ACC overhauls sexual abuse care service

A news report from Radio New Zealand News by Michael Cropp

The Accident Compensation Corporation has overhauled its sensitive claims service, with its minister saying it made big mistakes in the way it dealt with victims of sexual assaults.
Before 2009, ACC accepted thousands of sensitive claims, but after changes to the system that number plummeted, and in 2011 just 135 claims were accepted.
Survivors' advocate Louise Nicholas said the impact when ACC clamped down on the numbers of claims it accepted was devastating and in some cases victims committed suicide. Support workers no longer wanted to be part of the system, she said.
"We lost hundreds upon hundreds of counsellors who refused to work in such an inhumane system," she said.
"We lost survivors, and I mean literally, lost survivors. So people just backed right off and said 'we don't want a part of this'."
Ms Nicholas had been a member of a panel that worked to overhaul what she said was a highly bureaucratic process which re-traumatised sexual assault survivors and denied them the help they needed. Many struggled with ACC forms asking them what kind of accident they had had - while constant assessments to qualify for assistance wore people down.

More support
Under the new service, that is set to change. There will be a support package for people who have suffered sexual abuse or assault, access to therapy is free and people are covered for longer. People are also able to enter and exit the system for support at any time. As well as the person who was sexually assaulted or abused, family and whānau are also able to seek help free of charge. The form, too, has changed to reflect the sensitivities of the situation.
ACC strategy manager for sexual violence, Emma Powell, said the changes required a big re-think of how ACC dealt with clients.
"It's a tailored response and a tailored approach, trying to put as much control back into the hands of our clients."
The client is able to choose who they see and if things were not working out the Sensitive Claims team would arrange an alternative.
"We talk about the fact that the counsellor-and-client relationship is critical to success, so if it's not working we need to offer ways that people can seek other supports," she said.
The public issues Chair for the NZ Association of Psychotherapists, Kyle MacDonald, worked with sensitive claims clients and helped advise ACC on the changes. He said the new system was much more sympathetic to a survivor's needs.
"I think that ACC have engaged really willingly in the process of recognising that actually the system wasn't working and that they needed to fix it," he said. "they have essentially redesigned a services which looks to address a lot of the concerns raised [in 2012]."
ACC Minister Nikki Kaye, said the old system was not working, and she wanted people to know it had changed.
"There's a lot of work to do, both around how do we prevent these things from happening, but then how do we make sure people are cared for right throughout government," she said.
The Minister said the changes were just the start of a much bigger process, which she hoped would provide better care for survivors and help prevent the violence from happening.

* If you, or someone you know, is affected by sexual violence you can find out more about these services at ACC Find Support site or call the ACC sensitive claims team on 0800 735 566.

© 2015 Radio New Zealand

http://www.radionz.co.nz/news/national/267591/acc-overhauls-sexual-abuse-care-service

ACC privacy ruling welcomed for sensitive claimants

A press release from the New Zealand Association of Psychotherapists

Yesterday’s District Court ruling, that the standard ACC release of information form the “ACC 167” is illegal, has been welcomed by psychotherapists and clinicians working with sexual abuse survivors.
“The Disley Independent Clincial review of the ACC’s treatment of sensitive claimants, undertaken in 2010, outlined serious concerns about this form and the ACC’s approach to the gathering of health information. This decision is welcomed, but long overdue” says Kyle MacDonald, New Zealand Association of Psychotherapists Public Issues spokesperson.
The Disley review included a legal opinion, which noted concerns about the ACC 167, and explained the limitations that apply to the collection of health information. Those working with all ACC claimants, and specifically in the sexual violence sector, have long expressed these concerns.
“We’ve known for a long time that this form, and its implementation, has caused specific problems for sensitive claimants” says Kyle MacDonald, “it has been common practice for the ACC to request ALL of a claimants GP or Mental health notes, and not accept a health professional acting in accordance with the Privacy act by providing only those parts of the record relevant to the claim. Furthermore the ACC have quite explicitly declined to advance a claim if individuals refuse to sign the waiver due to quite legitimate privacy concerns.”
This has set up a perception that ACC have gone on “fishing expeditions” for reasons to decline claims, rather than sticking to the limits of the Privacy Act, like all other health professionals are required to do.
“Hopefully this decision allows people who have had their claim declined due
to the illegal acquisition of health information to have their claim revisited. It should also allow those who have had their claim declined due to their refusal to sign this form to also re-apply for cover and treatment.”

http://www.scoop.co.nz/stories/PO1404/S00230/acc-privacy-ruling-welcomed-for-sensitive-claimants.htm

