Questions for written answer

9554 (2010). Lynne Pillay to the Minister for ACC: What, if any, papers has the Minister taken to Cabinet, relating to sensitive claims and or ACC’s Sensitive Claims Unit since 1 January 2010, by date and title?
Hon Dr Nick Smith (Minister for ACC) replied: I have taken no papers to Cabinet relating to sensitive claims or ACC Sensitive Claims Unit since I became Minister. The changes to the management of sensitive claims have been made entirely by ACC, involving medical practitioners based on the guidelines produced by Massey University and launched by Hon Steve Maharey in March 2008. The only decision I have made is to initiate an independent clinical review.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/0/e/QWA_09554_2010-9554-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

9589 (2010). 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, if any?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the member to the answer to Parliamentary Written Question 09590 (2010).
http://www.parliament.nz/en-NZ/PB/Business/QWA/4/3/9/QWA_09589_2010-9589-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

9590 (2010). Lynne Pillay to the Minister for ACC: How many sensitive claims, if any, have been declined by ACC that involve counselling for sex abuse victims and/or victims of domestic violence in Wairarapa since 1 November 2009?
Hon Dr Nick Smith (Minister for ACC) replied: Claims, commonly known as ‘sensitive claims’, receive cover under the ACC scheme when there is a significant mental injury as a result of certain criminal acts, dealt with in the Crimes Act 1961. Section 21 of the Accident Compensation Act details the cover provisions for such claims. The twenty specific criminal acts covered by ACC are stipulated within Schedule 3 to the Accident Compensation Act. ACC does not keep specific data on claim numbers for counselling accepted, declined or pending. Data is kept on claim numbers of which counselling may be one of the treatment options.
http://www.parliament.nz/en-NZ/PB/Business/QWA/0/b/6/QWA_09590_2010-9590-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

9591 (2010). Lynne Pillay to the Minister for ACC: What sensitive claims, if any, 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: I refer the member to the answer to Parliamentary Written Question 09590 (2010).
http://www.parliament.nz/en-NZ/PB/Business/QWA/0/7/b/QWA_09591_2010-9591-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Louise Nicholas to open inaugrual SOSA NZ summit

A press release from SOSA

Nine months ago the conditions under which sexual abuse survivors could gain support under ACC changed. In the meantime 95% of survivors have been denied the professional help they need. Cuts continue to be driven under the “new clinical pathway” disguise, despite wide-ranging protests that seem to fall on deaf governmental ears. From this, the need arose to bring together survivors for networking and to find alternative ways towards recovery. This gave birth to SOSA (Survivors of Sexual Abuse) a non-profit, bi-cultural organisation. Like-minded volunteer survivors came together to create a day of unity, strength and inspiration.
SOSA’s vision is to carefully lift the shroud of silence and thereby re-claim power from a political and social environment currently perceived as re-traumatising and marginalising. We believe this summit is not a 'one-off', but the first of many. SOSA is being established as a charitable society that can then function as a survivor union, organising summits, giving courses, becoming politically active, and maybe even striving towards generating a funding source for those survivors who struggle to get funding for treatment.
This inaugural day-long hui takes place at AUT on the North Shore on the shortest day of the year – Sunday 20th June 2010. The symbolism of the darkest night of mid winter represents the darkness that many face when beginning their journey of recovery from such trauma.
A song written for this event will open the day at 9am. Louise Nicholas will pave the way for 8 other inspiring speakers, including MP Lynne Pillay to talk about their courageous journeys. Working through trauma can be debilitating and excruciatingly painful. Shame, self-blame and self-hatred are often taken on by survivors until the are able to give back these feelings to whom they really belong – the perpetrators of the abuse.
Creativity release is one way of working through this healing journey, therefore art and writing/poetry workshops will be offered for those in a creative mood. Wellpark College of Naturopathy are in charge of encouraging self-care – participants will enjoy safe massage, relaxation, aromatherapy, yoga and Ayurvedic ways of pampering. A soothing, meditational dance workshop will be led by an experienced mind/body therapist for those who prefer to be more active. So much choice, do it all, or just chat, mingle and have fun!
Comfort spaces will be set aside for those who may require a quiet space. Other survivors will display their crafts – harakeke (flax) weaving will be demonstrated and stunning bead work can be bought. New and second hand books about healing will be for sale. Nourishing and nurturing soups for lunch, teas and coffees are all included in the entry fee.
An informal forum will take place before day's end to korero about finding ways of getting better services, and the much needed help for survivors of sexual abuse. These findings will be delivered to government and will clearly demonstrate that survivors know best what works for them.
The gathering will take place with safety for all in mind. Places are limited so register now on www.sosanz.com. The entry fee is $15, going up to $20 a week before the summit to cover the cost of food. It is essential to register on the website beforehand.
We welcome all survivors, their supporters or those affected by another’s abuse to come into the light and join us on this important day in history. Please register at www.sosanz.com as soon as possible as numbers will be limited. Entry will be gained only by registering on the website and with a month to go, the time to do it is now!
We are unashamedly asking for support and donations, so that we can finance this day of hope. Please, push the donate button on www.sosanz.com and help survivors gain voice and advocacy. We very much appreciate your support.

http://www.scoop.co.nz/stories/PO1005/S00256.htm

Question for written answer

9324 (2010). Lynne Pillay to the Minister for ACC: What are the numbers of sensitive claims, lodged, accepted, declined, awaiting external information, under assessment by ACC for claims decision and duplicate, by region and by month since November 2009?
Hon Dr Nick Smith (Minister for ACC) replied: Corrected reply: I refer the Member to the attached table, which shows all new sensitive claims lodged with ACC from 1 November 2009 to 30 April 2010 by region of accident and the claim's current decision status as at 22 May 2010.
http://www.parliament.nz/en-NZ/PB/Business/QWA/1/a/a/QWA_09324_2010-9324-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

ACC SCU review and survivors of sexual violence lunchtime forum

Lunchtime Forum: Wednesday May 26th, 12-2pm
Venue: Centre for Global Action, Level 2, James Smiths Building, cnr Cuba and Manners Streets, Wellington

The financial support ACC’s Sensitive Claims Unit provides survivors of sexual violence, in the form of funding therapy, was radically altered in October 2009 with the introduction of a new clinical pathway. The Roundtable on Violence Against Women is hosting a forum to hear about how the new clinical pathway is impacting on survivors.

• Are most survivors' claims accepted by ACC?
• For those survivors who cannot access ACC-funded support, what is available?
• Finally, and most importantly, is the ACC Sensitive Claims Unit the most appropriate agency to help survivors and our communities recover from the harm caused by sexual violence?

