New Zealand's 2005 'no-fault' compensation reforms and medical professional accountability for harm.

AIMS To discover the effect of the 2005 'no-fault' compensation reforms on medical professional accountability for harm in the context of overall trends in New Zealand's medical professional accountability processes 2001-2010. METHODS Data for the 5 years before and after the 2005 reforms were compared including compensation claims to the Accident Compensation Corporation (ACC), ACC reporting to the authorities, patient complaints to the Health and Disability Commissioner and outcomes, referrals to the Medical Council and outcomes, and disciplinary proceedings and outcomes. RESULTS Following the 2005 compensation reforms, claims for compensation increased, ACC reporting overall increased but ACC reporting to the Medical Council decreased; patient complaints increased but the Health and Disability Commissioner investigated fewer complaints and referred fewer doctors for discipline while maintaining steady referrals to the Medical Council; referrals to the Medical Council decreased, and the Medical Council conducted fewer performance reviews and referred fewer doctors for discipline; disciplinary proceedings decreased but more hearings ended in guilty findings. CONCLUSIONS Accountability via compensation decreased following the 2005 'no-fault' compensation reforms, contributing to an overall decrease in medical professional accountability for harm.