,

David Lawson