National must stop meddling with ACC before the election

A press release from the Green Party by Kevin Hague

The redesign currently occurring at the Accident Claims Corporation (ACC) for sensitive claims needs to be put on hold immediately, said the Green Party today.
The Green Party is concerned about work currently underway at ACC involving the sensitive claims service that could impact on the availability of clinical psychology treatment for victims of rape and sexual abuse as well as their privacy. The Green Party believes that ACC is instituting a new level of bureaucracy in order to farm out sensitive claims to private providers.
“Instituting major structural change into the way ACC delivers services to New Zealanders a few weeks out from a general election is unacceptable,” Green Party ACC spokesperson Kevin Hague said today.
“The new corporate insurance model that ACC is moving towards creates a new layer of bureaucracy that may enable companies to set up and profit from procuring the services of specialised psychologists.
“Private companies should not be able to turn a profit from the money intended to support the victims of sexual violence and abuse.
“ACC’s new model involves the creation of new, non-specialist ‘supplier’ entities who will tender for the provision of services with pre-existing treatment providers.
“Moving towards this model could result in non-specialised third parties handling extremely confidential information which is currently only held by the Sensitive Claims unit and select providers,” Mr Hague said.
“The supplier organisations do not need to be specialists in sexual violence services, but are entirely new organisations set up for nationwide competitive tendering. It is not clear that in the event of a breach of privacy or process who would be held to account.
“The sensitive claims redesign could result in a decline in the specialist workforce and undermine the provision of wrap around services.
“Any psychologists not signed up with a supplier or themselves becoming a supplier will be unable to provide ACC funded specialist claims services.
“The Government has missed the opportunity to redesign the sensitive claims pathway and fully implement the Disley report recommendations.”
The Disley report, released in 2012, suggested a wide range recommendations including improving communications with clients, refining ACC’s systems and processes, ensuring treatment and assessment is carried out by a well-qualified, fit-for-purpose workforce.
“National is choosing to push through major changes without properly consulting clients, advocates, psychologists or the public,” Mr Hague said.
“The new direction National is taking ACC lacks proper checks and balances.
“The Green Party will stop this attempt at privatisation of ACC by stealth.
"The Green Party has previously laid out a ten point plan for rehabilitating ACC and bring it back to the core principles it was founded on.”
Link to Green Party ACC plan: https://www.greens.org.nz/press-releases/acc-rehabilitation-plan-announced

© 2014 Scoop Media

http://www.scoop.co.nz/stories/PA1408/S00211/national-must-stop-meddling-with-acc-before-the-election.htm

Govt questioned over ACC policy

A news report from Radio New Zealand News

Opposition parties are questioning how long the ACC Minister has known about a privacy waiver used by the corporation that has now been ruled by a court as too broad.
ACC Minister Judith Collins, questioned in Parliament, said she was told about the court decision on Friday and was not aware of the significance of the issue.
But Labour and the Greens say Ms Collins has known about the issue for years, as it was raised in a report about a privacy breach 18 months ago.
Green MP Kevin Hague said after serious privacy breaches by ACC in the past, Ms Collins made public confidence in the corporation a ministerial concern.
Labour's ACC spokesperson Iain Lees-Galloway said it was implausible Ms Collins heard of the issue only last week.
"It was in the review of the Bronwyn Pullar case that issues with this form were first identified. In fact, there were media articles about this late last year as well. It's implausible the minister only heard of this issue last week."
In August 2011, details of more than 6000 ACC clients were mistakenly sent to Auckland claimant Bronwyn Pullar, resulting in the resignations of ACC minister Nick Smith, ACC chair John Judge, two directors and chief executive Ralph Stewart.
Outside the House on Wednesday, Judith Collins said ACC should not be handing over people's sensitive claim information to prospective employers and she hadn't heard about the sensitive claims complaint until Wednesday.
"I am actually very concerned about that and I want to find out what are the facts behind it. Is this correct? I understand that there has been some complaints filed with the Human Rights Commission. If that is true, I look forward to seeing what has occurred and when it has occurred."
Ms Collins says she wants to make sure that people's privacy is protected.

http://www.radionz.co.nz/news/national/241780/claims-acc-sent-sensitive-files

© Radio New Zealand 2014

Question to Minister

10. KEVIN HAGUE (Green) to the Minister for ACC: Have all of the recommendations of the 2012 Independent Review of ACC’s Privacy and Security of Information been implemented; if not, why not?



