ACC appeals overloaded

An article from the Otago Daily Times by John Gibb

Critics say the ACC appeals system is threatening to burst at the seams, with review applications soaring to 9900 during the past year and 1446 cases stacked up at the district court.
Dunedin ACC campaigner Denise Powell and city lawyer Peter Sara, who has been handling ACC cases for more than 30 years, are urging a rethink of the way ACC is operating. An excessive emphasis on cost cutting and excluding many such claimants from coverage was causing the upsurge in reviews and appeals, Mr Sara told the Otago Daily Times.
The Green Party recently called for an independent review of changes made to ACC by the Government during the past two years, after a review of controversial changes to ACC's sexual abuse assessment procedures highlighted major flaws.
But ACC claims management acting general manager Mike Tully said he found it "hard to imagine how ACC could be too focused on cost containment when we have a $10.3 billion deficit to contend with."
"The fact is that the future of the ACC scheme was in jeopardy and some difficult decisions were necessary," Mr Tully said. An increase in reviews and appeals was "to be expected given our much tighter focus on applying our legislation properly".
"We also recognise that the benefits of being on ACC are considerable, especially if time off work is required, so we expect that people will do whatever they can to get on to ACC.
"What's important is that over the last couple of years the proportion of reviews and appeals upheld in ACC's favour has remained relatively steady in most areas, at about 75%." ACC decision-making processes were "fair and robust", he said.
Long-term ACC claimant numbers dropped from 15,271 to about 12,500 during the 2009-10 financial year, and ACC plans to cut at least 1150 more clients from its long-term claimant list by the middle of next year. Applications for reviews of ACC claim decisions had earlier risen from 6256 to 8160 over the 2008-09 financial year, a parliamentary report noted.
Officials at Disputes Resolution Services Ltd (DRSL), an ACC subsidiary which operates independently of ACC, said 9900 applications for review had been lodged with it in the 12 months to June 30 this year. A total of 9430 reviews were also completed or withdrawn over that period.
Ministry of Justice tribunals national manager Wayne Newall noted that if claimants were "unhappy" about an ACC claim, the first step was for ACC to review the decision, including through DRSL. If people were still not satisfied, they could apply to the Accident Compensation Appeals District Court Registry to further review the decision. The registry hears claims against decisions by DRSL, and district court judges deal with the appeals. The judges decided 236 cases last year, and 625 new cases were lodged. Of the 1446 "live" appeal cases before the court, 115 originated in Dunedin, Mr Newall said.
Denise Powell, who is the president of Acclaim Otago, an ACC claimant support group, said the appeal system was "getting so overloaded that it could burst at the seams".
"There must be a point at which they say, whether the courts say, or ACC says, something's wrong and if this continues we just can't keep up with the number of reviews and appeals that are coming through."

© Allied Press Limited 2010
http://www.odt.co.nz/news/dunedin/128144/acc-appeals-overloaded

ACC's flawed review

A letter to the editor of the Dominion Post by Gordon Waugh

No wonder the report by the independent panel reviewing ACC sexual abuse claim procedures has been kept quiet.
The panel relied heavily on emotive sex abuse industry anecdotes, myths and misinformation.
It ignored good science and the interests of taxpayers who pay for ACC sex abuse claims.
It recommends a diluted, weakened and more costly process. Instead, the need is for fairness, healthy scepticism and robustness.
The panel made much of the supposed causal link between sexual abuse and mental injury. I understand no sexual abuse syndrome exists because there is no scientific evidence that sexual abuse causes any specific psychiatric, psychological or behavioural condition.
Disdaining such elementary science, the panel relied on the Massey Guidelines, which claim more than 700 symptoms or indicators of sexual abuse have been identified. That covers almost every human behaviour.
The panel accepted sex abuse industry myths that most victims never disclose their abuse, and only 9 per cent of sexual offences were reported to police. It is impossible to know about undisclosed or unreported events. The panel failed to apply critical thinking. It was a deplorable waste of our resources.

http://www.stuff.co.nz/dominion-post/opinion/letters-to-the-editor/4158659/Letter-ACCs-flawed-review

Question to Minister: ACC

Hon DAVID PARKER (Labour) to the Minister for ACC: Does his recent admission that ACC has handled the issue of counselling for sexual abuse victims badly give him cause to question whether ACC has also treated victims of hearing loss badly?
Hon Dr NICK SMITH (Minister for ACC) : No. The issue of sensitive claims was about best clinical practice, and with the assistance of the independent clinical reviews supported by the Accident Compensation Corporation (ACC), it has resulted in a good outcome. The issue of hearing loss is about policy and regulation, and arises from a Cabinet decision last year that ACC should, as per its legislation, be responsible only for injury-related hearing loss and not for that caused by other factors such as age. In short, age is not an accident.
Hon David Parker: Does the Minister still assert that he had no responsibility, nor blame properly attached to him, for the mistakes made in relation to the withdrawal of accident compensation counselling for victims of sexual crimes; if so, why did we bother with question time where he was repeatedly warned about his folly?
Hon Dr NICK SMITH: Of course, I am responsible; I am the Minister for ACC. But my response to the issues that were raised was to seek an independent clinical review. Members opposite have been misleading when they have asserted that decisions made by clinicians were made by either me or Ministers in respect of sensitive claims.
Hon David Parker: Given the Minister’s earlier assertions that he relies on expert advice, why has he ignored the evidence from Professor Thorne and Dr Welch of the department of audiology at the University of Auckland who said: “The introduction of a percentage handicap threshold for NIHL [noise-induced hearing loss] appears to be a reaction to the cost of claims and is apparently not based on an understanding of the real NIHL situation in New Zealand.”?
Hon Dr NICK SMITH: The member is making reference to the ACC amendment legislation that introduced the 6 percent threshold. That decision was made finally by the Parliament but with my strong support as the Minister. I note that every workers’ compensation scheme in Australia has a threshold—
Grant Robertson: We’re in New Zealand.
Hon Dr NICK SMITH: Members opposite say that we are in New Zealand. Well, yes we are. But I also say that as a consequence of the multibillion-dollar losses that the previous Government passed on to us in the area of accident compensation, we have had to be very careful about ensuring cost-effectiveness of ACC’s expenditure.
Michael Woodhouse: What discussions has the Minister had with his colleague the Minister of Health to ensure that ACC’s systems properly respond to any changes to ensure that people are able to secure health support for any age-related hearing loss?
Hon Dr NICK SMITH: I have had very close discussions with the Minister of Health, and officials from our respective agencies have been working closely together. The current rule is that if any support for hearing loss is provided through the accident compensation scheme, then the claimant is ineligible for any support from the Ministry of Health. This has led people in the sector to assume a lack of any support from the Ministry of Health where a person has industrial hearing loss as well as age-related hearing loss. The Government is working through the options and considering the submissions that have been made. We are confident that we can come to an answer between ACC and the Ministry of Health that will be fair and will work for those who require hearing assistance.
Hon David Parker: Has the Minister seen the latest issue of the National Foundation for the Deaf’s magazine, which contains a report about people on whom his decisions are impacting, like Les Slattery, who is reported to have repaired chainsaws in the 1970s without earmuffs. If it were not for that job, he would not need hearing aids, but now at age 72 he faces cuts to his accident compensation cover for his work-related hearing loss.
Hon Dr NICK SMITH: Let me make the issue absolutely plain: ACC will meet its full obligations for hearing loss that has occurred as a consequence of industrial hearing loss. We have made that absolutely plain. As I have said, I am working closely with the Minister of Health to ensure that where a person has a mix of both industrial and age-related hearing loss, the total package is one that works well for New Zealanders.
Michael Woodhouse: Can the Minister confirm the facts of the audited accounts of ACC, which show losses of $7.2 billion in 2007 and 2008; if so, has he received any calls for a full and independent inquiry into those losses?
Hon Dr NICK SMITH: Yes. The audited ACC accounts show a loss of $2.4 billion in 2007-08 and $4.8 billion in 2008-09. This total of $7.2 billion exceeds that of the expected losses from all of the 61 failed finance companies. The cost of ACC’s loss to the public purse exceeds by a factor of 10 the cost of the deposit guarantees scheme. I have not received any calls from the Opposition for a full public inquiry into those losses, although I note that the inquiry into the failure to disclose the losses in the non-earners account shows that it was a breach of the Public Finance Act.
Hon David Parker: Why would older New Zealanders not see his refusal to provide proper accident compensation cover for work-related hearing loss as just part of National’s campaign to target elderly for cost-cutting, with other examples being cuts to home support, the National Falls Prevention Strategy, and orthopaedic operations for older workers who have suffered shoulder injuries?
Hon Dr NICK SMITH: This Government is very committed to providing proper support for older New Zealanders—for instance, tax changes will come into effect on 1 October, and the average superannuitant will be significantly better off with those changes. We need to look only at the biggest ever increase in elective surgery, which my colleague Tony Ryall has delivered, or at the very good work that my colleague John Carter is doing as the Minister for Senior Citizens, to realise that older New Zealanders are so much better off with the leadership from this Government.

