ACC changes - background information

An article from ANZASW NoticeBoard by Cathy McPherson

In May 2009 ACC counsellors received forms requesting information on qualifications, recent training and preferred treatment modalities - no reason for this was given, though it was obviously in preparation for selecting preferred treatment modalities.

On August 10 2009 Dr Peter Jansen, Senior Medical Advisor to ACC, and Ann Aitcheson began rolling out ACC’s “Clinical Pathways”, the plan to radically change how the Sensitive Claims Unit managed new claims. This came as a complete shock to all counsellors, psychotherapists, social workers and some psychologists working with survivors of sexual abuse. ACC intended these new pathways to be implemented on 14 September - a whole three weeks’ notice!

The Clinical Pathways project had been developed away from counsellors, psychotherapists and social workers. SCAG was ignored and TOAH NNEST (Te Ohaakii A Hine - National Network Ending Sexual Violence Together), which had been working with Government Ministers for two years, had heard nothing about what was being planned either.

Further, the Clinical Pathway has been implemented without consultation with Maori, and lacks connection with appropriate pathways to help Maori claimants. In discussions with Maori members of various professional bodies, many Maori feel the mainstream systems again have not yet recognized the resources and richness of healing methods for dealing with victims of sexual violence which can be used by Maori counsellors. There have been numerous attempts as groups and individuals to keep the Maori voice vocal. Although the new system is in place now it is important to continue to challenge this ACC process, and its lack of safety for Maori clients particularly. Pacific Island groups had not been consulted either, nor any other ethnic groups.

SCAG members believed that the announcement of the new Pathways was deliberately chosen to occur between the SCAG meeting in March (where there was no mention of the new Pathways) and the next scheduled meeting in October.

Widespread anger and discontent from all NZ counselling, social work and psychotherapy associations along with organisations such as Rape Crisis (as well as clients and ex-clients) directed at ACC and the Minister of ACC, Nick Smith, in response to the proposed changes. Bowing to pressure from professional bodies, Peter Jansen then decided to delay implementation date by a month while ACC “consulted” with professional organisations. Submissions were called for. Consultations, however, constituted professionals being informed what the clinical pathways entailed.

SCAG members wrote to Nick Smith requesting a meeting. Despite numerous follow-up calls, no meeting eventuated because of his firm refusal to meet with us.

September 18 at the NZAC Conference in Hamilton, Peter Jansen and David Chapman attended an ACC Forum along with a vocal group of counsellors. Dr Jansen would not back down on his desire to see the Pathways implemented, and continued to reiterate that ACC was following the Massey Guidelines and “best practice”. Some counsellors walked out in protest at his refusal to hear their concerns and put the changes on hold until further full consultation.

In media interviews Dr Jansen told reporters that claimants who are denied counselling can easily access counselling through other community agencies, mental health providers, etc, which most counsellors in every region believe is not the case.

September 30 TOAH NNEST met with ACC and its Tauiwi caucus presented ACC with their Principles for the Development of a Clinical Pathway. ACC insisted on using DSM-IV even though there are other assessment methods which show clear links between the abuse and its effects.

ACC met with SCAG on October 2 and SCAG requested an urgent workshop to precede implementation of the Pathways. This request fell on deaf ears. However, it was announced that the Pathways would be delayed yet again for another two weeks to further “consult”. No actual consultation took place.

During the period from early October to the implementation of the Pathways on October 27 ANZASW along with members of all counselling associations took every opportunity to issue press releases, write to ACC and Nick Smith, talk with government and opposition MPs and spread the word through community agencies and local and national media. On October 28, a day after implementation date, further changes to Pathways announced. ANZASW, together with other professional bodies, makes yet another press statement about our concern about unsafe, unethical practices.

Press releases on the ethical implications of the Pathways given to media by NZAC.

On October 27 an online petition with almost 4000 signatures, calling for the Pathways to be stopped, was presented to Parliament. Many professional announce that they will not accept futher ACC referrals under the new system.

The same day ACC Minister Nick Smith announced an “independent” review of the ACC Pathways which would be finalized after six months (after repeatedly stating that the Government was not getting involved in the issue).

By the time you are reading this column no doubt other significant events will have taken place. One of the positive outcomes of these struggles is that the counsellor, psychotherapy and social work associations are communicating with one another, strategising, sharing experiences and supporting one another through this exhausting process.

MASSEY UNIVERSITY HAS NOW DISTANCED THEMSELVES FROM ACC’s USE OF THEIR RESEARCH SAYING IT IS BEING INAPPROPRIATELY INTERPRETED – which makes their frequently quoted “best practice” a mockery and vindicates what professionals have been saying all along.