ACC to rethink abuse link

An article from the Sunday Star Times by Sarah Harvey

A judge has ruled in favour of an ACC claimant in a case expected to have "enormous" ramifications for the way mental health patients are treated. In the decision, released recently, Judge Grant Powell in the Wellington District Court agreed with a psychiatrist who said a man's schizophrenia had been caused by trauma from sexual abuse in childhood.
Two ACC-employed psychiatrists had earlier said there was no evidence schizophrenia was anything other than a biological condition passed down through families and so the man's abuse had nothing to do with his condition. However, the judge agreed with a growing body of research that says traumatic events can cause psychosis.
The research includes the work of clinical psychologist John Read, who has been at the forefront of research to show a relationship between childhood sexual and physical abuse and psychotic symptoms, including schizophrenia. Read said the ramifications of the decision were "enormous".
"It is gratifying that years of research on this issue is impacting the judicial system. These rulings will also make it harder for psychiatrists to ignore disclosures of sexual abuse by severely disturbed patients, or to dismiss them as either irrelevant or imagined.
"This is a significant victory for all those patients and researchers who have been saying for many years that the experiences which biological psychiatry believes are symptoms of a brain disease called schizophrenia are best understood as responses to adverse life events.
"Very often the voices abused people hear are the actual voices of the perpetrator of the abuse."
Read said it was "alarming" that the two ACC psychiatrists "either knew nothing about the many studies documenting the relationship between child abuse and psychosis or were trying to mislead the judge".
The man referred to in the finding had been covered by ACC for his history of sexual abuse but it was schizophrenia that had stopped him from working. He had sought to gain an independence allowance from ACC in December 2010. An independence allowance covers people who are permanently impaired as a result of an injury. The maximum weekly allowance is $84.97.
In 2011, ACC decided it would not cover the allowance because it said his schizophrenia was not linked to his covered injury - a significant history of sexual abuse between five and 13.
He was assessed by a psychiatrist who prepared three reports but concluded sexual abuse "is not likely to be the material cause of the current condition. There is no evidence of sexual abuse as an etiological factor [cause] in schizophrenia." His claim was declined and despite an appeal and subsequent reviews it was again found his incapacity related to his schizophrenia, which ACC said was a health issue unrelated to the sexual abuse.
After another appeal, psychiatrist David Codyre provided a report that completely disagreed with the previous psychiatrists.
"With due respect to my colleagues who undertook the prior psychiatric reports ... their opinion that sexual abuse is not causally related to schizophrenia is not evidence based."
Judge Powell said ultimately he found Codyre's analysis "a more compelling and inherently more credible cause of the appellant's schizophrenia".
Read said the finding would reduce the frequency with which psychiatrists dismissed abuse disclosures as irrelevant or imagined and increased the probability of people being offered trauma-based psychological therapy instead of anti-psychotic medication.
New Zealand Association of Psychotherapists public issues spokesman Kyle MacDonald said the judgement was encouraging and could mean entitlements for many other people.
"The reality is there a lot of people who would be in the mental health system who would have a diagnosis of a psychotic disorder who may now be entitled to access some treatment under the ACC.
"For a long time there has been a mindset of how schizophrenia and psychotic disorders are treated, which is that it is a biological disorder which needs to be medicated and managed.
"The reality is that actually these people are underserviced in terms of therapy and psychological intervention. This is a way to get people more therapy and more psychological help."
ACC said it would consider whether this decision "has any wider impact" but took the view it would have "limited" value as a precedent and it would "continue to carefully consider each person's unique situation and circumstances".

© 2013 Fairfax New Zealand Ltd

http://www.stuff.co.nz/national/health/9490650/ACC-to-rethink-abuse-link

Alarm over depression therapy cuts - corrected article

An article from the Herald on Sunday by Sally Webster

Funding for talk therapy is drying up just as increasing numbers of New Zealanders are feeling comfortable talking about their problems.
The country's biggest income protection insurer, Sovereign, says claims for depression have reached a crippling 40 per cent and the cost of counsellors it sends clients to "out of the goodness of our hearts" can't be sustained. It will recommend more clients do exercise and take medication.
Government departments have also reduced the counselling services they have offered for years. Free relationship counselling services offered by the Family Court are about to be axed; the Ministry of Social Development is tightening up on the extensive counselling it offers the mentally ill on the disability allowance. The ceiling on therapy sessions may be cut from 16 to as low as four.
Some of the cutbacks, particularly Sovereign's, have alarmed the Association of Psychotherapists' chair of public issues, Kyle MacDonald. He says they are being done simply to save money.
"We are up against the massively funded model of the drug companies who convince people that medication is the best treatment, despite evidence to the contrary for mild to moderate depression."
Sovereign's chief medical officer, John Mayhew, says it has decided that where antidepressants have been proven to work well, it is "efficacious" for them to be used.
"In the past we've had, say, a 50-year-old stockbroker with an income protection product who's become severely depressed.
"The first thing we'd do is get him seen by a psychiatrist, get a diagnosis and then start treatment. That might be a mixture of psychotherapy, medication and an exercise programme. But now we've decided a talk therapist isn't necessary for everyone.
"A guy whose wife has just left him might be depressed and struggling to cope but it doesn't mean he necessarily has to see a counsellor.
"Anti-depressants like SSRIs (selective serotonin re-uptake inhibitors) are proven to work."
The Ministry of Justice is gutting its free relationship counselling. The Court Proceedings Reform Bill before Parliament will kill off the remaining three hours' free relationship counselling for couples. That was halved from six in 2012.
Justice Minister Judith Collins says the ministry has no idea of the outcomes of counselling sessions.
These will be replaced with six separation mediation sessions, free to 60 per cent of users who fall under the civil legal aid threshold. Those above it will pay about $780 + GST a couple, or $390 a person. Those talking separation will be advised to pay for their own counselling, though judges can still order it be paid for if things get as far as the Family Court.
The squeeze on therapy has angered comedian and Nutters Club founder Mike King, who has had well-documented battles with addiction and mental illness.
"The reason I had talk therapy was because I was overwhelmed with suicidal thoughts.
"As much as the whole therapy thing went against everything I stood for, I was faced with death as the only option - I had to try it for my family's sake.
"I can say from experience that talk therapy absolutely works. But few people can afford it.
"We don't need less talk therapy. We need to be working with the Government and insurance companies to find ways for more people to get affordable or free therapy."
MacDonald of the psychotherapists association says that at its most basic, the choice is coming down to the cost of a pill versus $120-plus for a session of talk therapy.
"People are given medication as the frontline treatment - usually SSRIs - after just 15 minutes of consultation," MacDonald says.
"It is often not an effective form of treatment but people are getting this as the only option.
"We must find the reasons people are depressed and this is what therapy is for, otherwise it is likely to recur."

