Showing posts with label Annette King. Show all posts
Showing posts with label Annette King. Show all posts
14 September 2010
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
17 August 2010
Question to Minister: ACC
Hon ANNETTE KING (Deputy Leader — Labour) to the Minister for ACC: Does he stand by his statement on Radio New Zealand’s Checkpoint programme of 12 August 2010: “I’m not satisfied that ACC has handled the issue of counselling services for sensitive claims that well. I’m going to await the final report from the independent clinical panel before drawing final conclusions”; if so, why?
Hon Dr NICK SMITH (Minister for ACC): Yes, I do. I have been consistently cautious about interfering in the clinical decisions of the Accident Compensation Corporation (ACC) in this sensitive area. But given the level of concern from colleagues and the public I have established an independent clinical panel to review the corporation’s approach. That panel is doing a very professional and thorough job.
Hon Annette King: Does he now accept that he was warned by clinicians, by survivors, by he National Council of Women, and by 3,976 people who, last October, signed a petition that stated: “By doing nothing and allowing these changes to occur unhindered you are choosing to make recovery from horrific abuse harder for some of the most vulnerable members of this society.”?
Hon Dr NICK SMITH: I draw the member’s attention to the advice from the Royal New Zealand Colleague of General Practitioners, and I quote what it said in November last year: “All the clinical evidence suggests that the new approach ACC is adopting will be in the best interests of the patient”. Given that sort of advice I have been cautious about getting involved in a clinical debate where I am not well qualified, but in response to the concerns of colleagues like Chester Borrows, Jackie Blue, and Nikki Kaye, I have set up an independent clinical panel and I will be ensuring that the advice of that panel is taken by the ACC to ensure that we are providing proper care for people who are sexually abused.
Hon Annette King: Did the ACC advise him that the process to change the clinical framework or clinical pathway was started under a Labour Government as he has claimed many times; if so, when?
Hon Dr NICK SMITH: Yes, that is the advice I have received. There was concern in the research that was commissioned in 2003, at Massey University, by the previous Government. The key element — and I am not an expert on the clinical issues — is that the clinical concern in that research was that unlimited counselling would do more harm than good for sensitive claimants. I am advised by the ACC that the changes in the pathway were begun in 2008.
Michael Woodhouse: What steps has the Minister taken to try to have the issues over sensitive claims addressed as quickly as possible?
Hon Dr NICK SMITH: The independent clinical panel wrote to me on 16 July seeking an extension of time until September to enable it to provide a comprehensive report. My concern was that this delay would put back the addressing of the problems in relation to providing for sensitive and vulnerable claimants. I agreed to the extension until mid-September subject to the panel providing interim recommendations. On receiving those recommendations I immediately wrote to the ACC board seeking their implementation as quickly as possible, which the board has done.
Hon Annette King: In light of the Minister’s answer to my previous question, is he saying that the ACC was not telling the truth when less than 1 month ago, in answer to an official information request, it said: “No work was undertaken on either the clinical framework or the clinical pathway prior to 2009”, and when it also said that the clinical framework was developed by the clinical services directorate in 2009, long after a Labour Government had left?
Hon Dr NICK SMITH: I stand—[Interruption]
Mr SPEAKER: I apologise to the Minister. I believe that the member has asked a serious question, and the member’s colleagues should listen to the answer.
Hon Dr NICK SMITH: I stand by the advice I have been given by the ACC, which is that the work on the clinical pathways began in 2008, prior to the change of Government, as those documents make plain. Labour has tried to politicise this issue, but the changes in sensitive claims have been totally driven by the ACC’s clinicians, not by Ministers. They have not been driven by Cabinet but by clinicians trying to do their very best for sensitive claimants.
Hon Annette King: I seek leave to table a document from the ACC, dated 30 July 2010, that points out that no work was done on the clinical framework or clinical pathway prior to 2009.
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.
Hon Annette King: I raise a point of order, Mr Speaker. The Minister said that he had quoted from official documents from the ACC. I ask that he table them.
Mr SPEAKER: No, I do not believe that the Minister had an official document in his hand when he was answering that question.
Michael Woodhouse: What were underlying concerns that the ACC had that led to the changes, and has the Minister received any advice on whether those concerns were valid?
Hon Dr NICK SMITH: The concern that the corporation’s clinicians had, backed up by comprehensive research, was that ongoing unlimited counselling of victims of sexual abuse could lead to more harm than good. The clinical panel has confirmed the validity of this research and the need for professional oversight by psychiatrists and psychologists to ensure that long-term counselling is both beneficial and appropriate. I am advised by the clinical panel that where the corporation erred was in requiring such an assessment for all claimants when insufficient professional support was not available, resulting in unacceptable delays in providing care. I am confident that with the support and advice of the independent clinical panel we can improve the support provided for sensitive claimants.