Why are we objecting to the Clinical Pathways?
• Lack of safety particularly for Maori. There have been continued promises for ‘hui’ with Maori that never eventuate.
• Lack of safety for Pacific Island clients.
• Lack of action about different arrangements for children and adolescents, even though these have been promised by Peter Jansen.
• Lack of consultation with professionals in the field.
• Misuse of Massey Guidelines (2008) e.g. that 16 sessions is a suitable limit for most counselling survivors of sexual abuse. ACC was taking a comment made about a specific set of circumstances - adult victim of one sexual assault - and applying it to all survivors, e.g. childhood sexual abuse survivors who may have suffered numerous events and possibly numerous abusers. As stated above, Massey have finally spoken up about misuse of their research.
• Unethical aspects of the new Pathways - e.g. multiple assessments carried out at the beginning of ACC’s new process where many clients are likely to be unsafe. Clients would not have enough time to develop a therapeutic alliance with one counsellor – critical for positive outcomes for the client.
• The risk that some clients may become emotionally/psychologically unstable early in the disclosure process, where there is no provider clearly accountable to ‘hold’ the client through that early process of trying to establish a claim, is significant.
• There may be mental health casualties when potential claimants’ requests for help are not easily accepted, or their claims declined.
• Longer-term therapy with more complex clients under ACC is likely to disappear. Offering shorter term affectual symptomatic relief, on its own, is likely to lead to poor results.
• Insistence on the use of DSM-IV and assessment of ‘mental injury’ so early in the counselling process may create problems for people’s career paths, insurance prospects and future travel, and is quite inappropriate for children and adolescents. Somehow, requirement of mental injury has been transformed into a requirement for mental illness diagnosis with no legislative change. A legal challenge has been commenced on this issue.
• ACC foisting the Pathways on us under the guise of ‘concerns’ that it has regarding some ACC counsellors working too long with their clients, or that many counsellors are unable to write satisfactory ACC reports, is short-sighted. ACC could easily monitor these “rogue” counsellors and suggest targeted training to bring them up to the mark; it did not need to change the whole system.
• The preference for clinical psychologists and psychiatrists to carry out client assessments so early in the process, instead of permitting counsellors to complete their own assessments, when psychologists, on the whole, have not been the main group in the past who are experienced in delivering treatment interventions to traumatized clients, is limiting and not best practice. ACC does not appear to value the establishing of the therapeutic relationship as a tool for healing.
• The overseeing of the continued treatment (after the assessment) of the client’s therapy by ACC psychologists is another problem, which reduces therapeutic creativity, adherence to CLIENT and provider goals together, and inhibits other modalities effective operations. This was NOT a recommendation by the Massey Guidelines researchers!!
• Lack of clarity of choice for clients as to who carries out their assessments or becomes their later counsellor provider.
• Lack of consultation with Mental Health and NGOs about ACC’s expectation that declined clients will be absorbed by these organisations.
• Victims of crime (sexual abuse survivors) are being exploited by ACC in the name of saving money, despite the National-led government promise to create better outcomes for these people.
• SOCIAL WORKERS ARE NOT DEEMED TO BE ABLE TO USE DSM-IV SO NEED TO REFER TO A PSYCHOLOGIST FOR THEIR CLIENTS TO BE ASSESSED - WE BELIEVE THIS TO BE INSULTING TO OUR PROFESSION.
• Privacy requests by ACC in the new pathways go too far for the purposes of the ACC’s need for information at the point of entering the ACC system. Clients may lose many aspects of their own privacy if they sign the form required at the outset by ACC.

In conclusion, at this point of writing (early November 2009) we are still hopeful that there can be some turnaround or embargo placed on the ACC’s Clinical Pathway. We desire ACC to hold proper consultation with clinically-trained professionals who have already worked in this specialized area of trauma treatment. From this ACC could develop improvements that will make it safer and more ethical for clients and providers, for Maori and Pakeha, for complex needs clients, and for children and adolescents to receive the ACC rehabilitation under the ACC regulations which they are entitled to as victims of crimes.

These issues affect all of our profession. Please make your protest known to ACC. This is a social justice issue as vulnerable clients are now being denied the help they are entitled to.

You can email the architect of these changes with your concerns: peter.jansen@acc.co.nz.

Please email me with any concerns or ideas on how we can challenge this extremely abusive process: cathy.mcpherson@goalscentre.co.nz.