Speakers:

• Suzanne Johnson, Psychotherapist, Member of NZ Association of Psychotherapists (NZAP), Chair of NZAP Public Issues 2006-2010
• Wendi Wicks, Disability Coalition Against Violence
• Margaret Hester, ACC Claimant
• Helen Sullivan, General Manager Wellington Sexual Abuse HELP

The Wellington Sexual Abuse HELP Foundation provides 24/7 crisis support, counselling and primary prevention services in Wellington and Porirua.  A significant proportion of our counselling work had been funded through ACC Sensitive Claims and the impact of the clinical pathway has significant financial implications for our agency and its ability to maintain current levels of services for clients dealing with the impact of sexual violence on their lives.

http://wgtnywca.wordpress.com/2010/05/08/the-acc-review-survivors-of-sexual-violence-26-may-lunchtime/

ACC - Clinical Pathway to Lala Land

A blog entry from K1W1 by Jax

Like a few people I imagine, I'm pretty much playing "catch up" on the ole ACC saga. Sure, I saw the protests on TV some months back and yeah, I've heard rumbles from some about the "hideous" recommendations, but I never really thought more about it until I flicked through emails sent to me by another member.
Within two days of sifting through her copious emails I was livid. She's not a reporter but she sure as hell could give some of our current ones a run for their money. She's a nurse, a psych nurse, and she's deadly passionate about the changes not only in the legislation but in the effect it's having on those close to her. This is a woman who entered into the health profession with a sense of pride and today, she's "gutted" by her own health professional's unethical decisions. In short, she feels ashamed of them.

Read the rest of this entry at http://k1w1jax.blogspot.com/2010/05/acc-clinical-pathway-to-lala-land.html

Question to Minister: ACC - Minister's statements

Hon ANNETTE KING (Deputy Leader—Labour) to the Minister for ACC: Does he stand by all his recent statements on ACC?
Hon Dr NICK SMITH (Minister for ACC) : Yes.
Hon Annette King: Does he stand by his claim on 6 May in Parliament that the College of Psychiatrists had issued a statement strongly in support of the changes that the Accident Compensation Corporation (ACC) had made to the sensitive claims guidelines; if so, is the College of Psychiatrists not telling the truth in a letter it released on 10 May, stating that the college had not supported the new ACC pathway, and that, indeed, it had declined to release a press release in support of it? Will he now address this little inconsistency in his answer to Parliament?
Hon Dr NICK SMITH: I said that the Royal New Zealand College of General Practitioners had issued a statement that “ACC’s practice guidelines for sexual abuse and mental injury will strengthen these results still further. All the clinical evidence suggests the new approach ACC is adopting will be in the interests of the patient.” The advice I received from ACC was that the College of Psychiatrists had made statements to ACC in support of the guidelines and the change.
Hon Annette King: I raise a point of order, Mr Speaker. I know that you do not wish to have Hansard tabled in this House. I based my question on the Minister’s answer on 6 May, in which he named the College of Psychiatrists as having issued a statement.
Hon Dr NICK SMITH: No.
Hon Annette King: Yes, Mr Speaker. I have the Hansard. The Minister is saying no, but I seek leave to table the Hansard.
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is objection.
Hon Dr NICK SMITH: I seek leave of the House to table the statement issued by the Royal New Zealand College of General Practitioners dated 2 November 2009.
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.
Lynne Pillay: Why, in the face of overwhelming opposition throughout New Zealand to the ACC-imposed clinical pathways introduced under his watch, does he not simply reinstate the previous process? Even visiting American sexual abuse expert Dr Mike Lew says that ACC’s new criteria is a “real tragedy that would cause tremendous suffering,”.
Hon Dr NICK SMITH: I understand that that statement was made in respect of the requirement that for a person to receive accident compensation support, he or she is required to have a diagnosed mental injury. It is a requirement of the law that Labour put in place in 2001.
Melissa Lee: Are claims that there has been a dramatic decrease in the amount ACC is spending on sensitive claims since the new guidelines came into effect correct?
Hon Dr NICK SMITH: No, such claims are grossly misleading. The amount ACC has spent on sensitive claims for the year to date is $45.7 million, which compares with $46.7 million for the exact same period last year. The amount spent on counselling per month has been consistent over the last 3 years at $900,000. The average amount spent on sensitive claims counselling is $905,000 per month over the last 3 months.
Lynne Pillay: Does he agree that when a young woman is held at knifepoint for 15 hours and repeatedly raped it is outrageous that she should wait weeks before earnings-related accident compensation can be paid, which is what his colleague Chris Tremain told the media in 2006? How does he reconcile Mr Tremain’s outrage then with the fact that rape victims are now waiting months or indefinitely just for counselling to be approved by ACC?
Hon Dr NICK SMITH: The average time for processing sensitive claims at the moment, I understand, is about 20 days. That is unacceptably long. It is one of the reasons that I have established a clinical review of management of sensitive claims. I want ACC to work with clinicians and professionals to ensure that the best possible counselling support within the law is provided to those claimants.
Hon Annette King: Why did he tell the House on 6 May when I asked him whether he had heard of a group of survivors of sexual assault called Courageous Women, who are challenging the changes to accident compensation guidelines, that “I’ve heard of the group only through the newspaper” when at that point during question time he had full knowledge of the group, he had had a phone call with its spokesperson Louise Nicholas 3 days earlier, and he had had time to arrange staff members to listen in on that conversation with Ms Nicholas and make records of that conservation? Would he now like to address that little inconsistency in his answer to Parliament?
Hon Dr NICK SMITH: Mr Speaker—[Interruption]
Mr SPEAKER: I apologise to the Minister. What I take to be a serious question has been asked of the Minister; if the Opposition members wish to hear an answer they should respect the Minister.
Hon Dr NICK SMITH: When I had advised the House that I knew of the group, Courageous Women, through the media, I was stating a fact. Louise Nicholas had a conversation with me as a formal advocate for victims of sexual abuse. I did not know that she was formally connected to that group, and, quite frankly, I do not think there is any big deal about how I might have found out that this particular group, called Courageous Women, exists.
Hon Annette King: Does he recall these words on 6 May in answer to a question from me: “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.”, and would he know like to apologise to the House for saying he did not say those words in this House?
Hon Dr NICK SMITH: Each time the member has used the quote she has quoted the words slightly differently. I will be very clear for the member—
Hon Trevor Mallard: But it’s your Hansard.
Hon Dr NICK SMITH: No, previously the member opposite used a different set of words. For the member’s benefit I will be very clear. The College of General Practitioners issued a written statement. I was advised by ACC—and I would be happy to table the report from ACC—that the College of Psychiatrists formally advised ACC that it supported the guidelines.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. The member offered to table a document. I make clear and put on the record that if that is the case, the Opposition wants to see it.
Mr SPEAKER: The member knows that it is up to the Minister to table a document, unless he was quoting from an official document, which appears not to have been the case.
Hon Annette King: I seek leave to table the Hansard of 6 May, in which the Minister claimed that he had a statement from the College of Psychiatrists in support of his changes. The college has denied that it ever issued such a statement.
Mr SPEAKER: Because of the controversy, I will put that leave to the House. Leave is sought to table that document. Is there any objection? There is no objection.

http://www.parliament.nz/en-NZ/PB/Business/QOA/a/1/0/49HansQ_20100518_00000003-3-Accident-Compensation-Minister-s-Statements.htm

