But legislation, as it stands, means Bruce will never get his wife’s case heard by the Medical Disciplinary Tribunal. Four years on the trek to justice have taught him that the medical profession is "the biggest closed shop you’ll ever hear of in your life". Critics agree that methods of dealing with complaints are letting people down. Cases like Jill’s deserve a proper hearing.

It was a Friday night, business as usual, when Jill first complained of severe chest pain, a pain in her left arm and associated back pain. The couple immediately went to their family GP, Dr Hammond Williamson, who took an ECG, claimed it was normal, and diagnosed Jill as having indigestion. "I wanted to take Jill to the hospital but the doctor said he didn’t want to take up bed space at Timaru Hospital," alleges Bruce. It may have been a throwaway line but it still remains jammed in Bruce’s memory.

The next day Jill’s chest pain was more severe. On phoning Dr Williamson, the couple was allegedly told it was indigestion again and advised to get some medication to help the pain. Not content with the diagnosis, the pair made their way to the Waimate duty doctor, Dr Ralph Brock-Smith. He had spoken with the Wilson’s GP and, satisfied with his diagnosis, claimed Jill’s back pain was referred pain from the indigestion. He gave her a back rub and referred her to a physiotherapist.

Immediately on arrival to Scott’s Physiotherapy Clinic, Jill collapsed. She was admitted to Timaru Hospital’s Intensive Care Unit suffering from cardiac arrest, and remained there for ten days. Five and a half weeks in a coma followed, leaving Jill irreparably brain damaged. That also marked the end of any normal existence for Bruce.

He stopped work at the hotel. He spent the next three months with Jill in Timaru Hospital, and a further eleven months by her side at Burwood Hospital’s Brain Injury Rehabilitation Unit in Christchurch. Another five months at Bethesda Hospital followed, until Bruce decided the best place for Jill was at home with him. Here he is her legs, her strength, her comfort, and strongest advocate.

He’s up at seven each morning to turn her and check she’s all right. By 7.40 it’s time for her medication. A liquid breakfast fed through a gastronomy tube begins at 8.10; the other half administered at 8.30. He toilets her and bathes her; dresses her, dries her hair, and puts her back to bed. At 11.45 he gets her up again to repeat the drill, except this time the fortified liquid poses as lunch. He makes sure the music is always on for her. In the summertime he takes her out in the wheelchair for a drive or a stroll. Sleep follows. At 4.45 he wakes her. Dinner goes through the tube. Another toilet trip, another wash, more medication, then she’s back to bed. He turns her for the last time somewhere close to midnight.

Nowadays Bruce can only take care of the hotel’s administrative affairs while his son and a close friend look after the hands-on running of the place. Caring for Jill is a full-time commitment but Bruce knows he got the better end of the deal: "I’m the lucky one," he says. Though he’s not beyond conceding that, "unless there was a real deep love, you couldn’t do what I’ve done."

As for Jill, she may not know Bruce’s name – "she often calls me Ethol for some unknown reason" – but she knows he is her husband. "It is still a relationship and I do get feedback. We are very close. It’s not something I’d recommend to anybody, but we are still best friends," he says.

Jill does get vocal. She strings sentences together, and manages a conversation with the district nurses who come around every week. Bruce is buoyed by the odd occasion when he is doing the hotel’s banking and she turns around to ask "how much?" On the whole, however, her communication is limited: "Yelling is her only means of communication most of the time. If she wants something or if she’s hurting, that’s the only contact she’s got. Sometimes she just cries."

All this could have been averted, cracks Bruce, if only Jill’s symptoms had been properly diagnosed and she had been hospitalised. Shortly after the trauma, Bruce lodged a complaint against the two doctors who saw his wife. ACC accepted his claim as medical error, finding the management of the situation had been negligent on the part of both doctors involved.

We should add that neither of the two doctors involved in the case wished to add any comment of their own to this article.