Copyright © 2010 Aotearoa New Zealand Association of Social Workers
http://anzasw.org.nz/user/file/428/NB%20December%20Final.pdf

ACC Minister Defends “Rapist’s Charter”

Press release from Kyle MacDonald

As the author of the petition submitted to parliament on the 27th October, signed by nearly four thousand people opposed to the new clinical pathway for sensitive claims, I am greatly concerned about the Ministers ongoing defence of a clinical pathway seen by providers of sensitive claims to be unethical and a “rapist’s charter.”
In a letter thanking me for the petition, dated the 11th of December, the Hon. Nick Smith defends this new pathway as follows:
“The Corporation's decision to review its guidelines is driven, not by funding, but by the implementation of best practice for managing clients with a mental injury. This process began in 2008 with the Massey Guidelines… ... After consultation with providers, ACC issued its revised Clinical Framework in July 2009, and held a new series of workshops.”
The minister is yet to explain how it is that ACC have stated publicly “that it is ACC policy to reduce the number of Sensitive Claims” despite his assertion these changes are not driven by funding.
The minister is also yet to answer the concerns of experienced providers. A recent survey showed that: less than 10% intend to continue to provide counselling services under this new pathway and 83% disagree or strongly disagree with the compulsory use of the DSM-IV under this new pathway.
How does this government continue to contend that these decisions will be made by “clinicians not politicians” when clinicians continue to be vehemently opposed?
The minister is failing in his duty to protect the New Zealand public and monitor the activities of ACC. Recent figures show a 57% reduction in claims accepted since the introduction of the new pathway, when compared to last year.
What does the Minister say to those victims of childhood sexual abuse who have dutifully paid taxes and their ACC levies who will now suffer without care, unable to access funded counselling, unable to afford private care and unable to access mental health services?
Six months is too long to wait for a review when lives are at stake. I implore the minister to urgently review the current situation within the sensitive claims unit before lives are lost.

http://www.scoop.co.nz/stories/PO0912/S00227.htm

Dr Smith – sexual violence injures

Press release from NCWNZ

The National Council of Women of New Zealand (NCWNZ) today received communication from the Minister of ACC, Hon Dr Nick Smith, regarding its request that the clinical pathway be halted and the review undertaken immediately.
The main points raised in the letter from the Minister included the legislated criteria for ACC related assistance for those injured by sex crimes. The claims process, which included the DSM-IV diagnosis, and potential delays to approval arising from the absence of this diagnosis, were also outlined. The Minister did not mention however that prioritising of claims will also be based on whether a claimant is in “paid employment”, or for example, on a benefit or retired.
The Minister also stated that:
“For the independent review of the guidelines to be effective and meaningful, the system needs to have been in place for a period of time. I have determined that six months should be appropriate to see how the new guidelines are working and if changes need to be made.”
“This remains deeply concerning for the National Council of Women of New Zealand,” says Elizabeth Bang, NCWNZ National President. “There is already sufficient evidence presented by the experts in the field that the pathway is faulty and likely to cause harm. While a six month period appears reasonable in political terms; from the perspective of the providers and claimants it simply is not. From NCWNZ’s perspective this is a guaranteed six months of a heightened level of discrimination against women.”
Men and women who have experienced sexual violence would also be insulted by the following statement from the Minister of ACC in his correspondence, that:
“A client making a sensitive claim should be made aware that a diagnosis of mental injury, from a person qualified to make it, is part of a process that is more complicated than an individual decision to undertake therapy.”
The “complicated process” that Dr Smith refers to is the clinical psychologist ticking some boxes that indicate a victim has symptoms of mental illness, e.g. dissociation; a survival tool, and/or Post Traumatic Stress Disorder (PTSD); a condition which can manifest itself over years.
NCWNZ contends that the “individual decision to undertake therapy” is not an uncomplicated process, perhaps akin to deciding what one will wear that day. Private material gathered from survivors who made the “individual decision” includes the following:

• A person putting themselves forward for treatment/therapy feels haunted every step of the way. The experience includes: anxiety, sadness, fear, anger, self-loathing, hate, self-pity, badness and many other emotions.
• A victim doesn’t want to be there, doesn’t want to feel the way he or she feels, wishes there was a hole to hide away in, feels lesser than any other living person, wishes it had never happened, and is confused about who should be blamed.
• A victim doesn’t know who can be trusted, wants to be strong enough to be an “island unto himself”, doesn’t know why life seems so tough for him/her, is envious that others haven’t had the experience and their lives seem better and they seem superior.
• Making the “individual decision” includes will my friends know, will my family know and how might they react.
• If the offense was incest, can I function in my job, will I be a good parent. Can I break the cycle?
• You cry so much and feel like people can tell that you are “spoilt goods”.
• Therapy turns your heavily guarded world upside down, and you have to rebuild. It is complex.