Rape victims wait weeks for counselling

An article from the Otago Daily Times by the NZPA

Rape victims should not have to wait weeks to get help and that situation needs to improve, ACC Minister Nick Smith told Parliament today.
Labour's Lynne Pillay said that in 2006, when Labour was in government, National MP Chris Tremain highlighted the case of a young woman who was held at knifepoint for 15 hours and repeatedly raped but had to wait six weeks before earnings-related accident compensation could be paid.
"How does he reconcile Mr Tremain's outrage then with the fact that rape victims are now waiting months or indefinitely just for counselling to be approved by ACC?"
Dr Smith said the average time for processing sensitive claims was about 20 days.
"That is unacceptably long. It is one of the reasons that I have established a clinical review of management of sensitive claims. I want ACC to work with clinicians and professionals to ensure that the best possible counselling support within the law is provided to those claimants."
Dr Smith ordered the review after concerns were raised about changes to rules which stipulate ACC-subsidised counselling is only for victims with a diagnosed mental condition caused by sexual abuse, and is generally for 16 weeks, subject to further review.
Ms Pillay asked why the Government did not reinstate the previous process given the "overwhelming opposition".
Dr Smith said it was Labour that wrote the law which set a diagnosed mental injury as a requirement. He said that since the new guidelines came into effect the amount spent on sensitive claims had remained steady - for the year to date $45.7 million, compared to $46.7 million for the same period last year.
Labour MPs yelled out that the figures were static because new claims were not being accepted.

http://www.odt.co.nz/news/national/106609/rape-victims-wait-weeks-counselling

Survivors

A blog entry by Kyle MacDonald

In these enlightened times we deliberately choose to use language to more accurately describe the types of attitudes we think are morally important for society as a whole. For this reason we refer to people who have experienced sexual abuse as survivors, and try to avoid calling Maori cannibals ...

Read the rest of this entry at http://www.psychotherapy.org.nz/index.php?page=blog

Rape victim: ACC cut my lifeline

An article from the Sunday Star Times by Tim Hume

Last month, an Auckland mother died after her claim for ACC-funded counselling was rejected under ACC's new 'clinical pathway' for sensitive claimants. But many existing ACC clients claim they are also having their counselling for sexual abuse terminated. One multiple rape survivor tells Tim Hume how having her therapy discontinued has pushed her to the brink, and why she is speaking out to call for changes to the way abuse victims are treated.
The worst part is the nightmares. "Getting raped every single night when I go to sleep. I can only sleep for 45 minutes before I wake up screaming," says Danielle Martin. "I've got a hammer in my bed. If I knew it was going to be like that every night for the next 30 years, I'd kill myself."
The 32-year-old was first raped when she was 16. The attack happened at Red Beach, north of Auckland. Her attacker was known to her and she says he had a serious drug problem. As she ran from the scene, he chased her to the side of the road and laid into her with his boots.
A private-school girl who had been going through a tearaway stage after becoming estranged from her family, Martin took refuge in a caravan park. A few weeks later, her attacker tracked her down, tied her up and held her hostage for 38 hours, subjecting her to all kinds of indignities. "He cut up or destroyed everything I owned: clothes, photos. He was burning me with knives."
Martin eventually escaped by pleading to be allowed to do her park-cleaning duties, then running to the home of the managers, but not before the man had made a cut on her throat and threatened to kill her and her family if she told anyone.
She didn't, trying instead to forget and move on with her life, and eventually got a job at a bar in Auckland's Viaduct. But after a staff party one night, when she was 18, she was drugged and raped by one of the regulars. She remembers only brief flashes of what took place, but the attack left her with lasting physical injuries.
Her trauma went untreated and unacknowledged, and the subsequent years were filled with depression, addiction, nightmares and self-harm until she finally sought help from a counsellor. In October 2000, her claim as a rape survivor – a "sensitive claimant" – was accepted by ACC, entitling her to heavily subsidised counselling.
At first, the counselling had limited success. She went through about 20 counsellors and psychiatrists without feeling comfortable divulging or addressing the trauma at the core of her issues.
"I never felt safe or made that connection," she says. Life was hard, sometimes unbearable. As a result of the attacks, she had chronic post-traumatic stress disorder and major depression, conditions which constituted a disability and made it extremely difficult to leave the home, use public transport, or maintain social links.
But in the past two years she established a connection with a regular counsellor and a psychiatrist, who allowed her to finally "get into the grit" of her trauma. She made what her psychiatrist called "slow but significant progress" and began to study for a counselling degree.
This was all reversed in October when, out of the blue, Martin received a call from her ACC case manager telling her that her twice-weekly sessions with her counsellor were to come to an end.
In November came a letter: "We're pleased to tell you we've approved your decision for a final 20 sessions. Please note there will be no further counselling sessions approved."
Martin was devastated. "I've been suicidal as a direct result of this."
ACC senior medical adviser Dr Peter Jansen said that while Martin and her psychiatrist might have felt she was making progress with her present regime, the opinion of ACC's experts was that "the long-term counselling has created a dependency that has been counter-productive".
He said Martin had already had 280 ACC-funded counselling sessions. One of ACC's expert assessors, through an assessment which included a review of her case history, determined she would be better off at Segar House, a mental health treatment centre operated and funded by the Auckland District Health Board.
"We want the right care so that people recover from their injury."
Martin, who has had trust issues and finds it difficult leaving the security of home, felt she was incapable of undertaking the programme at Segar House, which has a group therapy component and would involve revisiting the trauma of her rapes with new counsellors.
Her psychiatrist agreed and wrote in a letter to ACC last month: "Since having funding for this intervention discontinued, she has in fact deteriorated significantly – is currently in fact more severely unwell than when first seen but is not accessing any care or follow-up other than that provided by her GP."
Martin said she had been "revictimised" by ACC, which had taken away her lifeline. "I don't have anybody I can talk to about this," she says. She has been calling mental health crisis helplines just about every day but they are not equipped to properly help.
During a recent call, after she woke up hyperventilating from a nightmare, she was advised to take a walk around the block.
"Rape is the ultimate form of powerlessness, the ultimate form of having your choices taken away. And I've been kept in the dark and given no options," she says.
"Therapy helped. My quality of life was improving, my prospects, my ability to be cohesive with other people and my chances of being a productive member of society. I've gone from having some semblance of a normal life ... [to being] a rape victim with worsening symptoms and no help."
Since her counselling was discontinued, Martin has made her blog publicly accessible and has been tweeting about the ordeal, including messages to the prime minister's account. (She received no reply).
"If I'm dead next week, I need this documented," she says. "I've done the right thing. I've been really honest with my treatment providers. I've worked really hard, I've stepped out of my comfort zone to get well. I can still potentially have a really good future. But they're not going to do the right thing unless they're shamed into it."
David Wadsworth of Access Support Services, who is advocating on Martin's behalf, said her case was symptomatic of ACC's "assault on sensitive claimants". "If ACC can get out of any funding of sensitive claims claimants, they'll do it by hook or by crook, as I see it. And they're really the most vulnerable group."
The corporation's new "clinical pathway", which required new clients to be diagnosed with "a significant mental injury" before their applications for sexual abuse counselling could be accepted, had seen the number of sensitive claims approved drop from 472 in the first two months of last year to just 32 in the same period this year. Last month, an Auckland mother died four days after her claim for counselling was rejected.
Meanwhile, many longer-term sensitive claimants were being subjected to reassessments of their treatment regime, which saw them pushed off ACC-funded counselling into DHB-funded programmes.
"They're leaving the claimant high and dry. Four months down the track the person hasn't had any counselling. It's caused a lot of damage to them. They're essentially being retraumatised," Wadsworth said.
Jansen said perceptions that ACC was turfing long-term claimants off counselling regimes to cut costs were incorrect. However, until recently, ACC had been funding treatment for many people who weren't covered by the legislation or weren't getting appropriate treatment.
"If the community is concerned that people are exiting from ACC, my concern would be that they exit because they are recovered."
For regional Rape Crisis help line numbers visit www.rapecrisis.org.nz.