Hon JUDITH COLLINS (Minister for ACC): ACC advised that it has implemented 37 of the 44 recommendations. A number have ongoing activity associated with them. Of the remaining seven, two are under active management, which relate to information governance and the implementation of data loss protection software. The other five involve a fundamental review of ACC’s end-to-end claims process activity. Accordingly, ACC advised that it has taken a deliberate decision to complete the end-to-end process review of claims management as part of its work around improving trust and confidence. This is to ensure all processes and information technology changes required under these five recommendations comprehensively meet the intent of the report.
Kevin Hague: Is she confident that the recommendations to ensure that consent forms follow the law and are best practice have been properly implemented, given that the court has just found that the way that ACC was using its ACC167 form was actually illegal?
Hon JUDITH COLLINS: I do not want to argue with the member, but, strictly speaking, the form was not held to be illegal, but the way in which it was used was outside of the statutory requirements. I agree with the member that the form must be changed to comply with the latest decision. I have also been advised by ACC that this form has in the past been approved by the Privacy Commissioner, by the Human Rights Commission, and, I have been told, by six different District Court decisions. So the fact that this latest decision has said that it has been wrongly used is something that ACC is taking very seriously, as am I.
Kevin Hague: How does she reconcile ACC’s illegal use of this form with the privacy review’s findings that stakeholders’ single-biggest concern was the attitude and culture of the organisation in dealing with their personal information, and the report’s finding that a consistent theme was that information not relevant to the claim was held on file?
Hon JUDITH COLLINS: I also recall that the review said that the form itself was able to be used. So I think the problem is that the past decisions of the courts and of other agencies, like the Human Rights Commission, the Privacy Commissioner, and also the review, have not actually said that the form has been misused. But I believe that the member is right that the form should be changed. ACC told me on Monday this week that it was not going to appeal the decision and that it would abide by it. I think that is the right outcome.
Kevin Hague: How do revelations today that ACC has been handing people’s full ACC files—including information on sensitive claims—over to prospective employers stack up against the recommendations of the privacy review?
Hon JUDITH COLLINS: I am sorry, I have not heard that claim, but if the member would like to provide me with the information, I will be happy to take some action. I seek leave to assist the member with the summary—
Mr SPEAKER: You are seeking leave to table a document?
Hon JUDITH COLLINS: It is a document that is the independent review recommendations and summary of actions as at 24 January this year, and I think that might help the member.
Mr SPEAKER: Leave is sought to table that summary of actions. Is there any objection to that being tabled? It can be tabled.
    Document, by leave, laid on the Table of the House.
Kevin Hague: How does the Minister reconcile the responsibility she took as Minister in 2012 and her comment that “I’m not going to sit back and let one of the most important Government entities we have let people down time and time again around things such as privacy. They have to act in the way that I expect them to act.” with her comments over the past several days that the implications of the court decision are an operational matter?
Hon JUDITH COLLINS: Well, strictly speaking, forms are an operational matter, but if the member is going to come to see the progress that has been made and what actions I have taken, I think that I have been very strong on this issue relating to ACC. I can look at the proof of just how successful that has been. In August 2012 there were 80 privacy breaches from ACC. A year later, in August 2013, that was down to 28. In March 2014—the month just past—it was down to 19. There are significant improvements in the ability of ACC to protect people’s privacy, and at the same time, to comply with its obligations under its own Act.

http://www.parliament.nz/en-nz/pb/business/qoa/50HansQ_20140416_00000010/10-accident-compensation-corporation%E2%80%94privacy-and-security

ACC claimants plan legal bid for more compensation

A news report from One News

ACC claimants who have had their private details exposed in a major privacy breach are launching legal action to claim more compensation.
Nearly 7000 clients have been offered less than a few hundred dollars in compensation after their personal details were accidentally emailed to former National Party figure Bronwyn Pullar.
However, the mother of a 12-year-old client involved in the privacy leak claims that figure is not enough.
The mother, whose identity cannot be revealed because her daughter is a sexual abuse victim, claims ACC's $250 compensation offer is insulting.
"I want her to see that those that have done wrong are going to front up and treat it with the appropriate, the appropriate response and not just be fobbed off with a bit of pocket money."
Her daughter is one of 200 sensitive claimants offered $250. Two months since the offer was made, only 84 have claimed the money.
She, along with other ACC claimants, is planning to pursue ACC for a payment worth thousands of dollars
"If you're just one person then $250 is a lot of effort to go to the Privacy Commissioner and the Human Rights Tribunal, but if there's a group then you know it makes more sense to go and we'll probably take some group action," said lawyer John Miller.
So far ACC have paid out $21,000 in compensation to privacy leak victims in exchange for their silence.
"There may be people in ACC right now who're saying 'well most people haven't taken up this offer, that's a bit of a win for us' - well actually hold the phone," Green Party ACC spokesperson Kevin Hague.
ACC refused requests for an interview, saying they are bound by a confidentiality clause in the compensation agreement.

© 2012 Television New Zealand Ltd

http://tvnz.co.nz/national-news/acc-claimants-plan-legal-bid-more-compensation-5108082

ACC specialists fees reveal huge doubts about independence

A press release from the Green Party by Kevin Hague

Evidence that ACC is paying some medical specialists up to half a million dollars a year, an average of up to $1666 each client, reveals huge doubts about the independence of some of the corporation’s favourite doctors, the Green Party said today.
“I have documents showing ACC paid some of its top specialists up to $500,000 a year for between 300 and 500 clients,” Green Party ACC spokesperson Kevin Hague said.
“The enormous volume of work and the huge fees paid to these specialists suggest they have been well and truly wrapped up in ACC’s processes for delivering its goal to ‘target the low hanging fruit’ – the people with long term injuries.
“It would be totally unacceptable if the corporation was using doctors it can rely on to deliver assessments that meet that target.
“ACC has a well-established and clear goal of exiting people from the scheme and it is crucial that medical assessments are seen to be truly independent.
“It seems little has changed since Judge Trapski’s damning 1994 report that found, in the case of one favoured ACC specialist, that he’d been used over the years as ACC’s “hit man.”
“Trapski warned then that ACC’s medical assessors need to not only function as independent specialists but must be seen to be independent.
“Favouring a select group of specialists whose medical opinions appear to favour ACC’s agenda is not being seen to be independent.
“The huge fees paid to these assessors, combined with the extremely high rate that ACC’s decisions on long term claimants are overturned at review, reveals real concerns about the fairness of their decisions.
“The ACC Minister must urgently enquire into the appointment of these specialists, and instruct her new board to devise a way to appoint truly independent assessors.
“In answer to my questions in the House today the Minister seems to share our concerns and be determined to actually achieve independent assessments.
“An option would be to bulk fund DHBs to provide a rolling roster of specialists to provide ACC assessments in their region, or contract with professional colleges to ensure the assessments are independent,” Mr Hague said.
Data received through OIA on the payments made and workloads of ACC assessors: http://www.greens.org.nz/misc-documents/data-received-through-oia-payments-made-and-workloads-acc-assessors