“We have a situation where ACC requires victims to worsen over time so that the desired number of boxes can be ticked, rather than recognising simply that sexual violence injures people”, says Elizabeth Bang.
“A change to the legislation is required,” says Elizabeth Bang. “The current definition, mental injury which is in practice will be assessed as mental illness doesn’t work for people.”
NCWNZ is aware that statistics have been released on the number of claims ACC has approved for treatment via the clinical pathway, versus the number of claims approved same time last year.
“A little more than one third of sexual violence victims have been approved to take this rockier than before pathway to recovery,” says Elizabeth Bang. “As for the rest, you will need to wait till you are fully symptomatic of mental illness and reapply then (given ACC maintains it has not had a decrease in the number of clients presenting for treatment and furnishing claims).”
NCWNZ was interested to read the Royal New Zealand College of General Practitioners’ press release supportive of the Clinical Pathway. The Minister of ACC had referenced this press release and attached it to his communication.
“This press release is almost a collectible,” says Elizabeth Bang. “We are certainly puzzled as to why the GP’s recently pulled their “public stance” off their website. Perhaps it is just a technical glitch seeing as the Minister is quoting it.”
NCWNZ will be making more materials available via its website ACC action page. The communication to and from the Minister of ACC will be part of the material posted.
“We are delighted with the response from individual supporters and organisational supporters, who have signed on to this information/education portal,” says Elizabeth Bang.
“While we do not welcome the new year for victims of sexual violence who will all be transferred on to the clinical pathway on 10 January 2010, we do welcome the reopening of all of our branches and their affiliate bodies. We anticipate substantive growth in awareness and support.”
Other communications which will be posted to the site include NCWNZ’s request to the Prime Minister to implement Temporary Special Measures, as mandated under articles 2 and 4 of the Convention for the Elimination of All Forms of Discrimination Against Women (CEDAW).
Also, NCWNZ’s official complaint to the Health and Disability Commissioner regarding the breach of the HDC Code of Health and Disability Services Consumers’ Rights, submitted on behalf of Maori Women will be accessible.
NCWNZ intends to submit a similar request to the Maori Party, calling for Temporary Special Measures as part of the Convention on the Elimination of All Forms of Racial Discrimination (CERD) mechanism, for the protection of Maori Women. The Maori Party has signalled its intention to investigate claims of discrimination via the ACC Minister.
A complaint to the Human Rights Tribunal is also being considered, however with the dissolution of the Women’s Action Plan, the only coverage women had, which afforded some prioritising under the New Zealand Action Plan for Human Rights (Priorities for Action 2005—2010), it is less clear if this is a suitable or equipped vehicle for women’s complaints. Also, the timeframe that NCWNZ is looking at for action may not fit with what is needed.
“We too are prepared to submit to a box ticking exercise,” says Elizabeth Bang. “We believe we have demonstrated the most seriousness of this situation to the Government on behalf of women. It certainly is not our desire to bully or harangue; however we are constitutionally bound to “serve the interests of women, children and families.”
“The effects of sexual abuse are wide ranging for the families involved,” says Elizabeth Bang. “Early intervention is essential for the recovery of the abused and in the long term must save treatment costs within ACC and the health system.”

http://www.scoop.co.nz/stories/PO0912/S00222.htm

Questions for written answer

19852 (2009). Lynne Pillay to the Minister for ACC: In terms of the preparation for the implementation of Sensitive Claims Clinical Pathway, have all necessary tools been developed, if so what tools, if not why not?
Hon Dr Nick Smith (Minister for ACC) replied: Yes. ACC has the tools it needs in place for clients, providers, and its own staff. Many of these tools are available online. These include processes and procedures, FAQs, forms, letters, data capture and reporting tools, and induction processes. These tools will continue to be improved on the basis of experience, and new tools will be developed as the need arises. For example, as part of the work with Corrections, tools will be developed specifically for use in the prisons. Further work is being done on tools specifically for use with children and young persons.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/0/0/QWA_19852_2009-19852-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21300 (2009). Lynne Pillay to the Minister for ACC: In terms of the preparation for the implementation of Sensitive Claims Clinical Pathway, have all systems been clearly communicated enabling professionals in the field to advise clients on the process and what they can expect, including the timeframe for assessment and approval ?
Hon Dr Nick Smith (Minister for ACC) replied: Yes. ACC has kept in contact with its providers, and has provided information by email, post, workshops, presentation, personal communications, and online. Timeframes for assessment and approval are also available with the expectation that when a claim is made the required information is provided to enable a decision.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/d/f/QWA_21300_2009-21300-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21476 (2009). Lynne Pillay to the Minister for ACC: Has ACC implemented the clinical pathway in advance of having in place the appropriate treatment plan for Maori?
Hon Dr Nick Smith (Minister for ACC) replied: No. Cultural competence is included in each treatment provider’s contract with ACC. Both the Code of Health and Disability Services Consumers' Rights, and relevant professional standards, require all health providers to take account of cultural aspects. ACC has published guidance on Maori preferences to ensure providers can meet these requirements. These are the Hauora competencies which can be found on ACC’s website at: www.acc.co.nz . ACC has a dedicated Pae Arahi (Maori Cultural Advisor) with the Sensitive Claims Unit and also works closely with Dr Catherine Hong (Manager of Cultural Services, ACC) to address issues for people of other ethnicities. Each treatment plan developed for clients takes into consideration the client’s clinical and therapeutic needs, as well as their context which includes cultural needs, geographical location, employment or other relevant circumstances.
http://www.parliament.nz/en-NZ/PB/Business/QWA/1/4/5/QWA_21476_2009-21476-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