http://www.stuff.co.nz/national/3702810/Rape-victim-ACC-cut-my-lifeline/

Goff adds voice against ACC cuts

An article from the Whakatane Beacon

An Eastern Bay woman who wrote a plea for help to opposition leader Phil Goff described how her despair and worry over the Government’s decision to change the guidelines on supporting victims of sexual abuse had contributed to her suicidal feelings.
The letter in part prompted Mr Goff’s third visit to Whakatane this year, where he met with the woman and her counsellor to gain a greater understanding of how she was being affected by the rule changes.
Those changes, introduced as part of the Government’s new sensitive claims unit in October last year, mean abuse victims must be diagnosed with a mental illness as a result of the abuse in order to receive ACC compensation. And under the new legislation the number of people eligible people who were approved for funding for such therapy had dropped from 312 in October 2008 to just 12 in February this year.
“I was lucky enough to have a stable and loving upbringing, so it is hard for me to come to terms with something like this,” Mr Goff said. “But there is no denying people like this have been through an absolutely traumatic experience. It is something that will blight their entire life unless the get help to move on.
“For a person who has been through that experience, but then gets the right help, they are able to turn their lives around and move on. We used to cover that under ACC, but they have changed the guidelines on who qualifies.
“Those figures are ACC Minister Nick Smith’s own figures, produced as an answer to a written question in Parliament. The initial figure they had was six, but the minister argued ‘No, it’s more than double that’. There’s still a drop of 300 people who are not getting the attention they need and Nick Smith being picky like that makes a farce of the entire situation.”
While in Whakatane Mr Goff also addressed a Grey Power rally attended by about 90 people, where he spoke of his concerns over the ACC changes as well as the effects of the Government’s predicted hike in gst to 15 per cent – tipped to be a staple of next week’s Budget.

© 2010 Whakatane Beacon
http://www.whakatanebeacon.co.nz/cms/news/2010/05/art10007146.php

Question for written answer

8732 (2010). Lynne Pillay to the Minister for ACC: When he told the House on 6 May 2010, "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", how did he expect them or other concerned members of the public to do that when the Accident Compensation Corporation website contains no such invitation, nor any contact details for the Review Group?
Hon Dr Nick Smith (Minister for ACC) replied: The Independent Review of ACC’s Clinical Pathway for Managing Sensitive claims will seek input as identified in the Terms of Reference to the Review. The Review will seek input where appropriate from relevant parties as identified and determined by the group. Notwithstanding this, there is nothing to stop interested parties making submissions at their own will, that is why a postal address and e-mail address, independent of ACC and my office, has been set up.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/a/5/QWA_08732_2010-8732-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Collateral damage worth the cost?

A blog entry from K1W1 by Jax

Let me see if I can get my head around this. The Minister of ACC, the right dishonorable Nick Smith, has decided to can government funded counselling to victims of sexual abuse "until" he hears back from a group of hand selected people on whether the "current system" is working or not. Am I doing okay so far? Right... This hand picked group of people do not seemingly advocate for the rights of sexually abused victims (do correct me if I'm wrong) but I don't see any front-line women's groups or men's groups for that matter being included in this wee round table affair.

Read the rest of this entry at http://k1w1jax.blogspot.com/2010/05/collateral-damage-worth-cost.html

Survivors' experience with the new ACC pathway

A blog entry from SOSA

We are still collecting responses from survivors about their experiences with the ACC process in the last 10 months. If you haven't done our survey yet, go to the survivors survey and make your voice heard. The last question in that survey was "comment on your overall experience with the new ACC pathway". This is what people had to say ...

Read the rest of this entry at http://gfrerichs.typepad.com/sashui/2010/05/survivors-experience-with-the-new-acc-pathway.html#

Questions for written answer

8420 (2010). Lynne Pillay to the Minister for ACC: How many case of sexual abuse reported in 2008, by region and gender, have received support from the Sensitive Claims Unit?
Hon Dr Nick Smith (Minister for ACC) replied: ACC does not record data on the number of reported cases where people “received support”. Data is kept on claims lodged by month and region but this is significantly less than the number receiving support. Data is also kept on total expenditure. Data is not collated from individual claim files on how much or how frequent contact they have had from health professionals or ACC and it would be a huge job to add up this information. The member needs to clarify the question so I am able to provide the information she requires.
http://www.parliament.nz/en-NZ/PB/Business/QWA/0/e/5/QWA_08420_2010-8420-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8421 (2010). Lynne Pillay to the Minister for ACC: How many case of sexual abuse reported in 2009, by region and gender, have received support from the Sensitive Claims Unit?
Hon Dr Nick Smith (Minister for ACC) replied: ACC does not record data on the number of reported cases where people “received support”. Data is kept on claims lodged by month and region but this is significantly less than the number receiving support. Data is also kept on total expenditure. Data is not collated from individual claim files on how much or how frequent contact they have had from health professionals or ACC and it would be a huge job to add up this information. The member needs to clarify the question so I am able to provide the information she requires.
http://www.parliament.nz/en-NZ/PB/Business/QWA/7/7/6/QWA_08421_2010-8421-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8423 (2010). Lynne Pillay to the Minister for ACC: How many case of sexual abuse reported in 2010, by region and gender, have received support from the Sensitive Claims Unit?
Hon Dr Nick Smith (Minister for ACC) replied: ACC does not record data on the number of reported cases where people “received support”. Data is kept on claims lodged by month and region but this is significantly less than the number receiving support. Data is also kept on total expenditure. Data is not collated from individual claim files on how much or how frequent contact they have had from health professionals or ACC and it would be a huge job to add up this information. The member needs to clarify the question so I am able to provide the information she requires.
http://www.parliament.nz/en-NZ/PB/Business/QWA/5/c/9/QWA_08423_2010-8423-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8424 (2010). Lynne Pillay to the Minister for ACC: In 2008 what was the average payout by the Sensitive Claims Unit, by month and region?
Hon Dr Nick Smith (Minister for ACC) replied: For the purpose of this question, ‘average payout’ per month has been defined as the average total expenditure per month per sensitive claim. This figure covers all payments for a claim, including medical fees, counselling, weekly compensation, lump sums and independence allowances. I refer the Member to the attached table, which shows the average amount spent on a sensitive claim for each month in 2008 by region. This information is for all sensitive claims, regardless of when the claim was lodged. It also includes payments made for declined claims, such as cover determination sessions.
http://www.parliament.nz/en-NZ/PB/Business/QWA/4/f/8/QWA_08424_2010-8424-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8425 (2010). Lynne Pillay to the Minister for ACC: In 2009 what was the average payout by the Sensitive Claims Unit, by month and region?
Hon Dr Nick Smith (Minister for ACC) replied: For the purpose of this question, ‘average payout’ per month has been defined as the average total expenditure per month per sensitive claim. This figure covers all payments for a claim, including medical fees, counselling, weekly compensation, lump sums and independence allowances. I refer the Member to the attached table, which shows the average amount spent on a sensitive claim in each month of 2009 by region. This information is for all sensitive claims regardless of when the claim was lodged. It also includes payments made for declined claims, such as cover determination sessions.
http://www.parliament.nz/en-NZ/PB/Business/QWA/9/3/e/QWA_08425_2010-8425-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8426 (2010). Lynne Pillay to the Minister for ACC: In 2010 what is the average payout by the Sensitive Claims Unit, by month and region?
Hon Dr Nick Smith (Minister for ACC) replied: For the purpose of this question, ‘average payout’ per month has been defined as the average total expenditure per month per sensitive claim. This figure covers all payments for a claim, including medical fees, counselling, weekly compensation, lump sums and independence allowances. I refer the Member to the attached table, which shows the average amount spent on a sensitive claim for each month in 2010 (up to and including April) by region. This information is for all sensitive claims, regardless of when the claim was lodged. It also includes payments made for declined claims, such as cover determination sessions.
http://www.parliament.nz/en-NZ/PB/Business/QWA/0/0/0/QWA_08426_2010-8426-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8427 (2010). Lynne Pillay to the Minister for ACC: How many sensitive claims were lodged, and how many did ACC approve and decline in March and April 2010, by region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached table which shows the number of claims lodged, those awaiting necessary information, those under assessment by ACC, the numbers declined, the numbers approved, and the duplicate claims. I urge caution in presenting the data, because the request is so soon after the period concerned most applications are awaiting further information.
http://www.parliament.nz/en-NZ/PB/Business/QWA/2/f/5/QWA_08427_2010-8427-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8428 (2010). Lynne Pillay to the Minister for ACC: What committees, taskforces, or other work groups, if any, has he or his officials established since 15 March 2010, relating to sensitive claims?
Hon Dr Nick Smith (Minister for ACC) replied: I have launched an independent clinical review to investigate the way ACC manages sensitive claims. The panel is chaired by Dr Barbara Disley and the members are Clive Banks, Ruth Herbert and Professor Graham Mellsop. The panel is expected to have completed the review by the end of July 2010. In addition, ACC facilitated a workshop for the Sensitive Claims Advisory Group and others to consider whether any gaps have arisen following implementation of the Clinical Pathway.
http://www.parliament.nz/en-NZ/PB/Business/QWA/e/4/b/QWA_08428_2010-8428-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8429 (2010). Lynne Pillay to the Minister for ACC: What, if any, written reports relating to sensitive claims has he received since 15 March 2010, by date and title?
Hon Dr Nick Smith (Minister for ACC) replied: The Member has other, more appropriate, avenues to request such information.
http://www.parliament.nz/en-NZ/PB/Business/QWA/6/7/b/QWA_08429_2010-8429-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8430 (2010). Lynne Pillay to the Minister for ACC: How many Sensitive Claims have been sent for review, by region, since 1 January 2010?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the member to the attached table which shows the number of sensitive claims referred to Dispute Resolution Services Limited (DRSL) from 1 January to 30 April 2010, by region. Please note that only 29 of the 96 sensitive claims referred to DRSL during this time period were to review a cover decision.
http://www.parliament.nz/en-NZ/PB/Business/QWA/3/0/a/QWA_08430_2010-8430-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