© Copyright 2013, APN Holdings NZ Limited

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10904336

Alarm over depression therapy cuts

An article from the Herald on Sunday by Sally Webster

Funding for talk therapy is drying up just as increasing numbers of New Zealanders are feeling comfortable talking about their problems.
The country's biggest income protection insurer, Sovereign, says claims for depression have reached a crippling 40 per cent and the cost of counsellors it sends clients to "out of the goodness of our hearts" can't be sustained. It will recommend more clients do exercise and take medication.
Government departments have also reduced the counselling services they have offered for years. Free relationship counselling services offered by the Family Court are about to be axed; the Ministry of Social Development is tightening up on the extensive counselling it offers the mentally ill on the disability allowance; and ACC is doing a major review of how it handles those who come to it with sexual abuse and assault trauma. The ceiling on therapy sessions may be cut from 16 to as low as four.
Some of the cutbacks, particularly Sovereign's, have alarmed the Association of Psychotherapists' chair of public issues, Kyle MacDonald. He says they are being done simply to save money.
"We are up against the massively funded model of the drug companies who convince people that medication is the best treatment, despite evidence to the contrary for mild to moderate depression."
Sovereign's chief medical officer, John Mayhew, says it has decided that where antidepressants have been proven to work well, it is "efficacious" for them to be used.
"In the past we've had, say, a 50-year-old stockbroker with an income protection product who's become severely depressed.
"The first thing we'd do is get him seen by a psychiatrist, get a diagnosis and then start treatment. That might be a mixture of psychotherapy, medication and an exercise programme. But now we've decided a talk therapist isn't necessary for everyone.
"A guy whose wife has just left him might be depressed and struggling to cope but it doesn't mean he necessarily has to see a counsellor.
"Anti-depressants like SSRIs (selective serotonin re-uptake inhibitors) are proven to work."
The Ministry of Justice is gutting its free relationship counselling. The Court Proceedings Reform Bill before Parliament will kill off the remaining three hours' free relationship counselling for couples. That was halved from six in 2012.
Justice Minister Judith Collins says the ministry has no idea of the outcomes of counselling sessions. These will be replaced with six separation mediation sessions, free to 60 per cent of users who fall under the civil legal aid threshold. Those above it will pay about $780 + GST a couple, or $390 a person.
The squeeze on therapy has angered comedian and Nutters Club founder Mike King, who has had well-documented battles with addiction and mental illness.
"The reason I had talk therapy was because I was overwhelmed with suicidal thoughts.
"As much as the whole therapy thing went against everything I stood for, I was faced with death as the only option - I had to try it for my family's sake.
"I can say from experience that talk therapy absolutely works. But few people can afford it.
"We don't need less talk therapy. We need to be working with the Government and insurance companies to find ways for more people to get affordable or free therapy."
MacDonald of the psychotherapists association says that at its most basic, the choice is coming down to the cost of a pill versus $120-plus for a session of talk therapy.
"People are given medication as the frontline treatment - usually SSRIs - after just 15 minutes of consultation," MacDonald says.
"It is often not an effective form of treatment but people are getting this as the only option.
"We must find the reasons people are depressed and this is what therapy is for, otherwise it is likely to recur."

