Over the weekend I blogged about Nick Smith’s manufactured crisis in ACC. National’s agenda is pretty transparent. They’re trying to soften up public support for our excellent accident prevention, compensation and rehabilitation scheme as they prepare to privatise it. Labour will strongly oppose National’s plan to carve up ACC and hand it over to the private insurance industry.
But we’ll also be looking at how we can improve the scheme that we have now, because although we think the system overall is a sound one, we agree that it could be even better. Over the past few months I’ve been meeting with a wide range of ACC stakeholders, from claimants and their advocates through to medical providers and medical assessors.
One of the issues that I’ve become increasingly concerned about is the lack of independence in the specialist medical assessor process. It’s pretty clear to me that ACC have some “tame” medical assessors who are giving them the result that ACC wants, rather than the one that is in the claimant’s best interests.
In some cases, these assessors are working almost exclusively for ACC, making them reluctant to bite the hand that feeds. I’ve also met with specialists who have been all but ‘black listed’ by ACC because they haven’t been willing to give them the assessment results that they want.
So the question I’ve been contemplating is whether we need a bit more independence in the ACC medical assessment process. Should specialist assessors be required to be ‘current practitioners’ in the field they are assessing? Should there be a limit on the proportion of a specialist’s work that can be ACC assessments? Should claimants be given more ‘choice’ over who they go to for specialist assessments?
I’m interested in your views and your stories. Like I said above, I think ACC is a very good system and I’d hate to see it carved up as National want to, but that doesn’t mean I’m not willing to debate how it can be constructively improved.
Way too radical to promote choice in medical assessment, Chris, to empower ordinary folks. Choice, and freedom to choose, are terms that can only properly be used by the right wing to promote the privatisation. Get with the programme.
Which is funny Jennifer since National and Act base their philosophy on freedom of choice – as long as you choose the right one of course.
As my partner has been working through the ACC process for a few years I may be a bit biased…
I agree about the “tame” medical professionals who write the report in a way that is vague enough for ACC to use to minimise costs. However, there are other issues as well. Problems where ACC doesn’t send the correct paperwork to the doctor, or sends paperwork for an unrelated injury. Then there are doctors who don’t appear to understand what ACC wants from them. This wastes huge amounts of money as the patient/claiment must attend all these doctor visits or risk losing ACC payment, even if they have already been informed that the doctor has the wrong paperwork from ACC.
If ACC staff had time to make sure they had the right injury with the right ACC injury code and the right specialist doctor, things might be less wasteful…..
The answer is to complain to the doctors professional body, no matter who pays the bill, the doctor must act professionally. In other professions , you get to sit in the doghouse if you have been found slanting your advice to suit the client and not what is the responsible thing to do.
The orthopaedic surgeons need to get some backbone and make waves against the dodgy doctors
@ ianmac, and those poor dairy farmers, scratching for a living, working every hour God sends, and all for the greater good of the nation, nothing in it for them. I bet they would just love the choice over whether or not they pay their fair share of tax. Oh, sorry, they already have that choice. And they choose no tax, not this year, or last. Maybe next year? Let’s see. I wonder if this choice idea might catch on?
“Should specialist assessors be required to be ‘current practitioners’ in the field they are assessing?” Easy answer – yes, absolutely.
Chris, from a levy-payer’s point of view, ACC have a lot of basic administrative issues. There seem to be a lot of things that their computer system and staff simply can’t handle. For example, when a part-time self-employed person earns less than a certain amount, their computer system incorrectly automatically defaults them back to a full-time basis and sends a bill out of the blue. It then takes time and money and interminable explanations to get them to change it back to part-time. People who can’t understand their inscrutable bills may well then pay the bill without knowing any better (particularly because ACC gets aggressive about collection) and their accountant may well not get to hear about it until a long way down the track, if at all, because ACC doesn’t foster the kind of relationship with accountants that IRD have. When ACC is asked when they’re going to fix the glitch that defaults levy-payers to the wrong status, the message seems to be that they’re not.
There’s lots of other examples of issues with their basic administration for levy-payers.
“It’s pretty clear to me that ACC have some “tame” medical assessors who are giving them the result that ACC wants, rather than the one that is in the claimant’s best interests.”
This is true of many govt or quasi govt departments, the Dept of Building and Housing trumpets impartial independent experts, but constantly directs them and stymies criticism of them.
ACC is less independent than when Labour was the government as the choice of access to a clinician has been reduced. Sexual abuse victims at times are being retraumatised by psychiatric assessment reports,threats of defamation,not recieving an answer within a reasonable time frame and being excluded from making a claim if a sexual assault occurred prior to the establishment of ACC in 1974.
Absolutely there needs to be a serious overhaul of ACC’s use of medical assessors. Medical assessors should be from the required discipline (no point a GP commenting on Orthopaedic issues as is the case now). Claimants should have choice, theyi used to. As mentioned, it is true that ACC are using preferred specialists, who predominately provide ACC with opinions that allows ACC to disentitle claimants. This practice has been going on for a number of years. Those assessments, if they do end up in the courts are now being critisised by the judicary, even those judges who traditionally support ACC decisions are changing their views. If claimants could boycoutt ACC’s preferred specialists (known as toadies in some circles), then it would soon cut off an easy income stream for those doctors who are greedy enough to misreport/misdiagnose just to keep getting the work. However, for claimants to do that they end up losing entitlements anyway. For some it is easier to go to the ACC Toady knowing they will be disentitled but at least they have a decision they can challenge in court. Which leads me to another issue, how much is ACC spending on litigation, reviews, appeals and lawyers to defend their decisions. I saw some states recently that on average 40 percent of these cases go in favour of claimants, one would think if ACC had done their job properly in the first place that is 40 percent of cases where they have wasted money on fighting claims that should have been accepted in the first place. Remember though, these are only the cases that are appealed, most claimants denied assistance walk away without challenging ACC’s decisions because they can not afford to fight the decisions (despite ACC supposedly paying review costs). Due to the highly legal manner of reviews, a lay person can not just go into reviews and fight their own case, this requires some knowledge of due process, the costs awarded at reviews do not cover legal representation, even though ACC, in some cases have used barristers in the review process. There is a real power imbalance in this process, a process that is inherently flawed. If elected, I wonder what Labour will do to change these processes?