8431 (2010). Lynne Pillay to the Minister for ACC: What is the average length of time it has taken ACC to determine whether to accept or decline a sensitive claim since 1 January 2010?
Hon Dr Nick Smith (Minister for ACC) replied: For new sensitive claims lodged in the period from 01 January 2010 to 30 April 2010 that have been either accepted or declined as at 01 May 2010, it has taken ACC an average of 24 calendar days to make a decision.
http://www.parliament.nz/en-NZ/PB/Business/QWA/0/0/6/QWA_08431_2010-8431-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Key should reprimand Smith for eavesdropping

A press release from the Labour Party by Lynne Pillay

Prime Minister John Key should reprimand ACC Minister Nick Smith for his attempts to bully sexual abuse survivor Louise Nicholas, Labour’s Victims Rights spokesperson Lynne Pillay says.
“Dr Smith today initially denied having bullied Louise Nicholas when she sought to make a time to meet with him to give him t-shirts detailing the abuse members the Courageous Women’s group had suffered and their concerns about the National Government-introduced ACC guidelines,” Lynne Pillay said.
“Bizarrely, after having denied bullying Ms Nicholas, Dr Smith then tabled an email which clearly showed that he had allowed staff members to listen in on his private conversation, and that staff members had then emailed John Key’s office about the phone call. Louise Nicholas has confirmed Dr Smith never informed her he was allowing staff members to listen in on the phone call and that she was indeed bullied.
“Why were staff members from John Key and Nick Smith’s office having email conversations about the phone call that was made to Louise Nicholas if there was no problem? It is simply unacceptable for Nick Smith to contact someone about concerns they have on sexual abuse guidelines and secretly allow other people to listen in. This is disgraceful.
“National’s guidelines on sexual abuse have resulted in a rapid increase in the number of sexual abuse survivors being denied counselling support by ACC. The Minister has consistently refused to acknowledge the problem and now he is bullying people who legitimately try and raise concerns with him.
“Labour calls on John Key to take action against Dr Smith and his unacceptable behaviour,” Lynne Pillay said.

http://www.scoop.co.nz/stories/PA1005/S00117.htm

ACC changes 'hurt sex abuse victims'

An article from the Marlborough Express by Penny Wardle

ACC rule changes have shut down help for sexual abuse victims in Marlborough, say Blenheim counsellors.
Sexual abuse referrals have completely dried up for Bread of Life counsellor Lorraine Moffat, who until last October was seeing about 50 victims a year.
Blenheim counsellor Lizzie Fulton has seen her sexual abuse workload drop from about two inquiries a week to nil.
Ms Fulton said that without counselling, sexual abuse victims were likely to become more unwell and less able to cope with everyday life.
"ACC might be saving money but there will be a cost to the health system and employment and society in drinking, drugs and petty crime," she said.
Women's Refuge manager Rachel Black said that since the changes, the service had been supporting more women who had been sexually abused, but could not offer counselling because staff were not qualified.
Victims were referred to approved counsellors, who were paid using alternative government funding when possible, "but eventually we might have to dip into our own funds".
"I believe Government is trying to push funding for sexual abuse on to the community," said Mrs Black.
Ms Fulton said that since October, ACC-funded counselling required a professional psychologist or psychiatrist's diagnosis of mental injury, such as depression or post-traumatic stress disorder, directly caused by sexual abuse. Previously, counsellors had been able to make that call.
"The purpose seems to be to shift the blame from sexual abuse to something else in the person's life, such as family circumstances, then refuse counselling."
Referral now took months, when previously, sessions started straight away. "I heard yesterday that a woman who has been waiting seven months to hear whether she will get counselling has been told that she had been allocated 10 sessions with an unnamed counsellor who would contact her. Ten sessions is not enough. It takes four, even five sessions to develop a rapport and comfortable counselling environment."
Not only women, but also children who had found the courage to speak up about sexual abuse "will have to go on dealing with the pain and the extra shame that they have talked to someone but weren't important enough to get help", she said.
Maata Waka advocate Vonda Walker described ACC's new process as "unethical and extremely harmful to survivors of sexual violence, their families and the community". Depression, self-harm, anxiety, impaired memory and even suicide could be the result.
"Victims have often told their story many times to people like police officers and hospital staff," she said. The added layer of a psychologist or psychiatrist's assessment meant going through painful memories one more time.
ACC figures released last week show that since October last year, 90 per cent of people making ACC claims for sexual abuse counselling have either been refused cover or left waiting for a decision.
Cases approved for sexual abuse counselling by ACC were down from 472 in the first two months of last year to 32 in the same period this year.
As a result, ACC Minister Nick Smith announced that ACC-subsidised counselling rules would be reviewed by a four-person panel chaired by former mental health commissioner Dr Barbara Disley.