http://www.parliament.nz/en-NZ/PB/Business/QOA/2/a/b/49HansQ_20100923_00000005-5-Accident-Compensation-Treatment-of-Hearing.htm

ACC independent review supports national outcry to stop pathway

An article from Te Whariki Tautoko by Ripeka August–Tampeau

Ka tangi te titi, ka tangi te kaka, ka tangi hoki ko au.
Kii mai koe ki ahau, he aha te mea nui o te ao?
Maku e kii atu he tangata, he tangata, he tangata.
(Author unknown)

You ask me “what is the most important thing in this world” and
I must reply “It is people, it is people, it is people”.

And that is exactly what the Independent Review Panel clearly concluded in their recommendations to the Minister of ACC, Nick Smith. The review concluded the pathway needed an urgent overhaul to its generic clinical pathway process to better support the needs of victims of sexual assault. ACC’s response was immediate with the introduction of the much needed counselling support sessions.
The review panel is also clear that immediate changes to the pathway are not possible. As a result ACC have supported the recommendations and started working with the Sensitive Claims Advisory Group (SCAG) to begin developing and implementing a new clinical pathway based on the recommendations.
The Independent Review panel addressed serious concerns to the poor response by ACC to Maori victims of sexual assault and their whanau. As a result of the clinical pathway many Maori counsellors refused to support this pathway further reducing the already under representation of ACC Maori counsellors. The damage of the clinical pathway was felt by many and was responded to by many. Recently, ACC general manager and SCAG members agreed to a separate working group to develop and implement a tikanga Maori pathway and this is to happen as soon as possible.  
Although Maori are happy that changes have begun, there is still the thought “will ACC follow through”. It is clear there is still further work for ACC to do and in consultation with Maori stakeholders to “get it right”.

http://www.tewharikitautoko.org.nz/portfolios/acc-scag

And now for the apology...?

A blog entry from Off The Couch by Kyle McDonald

I may be old fashioned, or conditioned by my profession to focus on “the relationship” but perhaps it’s now time for ACC to apologise.
In these times of “systemic failure,” independent reviews and Ministers who are unable (or unwilling) to take a position, there is still a lot to be said for a good old fashioned “sorry.” So what have ACC got to be sorry for?

Click here to read more.

SOSA response to ACC review

A press release from SOSA

The independent review panel proposed 14 recommendations to ACC’s clinical pathway. Whilst ACC are yet to agree on all recommendations, SOSA welcomed the immediate commencement of 16 counselling sessions granted to "new and/or existing claimants".
Ken Clearwater, SOSA board member who also spent two years as a member of TOAH-NNEST on the ACC Service Improvement Project in conjunction with Government for the Taskforce on Sexual Violence, is pleased “the Government has accepted that the clinical pathway was damaging and wants to make changes”.
SOSA President Gudrun Frerichs remains skeptical. “Although the report represents very well the concerns of survivors and mental health professionals, the recommendations formulated are quite vague and give ACC a lot of room to dodge the items.” Gudrun is concerned that whilst the recommendations are a step in the right direction, any improvement for survivors hinges on the independent supervisory panel [yet to be established] to interpret those recommendations. “It appears that ACC has actually not had a change of heart but is rather bowing down (reluctantly) to the pressure of the review panel.”
There is no disputing that the recommendations made by the panel are a positive step forward but concerns are being raised about just how or if ACC will implement any of the proposed changes. Given the report by the Otago Daily Times from Monday, 20 September, ACC plans to cut a further 1150 long term claimants from their list.
“We will continue to monitor the situation and maintain public pressure for all those recommendations to be implemented,” said Gudrun Frerichs.

http://www.scoop.co.nz/stories/GE1009/S00125/sosa-response-to-acc-review.htm

1150 to lose out in plans by ACC

An article from the Otago Daily Times by John Gibb

The Accident Compensation Corporation intends to cut at least 1150 more clients from its long-term claimants list by the middle of next year.
The company's Statement of Corporate Intent for 2010 to 2013, a copy of which has been obtained by the Otago Daily Times, reveals that those targeted include claimants receiving weekly compensation payments for a year, including "new" long-term claimants.
The latest projected cuts come on top of a big reduction - from 15,271 to about 12,500 - in long-term claimants during the 2009-10 financial year, and after recent controversy and criticism over the ACC's handling of claims involving sexual abuse.
ACC spokesman Laurie Edwards said that the "big picture" should be remembered over the reduction target, which should not be seen as a mainly economic issue. "It's a measure of how well we're doing in getting people back to their pre-injury lives," he said.
Individual circumstances were taken into account, and if claimants were unhappy with outcomes, they could use appeal mechanisms.
Denise Powell, president of Acclaim Otago, an ACC claimant support group, is worried about what she sees as the high human cost of further substantial cuts in long-term claimants.
Ms Powell told the ODT she was concerned about the effect on the mental health of claimants, of further attempts to remove them from weekly compensation support. "From talking to people, they're just worn out from having to battle [to retain compensation]," she said.
An earlier survey had shown some Acclaim group members had been badly depressed because of previous moves to "exit" them from ACC coverage, despite their serious injuries.
Ms Powell is also a member of ACC's Consumers' Outlook Group (COG), a national liaison group involving claimants and ACC senior management, and she plans to raise her concerns at the next COG meeting in Wellington on Friday.
A recent "fiasco" over handling of sexual abuse claims highlighted the need for ACC to avoid excessive cost-cutting and using simplistic criteria that did not take individual circumstances sufficiently into account.
Several of ACC's recent moves over work-related rehabilitation had been positive, including an emphasis on good early rehabilitation, through the Better at Work scheme. But, in the light of a critical independent review panel report on sensitive claims issues, released recently, ACC needed to take a "long hard look" at any future plans for further streamlining processes, such as in the rehabilitation area, to achieve spending cuts, she said.

