Changing the "culture" of an organisation is a subtle exercise, requiring care to see that it does not go too far. The Minister in charge of the Accident Compensation Corporation, Judith Collins, has taken drastic steps to change its culture since the Bronwyn Pullar business. The previous chairman, chief executive, two board members and several officials have departed. Now it has been given new orders: improving "trust and confidence" has replaced "cost containment" as the first priority.© 2012 APN Holdings NZ Ltd
The minister had been under pressure to go much further and change the corporation's primary aim of rehabilitation. Labour and the Greens have criticised staff incentives to get patients back to work as soon as possible. They call it "depriving people of their entitlements". Inevitably, they believe, some people will be driven back to work too soon. It should be remembered that nothing in the Pullar case supported that suspicion. She was aggrieved that the corporation would not provide her with an income but gave the public no evidence to strengthen her claim. Her disclosures concerned other cases accidentally "leaked" to her in an email from ACC.
That privacy breach turned out not to be as serious as she had led the country to believe. The "patient details" were no more than names, a case number that could identify the nature of each name's claim, and an indication of the outcome of a review of their claim.
The Privacy Commissioner has told patients it was mostly inoffensive information at the lower end of seriousness. The corporation has offered them consolation payments of something less than $500. The sum seems proportionate to the offence.
It is much harder to restore a sense of proportion to criticism of ACC's culture. The attitude expressed in messages between ACC staff, which Ms Pullar had also obtained, was as telling as the tape of the meeting in which her supporter, Michelle Boag, mentioned the leak to ACC officers.
The careless language and loose accusations in ACC's internal exchanges were probably the reason the minister took drastic action. It was an insight into a culture that has been been too hard on some categories of claim, especially those requiring surgery, as Herald investigations had found. Too many rejections of those claims have been reversed on appeal.
But it would be too easy to replace that culture with one at the other extreme. ACC cannot be an automatic entitlement with no questions asked. It is an unusual system, copied by no other country, in its uncritical attitude to the cause of injury. "No-fault" compensation may be a good way to save lawyers' fees but the same unquestioning principle could not be applied to medical assessments. When ACC seeks a second opinion, though, its medical officers must not influence it as they clearly tried to do in the Pullar case.
ACC is funded by employers, motorists and taxpayers as insurance against sudden disability. It offers cover that ordinary commercial insurance provides elsewhere. Since New Zealand has to be competitive it is vital that ACC's costs are not out of line with workplace insurance in other places. It has to ensure it is paying out only for genuine injuries and for loss of income only for as long as the claimant is genuinely unable to work.
Ms Pullar reportedly received $1 million from a private company for the injury for which she also sought ACC support. Since private insurance can set its own premiums, within the bounds of competition, it can afford to be more lenient. As a public insurer, ACC has to be rigorous.
But it should also be sensitive, fair, considerate and dignified in its dealings with people and its discussions about them.
That is as far as the culture change need go.
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10816711
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