Suicide danger in ACC delay: expert

An article from the Waikato Times by Maryanne Twentyman

A Waikato survivor of sexual abuse has been waiting seven months for ACC to determine whether he is eligible for counselling, a time frame which could have resulted in suicide, according to a Hamilton expert.
The man was recently told that his psychologist was now waiting for confirmation from ACC as to what should be written into his report, according to Male Survivors of Sexual Abuse Waikato manager Mike Holloway.
"When the man contacted ACC to see what the hold-up was he was told his paperwork had been `misplaced' which isn't uncommon," Mr Holloway said.
The situation was last week inflamed when information was released about an independent ACC report that referred to "draining the swamp" in cutting back services.
The report, obtained under the the Official Information Act by Labour acting ACC spokesperson Maryan Street, said ACC had "gone too far towards customer focus" and needed to begin "tightening the gateway by reducing the level and costs of treatment provided".
"Perhaps the most disturbing and callous phrase used in the Morrison Low report was the need for ACC to `significantly cut back to essential and core services only – effectively draining the swamp'," Ms Street said.
She claimed that the report highlighted a need for ACC staff to adopt a "tough love" approach.
"The report made it clear that if staff did not turn down enough claim applications they would get the sack," Ms Street said.
But ACC chief executive Dr Jan White said that was "absolutely ridiculous and untrue.
Dr White said the phrase "draining the swamp" referred to ACC's corporate office, not clients, and was written by a consultant, not ACC.
The report and subsequent controls put in place by ACC have outraged Waikato ACC advocate Quentin Mines.
"If you were to add up the dollars that claimants take from ACC it's a tiny sum compared to where ACC does not pay out where it should," he said.
Hamilton man Bruce Gardiner, who fought ACC over compensation for emotional trauma following an incident in which a man was killed after running under the milk tanker he was driving, said the report did not surprise him.
"They (ACC) are rotten to the core and the money they save would be a drop in the bucket compared to the money they spend on lawyers to get rid of cases like mine," Mr Gardiner said.
"ACC refused to accept my situation. For me it was an accident and it cost me enormously trying to prove my point in court," Mr Gardiner said.
But Dr White said ACC was governed by legislation that determined who was covered and who was not.
"We adhere closely to that legislation and provide services to meet our responsibilities.
"Clients have access to a free and independent review process if required," she said.

http://www.stuff.co.nz/waikato-times/news/3362909/Suicide-danger-in-ACC-delay-expert

Questions for written answer

1226 (2010). Lynne Pillay to the Minister for ACC: What are the terms of Reference for the Review of the ACC Sensitive Claims Pathway?
Hon Dr Nick Smith (Minister for ACC) replied: The Terms of Reference for the Review of the ACC Sensitive Claims Pathway have not yet been determined.
http://www.parliament.nz/en-NZ/PB/Business/QWA/8/1/3/QWA_01226_2010-1226-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1227 (2010). Lynne Pillay to the Minister for ACC: How many people have approached the ACC Sensitive Claims Unit for assistance, by region, since 1 January 2010?
Hon Dr Nick Smith (Minister for ACC) replied: Data is not kept on the numbers of people who approach ACC. The member may request how many applications have been lodged if she wishes.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/9/e/QWA_01227_2010-1227-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1228 (2010). Lynne Pillay to the Minister for ACC: How many sensitive claims has ACC approved since 1 January 2010, by month and region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table.
http://www.parliament.nz/en-NZ/PB/Business/QWA/f/4/a/QWA_01228_2010-1228-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1229 (2010). Lynne Pillay to the Minister for ACC: How many sensitive claims has ACC declined since 1 January 2010, by month and region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table.
http://www.parliament.nz/en-NZ/PB/Business/QWA/4/1/e/QWA_01229_2010-1229-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1230 (2010). Lynne Pillay to the Minister for ACC: What meetings has the Minister had regarding sensitive claims since 1 January 2010 detailed by date and organisation?
Hon Dr Nick Smith (Minister for ACC) replied: I have not had any meetings, specific to sensitive claims, with any organisation since 1 January 2010. I meet regularly with ACC officials and sensitive claims may form part of a wider meeting agenda.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/e/e/QWA_01230_2010-1230-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1231 (2010). Lynne Pillay to the Minister for ACC: What, if any, oral reports relating to sensitive claims has he received since 1 January 2010, by date and title?
Hon Dr Nick Smith (Minister for ACC) replied: I discuss a range of issues relevant to my portfolio at my usual weekly meeting and during informal conversations with officials. A record of oral reports by time and date is not always created.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/b/1/QWA_01231_2010-1231-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1234 (2010). Lynne Pillay to the Minister for ACC: What is the cost of all contractors hired by ACC’ Sensitive Claims Unit, per week, as broken down by individual contractor, since 1 January 2010?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/8/4/QWA_01234_2010-1234-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1235 (2010). Lynne Pillay to the Minister for ACC: How many, if any, casual staff have been employed by ACC in the Sensitive claims unit, since 1 January 2010?
Hon Dr Nick Smith (Minister for ACC) replied: No casual staff have been employed by ACC’s Sensitive Claims Unit since 1 January 2010.
http://www.parliament.nz/en-NZ/PB/Business/QWA/8/b/f/QWA_01235_2010-1235-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