21533 (2009). Lynne Pillay to the Minister for ACC: What sensitive claims, since 1 November 2009, are now pending with ACC that involve counselling for sex abuse victims and/or victims of domestic violence in Wairarapa?
Hon Dr Nick Smith (Minister for ACC) replied: Between 1 November and 11 December ACC received seven claims from the Masterton District. ACC has sought more information from providers for four of these claims and the other three are waiting for clinical assessment.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/2/1/QWA_21533_2009-21533-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

22490 (2009). Lynne Pillay to the Minister for ACC: Does the victim of a sex crime have to be classified as having a mental illness before ACC will fund any treatment?
Hon Dr Nick Smith (Minister for ACC) replied: Mental injury has always been a requirement, defined under legislation, in order for ACC to accept cover for a sensitive claim. There are two exceptions. These are intervention in the immediate aftermath of assault/abuse when the Doctors for Sexual Abuse (DSAC) and Sexual Assault and Treatment (SAAT) contracts apply, and treatment for physical injuries that have resulted from the assault. In these situations ACC contributes to a wide range of services, such as District Health Boards and general practice or other primary care services.
http://www.parliament.nz/en-NZ/PB/Business/QWA/a/c/e/QWA_22490_2009-22490-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

Prime Minister should act to protect sexual abuse survivors from ACC cutbacks

A press release from the Labour Party by Annette King

The Prime Minister must put a halt to ACC cutbacks that have restricted the ability of survivors of sexual abuse to access counselling, Labour Deputy Leader Annette King says.
“The National Council of Women, which Deputy Prime Minister Bill English has described as highly respectable, have written to John Key asking him to take urgent action to overturn Cabinet’s decision to allow cutbacks to ACC funded counselling for sexual survivors,” Annette King said.
“The National Council of Women state that the new ACC sexual abuse guidelines are discriminatory under UN conventions, particularly the Convention on the Elimination of all forms of Discrimination against Women and Elimination of all forms of Racial Discrimination and therefore the Government must act to address this.
“The National Council of Women has joined a long list of organisations and individuals who have pleaded with the Government to listen to their concerns.
“Just how long will the Government allow people who have already suffered horrifically because of sexual abuse to suffer, before they listen?
“The Government’s decision to limit access to ACC funded counselling for sexual abuse survivors is flawed and they should act now to overturn a decision that re-traumatises those who have already suffered enough,” Annette King said.

http://www.labour.org.nz/news/prime-minister-should-act-protect-sexual-abuse-survivors-acc-cutbacks

ACC changes hurt sexual violence victims

A blog entry from Frogblog by Catherine Delahunty

The biker lobby has managed to get considerable public attention and support for motorcyclists’ grievances over ACC levies, but there is a group of more vulnerable people who cannot march in their thousands on Parliament grounds to defend their ACC access. Many of them cannot email Members of Parliament because it exposes them as possibly mentally damaged as a result of sexual violence. Who are these people?