http://www.scoop.co.nz/stories/PA1209/S00211/acc-specialists-fees-reveal-huge-doubts-about-independence.htm

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

Independent medical assessments must be a top priority

A press release from the Green Party by Kevin Hague

The newly constituted ACC Board needs to demonstrate its commitment to culture change in the organisation by immediately changing the way it commissions the services of specialist medical assessors, Green Party ACC spokesperson Kevin Hague said today.
Melanie Read's 60 Minutes story, which screened earlier this evening, has revealed to the public what ACC advocates, long term claimants, and the Green Party have known for some time: that ACC is selectively contracting favoured medical assessors who deliver the assessments that ACC needs to end the entitlements of long-term claimants.
"There is no doubt that ACC has a standard practice of using specialist medical assessors who are likely to make an assessment favourable to ACC,” said Mr Hague.
“The many claimants' stories I have on file show, in particular, it is common for ACC medical assessors to have views which are unusual in their specialty, and who are willing to offer opinions outside of their recognized scope of practice.
“Dr Du Plessis, who was interviewed in Melanie Reid's story is far from unique.
“This is not a new problem. The review of ACC claims management undertaken by Judge Trapski in the wake of the scandal in which Dr. Laurie Gluckman was used by ACC to give opinions in ACC's favour, recommended in 1994 that specialist medical assessments should be genuinely independent of both the claimants and ACC itself.
"It is scandalous that ACC is still engaging in these unethical practices. It is yet another illustration of the sick culture of disentitlement that has taken hold of the organisation,” said Mr Hague.
“It will be an important test of the Minister and the new Board whether urgent action is now taken to introduce truly independent assessments.
"The Green Party has suggested several ways of doing this to the Minister. One is to engage with the specialists' professional colleges to have them appoint medical assessors. Another is simply to extend the contracts ACC already has with District Health Boards so that DHB specialists make the assessments,” said Mr Hague.
Mr Hague has also raised with the Minister ACC's intention to now exercise greater control of the clinical "gateway" into the scheme.
"ACC is now extending the methods they have used to 'exit' long term claimants to the processes by which accident victims are referred into the scheme by general practitioners. The Minister has indicated that our grave concern about these practices will be considered by the new Board. This can't come soon enough,” said Mr Hague.

http://www.scoop.co.nz/stories/PA1209/S00112/independent-medical-assessments-must-be-a-top-priority.htm

Rebstock’s appointment highlights opportunity for ACC

A press release from the Green Party

The appointment of Paula Rebstock as permanent chair of ACC is an opportunity to steer the corporation back towards the role and principles it was founded on, the Green party said today.
Ms Rebstock has been interim chair of ACC since John Judge stood down and today was appointed chairperson.
“Ms Rebstock has a huge responsibility to turn the ACC ship around,” Green Party ACC spokesperson Kevin Hague said today.
“Recent reports into ACC by the Auditor General and the Privacy Commissioner have called for major top-level change at the corporation.
“New Zealanders will expect a very different performance and attitude from ACC than they saw when Ms Rebstock was a board member under John Judge and the previous ACC minister Nick Smith.
“Her dual roles in both ACC and Work and Income will require her to be particularly conscious that it is not acceptable to exit people from ACC only to have them end up on WINZ benefits.
“Ordinary New Zealanders don’t like the profit-driven, privacy-abandoning organisation that ACC has become and want it to return to the principals it was founded on.
“It’s pretty basic really. Kiwis gave up the right to sue for a no-fault system that guaranteed them proper compensation and rehabilitation when they were hurt and injured. Its about giving injured New Zealanders the chance of a good life and a fair future.
“Ms Rebstock has a huge job to lead the top-level change that’s needed to make that happen,” Mr Hague said.

http://www.scoop.co.nz/stories/PA1209/S00033/rebstocks-appointment-highlights-opportunity-for-acc.htm

