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Australian Lawyers Alliance Having now interviewed close to 150 patients and relatives involved in hospital-caused harm, we know that the principal gestures that patients expect are: an apology; timely and honest communication and information flow; acknowledgement of the error and for responsibility to be taken; reassurance that the incident will not happen again and that the service seeks to improve as a result of the incident; and emotional support. One other important expectation is financial support. Where reparative gestures are predominantly communicative in nature, financial support has, besides a communicative dimension (as gesture), also a material dimension (as resources, for example, money). Deciding what is appropriate financial compensation is challenging for a number of reasons. Australian health services, by and large, tend to shy away from offering compensation outside of a finding of legal liability. This may be because the service's insurer refuses to repay the service for monies paid in this way. It may also be because the service lacks the necessary bureaucratic-administrative mechanisms for making money available to patients who are harmed , or for determining amounts to pay for non-hospital related costs. Or it may be that the service's lawyer advises against awarding payments lest they be converted into attributions of legal liability under our fault-based system of compensation. In some states - for example, Queensland - public system monies have now been made available by the health bureaucracy to allow services to make limited 'ex gratia' payments. Findings from our Open Disclosure studies indicate that both clinicians and patients want a better method of providing compensation, including 'ex gratia' payments, for expenses incurred as a result of adverse incidents. |
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