Read the rest of this entry at http://blog.greens.org.nz/2009/12/16/acc-changes-hurt-sexual-violence-victims/

Question for written answer

19447 (2009). Lynne Pillay to the Minister for ACC: What evidence has the Minister or his officials seen of any gender impact analysis/statement which was undertaken to identify the potential impacts of implementing the ‘clinical pathway’?
Hon Dr Nick Smith (Minister for ACC) replied: I have not seen any gender impact analysis/statement because no gender analysis was undertaken. Most of ACC’s sensitive claims clients are women and the development of the pathway took this fact into consideration.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/5/1/QWA_19447_2009-19447-2009-Lynne-Pillay-to-the-Minister-for-ACC.htm

Question to Minister: Vulnerable citizens

Hon ANNETTE KING (Deputy Leader—Labour) to the Prime Minister: Does he stand by his comment “this Government is not prepared to turn its back on our most vulnerable citizens”?
Hon GERRY BROWNLEE (Leader of the House) on behalf of the Prime Minister: Yes.
Hon Annette King: Does he believe that women who have been sexually abused are vulnerable citizens; if so, is he aware that women have had their accident compensation-funded treatment stopped partway through because of recent changes made by his Government to accident compensation guidelines, an action that has been described by clinicians as unethical and immoral?
Hon GERRY BROWNLEE: The changes that the member refers to were initiated by the previous Government long before the accident compensation scheme’s financial problems were revealed. This Government agrees, though, that clinicians, not politicians, should make decisions about sensitive claims. However, we have already signalled that there will be a review of the changes, and we will act if the review finds that the changes are not working.
Hon Rodney Hide: I raise a point of order, Mr Speaker. Even those of us who are sitting quite close to the Minister could not hear any of that answer, because of the constant barracking from at least a dozen Labour MPs. I think it is tough for this Parliament and for the acting Leader of the Opposition to ask a question and then have her colleagues scream down the answer so that no one can hear it. I ask how that helps Parliament.
Hon Darren Hughes: Speaking to—
Mr SPEAKER: I do not need further assistance on this. I accept that the members of the Opposition did not like the answer they were hearing, but they must be reasonable in their interjections so that members can hear the Minister’s answer.
Hon Annette King: Is he aware that both Massey University and now the Accident Compensation Corporation (ACC) have disowned the statement made by the Minister for ACC, Nick Smith, that the new accident compensation guidelines that affect victims of sexual abuse were developed by Massey University when, in fact, they were developed by the ACC under this Government, not a Labour Government, and that yesterday the guidelines were labelled by clinicians as a “rapist’s charter”; and will he now listen to the clinicians, even if his Minister will not?
Hon GERRY BROWNLEE: It is a very, very sensitive issue that we are dealing with, quite obviously, and it is not at all helped by the inflammatory language used by the member in asking that question. The Prime Minister is well advised on these matters and has stated that the Government has already signalled there will be a review of the changes. We will act if the review finds that the changes are not working.
Hon Annette King: Has he seen the list released by clinicians yesterday, which highlighted 54 individual cases of people who have been sexually abused, some as young as 12 years of age, who have had their treatment denied or stopped because of changes made to the scheme by his Government; and will he intervene to stop this roll call of shame growing?
Hon GERRY BROWNLEE: I am unable to answer as to whether the Prime Minister has seen that list, but I repeat again that the Government has signalled there will be a review of the changes. We will act to make further changes if we find that the system is not working. It all takes time.
Hon Annette King: Does he believe that Bill, a former railway engineer who lost his hearing from a workplace injury and who is now not eligible for a hearing aid under the changes that his Government has made to the accident compensation scheme, is a vulnerable citizen; and will he have the Minister for ACC intervene in Bill’s case, as he did on television recently for war veteran Eric Brady, who had his dentures smashed in an assault?
Hon GERRY BROWNLEE: I would make it very clear that this Government inherited the accident compensation scheme in a dreadful state. The Prime Minister has every confidence that the Minister for ACC, the Hon Dr Nick Smith, is doing a great job in ensuring that New Zealanders continue to be well treated and served by the organisation that administers the scheme.
Hon Ruth Dyson: Does he believe that our elderly are vulnerable; if so, why has his Government cancelled the falls prevention programme, which keeps older people out of hospital and which research indicated saved $2 for every $1 spent on it?
Hon GERRY BROWNLEE: I do not have the details that the member wants to put in front of us—
Hon Ruth Dyson: I tabled it.
Hon GERRY BROWNLEE: The Prime Minister does not read every scrap of paper tabled by the Opposition, because that is what most of them are—scraps of rubbishy paper. The Prime Minister, though, has every confidence that the Hon Dr Nick Smith is doing everything that he can to ensure that ACC continues to deliver excellent service to New Zealanders.
Lynne Pillay: Why does his Government believe that a 12-year-old girl who was coerced into a violent sexual relationship and who was declined counselling is not vulnerable enough to qualify under the National Government’s accident compensation guidelines?
Hon GERRY BROWNLEE: I have already stated that those provisions were initiated by the previous Government. But we have said that as a result of the review, should the changes that have come about be found to be in any way wanting, then we will act upon that.
Lynne Pillay: Why is it OK for the Minister of Finance to have claimed $900 a week to keep his family together when the National Government says that rape victims from dysfunctional families should get nothing?
Hon GERRY BROWNLEE: That is simply an untrue statement.
Hon Annette King: I seek leave to table the list of 54 individuals who have had accident compensation claims denied or stopped under this Government’s changes to accident compensation policy.
Mr SPEAKER: Would the member mind telling the House the source of the list.
Hon Annette King: It was put together by clinicians and was released to the media yesterday, but obviously not seen—
Mr SPEAKER: That is sufficient. Leave is sought to table that document. Is there any objection? There is objection.
Urgent Question to Minister
PHIL TWYFORD (Labour) : I seek leave to ask an additional oral question and three additional supplementary questions today to the Minister of Local Government, based on new information that has become available to members since the time for submitting questions. To assist the Minister I am happy to table my questions by leave to enable him to prepare an answer to them.
Mr SPEAKER: Leave is sought to ask an additional oral question accompanied by three further supplementary questions. Is there any objection to that course of action being taken? There is objection.
PHIL TWYFORD (Labour) : I seek leave to table the questions so that members can see the questions that the Minister did not want to answer.
Mr SPEAKER: The member is seeking leave to table a document that is apparently a question. Is there any objection to that course of action being taken? There is objection.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/7/7/a/49HansD_20091210_00000038-Questions-for-Oral-Answer-Questions-to-Ministers.htm