© Copyright 2013, APN Holdings NZ Limited

webcache.googleusercontent.com/search?q=cache:iJjMd0-8B5kJ:www.nzherald.co.nz/nz/news/article.cfm%3Fc_id%3D1%26objectid%3D10904336+&cd=1&hl-a

ACC assessments also key for sensitive claimants

A press release from the New Zealand Association of Psychotherapists by Kyle MacDonald

Last night’s shocking expose on TV3’s 60 minutes showed how even “insiders” from ACC admit that a deliberate process of using medical assessors favourable to ACC has lead to a clear and dramatic increase in the “exit” of long term claimants from the ACC’s books.
This approach also continues to detrimentally affect survivors of sexual abuse and violence, or “sensitive claimants” says psychotherapist Kyle MacDonald.
“What was not widely reported with the release of the recent monitoring report of the Independent Clinical Review of the Sensitive Claims treatment pathway was how the ACC’s independent assessors are also preventing New Zealander’s accessing counselling.”
To access ongoing counselling, beyond sixteen support sessions, the client must have a cover determination report, or an external psychological assessment. This is usually conducted by an ACC appointed and contracted assessor.
“What is shocking is to me is that the report details that less than 4% of claims have been accepted based on these assessors reports, in 2011 and 2012. This is down from roughly 60% in 2008.” says MacDonald. “I believe this is further evidence of the cynical management detailed by 60 minutes. The idea that only 4 out of every hundred clients require more than four months of counselling to recover from sexual abuse and trauma makes no clinical sense.”
“It’s also clear that from the clinicians and clients I talk to that all the problems outlined with 'hatchet' assessors, outlined in last nights report also apply to long term Sensitive Claimants and the ACC’s psychological and psychiatric assessments.”
The “Monitoring Report on the Recommendations from the Independent Panel’s Review of the ACC’s Sensitive Claims Treatment Pathway: 18 months follow up” was released on the 17th of July, 2012. The quoted statistics can be found on p. 29.

http://www.scoop.co.nz/stories/GE1209/S00048/acc-assessments-also-key-for-sensitive-claimants.htm

Not cute

A blog post from Off the Couch by Kyle MacDonald

I think that politics and psychotherapy are worlds apart, and largely in the different ways they approach the truth. Psychotherapy is largely the search for the truth along with understanding and validating one persons experience of it.
Politics these days seems to be largely about the manipulation of the truth, to most closely match whatever agenda is being pushed. In some ways I can live with that, it’s what I expect from politicians and a healthy news media can assist us to dive into the debate and decide who and what we want to believe. But it’s much harder to take from a public organization charged with the care and treatment of all New Zealanders.
Both of the recent reports into the ACC by the Auditor General and the Office of the Privacy Commissioner  point to “culture problems” within the ACC.  (See: “Dual investigations shows culture problems at the ACC“). In my view this starts to get us to the heart of the problems that have plagued the Sensitive Claims Unit for a number of years. I believe the culture problem that exists within the ACC’s Senior Management is an ongoing pattern of cynical manipulation of the truth for financial and political gain. And sometimes blatant self-preservation...

Click here to read the rest of this post.

http://psychotherapy.org.nz/not-cute/

Dual investigations shows culture problems at the ACC

A press release from the New Zealand Association of Psychotherapists by Kyle MacDonald

Today’s dual reports from the Privacy Commisioner and the Office of the Auditor General into the privacy breaches at the ACC show deep concerns about the manner in which privacy is handled, and shows systemic weaknesses within ACC’s culture, systems and processes.
“This report will do little to reassure all those who were effected by the privacy breach and it is very clear that the ACC’s approach to privacy is still of deep concern and clear deficiencies remain,” says Kyle MacDonald of the New Zealand Association of Psychotherapists. “Along with the Auditor General’s report released today, I believe this underlines the fact that there have been, and remain, ongoing problems with the organizations culture.”
“It seems to me that despite ongoing statements by the ACC to the contrary, the blame for this massive breach of privacy and the subsequent frustrations of Ms. Pullar in trying to have her concerns heard, land squarely at the feet of the ACC and senior management. The ACC’s efforts to attack and dis-credit Ms Pullar should now also be called into question.”
The independent report commissioned by the Privacy Commissioner describes an “almost cavalier” approach to the management of private claimant information, and that “the importance of personal information and respecting individual’s personal information is not consistent and is often de-emphasised over dealing with the management of the claim/claimant."
Both reports emphasise the failures of Governance and the systemic and cultural issues that lead to the privacy breach and the way that subsequent events were handled.

http://psychotherapy.org.nz/dual-investigations-shows-culture-problems-at-the-acc/

Problem solved

A blog post from Off the Couch by Kyle MacDonald

In breaking news today the National Government has responded enthusiastically to the Dr. Barbara Disley authored 18 month monitoring report on the ACC’s Sensitive Claims treatment pathway calling it “a triumph of policy over reason.”
New details revealed by the report show that in 2008, claims accepted and therefore the level of PTSD as a result of sexual abuse and assault was diagnosed by the ACC’s assessors was at a whopping 60%.
However since the National led Government’s change of direction at the ACC the percentage of claims accepted dropped dramatically to 40% in 2009; 13% in 2010; 3.5% in 2011 and thus far in 2012 just 3.6%.