Damning reports show Government’s role in ACC dysfunction

A press release from the Green Party by Kevin Hague

Reports into ACC provide the most compelling evidence yet that the Government’s focus on saving a buck has caused ACC to lose sight of its role in helping injured and vulnerable New Zealanders, the Green Party said today.
Following requests from the Green Party, reviews into the Bronwyn Pullar Privacy breach and ACC board governance were conducted by the Privacy Commissioner and the Auditor General. Reports on both were released today.
“They reveal a corporation in desperate need of a culture change which the Privacy Commissioner stated must ‘start at the very top’,” Green Party ACC spokesperson Kevin Hague said.
“The reports cite the previous ACC minister’s focus on denying claimants every dollar he could as driving the culture at the corporation.
“And they show that ACC was prepared to sustain human casualties in its drive to achieve the Government’s goal.
“The current minister must now lead the top level change that’s been called for.
“The reports reveal a corporation bumbling along with archaic ideas about communication and responsibility which meant it failed both to treat claimants with decency, and to recognise enormous risks to the organisation even when they hit it in the face,” Mr Hague said.
The Auditor General expresses concern that serous ‘accusations of systemic illegality and fraud were not taken seriously by the corporation’.
And the Privacy Commissioner highlighted ‘an almost cavalier attitude towards its clients and to the protection of their private information’.
“These are two of the most damning reports on a Government entity I’ve ever read.
“It is clear that if board chairman John Judge had not already resigned, he would have been sacked today,” Mr Hague said.
The reports highlight three key issues:

1. As a result of Nick Smith's direction to prioritise ACC's bottom line, the organisation had inadequate focus on the needs of its clients;
2. The culture policies and systems of the organisation are a chaotic shambles that are not fit for purpose;
3. Restoring public trust and confidence is an essential goal and will require very major change starting from the top.

“Given the seriousness of the findings, the Minster must now request that the Auditor General bring forward her review into claims management at ACC. Most of the serious claims Ms Pullar made appear not to have been considered by the board.
“What’s now needed is for visionary leadership to turn this organisation around and focus on the original principals on which it was founded.
“The Minister must ensure that future appointments to the board are up to this task,” Mr Hague said.

http://www.scoop.co.nz/stories/PA1208/S00337/damning-reports-show-governments-role-in-acc-dysfunction.htm

Minister furious over ACC's privacy stance

An article from Stuff by John Hartevelt

ACC Minister Judith Collins wants the state insurer to start sacking staff who breach a new "zero tolerance" policy on privacy breaches.
A furious Ms Collins has revealed her astonishment at the failure of ACC to include privacy among nine of its "top priorities".
"I'm not going to sit back and let one of the most important government entities [that] we have let people down time and time again around things such as privacy.
"They have to act in the way that I expect them to act. When I go around the branches, most of the people there absolutely understand it.
"But, actually, a few are letting them down and when we have things like the audit and risk committee having nine priorities for the year and not one of them [being] privacy, how can that be acceptable given everything else that's going on?"
Ms Collins' comments come as figures from ACC show 11 staff members have been reprimanded over "serious misconduct" since 2010. The breaches involved: theft; fraud against ACC or a claimant; serious misuse of ACC property, including information and systems; dishonesty; disobeying a lawful and reasonable instruction from a manager; and any act that had the potential to bring ACC into disrepute. Nine staff were sacked as a result of the breaches and two were given final written warnings.
Ms Collins said while the serious misconduct cases were "a shame", she was pleased they were taken seriously and not covered up. "I think that they need to be - and they are now - taking on a culture of zero tolerance to privacy breaches, in particular," she said.
Police had a "zero tolerance" approach to staff accessing private details about people without good reason.
"People lose their jobs over it, and that's something that I think ACC needs to have, which is that we have people's very personal information, we should treat it with respect and should understand it's a very privileged position."
ACC has been under siege over repeated privacy breaches since March, when it was revealed the private details of 6500 clients were accidentally sent to claimant Bronwyn Pullar. The revelation sparked a string of controversies, culminating in three inquiries and the resignations of Cabinet minister Nick Smith, board chairman John Judge, chief executive Ralph Stewart and three other board members. Separate inquiries by the privacy commissioner and the auditor-general will be released within weeks.
Ms Collins said she expected the new board members, including a new chairperson, to be in place "just after that".
"When I reappoint or appoint people to the board, that has to be someone who is going to be able to spend the time necessary in bringing about the cultural change that I expect from ACC . . . We need to do an awful lot around the culture of customer service and respect towards members of the public that I know most of our staff are providing."
Green MP Kevin Hague said even basic data protection systems at ACC still appeared to be hopeless.
"When every other state agency, let alone private sector organisation, was busily doing its best to protect data and figure out how to keep people's privacy protected, how come ACC, an organisation that was dealing with some of the most sensitive information out there in the state sector, was effectively doing nothing? I suspect that their focus has been not on meeting client needs. I think their focus has been on their financial result . . . thinking about clients as liabilities rather than people to whom they owe service."

© 2012 Fairfax NZ News

http://www.stuff.co.nz/national/politics/7464891/Minister-furious-over-ACCs-privacy-stance

Green MP says report reveals ACC anti-claimant culture

A report from Radio New Zealand

The Green MP, Kevin Hague, says a new report on the Accident Compensation Corporation is more proof the corporation's been more focussed on getting claimants off its books than on providing help.