'Charter for rapists' - critics savage ACC

An article from the New Zealand Herald by Simon Collins

Psychotherapists and counsellors say tight new rules for claiming ACC subsidies for sexual abuse counselling have become "a rapists' charter".
The national associations of psychotherapists, counsellors and social workers have released anonymous details of 54 cases showing longer delays and more rejections since the new rules took effect on October 27.
"ACC's own statistics show a serious reduction in approved claims," they said in a joint statement. "This must please the rapists and paedophiles. They believe that what they do doesn't cause any harm - the new ACC pathway is a rapists' charter."
The new rules provide subsidised counselling only for sexual abuse victims with a diagnosed mental condition caused by the abuse, and generally only for up to 16 weeks before a further review.
Most counsellors and psychotherapists do not have specific training to make psychiatric diagnoses, so they have had to refer cases to psychologists or wait for ACC to get its own psychologists to assess clients.
Auckland's two main specialist agencies, Auckland Sexual Abuse Help and South Auckland's Counselling Services Centre, both said yesterday that they had still not had a single new ACC claim approved since October 27.
Counselling Services Centre manager Emma Castle said several other cases, which would have been accepted under the previous policy, had been declined.
"It's horrendous for our clients," she said. "For us as an agency it's just awful."
In one recent "acute" case, ACC told a woman to get support from her general practitioner and community mental health services.
"She doesn't have a mental health condition. She's been raped," Ms Castle said.
"What will her GP do? He will refer her to us. This was someone raped horrifically over a three-hour period who ACC has not decided if she needs counselling. We are seeing her. We are carrying the cost."
The national associations listed five cases in which ACC refused to subsidise counselling on the grounds that clients' mental conditions were caused by the "dysfunctional families" in which they grew up, and not specifically by the sexual abuse that they suffered.
One therapist reported three children's claims from three separate families declined on the basis that they had been taken into foster care, showing that their original families caused their problems, not the sexual abuse.
In another case, ACC declined subsidised counselling for a 12-year-old girl on the basis that she had "consensual sex" with an 18-year-old man who, the girl's therapist said, "used shows of violence (e.g. punching walls) to intimidate her into providing sex".
A woman now in her 40s, who was raped at age 16 when she was a patient in a mental hospital, was refused the subsidy "because there was an overlap of symptoms" with the original mental condition for which she was hospitalised.
Takanini family therapist Sue Ushaw, who supervises several other South Auckland therapists, said clients were being retraumatised by the amount of information ACC now required at the first counselling session to make a subsidy claim.
The last official figures show that approved claims for sexual abuse counselling declined even before the new rules formally took effect, from 246 in August and 224 in September to 135 in October.
But ACC operations director Graham Bashford said the number of people seeking ACC help had not fallen drastically.
"If there should be a drop, it might be argued that it is a consequence of ACC adhering more closely to its legislation," he said.
"Some might also suggest that the scaremongering being undertaken by certain lobby groups has also put off some clients from seeking ACC help. Today's description of the new process as a 'rapists' charter' is one such example."
Turned down:

• Five people whose symptoms were put down to their "dysfunctional families".
• Girl, 12, intimidated into sex with man, 18.
• Woman abused in mental hospital, whose symptoms may have been caused by her original mental condition.

