General practitioner groups say an ACC plan to keep a tighter watch on the use of medical certificates is a sign of the Crown entity’s misplaced priorities, expressing frustration over poor communication.
Newsroom last month revealed that injured New Zealanders seeking ACC compensation may soon face a tougher time getting medical certificates, with the organisation developing a ‘prototype agreement’ to improve medical certification practices.
The Crown entity told Newsroom it wanted to ensure the use of medical certificates more accurately reflected a person’s injury and their potential for recovery, with work an important part of the rehabilitation process.
However, the Opposition has expressed fears it is focused on reducing payouts rather than on injuries, while GP groups have now weighed in with their own concerns.
General Practice Owners Association chair Dr Angus Chambers told Newsroom ACC’s approach was misplaced, with the organisation needing to improve its communication with GPs rather than going through third-party groups.
“They won’t engage, we can’t engage with them … ACC is a little bit of a ‘speak to the hand’ kind of organisation.”
The ‘meso-level organisations’ being invited to take part in the new oversight arrangement often fought for their own interests rather than those of GPs, and were in some cases competing to provide services.
Chambers said GPs’ obligation to their patients was their top priority, but that did not extend to doing whatever the patient wanted when it came to issues like medical certificates.
“It’s a difficult thing to say to somebody that, no, I don’t think this is the best thing for your health [to be away from work] … some people are better equipped than others to deal with that situation.
“People are generally trying to find a way to meet their patients’ needs, but also we’re kind of being responsible for public money, so we’ve got that obligation and duty on us as well.”
Chambers said there were often delays associated with specialist care that could impede a patient’s return to work, while access to rehabilitation services could depend on where the person lived.
Royal NZ College of General Practitioners medical director Dr Prabani Wood told Newsroom that ACC was looking at the wrong problem, with little evidence to suggest GPs were being overly liberal in issuing medical certificates for time off work.
“When we fill out an ACC claim we’re filling the information based on what the patient’s telling us … I don’t see why a GP would sign off someone for too long if they didn’t feel like they needed it.”
‘They’re looking at the wrong issue by pointing the finger at the wrong group of people‘
Dr Prabani Wood, Royal NZ College of GPs
Wood said patients often faced delays in securing appointments with their GP and other healthcare providers, likely a factor in rising compensation claims.
Gathering information requested by ACC was often a time-consuming process, given difficulties in accessing historical notes.
“I think the record I got was something that happened in 1990, so 35 years ago, and you’ve got to go through the notes to pick out the bits that are relevant for any claim … if you don’t do it then that patient may not get the care that they need, so the onus is on us.”
Wood said the process could be streamlined if all the healthcare providers involved in an ACC claim had real-time access to joint records for a patient, avoiding unnecessary delays in gathering information.
“They’re looking at the wrong issue by pointing the finger at the wrong group of people: actually, if they want things to run better it’s … having a clear form of communication in real time.”
ACC acting chief clinical officer Dr Dilky Rasiah told Newsroom the organisation’s tender was seeking solutions from the primary care sector rather than asking for a specific service, and had been developed based on feedback received through its health sector engagement events.
“As part of these events, we formally sought ideas from the sector and established a primary care external reference group to provide guidance on potential solutions aimed at reducing known pain points for this sector.”
Rasiah said ACC also stayed connected with primary care providers through an online newsletter and regular engagement with professional bodies and other key organisations, and was looking forward to seeing what potential solutions were generated by the sector.
* This article has been updated with additional comment from ACC