1236 (2010). Lynne Pillay to the Minister for ACC: What, if any, meetings has the Minister had with lobby groups since 1 January 2010, by date and group, relating to sensitive claims?
Hon Dr Nick Smith (Minister for ACC) replied: None.
http://www.parliament.nz/en-NZ/PB/Business/QWA/5/5/6/QWA_01236_2010-1236-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Victims of sexual abuse are feeling the effect

An article from the Taranaki Daily News

Some of those most affected by ACC's harder line are victims of sexual abuse.
"People who are victims of sexual crimes don't have a voice. They speak with their feet. They're not turning up for counselling, referrals are right down. People are not prepared to come in and be given a label of mental illness," New Plymouth Safer Centre counsellor Bob Stevens says.
The New Zealand Association of Counsellors is agitating across the country, he says.
"When do you suddenly become a mental health patient because you have been sexually assaulted?"
Since October, ACC has started to lay on an "unsuspecting public" new clinical pathways.
"They've decided arbitrarily, because there had been no change to legislation, that the only way you can fund ACC counselling is to have a diagnosis under the American psychiatry bible DSM-IV. Those of us who have being doing this work for half a lifetime, 18 years for me, are sidelined because we are not trained to use the diagnostic criteria, therefore we can't do assessments."
To become ACC approved, sexual abuse counsellors had to "jump through more hoops than a circus", he says. And yet now they are not deemed qualified enough to make the assessments.
He's appalled at the new approach.
"People come in here and tell me I can't take this any more."
Under the new rules, people who are victims of sexual abuse have to tell their stories to a sexual abuse counsellor, who passes on the information to ACC. The claim is then assessed by a psychiatrist and psychologist, out of the area, who make the decision whether or not to accept it, without meeting the clients. However, sometimes, an extra assessment is required by ACC and then the client may end up telling their story to a number of different people.
The psychiatrists and psychologists are "hell bent" on looking at whatever psychological problem they can find - to hell with the event, Mr Stevens says.
ACC senior medical adviser Peter Jansen says there has been a lot of coverage lately of the new "pathway", much of it uninformed and negative.
"It's important to understand that ACC is not cutting services to people who are entitled to them. Our legislation is very clear: we can provide cover only for injuries. The entitlements that follow from an accepted claim will depend on the nature of the injury."

So to pay for psychological treatment or therapy such as counselling for sexual abuse or assault victims, ACC needs to be satisfied that sexual abuse or assault has caused a mental injury. This is a clinical diagnosis, which can be made only by registered health professionals with appropriate training, qualifications and experience, Dr Jansen says.
"In the past, we have not followed this requirement as closely as we should have. The result is that we have paid for counselling and other benefits for some people not entitled to it. This is not to say that these people do not have psychological needs; it is simply that ACC cannot legally cover them. Other agencies such as Health and Social Development often can."

http://www.stuff.co.nz/taranaki-daily-news/features/3352813/Victims-of-sexual-abuse-are-feeling-the-effect