© Allied Press Limited 2010
http://www.odt.co.nz/news/national/127150/1150-lose-out-plans-acc

ACC backdown welcomed

An article from the Manawatu Standard by Janine Rankin

Sexual abuse survivors denied help under tough new rules introduced last October can look forward to better services in future now that ACC has backed down on the changes. Palmerston North counsellor Paulette Berryman says she is battle-weary but elated that ACC has accepted a caning from an independent panel condemning its approach and forcing a back-down.
The New Zealand Christian Counsellors' Association representative on the sensitive claims group told the Manawatu Standard that the quality of help available for survivors could become better than ever once all of the panel's recommendations were put into place. She said her hard work in protesting against the changes, including taking two of her clients to Wellington to provide evidence about the harm the changes were causing, had paid off. "For almost a year we have been fighting, but it's been worthwhile, with positive changes for sexual abuse survivors," she said.
The review found that the changes, which required clients to gain a diagnosis of mental injury before they could get treatment, were introduced "prematurely and precipitously". The ACC changes had discouraged survivors from seeking help and caused a halving in the number of claims submitted in the first three months of the cuts. Delays were unacceptable and ACC's communications with sexual abuse survivors and providers had often been "inappropriate and inadequate". The panel recommended fast-tracking of the introduction of 16 sessions of support for new clients ahead of the full report's release last week.
Mrs Berryman said the 16-session scheme was a "welcome measure, in the right direction", but the response from potential clients had been low key. She remained concerned that people who could benefit still had not realised how easy it was to contact an ACC treatment provider directly to begin the healing process. Mrs Berryman is continuing her fight to ensure survivors of sexual abuse get the help they need, and is involved in consultation in how other recommendations can be implemented. These include recognising alternative ways for diagnosing mental injury, dealing with the particular needs of children, providing support for Maori and helping people with complex health needs.

http://www.stuff.co.nz/manawatu-standard/news/4142528/ACC-backdown-welcomed

The sensitive claims pathway for Maori

Erina Smith from Te Karere talks to counsellor Ripeka August-Tampeau and ACC's Denise Cosgrove

Maori healthworkers are overjoyed at the new recommendations that have been put to ACC regarding their sensitive claims pathway for sexual abuse victims. There is a Maori pathway to heal Maori victims of sexual abuse.
Ripeka August-Tampaeu: "The changes that we recommended have finally been addressed and now we're goign to get on and do something about it." This is a result of an independent review of the changes ACC made to their sensitive claims pathway for sexual abuse victims in order for them to receive help. "The recommendation that we put in was to have a separate pathway for Maori or an alternative pathway for Maori to have and out of that look at tamariki and rangatahi as well.  So we're looking at starting that as soon as possible."
Te Karere followed Ripeka August and other Maori sexual abuse workers in July when they put forward their submissions to the independent review panel. Their work has paid off. "We'll be bringing together a group of rangatira Maori within the field of sexual assault and rangatira Maori within te ao Maori to come together and develop a pathway."
ACC agree that action is required in some areas. Denise Cosgrove: "So we've done some really good work already with the sector on understanding their issues and concerns with the pathway and how we can make that and facilitate that process better for our clients." Despite the challenges of this job, the positive thing is that Maori now have the power to be able to build their own pathway to heal their own people.

© 2010 Television New Zealand Ltd
http://tvnz.co.nz/te-karere/2010-wednesday-video-1027496

Psychotherapists welcome review report

A press release from the NZAP by Kyle MacDonald

The New Zealand Association of Psychotherapists welcomes the Independent Review Panel´s report into the ACC´s failed new clinical pathway and its recommendations for changes.
"The report is clearly an indictment of both the intention and application of the change process ACC embarked on in October last year," says Kyle MacDonald, NZAP spokesperson. "It is validating for all clinicians and survivors that the review panel´s report echoes the concerns that we have had since the very first draft of this new pathway was released."
Most damning is the review panel´s view that "the Panel found no evidence of formal planning for implementation ... Evidence obtained from presentations and submissions was that implementation was poorly planned without adequate consideration of the impact on clients and the Pathway was introduced prematurely and precipitously." They further have grave concerns about the fact that ACC failed to follow rudimentary processes about change implementation required of State Services.
"The picture is one of grave incompetence, and New Zealanders deserve to now know how this was allowed to happen," says MacDonald.
Of most encouragement to clinicians and survivors will be the clear recommendation that ACC cease using the DSM-IV as the measure of a mental injury, and that the legal opinion obtained by the review panel states that ACC have "over-reached" in their interpretation of the law justifying this. Furthermore the review states that the higher level of proof of "causality" is not supported by the current common law.
"The key thing now is for ACC to quickly implement all the recommendations, and remove the unreasonable impediments to survivors wanting to access treatment. While some moves have been made in the right direction, we will wait and see how the actual implementation of these recommendations plays out over the net few months."

Question to Minister: ACC

Hon Annette King to the Minister for ACC: Is he satisfied with the performance of ACC?
Hon Dr Nick Smith (Minister for ACC): Generally, yes, I am very satisfied. The Accident Compensation Corporation (ACC) has made huge progress in reversing years of huge deficits, and has markedly improved rehabilitation rates. The one area that I am not satisfied with is sensitive claims, which make up 0.2 percent of claims. That is why I instigated an independent clinical review of ACC’s processes, and I am pleased with the way that ACC has responded to the clinical panel’s recommendations. [extract]