But the ACC finding bore little weight with the New Zealand Medical Council, which saw things differently. It investigated Bruce’s complaint like every other referred to it, by convening a Complaints Assessment Committee (CAC), an independent body made up of two doctors and a lay-person who determine whether a case should be taken through to disciplinary proceedings. Where it is decided there is a charge to be answered, the case is referred to the Medical Disciplinary Tribunal. The only other body that can lay charges before the Tribunal is the Director of Proceedings, to whom complaints might be referred by the Health and Disability Commissioner. As it was, Bruce’s complaint fell under the Council’s jurisdiction. And it never made it past first base.

The CAC decided not to lay charges against Dr Williamson, the family’s GP, including in papers supplied to Bruce that, "diagnosis is not like driving a car. An element of trial and error is almost inevitable. The nature of the exercise means some degree of latitude has to be inherent, or there would scarce be a practitioner who did not end up before the Tribunal within years of graduating."

Dr Brock-Smith had his competence reviewed in the field of cardiovascular diagnosis and management. That wasn’t enough for Bruce. Devastatingly though, the CAC’s decision was final. No other authority in the land could override it, and that means Jill’s case won’t ever get heard.

That is the real difficulty with the present legislation, says Brookfields Medical Law Partner Antonia Fisher:

"In the Medical Practitioners Act (1995), there is simply no provision for appeal from the Complaints Assessment Committee’s decision. And given that this committee has been created by statute and its powers are defined by the statute, there is no way around it."

Such a bureaucratic fortress spells doom to Bruce’s plight for a disciplinary hearing. According to Fisher, "that’s a great pity because people who feel they have suffered a wrong at the hands of a medical practitioner need a forum to have their grievances addressed. If you feel that you haven’t had a fair go, you should be able to take it to a higher level." Indeed, even decisions of the Tribunal itself can be appealed to the District Court. But the non-negotiable opinion of the CAC has driven Bruce into a dead-end.

The only remedies available to him now are expensive and essentially come down to civil proceedings. A High Court Judicial Review could look into the process through which the Complaints Assessment Committee reached its decision, but cannot review the decision itself. Such a review is expensive; it would rely on evidence from other doctors, and could only succeed with proof of a CAC finding being so outrageous that no reasonable person could have reached a similar conclusion. That may explain why there has never been a judicial review of a CAC sought by a complainant.

Alternatively, Bruce could file for exemplary damages on behalf of Jill but, explains Fisher: "You find exemplary damages in situations of domestic violence, sexual abuse, or wrongful imprisonment. They don’t sit very well in situations of medical negligence, where the doctor has genuinely tried to do his best but has fallen short of what he should have done. The New Zealand courts have shown a reluctance to award damages against a doctor to date."

Fisher, who receives up to five new inquiries about medical complaints most weeks, is all too familiar with scenarios like that of the Wilson’s. "It’s a very frustrating situation where people really have only one shot at getting some kind of resolution to what’s happened. The new legislation is not really consumer oriented at all. You are not even allowed to have your own lawyer."

Bruce has been left with a poor impression of New Zealand’s medical standards, believing that doctors are out to protect one another. Fisher sympathises, saying: "It would be rare indeed to find other doctors willing to testify that ‘what’s happened here is outrageous." She adds, "I don’t think it’s a situation where doctors think ‘I’m going to protect my colleague’, but they more see the situation as ‘there for the Grace of God Go I…I’ve made mistakes too. I’ve got to get on with my colleagues’.

Alliance MP Phillida Bunkle has for years expressed concerns about doctors sticking shoulder to shoulder in professional solidarity: "It’s a successful tactic for them – they’ve managed to maintain a closed shop."

Her views are unconstrained: "There is no mechanism at all for holding these people responsible." Doctors outweigh the laity on a Complaints Assessment Committee which, according to Bunkle, "clearly manipulates the outcome."

"CACs shouldn’t be in the position of having such arbitrary power. They identify with the doctor…not the victim, so they make judgements that are protective of personal self-interest. They look at the doctor thinking, ‘it could’ve been me’. They don’t look at the woman and think ‘I could be lying there.’"