http://www.stuff.co.nz/marlborough-express/news/3664370/ACC-changes-hurt-sex-abuse-victims

Nicholas accuses Minister of bullying

A news report from TVNZ

A pile of t-shirts has become the source of a stoush between sexual abuse survivors and the ACC Minister, who the high profile anti-abuse advocate Louise Nicholas has accused of bullying. Nicholas wanted to present the shirts expressing concerns about counselling cuts to Nick Smith. But he turned her down in a phone call she claims was bullying and intimidating, something he denies.
Labour deputy leader Annette King read a message high-profile anti-rape advocate Louise Nicholas had hoped to deliver in person to Smith, along with 33 other messages written on t-shirts by abuse survivors.
"'I was raped. Now I have to fight ACC for counselling. When do I get to stop fighting?' Well, that's a pretty powerful message," says King.
But he turned Nicholas down in a phone call which she says was bullying and intimidating.
"For myself who has actually gone through, you know, bullies before, it was like being re-victimised all over again. It was this power and control attitude that came through," says Nicholas.
Labour took her cause to the house and tackled the Minister about the phone call, "berating and bullying her, saying the courageous women who signed t-shirts were part of a fiasco and a media circus," said King.
Smith firmly denied King's claims. "I totally reject the assertions that the member has made," he said. The Minister confirms he made the comments described. But staff who listened in on the conversation say in no way was he bullying, angry or aggressive.
Nicholas, who has had plenty of battles in the past, sees it differently. "I was saddened and I was frustrated that I was unable to do my job which is survivor advocate," she says. She says she is still hoping to get the Minister to listen to the voices of victims.

http://tvnz.co.nz/politics-news/nicholas-accuses-minister-bullying-3530160

Labour accuses ACC minister of bullying woman

A report from Radio New Zealand News

ACC Minister Nick Smith has been accused of bullying a woman who is protesting the Accident Compensation Corporation's policy on funding of counselling for sexual abuse victims.
The Labour Party questioned Dr Smith in Parliament on Thursday about the policy introduced last year which restricts counselling to those who suffer from a diagnosed mental injury.
Labour says it means many sexual abuse victims are not getting help and many are suicidal.
Dr Smith last week announced a review to assess the impact of the policy change.
In Parliament, Labour's deputy leader Annette King asked Dr Smith why he telephoned Louise Nicholas, who was at the centre of the police rape investigations and who is protesting the policy, "berating and bullying 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," she told the House.
Dr Smith rejects Ms King's assertion, but says it was appropriate to direct Ms Nicholas to the review.

Copyright © 2010 Radio New Zealand

http://www.radionz.co.nz/news/stories/2010/05/06/12480387c4b0

Parliament takes on clothesline look

An article from the Associated Press

Parliament briefly resembled a backyard clothesline today, when Labour MPs held up row after row of T-shirts in a bid to highlight the plight of sexual abuse victims. On the T-shirts were written the stories of the former owners, members of Courageous Women, a group for survivors of sexual abuse. The group had offered the shirts to ACC Minister Nick Smith, but he had so far refused to take them, a spokeswoman for Labour Party deputy leader Annette King told NZPA.
Dr Smith has overseen changes to clinical guidelines as to the amount of sexual abuse counselling ACC will fund. Courageous Women oppose the changes.
The T-shirts were raised in unison by the Labour MPs, after Ms King had quizzed Dr Smith on his refusal to meet a Courageous Women member this week. Ms King said Dr Smith had phoned one of the sexual assault victims this week "berating and bullying her" and calling the T-shirts a "fiasco and media circus".
Dr Smith said he totally rejected that. The woman had phoned his office several times requesting a meeting, then said if he did not respond she would go to radio news. He said he had told her an independent clinical review panel of skilled clinicians set up to investigate if ACC was properly meeting its legal responsibilities to sexual abuse victims was the appropriate place to address her concerns.
After Dr Smith answered the T-shirts were raised in rows. Speaker Lockwood Smith was unimpressed, saying the shirts were to be removed immediately, or the MPs would be told to leave the debating chamber. Standing orders said only MPs who were speaking could use visual aids, he said.
Labour MP Lynne Pillay said some sexual abuse victims were suicidal, and by the time the review reported it could be too late for them.

http://nz.news.yahoo.com/a/-/top-stories/7184986/parliament-takes-on-clothesline-look/

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.
http://www.scoop.co.nz/stories/PA1005/S00119.htm

Compo changes shock

An article from the Waikato Times by Maryanne Twentyman

An international expert on sexual abuse recovery is shocked by new ACC guidelines that require victims to be diagnosed with a mental injury to be eligible for compensation.
American Mike Lew is a world renowned psychotherapist from Boston who was in Hamilton today leading a workshop for health professionals who work with male survivors of sexual abuse. He said New Zealand's compensation system was once a world leader.
"I travel the world taking these types of workshops and ACC's enlightened stance on sexual abuse survivors was pioneering in how it supported survivors, which in turn facilitated positive growth and healing," Mr Lew said.
But ACC's new criteria were a "real tragedy that would cause tremendous suffering," he said.
It also angers Male Survivors of Sexual Abuse Trust (MSSAT) national manager Ken Clearwater.
"I have been to international workshops with Mike (Lew) and people were blown away by ACC's stance in the past – but now the Government is getting it all wrong and my major concern is that Nick Smith and the prime minister have been given misleading information in terms of clinical pathways," Mr Clearwater said.
More than 80 doctors, psychologists, psychiatrists and counsellors were taking part in today's workshop at Hamilton Gardens, where Mr Lew hopes to change attitudes about the way male survivors are supported by all health professionals.
"A lot of the pioneering work done on sexual abuse recovery was mainly by women for women – but we need to look at new models and recognise the different needs of males," Mr Lew said.
One in six males is thought to have suffered some form of sexual abuse including child sexual abuse, rape, physical violence, emotional abuse and neglect.
Mr Lew said there was a lot of "misinformation, fear and shame about what disclosure would mean" for male survivors. "People wrongly believe a boy that's abused grows up to be an abuser – but that is not true.
"Most of them grow up to be protectors, it's a small minority that go the other way" he said.
While Mr Lew works with both men and women who have been abused, he said males found it much harder to come forward.
"It's important to emphasise the strengths of male socialisation and not try and fit men into a model that doesn't fit," he said.
It was important for health professionals to create respect and safety for clients.
"After that survivors themselves can go on to do extraordinary work. I think it's important to remember that for both males and females recovery is real – all of the work they do does pay off and life does get better," he said.