Click here to read the rest of this post.

http://psychotherapy.org.nz/problem-solved/

ACC's patchy progress in sensitive claims

A report from Radio New Zealand

An independent report shows ACC has made only patchy progress in implementing the recommendations of a review into its handling of sensitive claims.

Copyright 2012 Radio New Zealand

http://www.radionz.co.nz/national/programmes/morningreport/audio/2525415/acc%27s-patchy-progress-in-sensitive-claims

Abuse survivors struggling to access ACC

An article from Stuff by Paloma Migone, Stacey Kirk and Danya Levy

Therapists are having to "pick up the pieces" for the adult survivors of childhood sexual abuse because they are not getting the help they need from ACC, a leading psychotherapist says.
New Zealand Association of Psychotherapists spokesman Kyle MacDonald said progress made by ACC since changes to the way they handle sensitive claims were brought in has been too slow in coming.
"It’s fair to say there have improvements but it’s nowhere near enough. They’ve had 18 months to put these systems in place now."
Dr Barbara Disley yesterday released the second monitoring report of ACC’s progress on the development and implementation of 14 recommendations given by a 2010 Sensitive Claims Clinical Pathway review. She said there were concerns within the sector over the processes around independent assessment for cover.
"While there have been improvements, including the ability of the support counsellor to attend these assessments with the client, the narrow range of tools applied to determining mental injury and the limited number of professional groups who can administer these tools leads to bottle necks and delays in cover determination," she said.
"ACC needs to urgently review the assessment processes within the adult claims coverage context and broaden the range of tools and professional groups capable of undertaking these assessments."
Dr Disley said it was particularly important for adult survivors of child sexual abuse as the needs of the group were often complex and required specialist knowledge.
"A specific focus on the needs of this group needs to be now initiated," she said.
The number of clients that moved through the cover assessment process was low, falling dramatically from 5919 in 2007 to 235 last year.
Dr MacDonald said that was a "horrible number".
“This is clear evidence that the ACC’s policies are still failing New Zealanders and survivors of sexual abuse. And it’s worth remembering this report pre-dates the privacy breach of over 6000 ACC claimants, and subsequent events.”
Dr MacDonald, who sits on the Sensitive Claims Advisory Group, which ACC regularly meets, said the low number of successful claims was a direct result of the changes.
"This report demonstrates how victims of sexual abuse and assault are still struggling to access the support they are entitled to as a direct result of the National Government-led cost cutting drive in 2009. The fallout of this ill-informed policy is still being felt."
Among the changes that resulted four months later was a rule that new claimants and people waiting for a decision on whether they qualified for treatment could get 16 hours "initial support". These 16 free sessions have to be undertaken by an independent, but ACC appointed, assessor.
"The idea of going to talk to a complete stranger is sometimes one of the worst thoughts imaginable for our clients, and they have to go in there and open up to someone they barely know about some of the most traumatic experiences from their past," Dr MacDonald said.
He said clients were simply choosing not to go through with it.
"I think it was probably something that many psychotherapists and clinicians were expecting when the changes came into play. We’re essentially trying to pick up the pieces from an idea that was theirs in the first place."
The report said ACC urgently needed to review its assessment process for adult survivors of childhood sexual abuse with mental injury. In the report, Dr Disley also said Maori must be given priority as progress in that area had been slower than expected.
However, the process for children and adolescents in relation to accessing immediate support and moving through the cover process had improved. Overall, Dr Disley found ACC had made "excellent progress" implementing one recommendation and good progress on another six.
"There’s still work to be done in some areas," she said.
Greens ACC spokesman Kevin Hague said the Government and ACC had created a culture of "severe disentitlement" when it came to sensitive claims. ACC was purposely making it harder for clients to get their claims accepted following evidence released by the Greens showing ACC staff were paid bonuses for cutting claimants from the ACC books, he said.
ACC Minister Judith Collins said there had been progress on all but one recommendation but there was still more work for ACC to do.
"Obviously not everything that has been recommended has been completed to the level it should have been. I expect most of them will be completed in the next 18 months."
ACC was undertaking major changes in the area of sensitive claims, 范she said.
"Ultimately they have to make sure they make those changes sustainably and right through the organisation."
The 2010 review, requested by then ACC Minister Nick Smith, made 14 recommendations, including that a process be established to independently monitor the development and implement the review’s suggestions.

