MANATU
HAUORA
MINISTRY or H[ALTH
133 Molesworth
Street
PO Box 5013
Wellington 6140
New Zealand
T +64 4 496 2000
11 August 2023
M Smith
Email:
f yi-request-23510-571429a2@requests. f y i .org. nz
Ref:
H2023029160
Tena koe M Smith
Response to your request for official information
Thank you for your request under the Official Information Act 1982 (the Act) to Manat0
Hauora (the Ministry of Health) on 16 July 2023 for information regarding out-of-scope
diagnostics, patient notes and general practitioner (GP) responsibilities. Please find a
response to each part of your request below:
Which specialists have the authority to diagnose conditions from the DSM-5 such as
somatisation syndrome, functional neurological disorder? In other countries, these are
predominantly under psychiatry/neurology, but it has
come to light that ED physicians,
general medicine and gastroenterology specialists are giving these diagnoses without
appropriate assessment,
and essentially shut patients off from receiving further care
and appropriate treatment.
In Aotearoa New Zealand, there is no restriction on which specialty may make the listed
diagnoses. There is an expectation that health care providers practice within their scope of
practice and consult appropriately with other specialties if they have diagnostic uncertainty.
Generalist scopes, including specialist general practitioners, emergency physicians, and
general physicians would commonly diagnose and manage patients with functional
neurological disorder (FND).
Where a patient considers there has not been appropriate care and treatment, they should
raise this with their treating provider, the healthcare facility arranging the treatment, or with
Te Toihau Hauora, Hauatanga Health and Disability Commissioner (HDC). The HDC can be
contacted by emailing [email address] or by calling freephone 0800 11 22 33. More
information can be found on the HDC website here: www.hdc.org.nz.
There are a
few information sheets
online such as
through the Medical council on
keeping patient notes, but I cannot find anything regarding the type of language that is
appropriate.