Hon Annette King: Has he seen the announcement from the National Foundation for the Deaf four days ago that ACC has also got wrong the criteria for workplace hearing injuries, and in light of the fact that it took over a year of clinical and public pressure before the Minister and ACC admitted that the had got wrong the criteria for sensitive claims for sexual abuse, will he listen to their clinicians before any more damage is done to those people who have been denied help?
Hon Dr Nick Smith: I have met with the Deaf Association and with the key associations with expertise in audiology. The key element that those organisations accept, which is the Government’s position, is that age is not an accident, and that it is not right that accident compensation pick up the cost of the very substantive bill associated with age-related hearing loss. That is not the function of the scheme. [extract]

http://www.scoop.co.nz/stories/PA1009/S00215.htm

About-turn on abuse

An article from the Taranaki Daily News by Lyn Humphreys

Taranaki campaigner for sexual abuse victims Bob Stevens is celebrating ACC's about-turn on strict new claims criteria which denied help to hundreds of sexually abused New Zealanders. "For those of us willing to stand up and fight, it has come to pass," Mr Stevens said.
An experienced sexual abuse counsellor, Mr Stevens was among the first to condemn ACC's toughened stance which required claimants to have a diagnosed psychiatric condition.
Last week an independent panel, the Sensitive Claims Pathways Review Panel headed by Dr Barbara Disley, strongly criticised ACC for implementing the new pathways. It has called for urgent action to ensure sexual abuse survivors, especially children and those with special needs, get fast-tracked assistance from ACC in future. It also wants to see a representative working party put in place to ensure processes are improved and are focused on the client.
Last year, Mr Stevens was so incensed with ACC that he threatened to return the QSM awarded for his pioneering work in the field of sexual abuse.
Mr Stevens says he is gratified by the panel's 14 recommendations to ACC Minister Nick Smith, calling it a credit to those who put it together. "While they have certainly given ACC a lot of reasons to reconsider their clinical pathways, they have done it in a respectful and helpful way that will help ACC to reconsider," Mr Stevens said. "At the end of it all, let's hope the people who have been affected by this can now receive the help that is due."
Mr Stevens was particularly angered that, since October last year, ACC required victims to be "labelled" with a mental illness.
ACC Minister Nick Smith implemented the investigation in May this year after acknowledging many were missing out on assistance. ACC had already taken action when last month it implemented an interim recommendation from the panel, immediately offering 16 counselling sessions to all sexual abuse claimants. After receiving the panel's final report last week, Dr Smith confirmed he was not satisfied with ACC's handling of the issue.
The minister, who had earlier said he would not involve himself in clinical decisions, promised that ACC would now be putting the panel's recommendations in place. "The report is quite critical of the way that ACC managed [the changes] and I accept the criticisms that are directed at ACC regarding that," Dr Smith said.
The panel said ACC's communications with sexual abuse victims and providers had often been inappropriate and inadequate. "These need to be improved as a matter of urgency," the panel said. Some claimants, especially children and young people, had been waiting 10 months to be assessed. The panel's recommendations include:

• Priority is given to claims for children.
• All communications with survivors of sexual abuse be urgently reviewed.
• Establishing a working party to examine whether the workforce is meeting quality standards.
• That ACC works with the sector, survivor representatives and relevant government agencies to develop and implement a comprehensive quality framework.
• Ensuring all claims processes protect client safety, take a client focus and recognise the special needs of groups such as children and people with mental illness etc.
• Future changes are made in meaningful consultation with the sector and relevant government agencies.
• That in determining a mental injury, the test should be that the sexual abuse was a substantial or material cause of the injury.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/taranaki-daily-news/news/4121555/About-turn-on-abuse

Mis-sent file victim being investigated

An article from the Sunday Star Times by Lois Cairns

A sexual abuse victim who claimed to have obtained internal ACC memos calling her a "mental health nutter" who should consider suicide is under police investigation.
The woman's computer equipment and documentation relating to her battle with ACC have been seized as part of the investigation, which saw six police officers search her Eastern Bay of Plenty home.
The officers gave the woman, who cannot be named for legal reasons, no explanation of what they were looking for, although the search warrant said police had "reasonable grounds" to believe they would find evidence of forgery.
The woman believes ACC sparked the investigation because it was fed up with her persistent battling of the system, and was angry she made public the story of her patient file being sent to a local store.
The file, managed by ACC's sensitive claims unit, contained an estimated 250 pages of psychological reports and case notes.
"They want to shut me up. They want to turn me from a victim into a perpetrator so that they can get rid of me," the woman told the Sunday Star-Times. "They're sick of hearing from me and this is their bully-boy way of trying to make me go away."
The misdirected patient file was the latest in a line of problems the woman, who suffered sexual abuse in the 1980s, has experienced with ACC. In April the Star-Times revealed details of internal ACC emails labelling her a "mental health nutter" who should consider taking her own life.
ACC said then it believed the emails were fakes and was considering laying a complaint with police. The woman is adamant they were leaked to her.
A spokeswoman confirmed that Whakatane police had executed a search warrant in relation to a complaint from "an external party" about a potential fraud. A computer and some paperwork were removed from the property.
ACC said it could not comment.

Copyright 2010 Fairfax New Zealand Ltd
http://findarticles.com/p/news-articles/sunday-star-times-wellington-new-zealand/mi_8185/is_20100912/mis-file-victim-investigated/ai_n55232006/

Response from Denise Cosgrove

A letter to the editor of the Sunday Star Times

Your story "Academic with link to sex abusers silent on role in drafting ACC rules" (News, August 29) was misleading in some important respects. The article suggests that Dr Felicity Goodyear-Smith was involved with the development of the ACC clinical pathway for sexual abuse claims. She was not. Goodyear-Smith had no role in the development of the pathway. The report she and two other researchers produced five years ago was an inconclusive study which compared treatment rates provided to ACC sexual abuse clients by psychologists, psychiatrists and counsellors. So it was not relevant to the development of the pathway.
Yes, one of their recommendations was that there should be diagnosis before treatment, using an assessment tool called DSM-IV. Yes, that is what we've been doing. But we didn't do so because it was in their report. Far from it. We did it because it was internationally seen as best practice, because the courts in NZ had endorsed DSM-IV as an appropriate method and because no suitable alternative options have been put forward. Goodyear-Smith had no part in any of that.
The article also failed to mention the work that ACC is currently doing with the Sensitive Claims Advisory Group and others to ensure that, moving forward, we continue to provide the most appropriate services for our clients.
Denise Cosgrove
General manager, claims management ACC

Copyright Fairfax New Zealand Ltd 2010
http://findarticles.com/p/news-articles/sunday-star-times-wellington-new-zealand/mi_8185/is_20100912/sexual-abuse/ai_n55232011/

NZPsS supports findings of the independent review panel

A press release by the New Zealand Psychological Society

The New Zealand Psychological Society (NZPsS) is pleased that the independent panel set up to review the clinical pathway implemented by ACC for the management of sensitive claims has clearly identified issues which must be addressed. The NZPsS, along with many other agencies identified a number of serious concerns which we considered impacted on sexual abuse survivors and the ability of psychologists and other practitioners to provide appropriate services. Until the independent review validated these concerns many lay unaddressed.
Dr Kerry Gibson, NZPsS Director of Professional Development and Training said today that there is clearly a need for a protocol for managing change in the public sector particularly when getting it wrong can have serious consequences for the health and wellbeing of the public. Vulnerable people who seek assistance should not be subjected to processes which deny them that assistance or make it so difficult for them that they choose not to receive assistance. The issues which emerged in relation to the sensitive claims clinical pathway clearly point to a need to do things differently she said.
An important part of the protocol would be to consult with and hear the concerns of consumer groups and practitioners at an early stage of the proposed change. It is also essential for an organisation like ACC to be able to acknowledge when things are not going well, move in a new and appropriate direction and avoid the need for expensive independent reviews and monitoring groups.
Dr Gibson said the most important thing now is to ensure that those seeking ACC’s sensitive claims assistance get the help they need as soon as possible. Establishing protocols and processes to effectively manage any future change is also an important priority.

http://www.scoop.co.nz/stories/GE1009/S00066/findings-of-the-independent-review-panel.htm

Sexual abuse survivors applaud report which criticises ACC

A news report from Morning Report on Radio New Zealand National

Critics of the Accident Compensation Corporation's system for dealing with victims of sexual abuse are applauding a highly critical report into ACC's management of sensitive claims. Click here to listen.