The figures tend to support Bunkle’s view. With all complaints now going to the Health and Disability Commissioner first, there has been a marked drop in cases handled by the Medical Council. Nevertheless, of the 342 complaints determined by CACs in the space of two years (1998 and 1999 financial years), 27 were referred to conciliation, 17 went through a competency review, and 267 led to no further action. Only 31 cases were brought before the Medical Practitioners Disciplinary Tribunal. These statistics also include CAC findings on 24 ACC referrals to the Council; in 16 cases no further action was taken; 5 were successfully conciliated, and only 2 went on to disciplinary proceedings.

Fisher believes the CACs are acting in the role of a Medical Tribunal: "Their role is not to assess the guilt or innocence of the practitioner. The CAC needs to be given very clear guidelines that they are not the Tribunal, and they are not ruining someone’s life if they say a case should be considered by the Tribunal.

"Under today’s legislation, very few complaints proceed to a formal hearing, and you can’t convince me that that’s because standards have improved. On the contrary, the situation is getting worse."

The Medical Council rejects any criticism of the CAC process, noting: "CACs are independent assessment teams that include a member of the public. They are very conscious of the need for objectivity and transparency. The complainant is involved all the way through the process, and regular audits of satisfaction with the process are done."

Chief Executive Sue Ineson says, "The Council has expressed and continues to express its real concerns for Mr and Mrs Wilson. They are in a tragic situation, so therefore Bruce feels he is looking for some remedy to that.

"The issue is the difference between one mistake, which has tragic outcomes, and a real problem-issue that would go through a Tribunal. One mistake would not mean that the doctor is incompetent."

Auckland Barrister, Dr Murray Jamieson, agrees that "error is a part of the human condition, and perfection is no more available in professional activity than it is available in anything else." But according to this medical law expert, "once the error has occurred, we can do better in dealing with it. Clearly, to have disgruntled, unhappy, and distraught people like Mr Wilson is not in anyone’s interests. "

Though it’s too late for Bruce, Jamieson believes we should redress the balance of a CAC to erase the public perception of an inherent bias within the process. "The committee should consist of one experienced practitioner in the field in which the complaint has been made, and two skilled lay-people with the right to seek advice from whoever they wish." Jamieson does however know from experience that the doctors on these committees are severe on their colleagues, though it is difficult sometimes for the complainant to see that.

Near impossible for Bruce to see it. And he’s not counting on the fog lifting any time soon. In the meantime, he vents his spleen by fighting for Jill in other ways. He’s currently working on getting a shower fitted for her, and has applied for a special vehicle with wheelchair provisions. He takes care of her pain: "Her arms hurt a lot and she gets an arthritic hand. She also gets muscle spasms as a result of the brain damage."

ACC offers financial assistance, visits from a district nurse, and regular physiotherapy but, for all the support, Jill’s long-term prognosis is uncertain: "I just take everyday as another day," says Bruce. And he prefers to take the burden on himself.

"The whole ordeal has been very very hard on the kids," aged 24, 30 and 32. "It’s knocked them around…they are all really hurting." For their sake, Bruce has tried to push them back: "I’ve made sure none of them were ever able to be involved with my fight against the Medical Council. They’ve got their own lives to lead."

But Bruce, it would seem, cannot lead his life without Jill. "On the weekend I went to the wedding of one of Jill’s cousins over the coast. Over the time of our marriage I’d never been to any outing on my own." This wedding, and two funerals, are the only family occasions he has mustered up the energy to attend in the last four years.

"But I just couldn’t handle it," he says heavily. "You just don’t go out. You’re not good company to anyone."

On this occasion, it was only the return home that filled the hole he had felt all day. "When I got back that night I got the same sort of reception as I used to if I’d come home late from the pub. But after five minutes she came right again." That’s all the feedback he needs. She missed him, too.

Jill’s quality of life was worth more than the medical authorities will acknowledge – Bruce will carry on proving this point for the rest of his life. The reward for his commitment is plain to see: "She’s still there. There is still a purpose to my life. I couldn’t care less if the hotel fell down, I’ve still got her."