http://www.stuff.co.nz/waikato-times/news/3659195/Compo-changes-shock

Disarray in Bay’s sex abuse service

An article from New Zealand Doctor magazine by Lucy Ratcliffe

Seven months of negotiations have failed to bring agreement on who will deliver a new model of sexual abuse assessment and treatment in the Bay of Plenty.
Western Bay of Plenty PHO has pulled out of contract negotiations for the ACC-funded Sexual Abuse Assessment and Treatment Services, or SAATS, because concerns couldn't be allayed. Bay of Plenty DHB isn't impressed. "The PHO's decision has resulted in seven months of lost time and is very disappointing," DHB chief executive Phil Cammish writes in a report to his board.
What's more, other PHOs are unlikely to step up because of capacity and capability issues, Mr Cammish says.
Western Bay of Plenty PHO chief executive Roger Taylor says contract negotiations ceased mainly because of the DHB's reluctance to provide an appropriate facility to undertake the assessments in Whakatane, and contract terms relating to management fees and fee-for-service.
The contract's draft terms included an "exceedingly poor" management fee, and in response to that, Mr Taylor says, it was stated clearly in the fee-for-service component that any savings made during delivery of the programme could be thought of as a management fee top-up and retained by the PHO.
Mr Taylor says the PHO wanted absolute clarity about what the money could be used for.
There were also clinician concerns about a different ACC issue - the new clinical pathway for sensitive claims.
The new pathway, begun last October, was designed to tighten controls over sexual abuse claims. Changes included a new requirement for a DSM-IV diagnosis in order to access ACC-funded therapy.
The organisation Doctors for Sexual Abuse Care says this has removed the ability of many individuals to access timely psychological support.
The PHO agrees.
Mr Taylor says: "At a time when we are endeavouring to grow the number of doctors and nurses involved [in this service], the uncertainty and concern make them think twice."
ACC's programme manager for SAATS, Kendra Sanders, says she was not told of concerns about the new clinical pathway.
The pathway and SAATS are two separate matters; the pathway deals with mental injury and SAATS deals with physical assessment.
The SAATS contract replaces what was previously known as the DSAC contract held and delivered by doctors trained by the DSAC organisation.
It is intended SAATS will continue to be delivered by DSAC-trained doctors or clinicians with appropriate training as the contracts are finalised and rolled out nationwide. Fourteen DHBs have finalised their contracts so far.
Ms Sanders says the new SAATS model was developed by ACC, the Ministry of Health and police after the DSAC workforce came near crisis point in 2006.
ACC's manager of treatment and rehabilitation services, Phil Wysocki, says SAATS is designed to be a more comprehensive model of care allowing consistent coverage across the country.
The SAATS contract is now held by DHBs, which contract providers to run the service.
DSAC national manager Hayley Samuel says this is the first the organisation has heard of clinician concerns about the clinical pathway interfering with the SAATS contract negotiations.
Bay of Plenty GP and DSAC coordinator Jillian Caisley was not aware of the concerns either, but Mr Taylor maintains there are clinicians not yet involved in delivering a service, for whom such concerns preclude involvement.
"The DHB is aware of our position and dialogue continues to occur," he says.
The DHB declined a request for an interview on the matter.
In a written statement, Grant Pollard, acting general manager of planning and funding, says the DHB is in discussions with another provider.
Meanwhile, as New Zealand Doctor went to print, ACC minister Nick Smith announced the new pathway would undergo an independent clinical review, with a report due back in July.

http://www.nzdoctor.co.nz/in-print/2010/may-2010/05-may-2010/disarray-in-bay%E2%80%99s-sex-abuse-service.aspx

Support agencies 'near collapse'

An article from the Taranaki Daily News by Lyn Humphreys

Support agencies for the sexually abused are within months of collapse after ACC rejected up to 90 per cent of claims in the last six months, says national rape crisis advocate, Dr Kim McGregor.
"It's a critical situation. Because of the impact [of the new clinical pathways] put in place in October, it has almost destroyed our sector," Dr McGregor said.
The New Plymouth Safer Centre is an exception however, with management saying the bulk of its work comes through work from other agencies.
Dr McGregor heads Rape Prevention Education, in Auckland, and is a member of the Taskforce for Action on Sexual Violence.
She and New Plymouth advocate Bob Stevens are battling to get justice for those they believe have been abandoned by ACC. ACC's figures released last week show that since October last year 90 per cent of people making ACC claims for sexual abuse counselling have either been refused cover or have been left waiting for a decision.
As a result, ACC Minister Nick Smith last week announced an independent review of ACC's new management of sexual abuse claims.
For six months, ACC assessors have required that claimants are diagnosed with mental illnesses which can be proved to be directly attributed to the abuse.
But Dr McGregor said the independent review would not be completed until July which was too late for some.
"The fact is, many survivors are suicidal and there was no alternative put in place," Dr McGregor said.
One Auckland woman had died since she was declined counselling, Dr McGregor said.
Safer Centre manager Lynne McKenzie-Brown, of New Plymouth, said Safer's funding had been greatly reduced by the new ACC regime but they would continue to work hard at finding alternative funding for those denied cover.
The ACC process was particularly unsuited for children for whom the review should be made urgent, she said.
The centre's major concern was that some who had been sexually abused were not coming forward for help because of the negative publicity.
The message for these people was to ensure they did get assistance, either from their GP, Victim Support or the Safer Centre. "Don't give up," Ms McKenzie-Brown said.
Dr McGregor said most of the 600 registered private practitioners in New Zealand, had been forced to find other work. This had left only about 30 specialist sexual assault support agencies, such as Taranaki's Safer Families Centre, which were still employing registered ACC counsellors.
Unless there was a major injection of funding into these specialist services they too would be lost in the next few months, Dr McGregor said.
ACC had estimated that their changes would mean $5 million of the $20m paid out to claimants each year would be saved.
However, Dr McGregor praised the Government's move to support the recommendations from the Taskforce for Action on Sexual Violence. "It was fabulous news for us."
Minister of Justice Simon Power has promised $1m over the next two years for sexual violence prevention education programmes. In addition, abuse survivor advocate Louise Nicholas was given continued funding for her role working across government agencies for the next three years.

http://www.stuff.co.nz/taranaki-daily-news/news/3653089/Support-agencies-near-collapse