© 2012 Fairfax New Zealand Ltd

http://www.stuff.co.nz/national/politics/7297268/Abuse-survivors-struggling-to-access-ACC

ACC sensitive claims monitoring report a “fail” mark

A press release from the New Zealand Association of Psychotherapists by Kyle MacDonald

The 18 month follow up monitoring report of the ACC Sensitive Claims Clinical Pathway shows clearly that only three of the 14 recommendations have been fully met.
“I consider this a fail mark” says Kyle MacDonald. “This report demonstrates how victims of sexual abuse and assault are still struggling to access the support they are entitled to as a direct result of the National Government led cost cutting drive in 2009. The fallout of this ill-informed policy is still being felt.”
The report details some areas of improvement, but strong concerns remain around the use of external ACC appointed assessors, implemented in 2009 due to the ACC’s “reinterpretation” of the legislation. Also of concern is the manner in which the Sensitive Claims pathway often fails survivors of childhood sexual abuse.
Detailed in the report is the massive decrease from 40% of claims accepted versus claims lodged in 2009; down to 4% in 2011 and 2012. “This is a horrifying number.” says MacDonald. “This is clear evidence that the ACC’s policies are still failing New Zealanders and survivors of sexual abuse. And it’s worth remembering this report pre-dates the Privacy Breach of over 6000 ACC claimants, and subsequent events.”

http://www.scoop.co.nz/stories/PO1207/S00197/acc-sensitive-claims-monitoring-report-a-fail-mark.htm

Back to work

A blog post from Off the Couch by Kyle MacDonald

Freud was famously quoted (or possibly mis-quoted, translating from German to English can be a bit tricky) as saying his definition of good mental health, or “normal neurosis” was to “Live, love and work.”
It seems John Key’s definition is much simpler: Work.
Both our Prime Minister and the current Minister for the ACC have both revealed their lack of understanding of the world of disability and welfare by their answers to recent questions about the performance based targets at the ACC:

“She [Ms. Collins] said measures that helped ACC encourage people back into work where appropriate were “a good thing”. NZ Herald, June 22, 2012.

This was further reinforced with yesterday’s announcement that WINZ will have a target of reducing the number of long term beneficiaries by 30%.  No word on where the jobs, training or rehabilitation to facilitate this will come from.   Just a number. 30%, gone, by 2017.

Click here to read the rest of this post.

http://psychotherapy.org.nz/back-to-work/

ACC 'cold blooded' to victims

An article from the Sunday Star Times by Danya Levy

A survey around sensitive claims and the treatment of sexual abuse victims has raised more questions about the Accident Compensation Corporation.
It comes as a senior manager's comments are being interpreted as confirming there was pressure from the board on staff to dump sex abuse claimants.
Allegations ACC had turned from rehabilitating clients to saving money have seen three board members, including chairman John Judge, and chief executive Ralph Stewart, quit.
Now, the man behind the survey of 146 health professionals and 72 abuse victims, psychotherapist and blogger Kyle MacDonald, says there has been a "cold-blooded" directive from the board to look after the "bottom-line" regardless of the cost to victims.
In 2009 ACC reinterpreted the rules around sensitive claims so a diagnosed psychiatric illness was required to determine mental harm. That left many people ineligible for help, and led to a public outcry.
A year later former ACC Minister Nick Smith urged the corporation to adopt recommendations from a review, but MacDonald says the survey shows only two have been adopted, five have not been, four have returned mixed results, and another four were not being measured. Now a transcript of a presentation by claims general manager Denise Cosgrove last November acknowledges the sensitive claims changes "didn't work so well", and appears to confirm ACC was removing "low-hanging fruit and easy gains" from the scheme.
"I get that constant message from the board every day," he said.
Green Party ACC spokesman Kevin Hague said the survey showed there was "wilful resistance" to the call to improve, and, because there was a "culture of disentitlement", the board should be replaced. Labour's Andrew Little said: "They will say it is legitimate to minimise costs, but the whole basis of ACC is treatment, compensation for the bulk of your losses and rehabilitation."
An ACC spokesman said MacDonald was only one of those giving feedback and there would be no comment until a final report, which was "imminent", but Cosgrove's comments referred to system improvements, not claimants.
MacDonald dismissed that. "It's hard to interpret in any other way than referring to specific cases and claims."
He said the issue for claimants was ACC refusing to accept the advice of clinicians working with victims, and insisting they be interviewed by its own assessors. "You are required to report intimate and distressing detail to a complete stranger", which had an "incredibly detrimental effect".
"There has been a very intentional aim of getting the longest and most expensive claimants out. It's cold-blooded. What has become clear is that ACC is being directed from ministerial and board level to focus on the bottom line and that has been at the expense of sensitive claimants."
A spokeswoman for ACC Minister Judith Collins said board comments were a matter for the board but the minister expected ACC to check claims veracity carefully and to treat all professionally.

SURVEY

Counsellors
40.4 per cent say ACC has done "very little" to protect client safety
37.8 per cent say ACC has done "very little" to protect client therapeutic relationship
42.5 per cent say ACC has done "very little" to implement changes

Claimants
29.3 per cent say ACC has "not at all" protected their safety
38.1 per cent say ACC has "not at all" protected their therapeutic relationship
50.6 per cent say ACC has "not at all" implemented changes

© 2012 Fairfax New Zealand Ltd

http://www.stuff.co.nz/dominion-post/news/politics/7117501/ACC-cold-blooded-to-victims

Low hanging fruit

A blog post from Off the Couch by Kyle MacDonald

Sensitive claims sent to branch offices – ACC
Hundreds of sensitive ACC claims – those related to rape and other sexual abuse – have been transferred out of the corporation’s Sensitive Claims Unit to case managers in regional branch offices, the corporation has said.
Claimant advocacy groups are shocked by the move they say was made without consultation and in some cases without fully informing claimants.
NZ Herald, Thursday May 31, 2012

This story appeared in the Herald last week detailing the rumour suggested in my last blog.  The breach of the ACC’s own protocols about how sensitive claimants privacy are managed is deeply concerning, despite how the ACC might spin it.  But why have some 250 clients files been transferred outside of the Sensitive Claims Unit?

