4. Hon ANNETTE KING (Deputy Leader—Labour) Link to this
to the Minister for ACC
Does he think the huge culture change within ACC has gone too far?
Hon Dr NICK SMITH (Minister for ACC) Link to this
I am very conscious of the need to get the balance of accident compensation right between containing costs and levy increases and ensuring that people receive their proper entitlements. Costs were clearly out of control under the previous Government, and a culture change was needed. I am closely monitoring the accident compensation review data, and would be concerned if there were an increase in the number of Accident Compensation Corporation (ACC) decisions being overturned. There is no such trend. A similar proportion of claim decisions are being upheld now as were upheld under the previous Government, indicating that ACC has got the balance right.
As part of that culture change, does he recall ACC saying: “We take our relationship with counsellors and clinicians seriously,”; if so, why has he not ensured that ACC takes seriously the warning from clinicians at Ashburn Clinic—health professionals who provide New Zealand’s foremost treatment programme for victims of sexual crimes, who have had no referrals from ACC since October, and who have had to lay off 10 crucial staff?
Hon Dr NICK SMITH Link to this
Clinical decisions, whether in terms of surgery or in terms of sensitive mental health issues, are properly made by clinicians. I would be concerned if decisions that had been made by ACC’s clinicians were being repeatedly overturned in the independent review process. That would suggest that ACC had got the balance wrong. In regard to the specific issue of sexual abuse, I have initiated an independent review, which is being done by Dr Barbara Disley, and I am looking forward to receiving her report.
Does he recall ACC saying that it would like to explain the changes that have been made for victims of sexual crimes so that clinicians can see “what we are doing to improve service performance”; if so, how does he intend to explain the loss of the long-term residential service at Ashburn Clinic, which had helped victims rebuild their lives—a loss because of a $900,000 shortfall, while he boasts of a $2 billion surplus?
Hon Dr NICK SMITH Link to this
The key decisions on whether clients go to Ashburn Clinic or receive care in other establishments should be made by clinicians, not Ministers. If Ashburn Clinic or any members opposite believe that people are inappropriately being turned down for treatment, the proper process for them to follow is to seek a review of the case. If the member has evidence of that, I would be more than happy to see it.
David BennettBy how much did ACC’s claims and administration costs go up over the preceding 4 years, requiring a change in culture?
Hon Dr NICK SMITH Link to this
ACC administration costs between 2004 and 2008 went up by an average of $50 million extra per year—that is, from $302 million in 2004 to $494 million in 2008. In the National Government’s first year we reduced those administration costs by $35 million. Claim costs between 2004 and 2008 went up by nearly $300 million extra every year—a rate of increase that was 5 times the rate of inflation. That was clearly unsustainable. As in so many parts of the Public Service, Labour let costs get out of control.
Hon David ParkerCan the Minister not see that the change of culture and the push towards privatisation that he has lauded are exactly what led his appointed chair of ACC, John Judge, to say that doctors, in addition to facing disciplinary action, should pay financial penalties for medical errors?
Hon Dr NICK SMITH Link to this
Firstly, the member deliberately misquotes Mr Judge. He deliberately misquotes him, as is so often the case.
Hon Trevor Mallard Link to this
I raise a point of order, Mr Speaker. To deliberately misquote is to mislead the House. That allegation is not allowed to be made by a member of Parliament by way of answer.
Mr SPEAKERI accept the point the member makes. Perhaps the member could change his language so that he is not making that accusation.
Hon Dr NICK SMITH Link to this
The member misquotes the chair of ACC, who has had an incredibly challenging job, given that the previous Government in just 3 years, according to the audited accounts, let the liabilities of the accident compensation scheme blow out by $10 billion. Mr Judge has had an awfully challenging job to try to get them under control.
Is the Minister concerned that the chair of ACC is so obviously out of touch with the underlying principles of our accident compensation system that he is clearly pushing towards a litigious, Americanised private insurance model?
Hon Dr NICK SMITH Link to this
The member is way off beam. This Government is totally committed to an efficient, 24/7, no-fault scheme. But I make no apologies for this Government and Mr Judge looking at sensible ways that we can engage with the private sector to better manage claims in order to rehabilitate patients more quickly. I congratulate Mr Judge on reversing the decline in rehabilitation rates that occurred under the previous Government.
Why is the Minister so at ease with the undermining of the current accident compensation model by moves to privatisation and financial penalties for doctors—which is what John Judge did say, I tell the Minister—when it is abundantly clear that the Americanised insurance model that he and Mr Judge are pushing New Zealand towards leads to more conservative and expensive medical treatment as well as money being wasted on lawyers and insurance company margins?
Hon Dr NICK SMITH Link to this
Under any model to incorporate the private sector that this Government looks at, exactly the same entitlements will be involved and exactly the same independent review processes will be involved. We make absolutely no apologies for wanting to use the private sector so that we can rehabilitate people and get them back to work where they can make a positive contribution, rather than continuing the culture of the previous Government, which seemed happy to have thousands and thousands of New Zealanders sitting on accident compensation, not being rehabilitated, and not able to work.
I seek leave to table a letter from the medical director of Ashburn Clinic, which states: “Our primary concern is the care of the patients who are being denied treatment under the current ACC guidelines.”