Question to Minister: ACC sensitive claims clinical pathway

Hon ANNETTE KING (Deputy Leader—Labour) to the Minister for ACC: Does he accept ACC’s new clinical pathway for victims of sexual abuse, introduced in October 2009, has drastically reduced the number of people who have been sexually abused who are approved by ACC for counselling?
Hon Dr NICK SMITH (Minister for ACC): The decline rate for The Accident Compensation Corporation’s (ACC) sensitive claims unit has increased from 5 percent in 2000 to 41 percent in 2008, when the new guidelines were launched by the Hon Steve Maharey. The decline rates have continued to increase since they were introduced, although the major change in the reported data is the large number awaiting further information. These delays are a concern. That is why last week I announced an independent clinical review.
Hon Annette King: Is he aware of Ashburn Clinic, a psychiatric centre in Dunedin, which has worked successfully with ACC to provide treatment to victims of sexual abuse since 2000, but to which no patients have been referred since his announced changes to ACC guidelines; and, even more alarming, where patients in treatment have had their cases reviewed and funding stopped, often rendering planning for a safe discharge extremely difficult; where does he expect these people to get their treatment from?
Hon Dr NICK SMITH: I am not aware of any communication I have had with Ashburn Clinic. I would recommend that, if there are concerns that that private-hospital facility has about ACC’s management of sensitive claims, they refer them to the independent clinical review panel that was set up and is being led by Dr Barbara Disley, a former mental health commissioner, because I will take a very strong lead from that review team as to whether ACC is properly meeting its legal responsibilities for those victims of sexual abuse or assault.
Hon Annette King: I seek leave to table a letter written to me from the director of Ashburn Clinic pointing out all of the issues that I raised in my question today.
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection. Document, by leave, laid on the Table of the House.
Lynne Pillay: Has he seen the report from Rape Crisis that states that the new clinical pathway imposed in October 2009 has almost destroyed the sector, that the review, which will not be completed until late July, is too late for some, that many survivors are suicidal, and that no alternative was put in place?
Hon Dr NICK SMITH: The first point I make in response to the member is that clinical guidelines for dealing with sensitive claims were undertaken on research work done by Massey University and launched by the Hon Steve Maharey in March 2008. I invite the member and any counsellors, psychotherapists, or others who have concerns about those guidelines or ACC’s processes, to make direct submissions to that clinical review team.
Lynne Pillay: In light of the avalanche of evidence showing that the changes made to ACC’s clinical guidelines last October are having a disastrous impact on the lives of vulnerable people, will he listen, and reinstate the previous clinical guidelines while the review is under way?
Hon Dr NICK SMITH: The first point I make is that under the previous Government in 2008—
Hon Darren Hughes: I raise a point of order, Mr Speaker. My colleague is trying very carefully to put a very sensitive topic area to the Minister. She had no political content in her question; she simply asked about two dates, and what guidelines would operate while the review is under way. A Minister cannot stand up and say as the beginning of an answer: “The first point I would like to make is that the previous Government x, y, and z.” Clearly, this is all within his portfolio responsibilities for the warrant he holds at present.
Hon Dr NICK SMITH: In the member’s question, she made reference to the change in the number of sensitive claims. I wanted to point out to the House that to advance the argument for change, one has to show that cases were not being declined previously.
Mr SPEAKER: I invite Lynne Pillay to repeat her supplementary question because in my view it was not that. Her supplementary question specifically asked whether the Minister would contemplate going back to old guidelines while the review is being conducted. I invite Lynne Pillay to repeat her question.
Lynne Pillay: In light of the avalanche of evidence showing that the changes made to ACC’s clinical guidelines last October are having a disastrous impact on the lives of vulnerable people, will he listen, and reinstate the previous clinical guidelines while the review is under way?
Hon Dr NICK SMITH: I note that under the previous clinical guidelines that the member wants to return to, 2,400 sensitive claims were declined per year. I also point out that the member is incorrect in her assertion, in that both the Royal Australian and New Zealand College of Psychiatrists and the College of General Practitioners have issued statements strongly supportive of the changes that ACC has made. I do not wish to engage in a clinical argument. That is not my area of expertise. That is why I have sought an independent review team of skilled clinicians to look at the differing views and to provide recommendations on a constructive way forward.
Hon Annette King: Has he heard of a group of survivors of sexual assault called Courageous Women, who are challenging the changes to ACC guidelines, and is he prepared to meet them and hear their stories and the impact the changes are having on their lives?
Hon Dr NICK SMITH: I have heard of the group only through the newspaper. I have made no decisions as Minister in respect of the issue of sensitive claims, because it is such a clinical area in which I am not wanting to interfere in decisions; the only decision I have made is that there is sufficient concern to justify a clinical review, and I invite Courageous Women, or members of the Opposition, or any other group that has concerns about ACC’s work in this area, to make their submissions to that clinical review team.
Hon Annette King: In light of that answer, why did he phone a member of the Courageous Women who is an advocate against sexual assault, and berate and bully her, saying the Courageous Women who signed T-shirts to highlight their concerns at his policy were part of a fiasco and a media circus, and if she wanted to speak out, the only appropriate forum was his review?
Hon Dr NICK SMITH: Firstly, I totally reject the member’s assertions. On Monday I read claims in the newspaper that this group was to meet with me. The first my office had heard of any request was when I read that in the newspaper. The person concerned phoned my office three times on Monday—
Hon Annette King: For an appointment.
Hon Dr NICK SMITH: —that is right—and she said that if she did not get an answer by 4 o’clock she would be going on the radio. I phoned her and said to her that the proper place for her to direct her concerns was the clinical review, and I think that is entirely appropriate. [Interruption]
Mr SPEAKER: I say to Labour members that they must immediately remove that. If members do not want to leave the House they will remove that immediately. [Interruption] I am on my feet. Members know the rules. The member who is speaking may use visual aids when he or she is speaking; other members may not. A member was not speaking then, and that was totally outside the Standing Orders.
Hon Dr NICK SMITH: In light of the claims made by the Deputy Leader of the Opposition, I seek leave to table an email, in respect of the conversation I had with the person concerned, from persons who were listening to those who were part of the conversation, to show that the claims that have been made by Annette King are not correct.
Mr SPEAKER: Leave is sought to table that email document. Is there any objection? There is no objection. Document, by leave, laid on the Table of the House.
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