Craig Foss: I raise a point of order, Mr Speaker. During that exchange, and prior to it, the member Darren Hughes questioned whether the Minister was telling the truth, quite a few times. Members cannot do that; all members are honourable. I ask that the member reflect on that and withdraw.
Mr SPEAKER: The member has taken offence, and, strictly, the member should not imply—
Hon Darren Hughes: I was very careful in what I said, Mr Speaker. I—
Mr SPEAKER: The member will not repeat what he said. I heard very clearly what the member said. Another member has taken offence. A member should not imply that another member is not telling the truth. I ask the Hon Darren Hughes to stand, withdraw, and apologise.
Hon Darren Hughes: I withdraw and apologise.
Mr SPEAKER: Lynne Pillay; a supplementary question. [Interruption] I say to the Labour front bench that I have called one of their colleagues. I expect them to show some courtesy to their own colleague.
Lynne Pillay: Will the Minister now require the ACC to identify the estimated 2,000 people who were unable to participate in his Government’s accident compensation process because it was too traumatic; and will he offer them counselling?
Hon Dr NICK SMITH: As of Monday the corporation is offering 16 counselling sessions for those people who seek the services of counsellors. The corporation will work through a final solution when the full report is available from the independent clinical panel. I point out to the members opposite who are interjecting that way in excess of 2,000 accident compensation claimants were turned down for counselling during the time of the previous Government. In fact, when Labour was in Government, half of those who sought counselling were turned down.
Hon Annette King: When the Minister said in the Nelson Mail last week that “Some days I’m in politics and I think, ‘What the hell am I doing?’”, will he now accept that the victims of his bungled policy are asking the same question?
Hon Dr NICK SMITH: It is a pity that the member chooses to selectively quote. The overwhelming point I would make—[Interruption] Well, the comment was made in reference to visiting an oil rig in Tasman Bay, and I am not sure that that is particularly relevant to the issue of sensitive claims. Members opposite have attempted to play politics with this highly sensitive issue. [Interruption] They have—they have played it for all it is worth, when all the papers show that this issue is, in essence, a clinical issue in which neither I as Minister nor the board, for that matter, has made substantive decisions.
http://www.scoop.co.nz/stories/PA1008/S00258/questions-and-answers-17-august-2010.htm
30 June 2010
Question to Minister: ACC - Culture Change
Hon ANNETTE KING (Deputy Leader—Labour) to the Minister for ACC: Does he think the huge culture change within ACC has gone too far?
Hon Dr NICK SMITH (Minister for ACC): I am very conscious of the need to get the balance of accident compensation right between containing costs and levy increases and ensuring that people receive their proper entitlements. Costs were clearly out of control under the previous Government, and a culture change was needed. I am closely monitoring the accident compensation review data, and would be concerned if there were an increase in the number of Accident Compensation Corporation (ACC) decisions being overturned. There is no such trend. A similar proportion of claim decisions are being upheld now as were upheld under the previous Government, indicating that ACC has got the balance right.
Hon Annette King: As part of that culture change, does he recall ACC saying: “We take our relationship with counsellors and clinicians seriously,”; if so, why has he not ensured that ACC takes seriously the warning from clinicians at Ashburn Clinic - health professionals who provide New Zealand’s foremost treatment programme for victims of sexual crimes, who have had no referrals from ACC since October, and who have had to lay off 10 crucial staff?
Hon Dr NICK SMITH: Clinical decisions, whether in terms of surgery or in terms of sensitive mental health issues, are properly made by clinicians. I would be concerned if decisions that had been made by ACC’s clinicians were being repeatedly overturned in the independent review process. That would suggest that ACC had got the balance wrong. In regard to the specific issue of sexual abuse, I have initiated an independent review, which is being done Dr Barbara Disley, and I am looking forward to receiving her report.
Hon Annette King: Does he recall ACC saying that it would like to explain the changes that have been made for victims of sexual crimes so that clinicians can see “what we are doing to improve service performance”; if so, how does he intend to explain the loss of the long-term residential service at Ashburn Clinic, which had helped victims rebuild their lives - a loss because of a $900,000 shortfall, while he boasts of a $2 billion surplus?
Hon Dr NICK SMITH: The key decisions on whether clients go to Ashburn Clinic or receive care in other establishments should be made by clinicians, not Ministers. If Ashburn Clinic or any members opposite believe that people are inappropriately being turned down for treatment, the proper process for them to follow is to seek a review of the case. If the member has evidence of that, I would be more than happy to see it.
David Bennett: By how much did ACC’s claims and administration costs go up over the preceding 4 years, requiring a change in culture?
