Around the world, 10,000 people die each day as a result of mistakes, complications and other harms caused by their acute health care. This makes iatrogenic harm in health care the third biggest killer, behind deaths from smoking and lack of clean water and basic care for children.

In the 1980s and 90s the health system did not recognise the validity of patient complaints about their bad outcomes from health care.

That has gradually changed since the level of harm that patients suffer as a result of their health care was exposed in 1995 with the Australian Health Care Study (which can be downloaded from here).

The health system has refocused from seeing the patient as problem (via their complaints) to the system of health care itself; there is overwhelming evidence of patient injury and deaths caused by our overly complex and poorly designed system.

Most governments here and overseas have responded to the need to make the system safer by establishing state and federal bodies charged with reducing the number of errors and improving patient safety; they focus on the system not individuals.

Yet governments continue to respond to catastrophic events reported in the media by targeting the health professionals involved, rather than admitting the system itself is the problem. Is this because governments are yet to be convinced of the harm to patients? If so, we need a climate change.

An important report on patient safety was jointly released last week by the Australian Institute of Health and Welfare and the Australian Commission on Safety and Quality in Health Care. But governments, yet again, failed to seize the opportunity to stimulate a more informed debate about a critical issue.

The tight rein governments put on patient safety bodies is counterproductive to changing the health care system. Patient safety agencies should be leading and educating the public about patient safety and what they can do to help make the system safer; instead the public is denied much information about the systemic problems of health care, leaving the community no wiser about errors in the health system than they were 20 years ago.

No wonder patients are still locked into the blame game when they suffer a bad outcome. The health system needs to come clean and involve the community in their efforts to make the health system safer.

It can only do this if governments give them the go ahead.

Merrilyn Walton is co-author of the recently released, Safety and Ethics in Health Care: A Guide to Getting it Right (Ashgate Publishers)

Peter Fray

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Peter Fray
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