Institutional innovation and the handling of health complaints in New Zealand: an assessment.

This paper explores innovations in health complaints mechanisms in New Zealand, focusing on two legislative developments-The Health and Disability Commissioner Act 1994 and the Medical Practitioners Act 1995. Both pieces of legislation were introduced during a time of far-reaching institutional change in New Zealand, and were influenced by the findings of unethical practices by medical researchers at a women's hospital in Auckland. Although the legislation was driven by concerns over consumer rights and in particular women's health, there have been some unanticipated developments. An assessment is made of the impact of these innovations, based on the analysis of a number of data sources, including media reports, complaint reports and submissions to select committee hearings. The regulatory environment in New Zealand left health consumers heavily dependent on the medical profession's internal mechanisms of regulation. The failure of this internal regulation led to new external regulatory mechanisms designed to empower the consumer. The analysis suggests that even when empowerment appears to be written into legislation there are mechanisms available to limit empowerment further.