© 2010 Radio New Zealand

ACC changes "adding to" abuse victims' trauma

An article from the Dominion Post

Sexual abuse survivors are being retraumatised by ACC's new "sensitive claims" process, an independent review has found.
The agency tightened criteria for sexual abuse victims last October, limiting ACC-funded counselling to those clinically diagnosed with a mental injury resulting from abuse. As a result, sensitive claims submitted to ACC halved.
After protests, ACC Minister Nick Smith set up an independent review panel in April to assess the new process. Last month, ACC accepted an interim recommendation from the panel that sensitive claimants should receive 16 initial counselling sessions immediately.
The panel has now issued its final report, which found the criteria changes had led to long waiting times for claims to be processed, retraumatising vulnerable victims and prompting many to give up seeking help..
It was particularly worried about the time taken to process claims from children and teenagers – up to 10 months.
Relying on a clinical diagnosis meant many people were now being denied treatment, and ACC and counselling services needed to agree on other ways to identify whether a person had a "mental injury". The changes were "poorly planned".
Dr Smith said ACC would put its recommendations in place.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/national/politics/4114385/ACC-changes-adding-to-abuse-victims-trauma

Recommendations from the clinical review

An extract from the report of the Sensitive Claims Pathway Review Panel

Recommendation 1 That ACC ensures that all aspects of their Pathway(s) and associated claims processes are in line with the Massey Guidelines by seeing that they:
• are developed and implemented in ways that recognise and protect client safety and the importance of the therapeutic relationship;
• take a client focus; and
• recognise the special needs of particular groups including children, adolescents, people with mental illness, people with intellectual disabilities, Māori, and Pacific peoples. (page 14)

Recommendation 2 That future changes to the Pathway and associated processes are planned, managed and implemented with meaningful engagement and consultation with the sector and relevant government agencies. (page 18)

Recommendation 3 That, as a priority, ACC commence work with relevant sector experts to agree additional standardised systems for determining mental injury - including ones that would be appropriate for children and for Māori - and discuss how they should be used to confirm that a claimant has a mental injury for ACC when making cover decisions under its legislation. (page 24)

Recommendation 4 That, in determining whether a mental injury has been caused by a Schedule 3 event, the test should be that the sexual abuse was a substantial or a material cause of the injury. (page 24)

Recommendation 5 That all ACC communications with survivors of sexual abuse need to be reviewed as a matter of urgency taking a client perspective and using survivor and expert provider assistance in the process. (page 34)

Recommendation 6 That ACC establish an appropriately constituted working party involving professional groups to examine credentialing or other means of ensuring that the workforce for treatment and assessment, including the new therapeutic assessment and recovery support process, is fit for purpose and meeting quality standards. (page 38)

Recommendation 7 That, in order to ensure processes around the Pathway(s) are of good quality, safe and effective for ACC, clients, and providers, ACC work with the sector, survivor representatives and relevant government agencies to develop and implement a comprehensive quality framework including strengthened processes for:
• provider approval and auditing
• appropriate service standards and monitoring
• workforce training and development
• ongoing professional development, and
• continuous service improvement. (page 38)

Recommendation 8 That ACC move to improve access for survivors by introducing 16 hours of immediate therapeutic assessment and recovery support from a registered ACC treatment provider for new claimants, those currently under consideration under the Pathway, those who have had a claim declined and those who have chosen to withdraw their claim under the Pathway. (page 45)

Recommendation 9 That these initial changes are planned, managed and implemented quickly and effectively - giving priority to claims for children - with input and/or oversight from relevant sector experts and government agencies. (page 45)

Recommendation 10 That ACC work with sector representatives to evolve the Pathway(s) based on the Massey Guideline principles and the proposals and principles in section 9 of this report giving particular attention to the needs of children and adolescents. The amended Pathway(s) must clarify how cover for treatment according to need will be available to those needing more than the initial 16 sessions recognising that this will be particularly important for adult survivors of child sexual abuse. (page 45)

Recommendation 11 That a proportion of claimants may be required to undergo an assessment for cover from an assessor who is not their treatment provider before a decision about cover is taken or to review ongoing therapy. These assessors should themselves be experts who have worked with sexual abuse victims and, wherever possible and desired by the client, the client’s usual treatment provider should also be involved in the formal assessment process and in determining appropriate treatment goals and plans. (page 45)

Recommendation 12 That ACC ensure that any assessment for cover processes for all claims requiring a treatment decision have occurred and a decision has been made within 6 weeks of being notified that a decision on cover will be needed. If this is not possible for any reason outside the client’s control then further two weekly therapeutic assessment and recovery support sessions should continue to be funded until the assessment is completed and a decision on further cover is taken. The assessment and cover decision must be taken at the latest within nine months of the claim being lodged - and preferably sooner. (page 45)

Recommendation 13 That ACC provide mechanisms for involving families/whānau in therapy especially for children and adolescents. (page 45)

Recommendation 14 That a process be established to independently monitor the development and implementation of actions recommended in this report. (page 45)

Read the full report here.

Report criticises ACC's handling of sensitive claims

A news report from Radio New Zealand

A scathing report into the Accident Compensation Corporation's handling of sensitive claims has found that it was deficient in dealing with victims of sexual abuse. The report was prepared by an independent panel set up in April to review the clinical process for sexual abuse claims.
Last year ACC introduced a new clinical approach to dealing with victims of sexual abuse. But the report is highly critical of that approach, saying it was implemented with too much haste and without adequate consultation.
The review also says the appropriateness of the type and length of treatments should be looked at, as well as the timeliness and responsiveness of ACC's systems. The panel found that victims access to, and delays in receiving, appropriate care deteriorated significantly after the introduction of the new approach. It also found that ACC's communication with sexual abuse victims and practitioners who deliver treatment and assessment services was often inadequate and inappropriate.
The head of the review, Barbara Disley, says the panel found that the changes were too restrictive. It spoke to victims of sexual abuse who should have been getting access to services but were not.
ACC Minister Nick Smith urged the corporation to adopt the recommendations of the review. Dr Smith says he acknowledges that managing sensitive claims is challenging, but he is not satisfied with ACC's handling of such claims. He says he will be getting an independent monitoring group to ensure ACC implements the report's recommendations.
ACC says it has already begun responding to the report's recommendations.

© 2010 Radio New Zealand
http://www.radionz.co.nz/news/political/56426/report-criticises-acc%27s-handling-of-sensitive-claims

Report out on counselling for sex abuse victims

A news report from Checkpoint on Radio New Zealand National

ACC is being told to change its controversial rules on how sexual abuse victims can get access to counselling. Click here to listen.

