It seems a simple enough concept; counselling is meant to help victims to recover from their experience. The conditions for getting access to counselling are not supposed to leave the claimant feeling so re-traumatised that they give up and go without the counselling they need – or pay for it privately instead, if they can – rather than subject themselves to hostile grilling by the Accident Compensation Corporation as to whether they truly need and deserve the service.
We can now quantify some of the fruits of this process. Yesterday, Dr Barbara Disley released the second monitoring report of ACC’s progress in implementing the 14 recommendations made by a 2010 Sensitive Claims Clinical Pathway review. According to the report, ACC has made “excellent” progress on only one out of those 14 points, and “good” progress on another six. In other words – and despite having had 18 months to get its act together – ACC is falling short on half the 2010 recommendations, and this failure is having dramatic consequences for those ACC claimants who are legally entitled to support.
For example? As the Greens ACC spokesperson Kevin Hague has pointed out, the Disley report shows that in 2011 only 3.6 percent of “sensitive claims” lodged (eg for counselling for sexual abuse) were accepted by ACC, down from 60 percent in 2008 when National became the government. There could hardly be a clearer sign of a new policy mindset within ACC that victims of sexual abuse can sink or swim, for all it cares.
Not surprisingly, the victims of abuse are giving up in the face of ACC’s stance towards them. Not only has the rate of claims approved fallen dramatically, but the number of claims being lodged has also fallen by 36% since 2008, For those that do persevere, there are chronic systemic failings within ACC, as Disley points out in her report:
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….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.’’
Ah, but allowing the assessments to be done outside the narrow circle of like-minded clinicians on ACC’s payroll would run the risk of people being genuinely and independently assessed on their needs – rather than in accord with ACC’s unsubtle desire to get them off the books. ACC’s restrictive approach to entitlements has been spelled out in any number of ways in recent months – quite spectacularly by ACC general manager Denise Cosgrove in a presentation to an actuarial conference in Australia last year that only recently came to light:
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.
Damn those adverse media reports on how ACC is handling “sensitive claims” involving sexual abuse and elective surgery! In ACC’s skewed universe, there are not people who have been harmed with needs to be met and legal entitlements to be delivered – but only a risk that things may get out into the media, and that’s the process that needs to be managed with care.
Where, you might well wonder is Jo Goodhew, the Minister of Women’s Affairs in all of this, given that the vast bulk of “sensitive claims” victims are women? Ironically, Goodhew is right now at the United Nations in New York, where later today she will present New Zealand’s seventh report to the United Nations under the Convention on the Elimination of All Forms Of Discrimination Against Women.
Mrs Goodhew will also attend meetings to discuss best practice and new ideas for progressing gender equality, particularly in the complex and challenging areas of reducing the remaining gender pay gap and increasing women’s safety from violence.
Right, increasing women’s safety from violence. At home, ACC is hard at work ensuring that few of the women who are unsafe from violence get access to the counselling they deserve. Talk about junketing around giving lip service to the problems. Here’s Goodhew in one of her rare public forays into Women’s Affairs work, with a press release to mark Rape Awareness Week earlier this year:
Research has shown that around 20 percent of girls in New Zealand have experienced some form of sexual violence. A history of sexual violence increases their risk of experiencing further sexual violence and other forms of violence. For example, child sexual abuse victims are approximately twice as likely as non victims to be sexually assaulted later in life. The Ministry of Women’s Affairs is investigating how we can prevent re-victimisation, better understand the impacts on victims, and better support these girls and women,” Mrs Goodhew says.
Well, maybe Goodhew and the Ministry of Womens Affairs could bestir themselves to comment on what is happening to the victims of sexual violence when they engage with ACC – because that process seems to be all about re-victimisation, about misunderstanding the impacts on victims and about denying support to those girls and women. Let’s see. The last visible sign of interest in this subject from the Ministry of Women’s Affairs appears to have been late in 2009, in the course of what was basically a literature review.
Still, the document did contain this observation at para 2.4.1:
Long-term needs: Counselling and support to manage any post-traumatic stress disorder (PTSD) effects. Some victim/survivors may not be ready to access counselling support until years after the sexual assault, or will become more aware of the effects over time.
By the sound of it, ACC policy is systematically ignoring such long-term factors. It is being told to do so by the government, in order to cut costs. Perhaps the people in government who are being paid to represent women should start to earn their money, and should stand up and oppose such practices.