Hon Dr NICK SMITH: ACC administration costs between 2004 and 2008 went up by an average of $50 million extra per year—that is, from $302 million in 2004 to $494 million in 2008. In the National Government’s first year we reduced those administration costs by $35 million. Claim costs between 2004 and 2008 went up by nearly $300 million extra every year - a rate of increase that was 5 times the rate of inflation. That was clearly unsustainable. As in so many parts of the public service, Labour let costs get out of control.
Hon David Parker: Can the Minister not see that the change of culture and the push towards privatisation that he has lauded are exactly what led his appointed chair of ACC, John Judge, to say that doctors, in addition to facing disciplinary action, should pay financial penalties for medical errors?
Hon Dr NICK SMITH: Firstly, the member deliberately misquotes Mr Judge. He deliberately misquotes him, as is so often the case.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. To deliberately misquote is to mislead the House. That allegation is not allowed to be made by a member of Parliament by way of answer.
Mr SPEAKER: I accept the point the member makes. Perhaps the member could change his language so that he is not making that accusation.
Hon Dr NICK SMITH: The member misquotes the chair of ACC, who has had an incredibly challenging job, given that the previous Government in just 3 years, according to the audited accounts, let the liabilities of the accident compensation scheme blow out by $10 billion. Mr Judge has had an awfully challenging job to try to get them under control.
Hon David Parker: Is the Minister concerned that the chair of ACC is so obviously out of touch with the underlying principles of our accident compensation system that he is clearly pushing towards a litigious, Americanised private insurance model?
Hon Dr NICK SMITH: The member is way off beam. This Government is totally committed to an efficient, 24/7, no-fault scheme. But I make no apologies for this Government and Mr Judge looking at sensible ways that we can engage with the private sector to better manage claims in order to rehabilitate patients more quickly. I congratulate Mr Judge on reversing the decline in rehabilitation rates that occurred under the previous Government.
Hon David Parker: Why is the Minister so at ease with the undermining of the current accident compensation model by moves to privatisation and financial penalties for doctors—which is what John Judge did say, I tell the Minister—when it is abundantly clear that the Americanised insurance model that he and Mr Judge are pushing New Zealand towards leads to more conservative and expensive medical treatment as well as money being wasted on lawyers and insurance company margins?
Hon Dr NICK SMITH: Under any model to incorporate the private sector that this Government looks at, exactly the same entitlements will be involved and exactly the same independent review processes will be involved. Be we make absolutely no apologies for wanting to use the private sector so that we can rehabilitate people and get them back to work where they can make a positive contribution, rather than continuing the culture of the previous Government, which seemed happy to have thousands and thousands of New Zealanders sitting on accident compensation, not being rehabilitated, and not able to work.
Hon Annette King: I seek leave to table a letter from the medical director of Ashburn Clinic, which states: “Our primary concern is the care of the patients who are being denied treatment under the current ACC guidelines.”
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.
http://www.scoop.co.nz/stories/PA1007/S00006.htm
Hon Dr NICK SMITH (Minister for ACC): I am very conscious of the need to get the balance of accident compensation right between containing costs and levy increases and ensuring that people receive their proper entitlements. Costs were clearly out of control under the previous Government, and a culture change was needed. I am closely monitoring the accident compensation review data, and would be concerned if there were an increase in the number of Accident Compensation Corporation (ACC) decisions being overturned. There is no such trend. A similar proportion of claim decisions are being upheld now as were upheld under the previous Government, indicating that ACC has got the balance right.
Hon Annette King: As part of that culture change, does he recall ACC saying: “We take our relationship with counsellors and clinicians seriously,”; if so, why has he not ensured that ACC takes seriously the warning from clinicians at Ashburn Clinic - health professionals who provide New Zealand’s foremost treatment programme for victims of sexual crimes, who have had no referrals from ACC since October, and who have had to lay off 10 crucial staff?
Hon Dr NICK SMITH: Clinical decisions, whether in terms of surgery or in terms of sensitive mental health issues, are properly made by clinicians. I would be concerned if decisions that had been made by ACC’s clinicians were being repeatedly overturned in the independent review process. That would suggest that ACC had got the balance wrong. In regard to the specific issue of sexual abuse, I have initiated an independent review, which is being done Dr Barbara Disley, and I am looking forward to receiving her report.
Hon Annette King: Does he recall ACC saying that it would like to explain the changes that have been made for victims of sexual crimes so that clinicians can see “what we are doing to improve service performance”; if so, how does he intend to explain the loss of the long-term residential service at Ashburn Clinic, which had helped victims rebuild their lives - a loss because of a $900,000 shortfall, while he boasts of a $2 billion surplus?
Hon Dr NICK SMITH: The key decisions on whether clients go to Ashburn Clinic or receive care in other establishments should be made by clinicians, not Ministers. If Ashburn Clinic or any members opposite believe that people are inappropriately being turned down for treatment, the proper process for them to follow is to seek a review of the case. If the member has evidence of that, I would be more than happy to see it.