© 2010 Radio New Zealand

ACC Minister continues to fail sexual abuse victims

A press release from the Labour Party

ACC Minister Nick Smith’s continued buck passing on the issue of sexual abuse guidelines introduced under his watch is unacceptable, Labour Victims Rights spokesperson Lynne Pillay says.
“Nick Smith is apparently ‘urging’ ACC to take notice of a review of disastrous sexual abuse guidelines. That statement implies the Minister is not responsible for ACC and the decisions it makes,” Lynne Pillay said. “The Minister is responsible for decisions taken by ACC were taken under his watch, he was warned by health professional that the guidelines would re-victimise those people who had already suffered horribly and yet he continued to institute them.
“Throughout this process the Minister has repeatedly mislead and misinformed the public about his role and what was happening. The Minister’s behaviour is unacceptable and disgraceful.
“The guidelines were clearly introduced as a cost saving measure and to have ACC today come out and say those guidelines which denied thousands of people assistance as having merit is totally inappropriate.
“The National Government introduced guidelines clearly failed the people they were meant to help.
“I have no confidence in the Minister to right this horrific wrong, given both his and ACC’s statements today.
“Announcing that they would work with professionals working in sector into the future shows how badly this situation has been handled.
“The professionals working with those who have suffered sexual abuse, told ACC and the Minister even before the guidelines were introduced that they would lead to thousands of people being denied help.
“Given the Minister and ACC have failed to listen to health professionals again and again what confidence can anyone have that they will finally open the minds and admit they have failed and potentially caused harm to thousands of people,” Lynne Pillay said.

http://www.scoop.co.nz/stories/PA1009/S00172/acc-min-continues-to-fail-sexual-abuse-victims.htm

Opposition MPs critical over ACC issue

A news report on Voxy from NZPA

Opposition MPs have criticised ACC Minister Nick Smith over his response to a report into the corporation's handling of sexual abuse claims, but the report has mainly laid blame with ACC.
Dr Smith initiated a review when concerns were raised about the difficulties victims faced in getting adequate treatment.
Released today, the report set out 14 recommendations, saying it discovered a "precipitous drop" in sensitive claims when it compared the first three months of 2009 with the first three months of this year.
A review panel, headed by Dr Barbara Disley, said ACC had changed the systems it used with too much haste and did not adequately consult relevant government and non-government organisations, or its own Sensitive Claims Advisory Group.
Dr Smith said he acknowledged that managing sensitive claims was challenging, but that he was not satisfied with ACC's handling of the issue. "There are important lessons for ACC to learn from this report.
"As recommended, I will be implementing an independent monitoring group to ensure ACC delivers on the report's recommendations," he said.
ACC said today the changes it made were about targeting services to those covered by its legislation and to improve the outcomes those people achieved. "We still believe those are reasonable goals."
General manager of claims management Denise Cosgrove said the changes were never about saving money -- something that has been suggested by some opposition MPs. "Year on year, our total expenditure in this area has hardly fallen and it is only a tiny part of ACC's total expenditure," she said. "However, it became clear that the changes we had introduced had excluded more people than we expected and, more importantly, there was little else available for them outside of ACC."
Ms Cosgrove said the review panel's report raised serious issues and ACC had already begun responding to them.
Labour Party victims rights spokeswoman Lynne Pillay accused Dr Smith of "buck passing" over the issue. "Nick Smith is apparently 'urging' ACC to take notice of a review of disastrous sexual abuse guidelines. That statement implies the minister is not responsible for ACC and the decisions it makes," she said.
Ms Pillay said guidelines introduced since National came to power were clearly done as a cost saving measure.
Green Party ACC spokesman Kevin Hague said Dr Smith's acknowledgement that problems were caused by changes made by ACC highlighted a need for an independent review of all changes made by ACC since National took office, so as to ensure accident victims were not being re-victimised.
Dr Smith said he was confident there would now be a system in place ensuring that sensitive claimants got the right services at the right time, and that it would be a significant improvement on what previously existed.

http://www.voxy.co.nz/politics/opposition-mps-critical-over-acc-issue/5/62561

Independent review of ACC needed

A press release from the Green Party

Nick Smith’s acknowledgement that problems were caused by changes to how ACC deals with sexual abuse victims highlights the need for an independent review of all changes made to ACC since National took office, the Green Party said today.
“An independent review of the changes is needed to ensure ACC is doing its job and not re-victimising of accident victims,” Green Party ACC spokesperson Kevin Hague said. “The changes made to ACC's sexual abuse assessment procedures are the first to be assessed independently and the review, released today, confirms the changes were a disaster, with victims of rape and sexual abuse being denied essential care and unnecessarily.”
Since late 2008 ACC Minister Nick Smith has introduced wide-ranging changes to ACC cover, entitlements and assessment criteria. These include narrowing the criteria for approving surgery, restrictions on cover for hearing loss and work-related gradual process injuries, and widening the vocational independence assessment criteria under which ACC decides to stop paying claimants weekly compensation.
“Given that the panel has found major flaws in this area of changed procedures, the public can have no confidence that the other changed procedures have been handled any better, unless these are also reviewed independently,” Mr Hague said.
Mr Hague said recent revelations that the new approach to sensitive claims had been based on work by Dr Felicity Goodyear-Smith. ACC commissioned Dr Goodyear-Smith to provide advice on a number of occasions and then, according to the Sunday Star-Times, attempted to cover this up.
Dr Goodyear-Smith has a history of involvement with the Centrepoint community and held controversial views about sexual abuse. ACC’s former General Manager of Health Purchasing, David Rankin, confirmed over the weekend that ACC had known about this at the time, and that an expert panel of clinicians had recommended against Dr Goodyear-Smith’s recommendations.
Mr Hague said he suspected that cost cutting was the motivation for the changes despite Rankin and ACC’s denial. “The only possible explanations for the poor decisions that have come to light so far are that ACC has a sick culture, intent on cost-cutting through disentitlement, or that the organisation’s systems have failed to the point that catastrophic errors of judgment can occur.
“The New Zealand public deserves a thorough and independent review to determine the source of these problems and ensure that a fix is put in place, in which we can all have confidence.”

http://www.scoop.co.nz/stories/PA1009/S00169/independent-review-of-acc-needed.htm