Question to Minister: ACC strategic priorities

LYNNE PILLAY (Labour) to the Minister for ACC: Does he agree with the strategic priorities of ACC, which include “Ensuring New Zealanders have confidence in ACC”?
Hon Dr NICK SMITH (Minister for ACC) : Absolutely.
Lynne Pillay: Does he expect that the 30-year-old man who was raped and beaten as an 8-year-old and who first approached a counsellor in March 2009, will be feeling confident, when he still does not know whether he can receive treatment funded by the Accident Compensation Corporation (ACC)?
Hon Dr NICK SMITH: On the individual case, I am not able to give the member a response, but I would note that I am loath to interfere in clinical decisions about those who are eligible for counselling under accident compensation law. I would also note that it was, in fact, the previous Government that started the review of the sensitive claims process that has led to the changes that the member constantly raises.
Lynne Pillay: Does he expect that the young woman who was raped last year and who has had to reveal her assault separately to two therapists will be feeling confident, when her case has still not been decided by ACC?
Hon Dr NICK SMITH: Again I would say that for a member to raise cases in the House and to expect an answer from me when I have absolutely no details about them, and when there are 1.6 million claims for accident compensation each year, is not reasonable. It shows that the member is doing nothing more than political grandstanding, rather than being genuinely concerned about the condition of the claimant.
Lynne Pillay: Does the Minister think that the victims and survivors of sexual abuse have confidence that his experiment on them, which started on 27 October 2009, will be stopped after 6 months—
Hon Dr NICK SMITH: I raise a point of order, Mr Speaker. The Standing Orders are very clear that a member is not to make incorrect assertions in questions. To assert that I am experimenting with women who have sensitive claims, or with sexual abuse claimants, is, I think, offensive, and is not required in terms of the information the member is seeking.
Mr SPEAKER: I think the Minister has raised a perfectly fair point of order. This matter covers sensitive issues, and I ask members on both sides of the House to be mindful of that in their wording.
Lynne Pillay: I raise a point of order, Mr Speaker. The Minister has actually said there—
Mr SPEAKER: Order!
Lynne Pillay: It is a point of order.
Mr SPEAKER: Well, the member had not been acknowledged for a point of order. I had called her for a supplementary question. If she is calling for a point of order, I will hear her point of order.
Lynne Pillay: The Minister has said that the new pathway will be reviewed in 6 months’ time.
Mr SPEAKER: That has nothing to do with the order of the House. The member is seeking to debate an issue. The point of order raised by the Hon Nick Smith related to an assertion that the Minister was experimenting on people. That was unacceptable language. I ask the member to reword her question.
Lynne Pillay: Does the Minister think that victims and survivors of sexual abuse have confidence that his new accident compensation pathway, which has been set in place for a 6-month period, will be stopped after those 6 months; and why are counsellors still waiting to see the terms of reference for the review, or will they be shut out of that, as well?
Hon Dr NICK SMITH: The first thing I want to make plain to the House is that decisions about sensitive claims have been made not by me as Minister, or by Cabinet, or by the Government, but by highly qualified clinical specialists, who I think should make the decisions in areas such as this. It is true that concern has been raised by some counsellors about the new pathway. As a consequence, I have said that there will be an independent clinical review of ACC’s processes for dealing with sensitive claims. It is my intention to work with ACC to ensure that the clinicians on that panel are well qualified to provide the claimants and all New Zealanders with an assurance that what ACC is doing in this area is in the best interests of those claimants.
Lynne Pillay: How many sexual abuse psychotherapists, counsellors, victims, and survivors have been interviewed in respect of the 6-month review of the new accident compensation pathway, or is it simply a paper-based sham?
Hon Dr NICK SMITH: The policy was introduced in November. By my basic calculations, that means that the 6-month review will occur in April. The terms of reference and the review panel have not yet been determined, but I would be happy to consult members of the Opposition about both the terms of reference and the personnel, because I think all members would want to know that sensitive claimants are getting appropriate care from ACC.
http://www.parliament.nz/en-NZ/PB/Debates/Debates/b/0/8/49HansD_20100218_00000025-Questions-for-Oral-Answer-Questions-to-Ministers.htm

Government working hard to save ACC for Kiwis

A press release from the National Government by Nick Smith

The Government's reforms of ACC are all about ensuring the scheme is affordable and sustainable for future generations, ACC Minister Nick Smith says.
"The protest today led by the unions, the Labour Party and the Green Party claimed to be about saving ACC," Dr Smith said. "What they fail to realise is that this is exactly what the Government is doing through its ACC Reform Bill.
"Labour and the unions are in denial about the mess the previous government left ACC in. They are being hypocrites in now crying foul over those trying to save our no-fault insurance scheme.
"Labour's claim the cost-saving measures are all about business totally misses the point that it is families that pay the bulk of ACC levies. The Government's reforms are about avoiding extra levy increases for hard working New Zealanders.
"ACC's financial reports under Labour showed an increase in unfunded liabilities in their last term from $4 billion to $13 billion and a loss in the 2007/08 year of $2.4 billion. After this record loss, Labour recklessly extended the scheme to include suicide, self harm, seasonal workers and superannuitants while promising cuts in levies.
"It is a fact that ACC's claims costs over the past four years have risen by 57% - five times the rate of inflation - and to pretend that this can occur without impacting on levies is a fantasy.
"Saving ACC is what the Government is doing. The choices are putting up levies or cutting back on entitlements and the Government's approach is a balanced mix of both. The changes we are making will halve the levy increases this year and help secure the future of ACC for all New Zealanders."

