Saturday, 27 August 2011


I’ve always been intrigued with Science Fiction. It allows people to take a look at their own world from a slightly different perspective and subtly challenge both individual and societal belief systems. Perhaps at times its fanciful and unrealistic, but it is also one of the most effective ways to stimulate analytical thought and confront our ideas of the status quo.

An interesting example of this is a Star Trek (Next Generation) episode on the concept of marriage. In this episode of the popular science fiction TV series – a society exists where the default option for married couples is mandatory divorce after a five year period. Instead of staying together – the couples are asked to prove to a marriage tribunal after the five year period has elapsed that they want to remain married. It’s a simple concept in reverse and yet the implications on our culture today are fascinating. A far fetched scenario perhaps but one that focuses change at a system level instead of an individual.

Leaving the science fiction world, I read an article in an Australian national news publication that made me ponder how we institute change on a system level when so much is at stake for an individual.

The newspaper article in question revealed that an individual had suffered a significant adverse health outcome despite presenting to a Victorian emergency department upon feeling unwell. The article went on to discuss the involvement of legal representation and the potential allocation of compensation for the individual who has been left with medical complications and ongoing care needs for the rest of their life.  In this age of accountability and transparency – the article intimated that an individual or individuals at the health service might have to answer to claims of medical mismanagement or negligence.

In the health service industry, the system for compensation is structured in a way that one party must prove the other was at fault. The only possible option for the individual at the heart of this issue to receive compensation is to commence legal proceedings, thereby attempting to blame another individual or group for the adverse outcome.

Now lets employ some science fiction to this scenario for a moment. Imagine this individual had not sought the help of their local health service. Yet the same outcome ensued. The individual was left severely impaired for the rest of their lives but had not asked anyone for help after feeling unwell. Does this mean they are not entitled to compensation? The cost of their healthcare needs will not change. The impact on their life and those around them will not change. But who is responsible for their adverse health outcome?  The simple answer is that any person who experiences an adverse outcome should be compensated (mandatory compensation). It is our obsession with accountability and allocation of blame in the health system that needs to change.

 If we continue with the concept of mandatory compensation – the individual has limited scope to commence legal proceedings. In fact, the process of litigation may be completely bypassed altogether if all individuals were entitled to seek compensation in some form. Government or tax-payer money could be allocated to individuals on a case-by-case basis so that everyone who suffers an adverse outcome receives a level of compensation on an equitable basis. Instead of allocating tax payer dollars to private legal firms who ‘win’ cases, our taxes could then be spent elsewhere. As tax-payers do we really need to be lining the pockets of private legal firms?

The money saved from expensive legal fees and court time could be allocated to the system at fault - the health service. Years of successive government funding levels have meant that Australian health services are overworked and under resourced – yet still perform relatively well on the world stage.  Unfortunately, despite the allocation of resources, adverse outcomes will undoubtedly occur and individuals will continue to be affected. Also, there is some scope for exploitation to occur in the context of mandatory compensation.  Perhaps this is where the role of private law firms can be reversed – and expend their energy in preventing such exploitation from occurring.

The process of finding someone to blame for a bad outcome is not the answer, both in the context of a marriage breakdown or an adverse health outcome. However, changes to the status quo need to occur by examining a situation from many different perspectives – not just science ficiton. Compensate those individuals affected as the default option and let humanity underpin our relentless quest for accountability.