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Casebook Vol. 22 no. 3 - September 2014

You won’t be surprised to know that a significant proportion of my work at MPS consists of assisting members who have been involved in an adverse event.

We always advise members to be open about any errors made during the course of such an event – it is morally and ethically the correct thing to do, and can go a long way towards preventing a claim arising in the aftermath.

This is because we often find that claims derive from an angry or aggrieved (or both) patient or relative feeling they have been denied information and explanations – and, if appropriate, a simple apology – in the wake of an adverse outcome. Openness stands to benefit all parties and yet, quite understandably, there remains nervousness and uncertainty about delivering it.

In New Zealand, there is a statutory obligation for open disclosure; in the United Kingdom, a similar ‘duty of candour’ appears to be the government’s approach of choice, despite MPS believing a change in culture will be much more effective. Readers in Hong Kong may recall a fascinating article by Dr Chui Tak-yi at the Hong Kong Hospital Authority, who wrote in the September 2013 edition of Casebook about his systems approach to changing the reporting culture within the organisation.

Fear and anxiety over ‘blaming and shaming’ paralyses many healthcare professionals and prevents them from being open about mistakes that they may have made. This edition of Casebook features a truly harrowing first-hand account from Clare Bowen, a mother-of-two in England who lost her five-year-old daughter Beth in 2007 during surgery. A wall of silence from all involved in Beth’s care prevented Mrs Bowen and her husband from getting a full explanation of the causes of the tragedy. Our article on page 10 will make sobering reading for anyone involved in healthcare today.

However, this edition may also provide some relief for readers, in that our latest collection of case reports feature a significant number of successfully defended claims. We hope they will provide some reassurance that a mistake is not always judged to be negligent – and that the team at MPS are committed to protecting your reputation.

Dr Nick Clements – Editor-in-chief
MPS Head of Medical Services

Disclaimer: Information in this issue was correct at the time of publishing (September 2014)