Well, it’s a bit of story.  But worth the telling...

Click here to read the rest of this post.

Sensitive claims sent to branch offices - ACC

An article from the New Zealand Herald by Adam Bennett

Hundreds of sensitive ACC claims - those related to rape and other sexual abuse - have been transferred out of the corporation's Sensitive Claims Unit to case managers in regional branch offices, the corporation has said.
Claimant advocacy groups are shocked by the move they say was made without consultation and in some cases without fully informing claimants.
Claims related to rape and sexual abuse are managed by the standalone Wellington based Sensitive Claims Unit (SCU) because of their "highly personal nature", ACC says.
The corporation has been under fire since claimant Bronwyn Pullar revealed a privacy breach in which the ACC sent her a file identifying sensitive claimants. The breach also raised concerns that sensitive claims information was being shared with ACC staff outside the SCU.
But after weeks of rumours that some sensitive claims were being handled outside the unit, ACC claims management general manager Denise Cosgrove said 12 case managers from elsewhere in the corporation had been seconded to the SCU.
"These seconded staff were located throughout New Zealand, near to the approximately 250 clients with long-term sensitive claims they were looking after."
The case managers are in 12 regional offices and had been dealing with sensitive claims since last November.
Ms Cosgrove said all the seconded staff underwent intensive training in sensitive claims management, including training around preserving client privacy.
"In addition, access protocols were agreed for claims and no paper files were transferred," she said.
Ms Cosgrove said care was taken to ensure clients were properly advised of the change.
But ACC claimant advocates Denise Powell, of Acclaim Otago, and Auckland-based Kyle MacDonald, said they only became aware of the move after one claimant learned by accident her new case manager was based in a branch office.
"That was quite upsetting for her."
Ms Powell understood affected claimants were advised they had new case managers, "but ACC didn't necessarily state that their case manager was no longer based in Wellington".
"My understanding was the SCU was set up to be a stand-alone unit and was specifically isolated from the mainstream of ACC in order to ensure the utmost protection of those people's information and identity," she said.
Mr MacDonald, who is a member of the Sensitive Claims Advisory Group, which ACC regularly meets with, said the corporation never raised the change with his organisation. "The reality is 250 claimants are now being managed outside of the Sensitive Claims Unit in regional branches by case managers who are not sensitive claims specialists."

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10809718

When a secret is no longer a secret…

A blog post from Off the Couch by Kyle MacDonald

Recently I had an ACC claim. I strained some knee ligaments. Old injury, no problem, specialist appointment courtesy of the ACC, and after some appropriate exercise and a follow up appointment, all fixed.
If the file of that treatment got stolen, sent to someone in an email or otherwise treated carelessly, I would be angry. However I can guarantee I wouldn’t feel so ashamed I would want to die, frightened for my personal safety, or worried about being stigmatized by people who found out.
So it is a worrying start to the privacy investigation when the Assistant Privacy Commissioner has issued a letter reported on here saying things like this ...

Click here to read the rest of this post.