Sensitive claims

An editorial from the Otago Daily Times

Unless it is a statistical blip, evidence points to procedures within ACC's Sensitive Claims Unit having radically altered.
Figures show 32 sexual-abuse claims for counselling were approved in the first two months this year, compared with 472 in January and February 2009.
That is not far off a tenfold decrease.
And, on Monday last week, ACC Minister Nick Smith announced the way the corporation managed the claims of sexual-abuse victims was to be reconsidered.
To this end, he named a panel to undertake a "clinical review to ensure best possible practice in this sensitive area".
It is, of course, possible that the figures for 2009 were uncharacteristically high, or perhaps amplified in some way shape or form, but - much as it would be desirable - it is almost impossible that a dramatic fall-off in actual instances of sexual abuse a year later could account for such a wide discrepancy.
The conclusion must be that changes to the way in which ACC handles such claims, introduced in October last year by Dr Smith, have been responsible for the drop.
On the one hand, this will undoubtedly be helping to meet the savings of which the minister has made something of a mantra; on the other, it could mean that the changes have been "overcooked", laying the minister open to charges of callousness and injustice.
Labour's ACC spokesman, David Parker, was quick to oblige in this respect, saying that Dr Smith had "failed victims of sexual crimes".
Dr Smith firmly rejects a fiscal motive, insisting that the changes were never about "cost savings" and that he has "repeatedly stressed to the corporation that the focus must be on delivering to victims of sexual abuse or assault . . . the best help available to achieve a timely and successful recovery."
This much is politics.
In fact, it appears the guidelines were developed and launched in March 2008 under the previous Labour-led government.
What is less clear is the extent to which these were then altered or finessed under Dr Smith's purview.
Regardless, there were certainly warnings from the counselling professions before the introduction of the changes last year that they were poorly conceived and potentially dangerous to victims.
Notwithstanding an inevitable degree of self-interest in such protestations, valid points were made at this time.
Among these was perhaps the critical intervention that every client have a psychiatric diagnosis to determine "mental injury" and thus eligibility for ACC-funded counselling.
There are, of course, victims who might struggle and require help in the aftermath of sexual abuse who do not show the precise symptoms of recognised psychiatric diagnoses such as depression, anxiety disorders or post-traumatic stress disorder who might previously have qualified but who under the new regime now do not.
This will be a profitable area of study for Dr Smith's new panel, which will want to establish guidelines that strike a balance between a necessary degree of rigour in assessing the validity of claims but also make sure that genuine cases receive appropriate care.
The announcement of the review comes on the heels of publicity concerning the possible privatisation of some ACC provisions - a motive long ascribed to the Government by its critics, who suggest that any such move would be to the benefit of the mainly Australian insurance companies likely to be involved, and to the detriment of ordinary citizens, particularly the elderly, who tend to claim most and be hit hardest by age-related premium increases.
These are familiar objections and pay little heed to the constant necessity to find new ways of managing the burgeoning costs of ACC.
There is nothing wrong with private provision in and of itself - indeed it should be looked into - as long as it can be shown that it works to the benefit of New Zealanders.
Following an interim report by the ACC Stocktake Steering Group on such matters, Dr Smith may now have such evidence.
If that is the case, he is in a position to silence critics by sharing it with the employers, taxpayers and wage-earners of the country for whom the system is ultimately designed.

http://www.odt.co.nz/opinion/editorial/104370/sensitive-claims

2PRFSECU4HPH

Question for written answer

7214 (2010). Lynne Pillay to the Minister for ACC: What was the total cost of sexual abuse counselling provided in each calendar month of 2008 and 2009 and 2010, by region?
Hon Dr Nick Smith (Minister for ACC) replied: I refer the Member to the attached tables, which show net amounts paid for counselling for sensitive claims clients by month, broken down by the region where the event occurred, for the 2008 and 2009 calendar years, and for the 2010 year up to March. Please note that counselling costs include cover determination services, Psychological and Psychiatric services and assessments, and other related assessments. These costs represent only part of the expenditure for clients with sensitive claims.
http://www.parliament.nz/en-NZ/PB/Business/QWA/1/5/5/QWA_07214_2010-7214-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Sexual abuse survivors to challenge ACC changes

An article from the New Zealand Herald by Elizabeth Binning

A group of sexual abuse survivors plan to send Accident Compensation Minister Nick Smith a strong message this week through a silent protest over changes to subsidised counselling which they say are putting lives at risk.
One of the women, who was subjected to years of abuse by her then boyfriend, said counselling had been a lifeline, allowing her to start living her life again.
But with that lifeline now under threat following changes to ACC funding for sexual abuse victims, the woman is struggling and slipping back into a depression it had taken years to break out of.
"I can't go to see my counsellor at the moment because I can't afford to pay," said the young woman, who has been told she will have to wait until her case is reviewed before ACC decides whether she is entitled to any more counselling.
"I really do need to see her to ground myself and get some perspective, but it hasn't happened for three weeks ... Now it's too much - I'm crumbling."
The woman, a member of a group called Courageous Women, is one of dozens who will this week make their views and struggles known in a silent protest during Rape Awareness Week.
The members have all signed and written messages on T-shirts which will be taken to Wellington and given to Dr Smith by anti-rape advocate Louise Nicholas. Some of the women outline in their messages what counselling means to them and how the changes will affect them.
The new rules stipulate ACC-subsidised counselling is only for victims with a diagnosed mental condition caused by sexual abuse, and is generally for 16 weeks, subject to further review.
Another victim joining the silent protest is the Pukekohe woman who was subjected to a 4-hour sex attack when Roger Kahui invaded her home.
She said counselling had helped her through her darkest times, especially the court trial in which she not only had to be in the same room as her attacker again, but relive everything he had done to her.
She said that at times she was so depressed she had considered driving her car into the median barrier to end it all, but counselling had helped her get through the process.
She said it was unfair the new system would not make things so easy for future victims.
"What bugs me more than anything is these guys who did this are in prison getting 'rehabilitation'. Here we are having to beg to get counselling. It's so unfair."
The woman said sexual abuse victims were not like others who were able to protest in public. Many struggled even to get out of their homes following their ordeals. A silent protest was, however, one way of getting their message across.
Courageous Women facilitator Tania Blomfield said her role had significantly changed since the impact of the ACC changes started filtering down.
"I now spend a lot of time each month providing crisis support to group members who are not coping, who are self-harming or who are suicidal. This sort of crisis situation was previously dealt with by their counsellors."
The Herald revealed last week how a South Auckland mother died four days after her claim for ACC-funded counselling was rejected on the grounds that she had not suffered "a significant mental injury".
Dr Smith announced at the time that there would be a review of the new rules.

http://www.nzherald.co.nz/politics/news/article.cfm?c_id=280&objectid=10642370&pnum=0

ACC denies subsidisation of counselling for rape victims due to lack of “mental injury”

An article from Nexus by Hollie Jackson

The new rules regarding ACC-subsidised sexual abuse counselling has hit rape victims hard across the country. Now, in order to acquire funding for counselling, the victim must first be diagnosed with a mental condition caused by sexual abuse.
In February this year, a South Auckland mother of three died four days after her submission for ACC-subsidised counselling was denied. She had applied for help six months beforehand for sexual abuse she had suffered as a child, but was denied because she had not suffered “a significant mental injury”. She had reportedly suffered from suicidal tendencies and self-inflicted harm due to the sexual abuse.
Another victim, a 15 year old girl, is still awaiting a decision on her claim for counselling after she was raped over Christmas. The Association of Counsellors' representative on the ACC's sensitive claims advisory group, Elayne Johnston, said the girl hadn’t received counselling because ACC required her to be assessed by a psychologist to see whether she had suffered “a mental injury”.
ACC Minister Nick Smith announced last Monday that the new rules will be reviewed by a four person panel for efficiency. According to Dr Kim McGregor, the co-chair of the national sexual violence network, the four person panel fails to include any one of their “specialist experts that work day to day with survivors of sexual violence”.
Approved submissions for ACC-subsidised sexual abuse counselling has gone down from 472 in the first two months of last year to only 32 in the same period this year. Dr McGregor said almost all of the 600 to 700 private counsellors who were registered for ACC-funded work had also stopped taking applicants for ACC subsidies because of an ethical objection to labelling assault victims as mentally ill.

http://www.nexusmag.co.nz/news/acc-denies-subsidisation-counselling-rape-victims-due-lack-%E2%80%9Cmental-injury%E2%80%9D