David Bennett: By how much did ACC’s claims and administration costs go up over the preceding 4 years, requiring a change in culture?
Hon Dr NICK SMITH: ACC administration costs between 2004 and 2008 went up by an average of $50 million extra per year—that is, from $302 million in 2004 to $494 million in 2008. In the National Government’s first year we reduced those administration costs by $35 million. Claim costs between 2004 and 2008 went up by nearly $300 million extra every year - a rate of increase that was 5 times the rate of inflation. That was clearly unsustainable. As in so many parts of the public service, Labour let costs get out of control.
Hon David Parker: Can the Minister not see that the change of culture and the push towards privatisation that he has lauded are exactly what led his appointed chair of ACC, John Judge, to say that doctors, in addition to facing disciplinary action, should pay financial penalties for medical errors?
Hon Dr NICK SMITH: Firstly, the member deliberately misquotes Mr Judge. He deliberately misquotes him, as is so often the case.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. To deliberately misquote is to mislead the House. That allegation is not allowed to be made by a member of Parliament by way of answer.
Mr SPEAKER: I accept the point the member makes. Perhaps the member could change his language so that he is not making that accusation.
Hon Dr NICK SMITH: The member misquotes the chair of ACC, who has had an incredibly challenging job, given that the previous Government in just 3 years, according to the audited accounts, let the liabilities of the accident compensation scheme blow out by $10 billion. Mr Judge has had an awfully challenging job to try to get them under control.
Hon David Parker: Is the Minister concerned that the chair of ACC is so obviously out of touch with the underlying principles of our accident compensation system that he is clearly pushing towards a litigious, Americanised private insurance model?
Hon Dr NICK SMITH: The member is way off beam. This Government is totally committed to an efficient, 24/7, no-fault scheme. But I make no apologies for this Government and Mr Judge looking at sensible ways that we can engage with the private sector to better manage claims in order to rehabilitate patients more quickly. I congratulate Mr Judge on reversing the decline in rehabilitation rates that occurred under the previous Government.
Hon David Parker: Why is the Minister so at ease with the undermining of the current accident compensation model by moves to privatisation and financial penalties for doctors—which is what John Judge did say, I tell the Minister—when it is abundantly clear that the Americanised insurance model that he and Mr Judge are pushing New Zealand towards leads to more conservative and expensive medical treatment as well as money being wasted on lawyers and insurance company margins?
Hon Dr NICK SMITH: Under any model to incorporate the private sector that this Government looks at, exactly the same entitlements will be involved and exactly the same independent review processes will be involved. Be we make absolutely no apologies for wanting to use the private sector so that we can rehabilitate people and get them back to work where they can make a positive contribution, rather than continuing the culture of the previous Government, which seemed happy to have thousands and thousands of New Zealanders sitting on accident compensation, not being rehabilitated, and not able to work.
Hon Annette King: I seek leave to table a letter from the medical director of Ashburn Clinic, which states: “Our primary concern is the care of the patients who are being denied treatment under the current ACC guidelines.”
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.
http://www.scoop.co.nz/stories/PA1007/S00006.htm
18 May 2010
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
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
06 May 2010
Labour accuses ACC minister of bullying woman
A report from Radio New Zealand News
http://www.radionz.co.nz/news/stories/2010/05/06/12480387c4b0
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.Copyright © 2010 Radio New Zealand
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.
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.http://nz.news.yahoo.com/a/-/top-stories/7184986/parliament-takes-on-clothesline-look/
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.
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
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
16 December 2009
Prime Minister should act to protect sexual abuse survivors from ACC cutbacks
A press release from the Labour Party by Annette King
The Prime Minister must put a halt to ACC cutbacks that have restricted the ability of survivors of sexual abuse to access counselling, Labour Deputy Leader Annette King says.http://www.labour.org.nz/news/prime-minister-should-act-protect-sexual-abuse-survivors-acc-cutbacks
“The National Council of Women, which Deputy Prime Minister Bill English has described as highly respectable, have written to John Key asking him to take urgent action to overturn Cabinet’s decision to allow cutbacks to ACC funded counselling for sexual survivors,” Annette King said.
“The National Council of Women state that the new ACC sexual abuse guidelines are discriminatory under UN conventions, particularly the Convention on the Elimination of all forms of Discrimination against Women and Elimination of all forms of Racial Discrimination and therefore the Government must act to address this.
“The National Council of Women has joined a long list of organisations and individuals who have pleaded with the Government to listen to their concerns.
“Just how long will the Government allow people who have already suffered horrifically because of sexual abuse to suffer, before they listen?
“The Government’s decision to limit access to ACC funded counselling for sexual abuse survivors is flawed and they should act now to overturn a decision that re-traumatises those who have already suffered enough,” Annette King said.
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