http://psychotherapy.org.nz/when-a-secret-is-no-longer-a-secret/

Legal row over ACC blog

An article from Stuff by Kirsty Johnston

A senior medical officer in ACC's sensitive claims unit has made legal threats to a blogger who posted information about his employment history, in the wake of a mass privacy breach.
Peter Dodwell, the branch medical advisor of the unit that deals with rape and abuse victims, was fired from his previous job in Australia over a privacy issue.
Both Dodwell and ACC's senior medical advisor, Peter Jansen, have threatened legal action against blogger Kyle Macdonald, a psychotherapist who regularly speaks out against the corporation.
The revelations come as the Auditor General prepares to investigate ACC's governance, adding to an inquiry by the Privacy Commissioner into a breach that saw 6000 patient files - including 131 from the sensitive claims unit - released to claimant Bronwyn Pullar.
Documents show that in March 2008 Dodwell was sacked from his role as chief medical officer at HealthQuest, the medical screening body for all public servants in Australia, after an internal investigation into his behaviour. The investigator, former NSW Police Deputy Commissioner David Madden, found Dodwell had inappropriately passed on information to the Education Department about a teacher it intended employing, saying she was being investigated by police for defamatory website postings about him.
According to a report in the Sydney Morning Herald, there was no evidence the teacher was being investigated by police.
Madden said Dodwell passed on the information in an attempt to adversely influence the department's decision to employ her.
"The way in which he [ Dodwell] went about informing the Department of Education was inappropriate and not reasonable behaviour of a public official," the report said.
Madden said the teacher had no opportunity to defend herself against  Dodwell's claims, and he should be disciplined for breaching privacy restrictions. He was later fired.
After Mr MacDonald posted a link to the SMH story, and an opinion of its contents on his blog, he received a letter from Dodwell's lawyer requesting parts be changed or removed because they were defamatory. The letter was similar to one MacDonald received from Jansen in 2010 about a defamatory blog post and tweet, which he removed for fear of legal action.
Jansen was the senior ACC manager at the centre of another defamation case last year, involving a blogger who was also claimant of the Sensitive Claims Unit. The blogger, known as Jax, was under the police witness protection programme for sexual abuse at the time, and alleged her ACC file had been accessed by someone within ACC in order to find her contact details.
MacDonald said the threats against him, in his view, were another example of how ACC bullied critics and "whistleblowers" who had genuine concerns about the organisation.
Dodwell was hired to provide expert opinion about claims and treatment decisions, he said.
"I thought the information should be in the public domain, given someone with that kind of history is in a clinical role. The reality is that it's a political position, so the public have a right to express their views."
MacDonald said the fact Dodwell had a history with privacy issues was important given the recent breach and his role in sensitive claims.
"Privacy is important for people with a sensitive claim. Lack of it can cause emotional harm, but it can also be dangerous for people who are in hiding because of sexual abuse," he said.
In a statement, an ACC spokeswoman said: "The importance of confidentiality is vital to the good faith employment relationships between ACC and its staff. Consequently it would be inappropriate for ACC to comment on any individuals employment matters."
But ACC said that Dodwell had provided a complete CV to ACC when he applied for the job.
Dodwell himself said he disclosed, directly to his ACC manager, details of the matter that led to his dismissal in Australia.
As for the legal action, ACC said it had no role when an employee "acting independently or out of personal motives" initiated legal communications, proceedings or actions with an external party.
Dodwell argued there was no legal action "either taken or threatened".
"The letter acquainted Mr MacDonald with inaccuracies in his article, and invited him either to remove certain specified passages or to amend his article to reflect the true situation," he said.
Jansen said the material on McDonald's blog "seriously defamed" him. He wouldn't answer a question asking if he thought his actions were appropriate.

© 2012 Fairfax NZ News

http://www.stuff.co.nz/national/politics/6746061/Legal-row-over-ACC-blog

ACC adviser's shaky past

An article from the Herald on Sunday by Joanne Carroll

The medical adviser for the ACC sensitive claims unit left two previous jobs amid controversy.
Dr Peter Dodwell resigned as principal medical officer for the Civil Aviation Authority after a report found an unacceptably high error rate in decisions whether or not to clear pilots as medically fit to fly planes. The Scott-Gorman report into medical certificates for pilots also alleged the process for initially appointing doctors, supervised by Dodwell, had been "flawed from the outset".
Dodwell sought a judicial review against the CAA for failing to give him an opportunity to respond to the damning report. CAA director John Jones later apologised to Dodwell as part of an out-of-court settlement.
The ACC sensitive-claims unit has been part of a scandal involving thousands of claimants' details being mistakenly released to another claimant by email. Minister for ACC Judith Collins refused to comment on Dodwell's appointment, saying employment matters were the responsibility of ACC. Spokeswoman Stephanie Melville declined to answer questions about whether ACC was aware of the previous controversies before employing Dodwell. Dodwell went on to work in health in NSW, but was reportedly sacked in 2008.
This week, blogger Kyle MacDonald was forced to edit a post which contained information about Dodwell's employment history after legal threats. MacDonald said the post was changed after legal counsel for Dodwell expressed concerns about the impact of the post on his ongoing professional reputation. The blog had posted a link and comment from a Sydney Morning Herald article about Dodwell's departure from Healthquest.
Dodwell was sacked for communicating inappropriately with the Education Board about a teacher it intended to employ. An investigation by the former NSW Police deputy police commissioner David Madden found Dodwell inappropriately passed on information regarding the teacher - who had been found fit for duty by HealthQuest in 2006 - to the Education Department in an attempt to adversely influence its decision to employ her.
Madden found two of the five allegations made by the teacher against Dodwell were substantiated. An independent review by former magistrate John Heagney supported the Madden findings. The teacher was medically retired after being declared unfit for duty, a decision overturned by the Medical Appeals Panel five months later.
Madden said the teacher had had no opportunity to defend herself against Dodwell's claims and he should be disciplined for breaching privacy restrictions. To date he he has not been the subject of any tribunal proceedings in Australia.
Dodwell has indicated that there are two sides to the story of his departure from the CAA but did not respond to requests for comment this week.

© 2012 APN Holdings NZ Ltd

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10798897

ACC Sensitive Claims Provider and Client Survey: Results

A post from Off the Couch by Kyle MacDonald

For those of you who were kind enough to participate in the survey posted here in a previous blog, I thought you might be interested in seeing the results.

Click here to read the rest of this post.