Copyright 2012 Radio New Zealand

http://www.radionz.co.nz/national/programmes/morningreport/audio/2525394/green-mp-says-report-reveals-acc-anti-claimant-culture

Comments 'embarrassing' for ACC

An article from the Otago Daily Times by John Gibb

Recent comments by an ACC senior manager about sharply reducing long-term claimant numbers have been "very embarrassing" for the commission, a Dunedin lawyer says.
Peter Sara said the ACC had clearly not expected comments by ACC general manager Denise Cosgrove at an Institute of Actuaries of Australia conference in Brisbane would later be made widely available via internet and podcast.
Ms Cosgrove said ACC had faced major financial and other challenges but had since cut claims costs by $3.2 billion. ACC managers had "taken the low-hanging fruit", but now faced more complex claims which made rehabilitation and return to work "a bit harder", the conference transcript said. There had been targets for "actuarial release" and "stellar results", but there had also been adverse media coverage of issues such as "sensitive claims", involving sexual abuse, and elective surgery, she said. ACC administrators had done the right things but had "moved too fast and didn't take the sectors with us", the transcript said.
Mr Sara said he was a "very strong supporter" of ACC but was "appalled" by Ms Cosgrove's comment about "low-hanging fruit", made at the conference last November.
Dunedin ACC campaigners say the comments initially "flew under the radar" but have sparked parliamentary debate and media coverage since Green Party ACC spokesman Kevin Hague tabled in Parliament last month a transcript.
Mr Sara said many vulnerable, injured people had been viewed as "ripe for the picking" and had been removed from ACC scheme coverage in recent years, but in many cases rehabilitation had not been achieved. ACC's practices needed an "extreme makeover" if it was to recapture the public trust which had been lost, he said.
Darryl Frank, a Pricewaterhouse Coopers actuary, who has worked closely with ACC, told the conference there was "constant tension between the two sides of politics" in New Zealand and "differences in political ideologies". Labour governments were "typically increasing access to benefits" but this had been "to some degree reversed" by the National-led Government since 2009, given concerns about ACC finances, he said.
Dr Denise Powell, the president of Acclaim Otago, an ACC claimant support group, said a mask had slipped and the "incredibly blatant" truth had been revealed about the removal of large numbers of long-term claimants from ACC coverage in order to meet political objectives. She had listened to the conference on a podcast, and recalled "being quite shocked, sitting there with my mouth open".
Approached for comment, ACC lead media adviser Stephanie Melville said the term "low-hanging fruit" had been "used to describe the first raft of improvements"- that is "initiatives to yield rapid positive results to systems and process".
"It does not refer to individual clients or any attempt to stop people making claims."
No client was denied ACC help "before they're ready for vocational independence", she said.

© Allied Press Limited 2012

http://www.odt.co.nz/news/dunedin/215256/comments-embarrassing-acc

ACC shows kinder face, cuts back-to-work goals

An article from the New Zealand Herald by Adam Bennett

ACC is to soften its drive to get long-term claimants back into work in the face of concerns it is pushing clients off its books before they are properly rehabilitated.
The corporation yesterday published its Service and Purchase Agreement for the 2012-15 period in which it sets out its targets and priorities. Improving "trust and confidence" was the corporation's number one priority in the agreement, replacing "cost containment" which was top of the list last year. Its second priority in this year's agreement is "improved management and security of private information".
Since March, the corporation has grappled with a massive privacy breach and ensuing scandal, a failed attempt to prosecute claimant and former National Party insider Bronwyn Pullar for blackmail, and an increasing spotlight on its controversial strategy to bolster its financial sustainability by moving costly long-term claimants off its books. That came top of a series of articles in the Herald highlighting ACC's tougher approach to elective surgery claims.
Figures obtained by the Herald last week showed the corporation cut the number of long-term claimants receiving weekly compensation by 3644 or 25 per cent to 10,773 in the three years since June 2009.
That was well ahead of targets. Last week ACC said its target for the 2012-13 year was a reduction of 253. In the agreement published yesterday that target was reduced to 200.
Acting ACC chairwoman Paula Rebstock said that as the number of long-term claimants declined, so did the targets for reducing that tally further.
She acknowledged "there was some discussion" about having the target slightly higher for the coming year, "but the board took the view that given the new priorities and the focus on addressing some of these other issues, that target would have to be slightly lower and we lowered it".
Those priorities and issues were spelled out clearly in ACC Minister Judith Collins' "letter of expectations" to former chairman John Judge in April which was also released yesterday.
While she said the corporation had done well managing its finances, the board had a broader set of responsibilities including "ensuring entitlements are delivered fairly and transparently to all New Zealanders".
"While the gains made by ACC over the past year are very pleasing, I am aware that the initiatives taken by the board to raise performance of ACC have had many and varied impacts on claimants, health providers, and other stakeholders" she went on to say. "ACC and the way it delivers services are now seen by many in a new light ... Recent events have not helped the public image of the corporation."
Greens ACC spokesman Kevin Hague said the new agreement was encouraging.
"I'd been looking at this document as a litmus test for whether Ms Collins' language about a culture change should be assumed to be empty rhetoric or whether it's likely to have substance, and very clearly in her letter of expectations and in the agreement ... she's actually followed through so far."
Claimants advocacy group the ACC Futures Coalition said Ms Collins had set out some good first steps.
"They should go a long way towards strengthening ACC as a public institution for the coming year" said spokeswoman Hazel Armstrong. "We welcome the emphasis on rebuilding public trust and confidence in ACC, but trust takes a long time to build and, as the corporation has just found out, can evaporate rather quickly."
However, the agreement said nothing about the need for ACC to use truly independent medical assessors and it still emphasised getting people off the scheme using "vocational independence".
"Both these factors have contributed to claimant disillusionment with the scheme and need to be addressed."

