The New Zealand Herald made a request to five District Health Boards (DHBs) for information about the nature and outcomes of public hospital work by cardiothoracic surgeons and neurosurgeons. The DHBs refused the request in order to protect the privacy of the surgeons and because the information could not be made available without substantial collation or research.
Under the Official Information Act 1982 (OIA), the DHBs should not have refused the request for the number and type of procedures performed by individual surgeon. Surgeons have a low privacy interest in such information, outweighed by public interest considerations favouring disclosure. Concerns about the limitations of the information can be addressed by providing explanatory information.
However, the DHBs were entitled to refuse the request for standardised, risk-adjusted information relating to major complications, readmissions and deaths, since that information is not currently held. The DHBs were also entitled to refuse the request for numbers and crude rates relating to major complications, readmissions and deaths at individual surgeon level.
Releasing individual surgeons’ outcomes data in its current state would do more harm than good given the current state of information in the New Zealand health sector. Public reporting of data that is misleading, incomplete or otherwise of poor quality could erode public confidence in the health system, undermine teamwork and result in surgeons seeking to avoid complex procedures.
New Zealand lags behind other comparable healthcare systems in disclosure of performance and outcomes information. Professionalism in a 21st century doctor should include a commitment to the collection and publication of meaningful outcomes data. Professional colleges, such as the Royal Australasian College of Surgeons, have an important leadership role to play.
It is, however, encouraging to see a greater commitment within the health sector to collect, analyse and publish data on the outcomes of healthcare interventions.
The Ombudsman has recommended that the DHBs release the numbers and types of procedures performed by individual surgeons, and that the Ministry of Health and Health Quality & Safety Commission provide publicly available, annual updates, from June 2017, on progress towards publication of meaningful quality of care measures across specialties by June 2021.
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