The Public Service Commission two weeks ago completed its investigation into two separate incidents at the Niue Health department that occurred several months ago.
The chairperson of the Commission, Ida Talagi-Hekesi told BCN News that the investigation found gaps in the system where variations were made in place of standard protocol. Something the government’s employing authority found disappointing in the findings of the investigation into the processes of the health department in relation to the handling of patients’ records and the over-prescription of controlled drugs.
Several weeks ago BCN News was made aware of the two separate incidents. The first involved the medical records of patients which were found inside the envelope of a different patient on referral to New Zealand.
The second incident involved the over-prescription of controlled drugs called benzodiazepines which led to a temporary hold on orders from Niue for drugs like clonazepam for the treatment of anxiety disorders, seizures, bipolar mania and agitation associated with psychosis.
Commissioner Talagi-Hekesi said that the findings of the investigation was disappointing for the Public Service Commission but it was necessary to ensure processes and protocols are adhered to in the public service.
The investigation found clear variations from standard procedures and protocols of the health department however the Commission affirms that patient care is of utmost importance to the Health Department and they will support the department strengthen their processes going forward.
“The key findings that actually came out from the investigation, there was a clear variation of processes of workflow processes and protocols which is disappointing. However, these protocols are put in place for a reason, to mitigate and minimize risks”
The Commissioner apologised to the patients affected by these incidents and assured the public that reviews are being made to ensure there are improvements in the system. She said that issues like staff shortage and resourcing the department also contribute to the gaps.
Talagi-Hekesi said that the Public Service Commission will look to ensure lessons learnt from this investigation will strengthen the processes of the health department.
“I do sincerely apologise to the patients concerned and reviewing and re-evaluating everything I’d like to think that our processes will be strengthened as we go forward” said Commissioner Talagi-Hekesi.
BCN News reached out to MedSafe NZ about the protocols or rules for the importation of controlled drugs like benzodiazepines. In a statement Medsafe spokesperson said
“The prescribing of medicines and controlled drugs within Niue would be regulated by the Niue Authorities, under their own domestic legislation.
Medsafe administers licensing of controlled drug imports and exports to and/or from New Zealand, in alignment with the United Nations international drug control conventions which are monitored by the International Narcotics Control Board (INCB – https://www.incb.org/incb/en/index.html).
“This includes licensing exports of benzodiazepine containing products. Medsafe is not involved with benzodiazepine containing products which are imported to Niue from countries other than New Zealand”
“When considering an application for a licence to export a controlled drug, Medsafe reviews the corresponding import authorisation (import permit) issued, in this case by the Niue Government for the proposed shipment and checks that the export is within the INCB quota allocations. In parallel the Niue Government is responsible for ensuring that total imports (from all countries) remain within their INCB quota allocation.”
BCN News understands that Niue Health Department had exceeded its quota allocation and reached out to the government’s Treasury Department responsible for paying of all purchase orders from government departments to find out if the Health Department ordered medication from countries other than New Zealand.
Head of Treasury, Financial Secretary Doreen Siataga confirmed to BCN News that Treasury only has New Zealand suppliers in their system for medication orders for the Health Department.
The Minister of Health Hon. Sonya Talagi said that she was aware of the investigation and that she hopes for a concerted effort to help improve the provision of health care on the island.
In an interview with BCN News earlier this month, Minister Talagi said that she had spoken to the staff to avoid a repeat of the mistakes but she also acknowledged the Health Department is struggling with staff shortage.
BCN News understands that the government’s employing authority the Public Service Commission is in the process of appointing a new Director of Health and Chief Medical Officer, with the out-going Director/Chief Medical Officer Dr. Edgar Akauola leaving soon, after serving in the role of CMO of the Health Department since 2011.
The Public Service Commission said the report of its investigation will not be made public given the sensitivity of the information it contains in relation to patient information.