ACC'S TARGETS
For culling long term claimants:
* 2009-10: 100
* 2010-11: 1150
* 2011-12: 406
* 2012-13: 200
* 2013-14: 89
* 2014-15: 50

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10816237

New contract to 'rebalance' ACC targets

An article from the Dominion Post by Andrea Vance

ACC Minister Judith Collins will set out tough new expectations in a new contract with the troubled corporation – to be tabled in Parliament today.
The document is a rolling three-year service and purchase agreement between the Government and the state insurer. It is understood to be a long way from an agreement signed in June 2010 by former minister Nick Smith, which focused on financial performance, and will "rebalance" its objectives.
Dr Smith and board chairman John Judge – who was let go this month – agreed ACC would get rid of 1150 long-term clients a year.
Ms Collins, who is in China, has said she wants to drive a "culture change" to restore public confidence in the corporation. In April, she said: "ACC must follow a fair process for assessing their eligibility and ensuring they receive fair entitlements."
The corporation has been attacked this year for operating a policy in which thousands of long-term clients – branded "low-hanging fruit" – were shed. The strategy paid staff bonuses to get clients off its lists. And the poor treatment of clients culminated in the Bronwyn Pullar saga – which claimed the scalps of Dr Smith, Mr Judge, chief executive Ralph Stewart and three other board members.
ACC called police after Ms Pullar went public with a mass privacy breach of the details of 6000 claimants. Police found no case to answer.
Green Party ACC spokesman Kevin Hague told Parliament yesterday that adjudicator Dispute Resolution Services had upheld almost half of the appeals lodged by long-term claimants kicked off ACC's books in 2012. He also revealed that the district court had also overturned half of ACC decisions upheld by Dispute Resolution Services.
Prime Minister John Key said that "over the past six years the average percentage of disputed decisions found in the corporation's favour is 71.8 per cent".
To say that "because a few cases go against the corporation, everything is broken there, is just simply incorrect".
Opposition parties yesterday criticised ACC for offering compensation worth $250 to victims of the data leak. Labour's ACC spokesman Andrew Little said the offer heaped "injustice upon injustice".

© 2012 Fairfax NZ News

http://www.stuff.co.nz/national/politics/7182650/New-contract-to-rebalance-ACC-targets

Question to the Prime Minister

12. KEVIN HAGUE (Green) to the Prime Minister: Does he stand by his reported comments regarding ACC that he “backed the corporation’s harder stance, saying it should continue and there was no evidence legitimate claimants were missing out”?

Rt Hon JOHN KEY (Prime Minister): I think the member might find that that was poetic licence taken by the *New Zealand Herald. I stand by my actual statement in response to a question, which asked whether I had any concerns that ACC is prioritising its bottom line over entitlements for claimants, to which I responded that I had not seen any real evidence of that. I also said that what has got to be carefully monitored is that we are not throwing people off the tail, or their support from ACC, if it is neither legally correct nor fair.
Kevin Hague: How can he be sure that legitimate claimants are not missing out when almost half of those long-term claimants who have appealed ACC’s decision to exit them in 2012 are found by *Dispute Resolution Services to have been wrongly kicked off?
Rt Hon JOHN KEY: There can and will be isolated cases where someone has not been treated fairly, and that is against what I think is appropriate, which is why I said on Monday that it had to be legal and fair. I would point also to the advice that I have in relation to *Dispute Resolution Services that over the past 6 years the average percentage of disputed decisions found in the corporation’s favour is 71.8 percent.
Kevin Hague: How can he be sure that legitimate claimants are not missing out when, of those decisions of ACC upheld by Dispute Resolution Services that are subsequently appealed at the District Court, around half of those are overturned?
Rt Hon JOHN KEY: As I said earlier, I cannot be sure in every case, which is why I said earlier in the week that it is very important that the corporation deals with people in a way that is both
legally correct and fair. It is also important that people have an avenue to test their rights, if they believe they have not been fairly treated, and people do. The Government separated Dispute Resolution Services from ACC, to emphasise its independence. As I said in answer to the last question, in terms of disputed decisions, 71.8 percent are found in the corporation’s favour.
Kevin Hague: Is he aware that a core competency required in ACC case manager job descriptions is that case managers “can decide and act without having the total picture”, and does he agree that the full picture is needed if the numbers of cases overturned on appeal are to be reduced?
Rt Hon JOHN KEY: No; that is an operational matter that should be put to the chief executive, or at the very least the *Minister for ACC.
Kevin Hague: Can the Prime Minister confirm that the average over 6 years of decisions by ACC that have been upheld under review in fact masks a trend whereby, in the last 3 years, those decisions have been below the 70 percent target that the Government has set, whereas in the preceding 3 years they were above it?
Rt Hon JOHN KEY: No. What I can say, as I said in response to earlier questions, is that over the past 6 years the average percentage of disputed decisions that are found in the corporation’s favour is 71.8 percent. The average percentage of elective surgery decisions found in the corporation’s favour is 64.6 percent. In the year to date the percentage of elective surgical decisions found in the corporation’s favour is higher than the rate under a Labour Government. But can I make this one point, and that is that the corporation deals, to the best of my knowledge, with about 1.5 million claimants a year. There are some very technical and difficult cases for everybody in amongst that. But for the most part we should be congratulating the corporation, because I think that for the most part it does a good job for New Zealanders.
Kevin Hague: What action, if any at all, has the Government taken to improve the quality of ACC’s decisions, given the increasing number of decisions that are being taken to review, and ACC’s repeated failure over the past 3 years to meet its contracted target of having at least 70 percent of its decisions about long-term claimants upheld at review?
Rt Hon JOHN KEY: As I said earlier, Dispute Resolution Services was made independent from the corporation to help in that regard. In terms of the success rate in favour of the corporation, it is very high, as I have been saying. There will always be individual cases, but for the member to make the case that, because a few cases go against the corporation, everything is broken there, is just simply incorrect.
Kevin Hague: I seek leave to table an ACC document. It is the job description for a case manager in claims management.
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/PA1206/S00419/questions-and-answers-june-27.htm