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10614305&pnum=0

ACC accused of discriminating against Maori and women

A news report from Te Karere



http://www.youtube.com/watch?v=rd6FHVV3mFY

Questions for written answer

18921 (2009). Hon David Parker to the Minister for ACC: Are the latest projections based on earlier trends for numbers of ACC funded sensitive claims prior to 2009?
Hon Dr Nick Smith (Minister for ACC) replied: The most recent claims liability projections were based on data and information through 30 June 2009. They were derived from patterns and trends of claim numbers based on the historical experience, giving more weight to the recent periods. Knowledge of operational and other changes were also taken into consideration; however, these often receive less weighting until evidence of the impacts can be demonstrated. These projections are currently being updated using data and information up to 31 December 2009. Mental injury has always been a requirement, defined under the legislation, in order for ACC to accept cover for a sensitive claim. The Corporation has put in place new guidelines implementing best practice for managing clients with a mental injury. This process began in 2008 with the publication of the Massey University Guidelines, for the assessment and treatment of people who experience mental injury as a result of sexual assault or sexual abuse.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/8/3/QWA_18921_2009-18921-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

18923 (2009). Hon David Parker to the Minister for ACC: What are the current rates and number of declines and accepted and pending for ACC funded sensitive claims by region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table which provides details of the number of sensitive claims lodged between 1 July and 30 November 2009, by region. This information is broken down by the current number and percentage that have been accepted, declined or are pending.
http://www.parliament.nz/en-NZ/PB/Business/QWA/a/9/a/QWA_18923_2009-18923-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

18925 (2009). Hon David Parker to the Minister for ACC: Are the current rates of accepted ACC funded sensitive claims by region less in November 2009 than in November 2008?
Hon Dr Nick Smith (Minister for ACC) replied: I am unable to respond to the Member’s request, as not enough time has lapsed for ACC to provide meaningful figures for the number of Sensitive Claims accepted in November 2009.
http://www.parliament.nz/en-NZ/PB/Business/QWA/a/e/c/QWA_18925_2009-18925-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

Question for written answer

18914 (2009). Hon Jim Anderton to the Minister for ACC: What were the number of claims made to the Sensitive Claims Unit for the mental health consequences of sexual abuse in each of the five years ended 30 June 2009, how many of these were accepted, how many were declined and how many are pending?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table which provides details of the number of claims made to the Sensitive Claims Unit, which were lodged in each of the last five financial years. The table also includes the number of claims accepted, declined or awaiting a decision. Please note, the number of claims accepted, declined or awaiting a decision do not necessarily add up to the total number of claims lodged, as some lodged claims were duplicates of claims that were already in the system.
http://www.parliament.nz/en-NZ/PB/Business/QWA/6/0/a/QWA_18914_2009-18914-2009-Hon-Jim-Anderton-to-the-Minister-for-ACC.htm

Question for written answer

18883 (2009). Hon David Parker to the Minister for ACC: How many sensitive claims did ACC approve for August, September and October 2008, broken down by region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table which provides details of the number of Sensitive Claims which were approved in August, September and October 2008. This information is broken down by region. The data in the attached table differs from the information I provided the Member in Parliamentary Question for Answer 12451 (2009). This is because the decision status of a claim may have changed since the data was last provided. Therefore, the number of approved claims has increased.
http://www.parliament.nz/en-NZ/PB/Business/QWA/3/f/8/QWA_18883_2009-18883-2009-Hon-David-Parker-to-the-Minister-for-ACC.htm

ACC and sexual abuse victims

A blog entry from Red Alert by Grant Robertson

Last night I hosted a public meeting on changes to ACC. One of the speakers was Eric Medcalf from the NZ Association of Psychotherapists. He gave an impassioned speech that showed how the changes are not only contrary to the principles of ACC but also risk re-victimising survivors of sexual abuse. The changes include requiring a full psychiatric diagnosis of mental illness and reducing treatment hours. As Eric said:
When ACC insist that all new claimants must have a full psychiatric assessment and a diagnosis of mental illness they are raising the bar to help for many thousands of people, women, children and men, who have suffered sexual abuse as children, or been sexually assaulted as adults. They are saying “prove to us you are mentally ill before we will give you any help”. This is insulting to victims of sex crimes.
If you want to read the full text of Eric’s speech, here it is.

http://blog.labour.org.nz/index.php/2009/12/01/acc-and-sexual-abuse-victims/