Review call into ACC's surgery rejections

An article from the New Zealand Herald by Adam Bennett

Pressure is building for an independent review of the ACC's handling of claims for elective surgery.
Late last year, the Herald highlighted the Accident Compensation Corporation's crackdown on access to surgery which saw claimants denied treatment, allegedly on flimsy opinions from advisers - usually doctors, some of whom were retired and often not specialists in the areas they advised on.
Auckland accident lawyer Philip Schmidt wrote to MPs and ministers twice last year seeking an inquiry into the ACC medical-adviser system.
Chief executive Jan White announced in December an internal review of ACC's elective surgery processes after the Herald ran a series of articles detailing a selection of the hundreds of complaints received.
Yesterday, however, after ACC chairman John Judge and Dr White defended the corporation's doubled rejection rate for elective surgery claims, the Labour Party and the Greens called for an independent review of the matter.
Greens ACC and health spokesman Kevin Hague said Dr White and Mr Judge were implying that surgeons were trying to get ACC to pick up the slack for a backlog of elective procedures in the public health service. "But what I thought ACC was really ducking was the whole business of in fact making it harder for New Zealanders to get that surgery."
Mr Hague said "catastrophic errors" in ACC's handling of sensitive claims from rape and sexual assault victims had only been exposed last year by an independent review. "What possible confidence can the public have that all of these other changes in procedures have not actually resulted in the same kinds of unjust and inequitable treatment of people with genuine injuries?
"What we really need to have is that same kind of independent review of what ACC has done in all of those areas."
Labour ACC spokesman Chris Hipkins said he was not satisfied ACC's internal review would deliver honest answers. "Having someone independent ... coming in and looking at it to see if it's fair, if it's best practice ... is really important."
Facing questions stemming from the Herald's series last year, Dr White yesterday told the transport and industrial relations committee the largest number of rejections for surgery claims were for "a procedure and operation that is very hard to get done in the public sector".
Surgeons had told ACC that sometimes when a patient who "really needs surgery" but who would not get priority in the public health sector, they would see if the patient had an injury "and then they could be under ACC".

TREND APPARENT
ACC's rejection rate for elective surgery claims:
* 11 per cent 2008
* 20 per cent 2010

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