http://www.national.org.nz/Article.aspx?ArticleId=32045

ACC clients renamed ‘swamp-dwellers’ under new tough love approach

A press release from the Labour Party by Maryan Street

Injured New Zealanders will be appalled by the culture change taking place at ACC which has been advised to be less ‘customer-focused’ to begin ‘draining the swamp’ of ACC clients, says Labour’s acting ACC spokesperson Maryan Street.
"The information is contained in two reports released to Labour under the Official Information Act, as part of its Government-directed ‘Value For Money Review’ and explains why increasing numbers of injured New Zealanders are suffering extremely shoddy treatment from the corporation and being declined cover they are entitled to.
“The reports, prepared for the new ACC board last year, say ACC had ‘moved too far towards customer focus’ and needed to begin ‘tightening the gateway by reducing the level and costs of treatment provided – especially rationalising the range of services available’.
“Perhaps the most disturbing example of the callous new approach however is the phrase used in the Morrison Low report to the ACC board which talks about the need to ‘significantly cut back to essential and core (services) – effectively draining the swamp,” Maryan Street says.
“So ACC staff are now being encouraged to view ACC clients as swamp-dwellers? It’s not only offensive, it’s a very disturbing example of the type of culture now pervading ACC.
“And what happens if staff fail to adopt the new ‘tough love’ approach (another phrase being used)? The reports make that clear. If they don’t turn down enough claim applications they will get the sack.
“One report says ‘there is a need for ACC to adopt more business/insurance-like behaviours…this may mean changes in the staffing and skills mix’ and ‘the introduction of stronger performance management mechanisms’.
“These reports raise serious questions about exactly what is going on at ACC and what staff are being directed to do. The public has a right to know how the ‘gateway’ is being tightened and exactly what services ACC staff are now being instructed to refuse to provide.”

http://www.labour.org.nz/news/acc-clients-renamed-%E2%80%98swamp-dwellers%E2%80%99-under-new-tough-love-approach

ACC abuse survivors 'betrayed'

An article from the Press by Charlie Gates

Sexual-abuse survivors feel "betrayed" that research they have helped develop has been used to tighten access to ACC counselling services.
ACC has changed access to counselling services, requiring greater proof that claimants have a diagnosis showing a mental injury caused by sexual abuse.
A review of progress after 16 counselling sessions is also required.
The ACC changes were partly influenced by 2008 Massey University research that included surveys and interviews with sexual-abuse survivors.
The 16-session review was developed using the Massey research.
A Christchurch sexual-abuse survivor, who was interviewed for the research, said he felt "double-crossed" by the way it was used by ACC.
The 49-year-old man, who wished to remain anonymous, was sexually abused by a cousin during childhood and received ACC counselling six years ago.
"They have double-crossed us. It is not right," he said.
"The research has been used against us ... We were never told it was going to be used by ACC."
He said he would be cautious about participating in future research.
Male Survivors of Sexual Abuse Trust manager Ken Clearwater had written to Prime Minister John Key expressing concerns about how the research was used.
"The research for male survivors of childhood sexual abuse is paramount for us and if the men we work with are not prepared to share their stories it could set us back several years," he wrote.
"The research has been used against victims and I just think that stinks," he said.
"The [victim] assessment is morally and ethically wrong. It is absolutely awful to put anyone through that process."
A second Christchurch man, who was sexually abused as a teenager and used ACC counselling services, said "no-one will get over this with just 16 sessions".
ACC senior medical adviser Peter Jansen said the review was not about cost-cutting, but about improving services.
He said the changes were not "set in stone" and could be adjusted for complex cases.
The 16-session review was established so ACC could make "an assessment of progress".
"I am sorry they feel betrayed, but there has clearly been a miscommunication," he said.
"We are not trying to withdraw things.
"The point of having this plan is to make the service better.
"We want to make better decisions about cover and then once someone is in therapy, ensure the best service is provided."

http://www.stuff.co.nz/national/health/3342587/ACC-abuse-survivors-betrayed#share