United States Studies Centre, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2012 Sep 3;197(5):296-8. doi: 10.5694/mja12.10322.
The 2011 report of the Productivity Commission (PC) recommended the establishment of a no-fault national injury insurance scheme limited to "catastrophic" injury, including medical injury. The report is welcome, but represents a missed opportunity to establish simultaneously a much-needed no-fault scheme for all medical injuries. The existing indemnity scheme based on negligence remains a slow, costly, inefficient, ill targeted and stress-creating system. A fault-based negligence scheme cannot deter non-intentional errors and does little to identify or prevent systems failures. In addition, it discourages reporting, and thus is antithetical to the modern focus on universal patient safety. A no-fault scheme has the potential to be fairer, quicker and no more costly, and to contribute to patient safety. No-fault schemes have been in place in at least six developed countries for many years. This extensive experience in comparable countries should be examined to assist Australia to design an effective, comprehensive system. Before implementing the recommendations of the PC, the federal government should ask the Commission to study and promptly report on an ancillary no-fault scheme that covers all medical injury.
2011 年生产力委员会（PC）的报告建议建立一个无过错的国家伤害保险计划，仅限于“灾难性”伤害，包括医疗伤害。该报告受到欢迎，但却错失了一个同时为所有医疗伤害建立急需的无过错计划的机会。现有的基于过失的赔偿计划仍然是一个缓慢、昂贵、效率低下、针对性差且制造压力的系统。基于过错的过失制度不能阻止非故意的错误，也几乎不能识别或防止系统故障。此外，它还阻碍了报告，因此与现代对普遍患者安全的关注背道而驰。无过错制度有可能更加公平、快速，成本更低，并有助于提高患者安全性。至少有六个发达国家已经实行了多年的无过错计划。应该审查这些在可比国家的广泛经验，以协助澳大利亚设计一个有效、全面的系统。在实施 PC 的建议之前，联邦政府应要求委员会研究并迅速报告一个涵盖所有医疗伤害的辅助无过错计划。
