Question to Minister

Question 4: Kevin Hague to the Minister for ACC: Does she agree with Peter Trapski's recommendation in his 1994 Report of that "the Corporation must ensure that the opinions it obtains from medical practitioners are independent, not only of the claimant, but also of the Corporation, and that they are seen to be so"?



Hon JUDITH COLLINS (Minister for ACC): Yes.
Kevin Hague: Is she concerned that just four of ACC’s favourite specialist medical advisers— Dr Martin C Robb, Dr Vic du Plessis, Dr Bill Turner, and Dr David Beaumont—are collectively paid up to $2 million a year from ACC for services rendered?
Hon JUDITH COLLINS: I believe that the member is referring to a TV3 report on Sunday evening—oh, no, he is not. When it comes to saying that people are paid up to an amount, it is not particularly helpful, because it is anything under that amount. But I have been advised by ACC that for medical case reviews, it has 338 doctors who can carry out those assessments, for initial medical assessments the number is 97, for vocational initial medical assessments it is 62, and for impairment assessments it has got 59, and that, on average, the four particular doctors who were discussed on the 60 Minutes programme, whom I thought he was referring to, actually conduct between 8.7 and 4.7 percent of those particular reviews. So I hope that is helpful to the member.
Kevin Hague: Does she believe that an ordinary person would consider it possible that medical advisers like Dr du Plessis, Dr Turner, Dr Beaumont, and Dr Robb could remain independent of ACC, when it pays them between $300,000 and $500,000 each per year?
Hon JUDITH COLLINS: I think that that is an issue that needs to be considered, and I have spoken to ACC about it. The member will be aware that there is a new board now put in place. I will be meeting with the board and discussing—obviously not the individual cases or the matters— how we can end up with a system that, obviously, achieves good, robust, and independent medical reports and assessments, and that can be seen as independent by both the claimants or clients of ACC and ACC. I also note that even back in the year 2000—12 years ago—the same lawyers for ACC clients were claiming exactly the same issues around what they said were non-independent medical assessments. So I do not think much has changed, but I am happy to work with the member to try to get things to change.
Kevin Hague: Does she agree that an ordinary person would find it unbelievable that ACC would continue to fly these doctors around the country and pay them an average of almost $1,700 for each client they see if they were not acting as “hit men”, to use the phrase that Laurie Gluckman was described as according to Judge Trapski, in targeting the exit of long-term claimants, which ACC has referred to as low-hanging fruit?
Hon JUDITH COLLINS: I think it is absolutely right that people who are not highly trained skilled medical professionals, just like people who are not highly trained, very skilled legal professionals, find the fees that are charged outrageous, but that is actually something that I think most people in New Zealand would say around this area. I do not know for certain and I cannot tell the House that the medical professionals he is referring to are paid any differently from any other medical professionals—
Hon Ruth Dyson: So that makes it all right.
Hon JUDITH COLLINS: —with that degree of expertise, and I am surprised that the former Minister for ACC, who left the job so abruptly, should want to call out about this issue.
Kevin Hague: Does she accept that there is a risk that the assessments performed by a doctor who earns up to half a million dollars a year working part-time for ACC could be affected by that doctor’s desire to continue receiving such lucrative contracts from the corporation?
Hon JUDITH COLLINS: Well, I think that there is always that perception. Whether the perception is reality is a different matter, because as I understand it, these very highly trained, experienced medical professionals are in great demand all over the world. What we do know is that in a country the size of New Zealand, which, of course, has a fabulous health system, thanks in good part to this Government, it is thanks also to the level of qualifications and experience and the work attitude of many of the medical professionals he is referring to.
Kevin Hague: Does she agree that contracting for specialist medical assessments with district health boards or professional colleges would help ensure that they are independent and are seen to be so, as Judge Trapski says they must be?
Hon JUDITH COLLINS: I think the member has raised a very good point, and he has privately raised that matter with me. It is certainly one that I have raised with ACC, and now that the new board is in place I wish to take that matter further and see whether or not that is a realistic situation that we should consider.
Kevin Hague: What are the instructions she has given the reconstituted ACC board about specialist medical assessments?
Hon JUDITH COLLINS: I have not yet met with the board. It has only been in place a few days, but I will be attending the first board meeting to discuss some of these issues with the board members and ask them whether they can start considering these matters. I have, however, met with the chief executive, raised those issues, and asked for some suggestions. I think it is a very important issue that the member has raised.
Barbara Stewart: Will ACC cap the annual amount it spends on any individual medical assessor to avoid the risk of incentivising advisers to provide reports that ACC wants rather than independent advice?
Hon JUDITH COLLINS: I am not sure that that would be a good idea, particularly if, for instance, there may be only two or three specialists with the level of expertise in the country. So I think that might be a bit of a blunt instrument, but I can undertake to look at all those considerations.

http://inthehouse.co.nz/node/15035