Deputy Health and Disability Commissioner Dr Vanessa Caldwell. Photo \/ James Gilberd Photography Ltd<\/p>\n
In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell found the doctor had breached a section of the health consumers\u2019 code <\/a>by failing to provide services with reasonable care and skill, largely through his failure to refer the woman in a timely manner.<\/p>\n Caldwell was also critical of how the doctor had taken the woman to the clinic\u2019s front desk and discussed the details of the process required for a planned termination with the receptionist in the busy waiting area. <\/p>\n She said more suitable options might have been a brief written note to the receptionist about what was required, or going to the reception area first to discuss next steps with the reception staff.<\/p>\n Investigation followed complaint referral <\/p>\n The HDC investigated the complaint following a referral from the Health and Disability Advocacy Service, with whom the GP clinic<\/a> refused to engage, despite five attempts, Caldwell said.<\/p>\n She said the GP clinic finally responded to the HDC\u2019s request for information about 18 months after its initial request.<\/p>\n There was a further seven-month delay before the investigation began, Caldwell said.<\/p>\n The incident when matters were discussed at reception happened during an initial consultation with the GP, when the woman requested a referral for a termination of the unexpected first trimester pregnancy<\/a>.<\/p>\n At the same time she was told her visa status meant the relevant services would not be publicly funded.<\/p>\n She was advised to return for a second consultation once preliminary investigations had been completed.<\/p>\n The doctor said it was common practise for him to manage such matters through two consultations to ascertain a patient\u2019s wishes whether to continue or terminate a pregnancy. <\/p>\n Consultation \u2018disputed\u2019 <\/p>\n The doctor told the HDC he did not carry out a consultation in the reception area. However, he acknowledged he took the woman to the front desk and told staff that \u201cshe needed a TOP (termination of pregnancy) workout\u201d in the full reception and waiting area.<\/p>\n He claimed this was necessary for the reception staff to co-ordinate the next steps.<\/p>\n He also said his reason for going to the reception area with her, after consultation, was \u201cpurely an act of doing a favour\u201d for the woman who he said seemed unsure about what to do next.<\/p>\n Caldwell said regardless of the intent, in her view, the doctor had a responsibility to consider the sensitivity of the matter and respect the woman\u2019s privacy. <\/p>\n \u201cI remain critical that other options available for having this conversation more privately were not utilised,\u201d she said.<\/p>\n Told to return after Covid lockdown<\/p>\n About 10 days after the initial consultation, when Auckland<\/a> had just entered Covid lockdown, the doctor phoned the woman and advised her to return to the clinic for a second consultation, after lockdown.<\/p>\n The doctor said because the woman was an international student, with very limited English, he felt a greater need to explain the referral process and therefore a second consultation was warranted.<\/p>\n She was also told that no (termination) services were available during alert Level 4 lockdown.<\/p>\n The advice was later found to be incorrect. <\/p>\n The doctor acknowledged his mistake in not knowing that a private sector pregnancy termination service was always available, even during Level 4 lockdown<\/a>.<\/p>\n He said had he known, he would have asked the woman to come straight to the clinic for a referral.<\/p>\nThe doctor said he did not carry out a consultation in the reception area, but acknowledged that he took the woman to the front desk where he spoke about the process. Photo \/ 123RF<\/p>\n