Summary of complaints and discipline

Council asked the Department of Health in September 1975 to refer complaints about Society members to the NZSP National Secretary.  Branches would investigate petty complaints, and the Society only work on serious ethical complaints[1].  In 1976 the-Physiotherapy Board stated that they were now prepared to look at all complaints[2].  There was a possibility in 1978 that when the rules of the Society were amended to include the disciplinary principles the Physiotherapy Board may opt out of this[3].   In February 1976 the Director-General of Health was asked for complaints lodged about physiotherapists to be referred  to the Society.  The reply stated that they could not do that[4].  

The Society expressed its disappointment.  The Board would only act in extreme cases providing the patient was willing to give evidence.  It was agreed that branches would be written to asking them report any complaints to the National Secretary,  whether the person was a member or not[5].

The issue of the rights and responsibilities of physiotherapy consumers and the laying of a complaint had been the responsibility of the original Complaints and Disciplinary Committee.  The suggestion to form such a Committee was made in 1977. The matter was re-considered in 1981, when the Society felt that those provisions of the Act which were about disciplinary matters should be repealed and replaced with realistic and necessary provisions from the point of view of the Society.[6].   Four cases were heard in 1982.

Mr.Lamont wanted to publish broad details of discipline procedures in the Journal in November 1980 . The Minister of Health requested that there be more disciplinary guidelines for this Society.  The Society approached the Dept of Health,  offering assistance for the discipline of physiotherapists on the same basis as is in operation for the medical profession[7].  The legal adviser said in March 1981 that disciplinary matters could only be published in the Journal after they had been proven.  The Department of Health advised that they envisaged legislation rather than an informal mechanism for the discipline of physiotherapists.. It was resolved that Mrs. Wood should meet them for clarification[8].

The Ethical Committee had investigated a number of complaints in 1987 initiated by a third person.  Two complaints were received from patients in 1988,  in both cases no grounds were found for invoking a penalty,  though in both cases manner and attitude weighed heavily in the complainant’s minds.  The Committee recommended that practitioners should be vigilant.[9].  The issue of publication of complaints was considered in 1987 and it was decided that findings about complaints should be published.  Findings from complaint hearings have been published in Annual Reports from 1987.  Poor record keeping is often a factor making resolution of a case very difficult.  Repeatedly the Committee recommended that practitioners should be vigilant and that physiotherapists must ensure that patients are informed of treatment costs together with the aim and objectives of the treatment.  Again in 1989 it was moved that the disciplinary mechanisms for physiotherapy should be contained within the Act,  be specific to the profession,  and be determined by the majority of physiotherapists.[10]

The Ethical Committee wrote out a procedure of “Laying a complaint against a physiotherapist” in 1990,  for members of the public who wished to complain,  or for physiotherapists who needed further information.  At the AGM in 1991 concern was expressed that if names were omitted from accounts of disciplinary action this could put innocent practitioners under suspicion.  However it was found that the disciplinary section of the Act did not allow the publication of names.  It was agreed that the present disciplinary section of the Physiotherapy Act was woefully inadequate and that the Society should continue urging Government of the need to update it.

In the Annual Report for 1991 the Ethical Committee felt the problem needed to be substantiated and presented in a concise quotable format.  The problem and dialogue continued in 1992 when legal opinion was sought on the matter of physiotherapists found guilty of fraud and name suppression.

It was decided that if a Society member is found guilty of defrauding the ACC the Physiotherapy Board will be asked to consider the necessary disciplinary action against the physiotherapist named.

In 1992 the Committee found it vexatious to deal with problems involving non members.  The Newsletter of June 1992 noted that in order to support reciprocity with Australia we need to amend the disciplinary section of the Physiotherapy Act.  The Board met on issues of legislation matter,  Body Corporate ethics and discipline.

The boundary between complaints dealt with by the Society and those dealt with by the Physiotherapy Board was considered in 1991 and 1992.  The matter was resolved in 1993 when it was decided serious cases would go straight to the Board Ethics Committee and should be published for distribution to all members of the Society.  In March 1992  it was agreed that the findings of the complaints and disciplinary Committee (now ethics) be published for distribution of all members of the Society.

1993 saw a change in this procedure when all complaints against Healthcare providers were handled by the Health & Disability Commissioner and then being forwarded to the appropriate disciplinary bodies.  In 1994 The Board now had the authority to award costs for disciplinary matters and would eventually be required to refer all disciplinary matters received to the Health and Disabilities Commissioner.[11]

It was thought the disciplinary section of the Act would need to be changed under the bill for this to occur.[12].  Rosemary Jarmey (Chairperson Ethical Committee) noted in the 1993 Annual Report that the advisory aspect of the Committee’s work was increasing  She found this encouraging because it showed that members were starting to consider the consequences of their actions.  The two main areas of concern were customer satisfaction surveys and employment of other physiotherapists.  Three complaints were dealt with by the Physiotherapy Board in 1994,  and four by the Society which were dealt with by correspondence.

Members were reminded about breaches of confidentiality in 1995,  if the physiotherapist breached the Privacy Code they would have to go before the Privacy Commissioner.[13]  In 1995 there was one complaint to do with the standard of practice.  The Committee noted that it is important to communicate directly with other professions.  The Committee decided in 1995 that it had a responsibility to advise complainants of their right to lodge a claim with the ACC in respect of medical misadventure or medical error.

In May 1996 the NZSP looked at the problem of the registering body being both the prosecutor and disciplinary body which could be resolved in the new legislation with regard to the new Physiotherapy Act and the role of the Health Commissioner.  In May 1996 it was decided to maximise sensitivity within our system - the ethical Committee to incorporate in complaint process guidelines.

The two options for the structure of the Disciplinary Tribunal were discussed in 1996;  one an independent Physiotherapy Disciplinary Tribunal and the other a multi-disciplinary Tribunal.  Under both options,  the recommendation is for three registered physiotherapists and one lay person. [14].  1996 saw a change of emphasis to the work of the Committee.  The advent of Professional Liability Insurance made the work much more complex with lawyers being called in more commonly.  The appointment of the Health and Disability Commissioner also changed the work,  with complaints regarding physiotherapists occurring after July 1996 going straight to the Health and Disability Commissioner.  Complaints in 1997 were dealt with by teleconference and concerned whether a physiotherapist had practiced with acceptable professional standards,  and in the best interest of their patients.

[1] E/M  20-9-75

[2] E/M  25-9-76

[3] E/M  20-5-78

[4]E/M  14-2-76

[5] E/M 26 - 6 - 76

[6] E/M 23-5-81

[7] E/M 29 - 11 - 80

[8] E/M 14 - 3 - 81 -

[9] Annual Report  1988

[10] E/M 22-4-89

[11] E/M 27-11-94

[12] E/M 13-2-93 -

[13] Annual Report 1995

[14] E/M 10-5-96 -