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Prioritisation and management of patient requiring ENT and radiology services (09HDC00891)

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(09HDC00891, 31 March 2010)

Public hospital ~ District health board ~ ENT ~ MRI scan ~ Public funding ~ Brain tumour ~ Vertigo ~ Tinnitus ~ Rights 4(1), 6(1)

A woman in her mid-twenties complained about the services provided by a district health board (DHB). This case examines the prioritisation and management of the woman, who was waiting for Ear, Nose and Throat (ENT) and radiology services from the DHB. She experienced symptoms that were recognised as serious by her GP and a private ENT specialist, but were not considered urgent enough by the DHB to warrant a publicly funded MRI scan. She was subsequently diagnosed with a brain tumour, part of which was then removed.

It was held that the DHB did not appropriately assess and prioritise the woman's level of need for an MRI and, as a result, she was denied access to a publicly funded MRI. In these circumstances, the DHB breached Right 4(1). It was also held that the DHB breached Right 6(1) owing to the lack of clarity and timeliness of the advice it provided to the woman.

This case highlights the need for clarity and timeliness of information about assessment and treatment options if publicly funded services are not available. It also illustrates the unfairness of "postcode lottery" access - where the ability to access publicly funded services depends on the patient's place of residence in New Zealand.