ACC’s compo deal should come with no strings attached

A press release from the Green Party by Kevin Hague

ACC should remove the obligation on victims of its privacy breach to sign away their right to talk about its compensation offer or take any legal action in the future, the Green Party said today.
As part of its $250 payment to victims of its mass leak of sensitive claimants’ details, ACC is asking them to accept it is a “full and final” settlement and to stay quiet about it forever.
“It’s neither fair nor reasonable for ACC to demand the claimants give up their right to sue in future over the breach or to complain about their treatment by the corporation,” Green Party ACC spokesman Kevin Hague said,
“The small sum of $250 should be seen as a nominal acknowledgement of harm by ACC and be given with no strings attached.
“It should not be seen as a fair settlement between two parties. There has been no negotiation, or any sort of process where the claimants have been able to have their individual situation heard and acknowledged, and which has led to a settlement.
“The insulting offer of $250 to everyone, regardless of their circumstances, on ACC’s terms alone, is symptomatic of the arrogance which got the corporation into this trouble in the first place.
“New Zealanders gave away their right to sue over injury when they agreed to the formation of no-fault ACC scheme in the early 1970s.
“These people should not feel compelled to give away their right to a full negotiation or compensation just because it’s convenient for ACC,” Mr Hague said.

http://www.scoop.co.nz/stories/PA1206/S00407/accs-compo-deal-should-come-with-no-strings-attached.htm

ACC's tougher line fails to satisfy independent reviewers

An article from the New Zealand Herald by Adam Bennett

ACC decisions to cut long-term claimants loose from entitlements have been overturned by independent reviews at a higher rate since the corporation adopted a tougher approach to them three years ago, new figures show.
But Prime Minister John Key yesterday backed the corporation's harder stance, saying it should continue and there was no evidence legitimate claimants were missing out.
ACC monitors what it calls its "review uphold rate" - the percentage of formal reviews of ACC decisions that are decided in favour of the corporation - as "an important measure" of the quality of its service. The rate gives "a key indicator of whether the proportion of ACC's decisions that comply with the legislation has changed".
Its target in recent years has been a 70 per cent success rate at review. Figures provided by the corporation yesterday showed that when it came to long-term claimants on weekly compensation for 2 years or more, it was meeting that target easily in the three years to 2009. In that time the review uphold rate for claimants managed by the specialist Recover Independence Services (RIS) division was between 73 per cent and 77 per cent.
But the corporation adopted a tougher approach to long-term claims in early 2009. In June 2010, then-ACC Minister Nick Smith and ACC chairman John Judge signed a three-year deal setting out a "priority" that the corporation would get rid of 1150 long-term clients a year. It had 13,157 clients when the service and purchase agreement was signed. In 2010 the RIS review uphold rate fell to 64 per cent, was 66 per cent last year and just 55 per cent in the 10 months to April this year.
Green Party ACC spokesman Kevin Hague said the review figures showed that ACC's "much more aggressive tone" since the 2010 agreement had led to clinically inappropriate decisions in dealing with clients.
But Mr Key said aiming to move people out of long-term support was the right goal because "it's very expensive and secondly unless it's appropriately applied we'd have too many people on it".