ACC urged to adopt panel's recommendations

An article from the NZPA

ACC Minister Nick Smith says he isn't satisfied with the way the corporation is handling sexual abuse claims and a monitoring group will be set up to ensure it delivers on recommendations from an independent review panel.
Dr Smith initiated the review and the panel's report was released today, setting out 14 recommendations and saying it discovered a "precipitous drop" in sensitive claims when it compared the first three months of 2009 with the first three months of this year.
The panel, headed by Dr Barbara Disley, said ACC changed the system with too much haste and did not adequately consult relevant government and non-government organisations or its own Sensitive Claims Advisory Group.
ACC's general manager for claims, Denise Cosgrove, responded by saying problems had been previously acknowledged and were starting to be addressed. Ms Cosgrove said ACC had met the panel and discussed its findings. "We agree that action is required in some areas and believe the initiatives we have already put in place will go some way to addressing their concerns," she said. "But I have to emphasise that not all of the answers sit with ACC. We are just one of a number of agencies with responsibilities in this area."
Dr Smith said he was urging ACC to adopt the panel's recommendations. "While I acknowledge that managing sensitive claims is very challenging, I am not satisfied with ACC's handling of this issue," he said.
"There are important lessons for ACC to learn from this report. As recommended, I will be implementing an independent monitoring group to ensure ACC delivers on the report's recommendations."
Dr Disley said the panel heard from about 50 survivors of sexual abuse, 30 organisations representing psychiatrists, psychologists, psychotherapists and counsellors, received nearly 180 written submissions and met all the relevant key government agencies. "Virtually everyone who made their views known to us told us of the major difficulties that have been caused," she said. "ACC has listened to our early concerns and made initial changes.
"As a result, survivors who make a new claim or have a claim already in the system now have 16 hours with a treatment provider available to them immediately."
The report said ACC's Sensitive Claims Pathway had aggravated the situation for sexual abuse survivors with particular needs, including Maori, children, adolescents, people with mental illness and those with addiction problems.
The panel's recommendations include:

• ACC should move to improve access for survivors by introducing 16 hours of immediate therapeutic assessment and recovery support from a registered ACC treatment provider for new claimants, those currently under consideration, those who have had a claim declined and those who have chosen to withdraw their claim;
• ACC should work with sector experts to agree additional standardised systems for determining mental injury - including those that would be appropriate for children and Maori;
• All ACC communications with survivors of sexual abuse should be reviewed "as a matter of urgency" using survivor and expert provider assistance; and
• ACC should work with sector and government agency representatives to develop and implement a comprehensive quality framework.

© NZPA 2010
http://www.odt.co.nz/news/politics/125470/acc-urged-adopt-panels-recommendations

ACC responds to independent review of services

A press release from ACC

Last year’s changes to how ACC manages sexual abuse claims were designed to achieve two goals. They were to ensure we targeted our services to those people who were actually covered by our legislation and to improve the outcomes those people achieved. We still believe those are reasonable goals.
The changes were never about saving money. Year on year, our total expenditure in this area has hardly fallen and it is only a tiny part of ACC’s total expenditure.
However, it became clear that the changes we had introduced had excluded more people than we expected and, more importantly, there was little else available for them outside of ACC.
“ACC has already acknowledged this situation itself and had begun working with the sector to put in place whatever support we appropriately can. For example, we recently introduced up to 16 hours of support for people with a new sensitive claim, or who are awaiting an assessment”, said Denise Cosgrove, General Manager, Claims Management, ACC.
The report of the Independent Review Panel, released today by the Minister for ACC, raises a number of serious issues and ACC has already begun responding to them.
“ACC met with the Panel to discuss its findings. We agree that action is required in some areas, and believe the initiatives we have already put in place will go some way to addressing their concerns.”
“However, we continue to believe that, for those who are accepted by ACC, the current Pathway offers considerable advantages over the previous process. It ensures people get a proper assessment before treatment is undertaken, that there is a plan in place for that treatment and checks that progress is being made towards set objectives. This represents sound clinical practice.”
“Nonetheless, to ensure we make good decisions moving forward, we have begun regular meetings with the sexual abuse treatment sector, including clients, to make sure that they are involved and their voices are heard. The feedback we have received from them and the Independent Panel about our early work has been very positive”.
Ms Cosgrove said work was continuing on the development of separate processes for children and other groups such as Maori. A workforce development plan for counsellors, to ensure they provided a high-quality service, was also being developed. “But I have to emphasise that not all of the answers sit with ACC. We are just one of a number of agencies with responsibilities in this area. The Government’s response to the Report of the Sexual Violence Taskforce will provide a ‘whole of government’ approach, which is a sensible way to ensure that the right solutions are put in place”.

http://www.scoop.co.nz/stories/PO1009/S00101/acc-responds-to-independent-review-of-services.htm

Minister welcomes sensitive claims clinical review

A press release from the National Government

ACC Minister Nick Smith is urging ACC to adopt the recommendations of an independent clinical review into the sensitive claims pathway released today.
“I initiated this review because I was concerned about the claims process for sensitive claimants but wanted expert independent clinical advice,” Dr Smith said. “The Sensitive Claims Pathway Review Panel has done a good job and I am confident that with the changes underway and those recommended, survivors of sexual abuse will receive timely and best possible clinical support.
“While I acknowledge that managing sensitive claims is very challenging, I am not satisfied with ACC’s handling of this issue. There are important lessons for ACC to learn from this report. As recommended, I will be implementing an independent monitoring group to ensure ACC delivers on the report’s recommendations.”
Chair of the Panel Dr Barbara Disley said it had heard from about 50 survivors of sexual abuse, 30 organisations representing psychiatrists, psychologists, psychotherapists and counsellors, received nearly 180 written submissions, and met all the relevant key government agencies. “Virtually everyone who made their views known to us told us of the major difficulties that have been caused by the Pathway,” Dr Disley said.
The report proposes some initial changes and gives a series of recommendations that ACC will need to carefully work through with stakeholders.
“I am heartened that ACC has listened to our early concerns and made initial changes” Dr Disley said. “As a result, survivors who make a new claim or have a claim already in the system now have 16 hours with a treatment provider available to them immediately. This has been welcomed by many people.”
The Panel’s proposals cover the thorny question of how ACC should make sure it operates within the law while still making certain that survivors can get ready access to high quality support and treatment that meet their individual needs. There are recommendations aimed at improving how ACC involves stakeholders and communicates with clients and with treatment providers.
The report also recommends that attention is paid to quality at all levels including the practitioners who deliver treatment and assessment services, the appropriateness of the type and length of treatments, and the timeliness and responsiveness of ACC’s own systems.
To view the report, click here.

http://www.scoop.co.nz/stories/PA1009/S00141/minister-welcomes-sensitive-claims-clinical-review.htm

Questions for written answer

29295 (2010). Hon David Parker to the Minister for ACC: What is the list of working parties, advisory groups and review bodies, if any, the Minister or ACC have set up since November 2008?
Hon Dr Nick Smith (Minister for ACC) replied: The Government has facilitated the formation of the Ministerial Inquiry into Disclosure of Funding Shortfall in ACC Non-Earners' Account and the Steering Group for the Stocktake of ACC Accounts. I also initiated the Independent Clinical Review into ACC's Clinical Pathway for Sensitive Claims.

http://www.parliament.nz/en-NZ/PB/Business/QWA/1/3/b/QWA_29295_2010-29295-2010-Hon-David-Parker-to-the-Minister-for-ACC.htm

29026 (2010). Lynne Pillay to the Minister for ACC: Which entry in the document tabled on 17 August 2010 "make plain" the work on the clinical pathways began in 2008, prior to the change of Government, as he claimed in the House on 17 August 2010?
Hon Dr Nick Smith (Minister for ACC) replied: The entries dating 2008 and preceeding it that show significant workstreams were under way prior to the change of Government on changing the way sensitive claims were managed by ACC.

