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?

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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/

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

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

Case for wider probe of ACC entitlement-cutting culture now even stronger

A post from Frogblog by Kevin Hague

A couple of weeks back I responded to ACC’s u-turn on handling sensitive claims by calling for a wider and urgent review of all the changes to entitlements and assessment procedures in order to save money, with a view to identify other categories of people who are being revictimised by the changes. So far there has been no response from Minister Smith.
Sunday’s revelations in the Sunday Star-Times about the role played by Felicity Goodyear-Smith are further cause for this investigation: we simply have to know whether ACC has been colonised by a sick culture, totally at odds with the Woodhouse principles and the intent of the scheme.
ACC both 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’s history of association with the Centrepoint “community” and extremely controversial views about sexual abuse are well-known.
It seems, then, that her engagement by ACC can only have occurred through some catastrophic failure of process and judgment or through a deliberate set of actions intended to reduce support for sensitive claimants.
New Zealanders need to know which of these it is and to be confident that this kind of disaster cannot recur. It’s time for Nick Smith to launch the urgent investigation that I have called for.

http://blog.greens.org.nz/2010/08/30/case-for-wider-probe-of-acc-entitlement-cutting-culture-now-even-stronger/

ACC adviser silent on links to sex abusers

An article from the Sunday Star Times by Tim Hume

Concerns are being raised over changes at ACC that denied sex crime victims access to treatment. Critics allege the changes were partly based on advice from an academic who is married to a sex offender.
Auckland University medical and health sciences faculty professor Felicity Goodyear-Smith was one of the authors of a 2005 paper on sexual abuse counselling funded by ACC.
She is the daughter-in-law of Centrepoint community leader and convicted paedophile Bert Potter. His son, her husband John, was jailed in 1993 on historic charges of indecent assault at Centrepoint. Her paper recommended a diagnosis of mental injury, as defined by the American Diagnostic and Statistical Manual, be made at the outset of treatment. Last year ACC accepted that criteria for those seeking support, denying hundreds of victims counselling and outraging counsellors, who said labelling sex crime victims mentally ill was stigmatising and unethical.
New Zealand Association of Psychotherapists' sensitive claims spokesman Kyle MacDonald said there were "obvious parallels" between the new rules and the research, and his group was opposed to Goodyear-Smith's involvement in ACC-commissioned sexual abuse research.
The mental injury diagnosis was not included in a 2008 Massey University guideline, a widely accepted document outlining best practice in the sexual abuse field, which ACC says guided its policy.
Last year's changes saw a drop in sexual abuse claims, prompting ACC Minister Nick Smith to set up a review panel that reports next month, but ACC has already reinstated 16 hours of counselling for victims.
Goodyear-Smith, who lived for years on Centrepoint land, working as the community's GP, is an outspoken critic of sexual abuse counselling, saying it can be as damaging as sexual abuse itself, and once telling a newspaper the "ACC scam's one of the biggest there is". She is the founder of a support group for men accused of sex crimes, and has acted for them in the courts and the media over the past 16 years.
Counsellor Barri Leslie – herself a former Centrepoint member – alleges Goodyear-Smith provides "an academic veneer" for attitudes similar to Bert Potter's. "It's outrageous she's been commissioned by ACC in the area of sexual abuse counselling," she said.
A special investigation in today's Focus outlines similarities between Bert Potter's and Goodyear-Smith's positions, including that not all sexual activity between adults and children is damaging.
ACC told the Star-Times last year it had not commissioned research from Goodyear-Smith but now admits it did. Smith's spokesman distanced him from the research, saying it occurred three years before he became minister, and that he had no information on the matter. "The minister does have concerns about the pathway and that is why he established the independent clinical review panel."
Goodyear-Smith would not be interviewed for the story.

© 2010 Fairfax New Zealand Ltd

http://www.stuff.co.nz/sunday-star-times/news/4072453/ACC-adviser-silent-on-links-to-sex-abusers

Conflicting interests?

An article from the Sunday Star Times by Tim Hume

Professor Felicity Goodyear-Smith is a senior academic and doctor who was commissioned by ACC to research sexual abuse counselling. She is also the daughter-in-law of Centrepoint guru and paedophile Bert Potter, is married to a convicted sex offender and has controversial views on the workings of the 'sexual abuse industry'. Tim Hume examines allegations of Goodyear-Smith's influence in ACC's recent drastic cut in support for victims of sex crimes.
Last October, ACC changed the rules governing the support available to victims of sex crimes, introducing a heavily criticised new regime that severely restricted access to counselling.
But what most concerned critics was an apparent similarity between a requirement in the new "clinical pathway", and a recommendation contained in research ACC had commissioned from a controversial senior academic. The research was led by Professor Felicity Goodyear-Smith, who has been a vocal detractor of the field of sexual abuse counselling and who, as the daughter-in-law of Centrepoint founder Bert Potter, has ongoing personal relationships with convicted child sex offenders.
During the eight months following the clinical pathway's introduction, ACC paid out $7 million less to 2889 fewer claimants than it had over the same period a year previous. Approved new claims, running at 1313 in the eight months prior to the pathway's introduction, subsequently dropped to 240 over the same length of time. Among the hundreds to have their claims denied were two women believed to have later committed suicide.
Despite a record $4.8 billion loss sustained by ACC the previous financial year, ACC Minister Nick Smith stressed the policy was not an attempt to cut costs, but was driven by a desire to implement best practice for sexual abuse victims, known as "sensitive claimants". Critics dubbed the new pathway a "rapists' charter".
The scheme's many detractors were primarily concerned by a new requirement that, before they could access ACC counselling and support, claimants had to be diagnosed formally with a mental injury as defined by the American Diagnostic and Statistical Manual (DSM-IV). Whereas previously, ACC might have accepted a GP or counsellor's description of symptoms such as flashbacks, panic attacks or nightmares resulting from a sex crime, now a formal diagnosis of a mental illness such as post-traumatic stress disorder was needed.
It's unclear exactly why. Nowhere was a DSM-IV mental illness diagnosis specified in the so-called "Massey guidelines", the widely accepted 2008 best practice manual which ACC had commissioned from Massey University researchers, and which it cited as having guided the formulation of the pathway ...

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© 2010 Fairfax New Zealand Ltd

Ideology of denial

A blog entry by Kyle MacDonald

Recently I was asked if my quote in this Herald article meant that I thought that ACC were deliberately looking for ways to decline claims, a contentious assertion to be sure. I don’t think that, and I said so. Such a crude and simplistic explanation clearly makes little sense. I harbour no ideas that the day to day workers in ACC have any cruel or malevolent intent, mostly I’m sure they are following orders and doing as much as they can within the limits imposed upon them. What interests me is what do the architects of this new aproach think to enable them to act in the ways they have over the last twelve months?

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