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10815507

ACC's quota deal with Smith revealed

An article from the Dominion Post by Phil Kitchin

ACC'S policy of ridding itself of thousands of long-term clients is laid bare in agreements the corporation signed with the Government revealing that a far tougher quota system was adopted two years ago.
Senior ACC managers have since spoken of their success at cutting long-term clients from the books at a conference in Australia, saying the "low-hanging fruit" was gone but the job would get harder.
General manager of claims management Denise Cosgrove told the actuary conference in Brisbane in November that ACC has now shifted its focus to high-cost claims and had "an absolute strategy" but was keeping it secret.
"But that's what we are developing this year. The dollar amount we can achieve in savings from the long-term tail service, so that's how we can drive some of these improvements," she said.
"You might sit there and say, 'Well yeah, sure, that's just all the low-hanging fruit and the easy gains. How are you going to sustain that momentum?' And I get that constant message from the board every day."
In June 2010, then ACC minister Nick Smith and outgoing ACC chairman John Judge signed a three-year agreement that stated as a "priority" that the corporation would get rid of 1150 long-term clients a year. It had 13,157 such clients when the service and purchase agreement was signed. For the first year of the agreement, ACC beat its target by "exiting" 1542 clients. The agreement was then amended, and last year aimed to reduce long-term client numbers by 406. ACC again beat that figure by cutting 843.
Ms Cosgrove told the group of insurers and actuaries in Brisbane that ACC had "an absolute strategy ... and we're not reporting it as a public measure yet". Its focus was now on high-cost claims because the "actuarial release" would be stronger.
The policy has drawn criticism from ACC clients, advocates and politicians.
Greens ACC spokesman Kevin Hague said the agreements showed ACC's board was under pressure to "literally remove thousands of claimants from the corporation".
The pressure from Dr Smith led to the board pressuring frontline staff and managers into adopting "highly unacceptable practices" such as bonus payments for getting clients off its lists, he said.
ACC had not yet signed an agreement with current ACC Minister Judith Collins, which would give her an opportunity to show her stated intent to "drive a culture change in ACC to restore public trust and confidence" in it.
"If, instead, the agreement she signs looks more or less the same as those of her predecessor, then her words will be seen as hollow," Mr Hague said.
An ACC spokeswoman said the long-term claims pool had decreased in recent years because there were fewer claims entering it and more leaving it.

© 2012 Fairfax NZ News

http://www.stuff.co.nz/national/politics/7162536/ACCs-quota-deal-with-Smith-revealed

ACC needs to refocus

A press release from Acclaim Otago

The documents released by Green Party MP Kevin Hague yesterday show case managers have specific targets to achieve. “This is especially concerning if it means that claimants are cut off from receiving justified entitlements when it is not clinically appropriate to do so,” said Dr Denise Powell, president of Acclaim Otago.
"There is the potential for such incentives to be twisted and the losers are those injured people who don’t receive appropriate and timely rehabilitation,” she said.
“We are also concerned about a small number of assessors who seem to be used rather extensively by ACC, and often produce reports that go against all previous clinical investigations and diagnoses."
“The pendulum of ACC’s focus needs to swing back towards the real rehabilitation of injured New Zealanders, and away from the “actuarial release” mantra of the last few years” Dr Powell concludes.

http://www.scoop.co.nz/stories/PO1206/S00303/acc-needs-to-refocus.htm

ACC bonus pay for claimant cull

An article from the New Zealand Herald by Adam Bennett

Cabinet minister Judith Collins has admitted that ACC staff get higher pay for kicking long-term claimants off the corporation's books but defends the strategy as "a good thing" because it gets the clients back to work.
The financial incentives are just one of a number of tactics - including handpicking medical assessors - that ACC has adopted to improve its bottom line, Green Party MP Kevin Hague alleges.
ACC documents obtained by Mr Hague yesterday showed case managers' pay was bumped up when they exceeded management targets, including reducing the number of long-term claimants being paid weekly compensation. Their pay was reduced if they failed to meet those targets. The performance-pay structure amounted to "a bonus - or a disincentive if they don't kick them off as fast as ACC would like", said Mr Hague, the Greens' spokesman on ACC. The performance-pay plan also applied to team leaders, technical claims managers and branch managers.
Ms Collins said that while meeting targets for the number of long-term claimants on ACC's books was among the criteria staff pay was linked to, it was only one component.
"If they do well in the rest of their framework then that shouldn't affect their remuneration," the ACC Minister said.
She said measures that helped ACC encourage people back into work where appropriate were "a good thing".
"I don't see any problem with that, but where I do see a problem is if anyone's being forced off ACC when they're simply not able to work, and I think that's a different thing all together," Ms Collins said.
But Mr Hague said the performance pay increased the risk that "we end up with decisions about whether or not someone is entitled to compensation being driven by the financial interests of the case managers and their managers rather than the clinical needs of the claimants, which is the basis they should be made on".
He said the information he obtained yesterday under the Official Information Act was unsurprising given "we've known now for quite some time that ACC has been pursuing a deliberate strategy of targeting these long-term claimants".
The performance-pay scheme "works hand in glove with ACC's use of medical assessors whom they have handpicked on the basis of being likely to give ACC the decision they would like, and that would be in the financial interest of the case managers".
Responding to Mr Hague's questions in Parliament yesterday, Ms Collins said ACC used specialist, independent vocational rehabilitation services and clinicians, "and that is quite different from the case managers".
ACC's strategy around long-term claimants dates back three years when the corporation identified them as a threat to its long-term financial sustainability. A 2009 Executive Leadership Team Issues Paper by senior manager Phil Riley outlined a tougher new approach to long-term claims, including a "culture change" he said should foster "a stronger balance by staff between customer focus and scheme-liability management, and increasing personal responsibility by clients".
Mr Riley estimated that the strategy could reduce ACC's liabilities by $900 million to $1.4 billion by next year.
Yesterday, Mr Hague said: "This sort of scheme is symptomatic of a sick culture within ACC. ACC needs to return to being an organisation that focuses on prioritising claimants needs."
In 2010 and again this year, the Herald ran a series of articles about the ACC's hard line with claimants, particularly those making claims for surgery. During the series, more than 400 people complained about their ACC cases.
Some lawyers and independent orthopaedic surgeons criticised ACC over its crackdown on surgery access. They alleged it relied on brief, weak opinions from its doctors, some of whom had retired from treating patients and were often not specialists in the areas they advised on.

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10814678