Focus of ACC review of sex-abuse claims must be on fairness

An editorial from the Press

When ACC changed the way in which it handled sexual-abuse claims last October the move was sharply criticised by many counsellors and psychotherapists.
They argued that victims would find it more difficult to get the treatment they required, with the accusation, in the context of the economies being sought elsewhere in ACC, that the new regime was introduced as a cost-cutting measure.
Both ACC and its minister, Nick Smith, rejected the attacks. But, in an apparent effort to mollify critics of the new system, Smith did promise that an independent clinical assessment of it would be carried out in April this year, after the regime had been in operation for six months.
It was a sound move to order this review. This should establish whether the new system used by ACC's sensitive claims unit is operating in a manner which is transparent and robust.
There is little doubt that the old system of dealing with sexual-abuse claims was in need of reform. In the year to last June the cost to the taxpayer of sensitive claims unit clients leapt by about 20 per cent to $58 million, including $14m on counselling, despite a drop in the number of new claims accepted.
It also transpired that five counselling arrangements had lasted between 12 and 14 years at a cost for each in the past five years of up to $500,000. The inevitable suspicion was that the criteria for handling sensitive claims had been interpreted too laxly.
Under the new clinical pathway regime, sexual-abuse victims' claims would be accepted only after a firm diagnosis had been made that they had a mental injury and that this was due to abuse.
There had always been a requirement that ACC could only accept claims following a diagnosis of mental injury, but this had been less rigorously applied in the past.
The stronger application of this requirement might help to explain why, of the 152 referrals received by ACC since last October, just nine have been accepted, with a dozen rejected and the remainder put on hold until additional information about the cases had been obtained.
The new system is also based on short-term and focused treatment for those whose claims had been accepted and ensuring that victims do not become reliant on their counselling.
ACC cited research which showed that the optimum number of counselling sessions for adults with mental injuries caused by sexual abuse was 16.
Although ACC is adamant that this is not a treatment cap and that those who were assessed as needing further sessions would get them, critics believe that it will lead to a reduction in the number of victims receiving longer term treatment.

The terms of reference for the review in April have yet to be released. But a priority must be ensuring that ACC has proceeded with its more rigorous application of the diagnostic test.
The review team, however, must also assess whether any victims who genuinely do require counselling because of sexual abuse are being turned down. This is a sensitive issue for victims, many of whom have been living with memories of abuse for many years. It is never easy to come forward and seek assistance.
Another role for the review should be ensuring that the length of treatment is appropriate. ACC understandably wants to avoid longer term victim dependence on counselling. There will be some victims, however, who will need weekly counselling for many years.
A key question here is whether this should continue to be funded by ACC or whether in long-term cases this should be provided through the health or justice systems.
ACC has long been a cornerstone of New Zealand's broader welfare system. But it is essential that there is confidence that ACC is fair to both the taxpayers and levy payers who fund the system and to those who genuinely require assistance.
With respect to cases in which mental injuries have been caused by sexual abuse the independent review in April should determine whether confidence in the system is warranted or not.

http://www.stuff.co.nz/the-press/opinion/editorials/3216886/Editorial-Focus-of-ACC-review-of-sex-abuse-claims-must-be-on-fairness