http://www.parliament.nz/en-NZ/PB/Business/QWA/f/e/8/QWA_29026_2010-29026-2010-Lynne-Pillay-to-the-Minister-for-ACC.htm

Sex abuse cuts "all about costs"

An article from the Sunday Star Times by Tim Hume

A former senior ACC manager says the corporation's cuts to sexual abuse counselling are "all about costs", contrary to ACC Minister Nick Smith's claims they were about ensuring best practice for clients.
David Rankin, now Child Youth and Family's senior medical adviser, has also revealed an advisory group of eight eminent psychiatrists cautioned ACC against introducing a Diagnostic and Statistical Manual (DSM-IV) diagnosis of mental injury as the threshold for victims of sex crimes to access support. "They said, 'Be very careful, this is not what it's used for, this is not what it's all about'," Rankin told the Sunday Star-Times. "They said: 'It doesn't indicate severity, it only indicates the presence of a condition and it doesn't in any way tell you what treatment is needed."'
ACC controversially introduced the requirement last year, cutting access to treatment for hundreds, before partially restoring support last month. Two suicides have been linked to the cuts.
Rankin, who was ACC's general manager of health purchasing until 2006, says the main goal of the changes was to cut costs. "ACC's an insurance company. Its premium-payers are grizzling."
ACC was "under extraordinary pressure to reduce its costs" and "anybody that looks at the counselling costs for sexual abuse must come to the conclusion that there is wasted money," he said. Although sensitive claims represented only a small amount of ACC's total spending, it was an area where the corporation had "extraordinary exposure" to liabilities.
In 2004, Rankin commissioned research into sexual abuse counselling that was co-authored by Auckland University professor Felicity Goodyear-Smith. He said the research was commissioned because "ACC was concerned at the increase in cost in counselling".
ACC has been criticised for commissioning the research from Goodyear-Smith, who is married to a convicted sex offender and is the daughter-in-law of Centrepoint's convicted paedophile founder Bert Potter. She has been an outspoken critic of sexual abuse counselling, labelling it "a scam".
Her research included a recommendation that victims be assessed with a DSM-IV mental injury diagnosis, which later appeared as a requirement in ACC's "clinical pathway", despite not having been specified in the Massey guidelines, a widely accepted "best practice document" which ACC said guided how the pathway was formulated.
Rankin said Goodyear-Smith's research had set out to determine whether psychologists provided more effective treatment than less-qualified counsellors. He had been "stunned" when her research had not borne out their expectation that they would.
He said he had been aware of Goodyear-Smith's links to sex offenders and strong views, and for that reason stipulated "that I personally read what she said before we published it". He blocked a number of her recommendations. "We acknowledged the agenda and protected both herself and us against it," he said.
He did not feel her background disqualified her from objective research, stressing that the research was "numerical" and adding "most people researching in that area have got a bias one way or the other".
Green MP Kevin Hague said he believed the commissioning of Goodyear-Smith reflected the corporation's agenda to cut costs. "If it's a numerical analysis you want, the public health departments of our universities are packed with biostatisticians who could do that. Why would you choose the researcher with the most extreme view about the topic itself to do this neutral task?
"They used Goodyear-Smith because they knew she would recommend less treatment and less costs for people who had been sexually abused. That, to me, is a scandal."
ACC Minister Nick Smith said he couldn't comment on ACC's objectives in Rankin's time. But he insisted that changes to sensitive claims over the past 12 months had had nothing to do with cost-cutting, but focused on clinical care. He said an independent clinical panel came to the same conclusion. "There's been a lot of politics around trying to frame the debate around sensitive claims in context of bigger financial issues around ACC, but the paper trail and the involvement of the clinicians driving this makes it plain these are quite distinct."
He was "uneasy" about Goodyear-Smith's involvement, but had seen no evidence her work had influenced the pathway.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/national/4096892/Sex-abuse-cuts-all-about-costs

Complexity in abuse viewpoint

An article from The Press by Rosemary McLeod

Someone up there must love Felicity Goodyear-Smith, but some do not, and I guess her life would have been less complicated had she never met her husband. Goodyear-Smith is Auckland University's medical and health sciences professor. More controversially, a change in ACC policy, now reversed, that impacted on help for victims of sexual abuse has now been partly sheeted home to her door.
Her critics are amazed that she was commissioned to provide input on this sensitive area. They see her as stigmatised by close association with the family of former Centrepoint guru - and convicted child sex and drugs offender - Bert Potter. She is married to his son, and was formerly the GP for the controversial community, where the consensus on sexual relations between adults and children seems, in hindsight, to have been not only potentially damaging, but loony, and the use and manufacture of drugs there downright reprehensible.
At the core of criticism is the view she has put forward that sexual contact between adults and children may not necessarily be harmful. To be fair, she cites research which could point to that conclusion. To be fair to her critics, there are compelling counter-arguments.
Goodyear-Smith also attacks the idea of recovered memory, famously featured in retrospective sexual abuse claims made following counselling, which, by the way, she is not convinced does much good. You can see why she could be unpopular.
I rather like mavericks, and for that reason I admire Goodyear-Smith's perversity in taking up the cause of the injustices done to some men by false claims of sexual abuse of children. I expect this false reporting does happen, especially in custody disputes: it's hard to prove or disprove, and the harm caused by an accusation would be almost impossible to shake off.
She acts as an expert witness for accused men, set up a group that specialises in that area, and can hardly be surprised that some people see that as tending to minimise what her husband (convicted of sexual contact with a child) and her father-in-law (who got a stiff jail sentence) were charged with.
Because of her academic standing, that background may not have occurred to her as being a problem when she agreed to help ACC. But academic credentials aren't everything: perception counts, too.
It would have been wiser of her to see the big picture and opt out, and much wiser of ACC not to ask her in the first place, since her views are well known, and polarising. If you disliked her, you'd say it was a bit like asking a ferret to give advice on the care of chickens. If you supported her you'd advise her against it because it was sure to rebound on both her and the corporation, for whom she does other, less controversial work.
I'll give her this: we have lived in strange times with our attitudes to sex, and history may well look back at all of us and laugh. Plenty of seemingly sensible people supported the teachings of Bert Potter - who is unrepentant - in the commune's heyday. Adults were bonking all over the place, coupling at his direction, and in front of the children. Solemn TV documentaries were made, and clever people joined up, handing over their worldly possessions to the former pest controller's wise governance.
Then, seemingly in no time at all, there was a complete reversal of attitude, and we became obsessed with child sex abuse. What was all Arcadian innocence yesterday suddenly had a dark side, and ACC began shelling out $10,000 payments to women who claimed they'd been sexually abused, without asking for corroborative proof. Women swiftly signed up for this by the tens of thousands, to nobody's great surprise, and against that background Goodyear-Smith told a newspaper the "ACC scam's one of the biggest there is".
Not the most useful view to have on record when contemplating research destined to impact on policy in that very area. How odd - and perhaps revealing - that Goodyear-Smith didn't see that for herself.

© 2010 Fairfax New Zealand Ltd
http://www.stuff.co.nz/the-press/opinion/columnists/rosemary-mcleod/4086350/Complexity-in-abuse-viewpoint