Scoop Election 08: edited by Gordon Campbell

Gordon Campbell on the incentive payments at ACC

June 22nd, 2012

The chances of achieving culture change at the Accident Compansation Corporation would seem to be almost zero if those in charge of the organisation cannot see that when you create a system of paying staff a bonus to cull ACC claimants, then this payment just might conceivably cloud their clinical judgement. That’s what bribes are meant to do – to achieve a pre-determined outcome. The desired outcome here is pretty clear. It is to tip people off ACC and into the category of being a job seeker, where they are likely to receive a lesser payment on welfare.

The corruption of the ACC scheme appears to be systemic. Not only case managers on the front lines, but team leaders, technical claims managers and branch managers also qualify for the incentive payments. On RNZ this morning, outgoing ACC chief executive Ralph Stewart stressed that the payments are only a small part of the remuneration package – but that is hardly re-assuring, or convincing. After all, surely an incentive payment has to be big enough to influence performance. That’s why it exists. In an ACC context, where clinically assessed assessment is supposed to be the determining factor in decision making, there is no place whatsoever for payments that threaten to skew the process.

Everyone, it seems, but ACC Minister Judith Collins can see the potential for abuse here. According to Stewart, ACC has two goals: to rehabilitate claimants and to manage its finances, and those two things are kept entirely separate. Ah-huh. Nothing is to be read – apparently – into the existence of the incentive scheme for the past three years, and the way the numbers of long term claimants have plunged over that period. Back in the real world though, the findings of say, the NZ Herald, appear considerably more credible:

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.

That kind of thing – the systematic denial of entitlements – is the core problem with ACC. In the name of cost cutting, a culture has been fostered that treats long term ACC claimants as malingerers. They are not. They have been the victims of accidents and the payment they receive is not a welfare handout – it is compensation for (a) an ongoing condition that may always prevent them from going back to work and for (b) agreeing to forego the right they otherwise had to sue for damages. ACC claimants have agreed not to pursue the route of suing for compensation in return for the state intervening, and providing an adequate level of compensation. The state is now not only welshing on its side of the contract – it is paying enforcers to help them to do so.

Can Judith Collins be relied on to clean out this perverse organization, and get it back on track? Clearly not. As she already shown with the Bronwyn Pullar case, Collins doesn’t seem to grasp the issues at stake. In her view, the main concern raised by the Pullar case was poor communication practices by ACC, and not a culture of denial when it comes to entitlements. With these incentive payments, she seems similarly unable to get it. The incentive payments “are a good thing” she says, if they get people back to work. “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 altogether,” Really? So if you pay case managers and their supervisors to terminate client entitlements – because that saves the organization money – and then lo, that outcome eventuates and people go off the books, we are supposed to believe these things are entirely unrelated? C’mon. That’s not just corrupt, it’s insulting.

ENDS

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    1. 13 Responses to “Gordon Campbell on the incentive payments at ACC”

    2. By Geoff on Jun 22, 2012 | Reply

      The AC Act 2001 is a statutory legal document outlining legal entitlements of all NZ claimants.

      It is therefore a breach of the law for ACC to include a clause within it’s KPI’s that incentivise staff at the ACC, the administrator of the Act,to Evade claimants entitlements. This is also morally wrong. Essentially ACC is using staff contracts to contract itself out of the ACT!

      Put a steak in front of a dog and what’s he going to do?

    3. By jack on Jun 22, 2012 | Reply

      This is how the insurance companies are run in the United States. So many claimants found that the insurance company would not pay out because of some trite clause.. Look at the documentary SICKO by Michael Moore.. This National government is Americanising ACC and New Zealand.. Is it any wonder when the Prime Minister made his 50 million working for Merrill Lynch as head of derivatives in Europe. Disgusting really when someone at ACC will hold back your claim because they want to buy a new car. National has to go big time.

    4. By Greg on Jun 22, 2012 | Reply

      I was culled from ACC in 2003 and forced onto the dole, i was trying to find work, as well as suffering from head injury trauma & pyschological problems that they never treated. If it was an illegal practice then compensation should be higher than the 6000k for privacy breaches. They have 3 billion dollars that will likely be stolen by the consolidated fund.

    5. By bizobumble on Jun 22, 2012 | Reply

      Great incisive piece. To be fair to Judith Collins, there were rumours ten years ago, that this incentive system was around when Labour was in government.. (having brought in by Jenny Shipley and kept on by Labour). However , when I had the chance at the time to ask Ruth Dyson face to face, she denied it. The process of rehabilitation of long term claimants is that of wearing them down, by visits to “ACC’ doctors, who as you mentioned, are not even experts in their field , but rather they have undertaken post grad work certificates in ‘Rehabilitation Medicine’. Its all a joke. And another question I have is why, even when they work on an incentive basis, are employees of ACC so jaded, cynical and generally unhappy? It seems as though the ACC culture of fear affects them also.

    6. By Rog on Jun 22, 2012 | Reply

      I heard the radio interview and there was no mentions of a bonus. Are you sure

    7. By BDBinc on Jun 23, 2012 | Reply

      This does not stop at staff members bonuses for stealing claimants entitlements( of which most are the entitlement of medical care) Judges are paid by ACC, doctors,drsl, lawyers,private claim mangers and other acc agents allegedly also get paid incentives to act against the very legislation ACC are legally bound by.
      Didn’t ACC pay the FBI quite a bit of dosh to teach them how to verbally abuse claimants?

      ACC are now the very antithesis of what they are meant to be.
      ACC are lawless, not under control and are causing much harm.

      Thank you for writing on this issue.

    8. By Andrew R on Jun 23, 2012 | Reply

      It would be good to see Nick Smith being asked hard questions about this seeing as how the bonus system was introduced while he was the Minister.

    9. By Joe Blow on Jun 24, 2012 | Reply

      There appears to be mirroring of the beneficiary bashing philosophy at MSD within ACC. The thing that really gets under my skin is that the policy has been in place for three years before the public get to know about it!

      Just one thing Gordon. You can’t give up your right to sue for an accident unless someone is at fault. ACC covers both accidents when no one is at fault and when the injury is a result of someone else’s negligence or non-negligence. It also covers the situation where the injury is due to the fault of the injured person. You can’t give up your right to sue yourself. Therefore, ACC only takes away that entitlement where the injury is due to someone else’s negligence. ACC covers far more than the entitlement to sue in the sense that it is a kind of universal insurance.

      New Zealand is lucky to have it. These bonus incentives to get long-term claimants off the books and onto welfare erode that universiality.

      I can’t believe we’ve got another two-and-a-half years with these clowns in power…

    10. By sam broad on Jun 24, 2012 | Reply

      As a 21 year old in the early 1990s under National ( and off the back of the still neo-liberal Labour)my first case manager at ACC sat me down and told me:
      ” the government has just paid out $600 million to save the BNZ and another $600 million to back up ACC, so i’m afraid there really isn’t much money to go round”…
      The culture of beaureucratic elitism and cardigan civil ‘servants’ is rife in NZ and the erosion of entitlement for civilians barely feudal.

    11. By Jared on Jun 25, 2012 | Reply

      My mother tripped and fell on a piece of concrete left in the pavement from a sign – by the council. She was apparently the second fall, and within a week, the lump of concrete was removed. But due to ACC and NZ’s approach to accident liability, she could seek no recompense from the Council. She broke her shoulder in several places. 3 operations later, she’s had to constantly re-apply for physio endlessly to ‘prove’ she needs it; she was left without payment for 3 months last year, and the best she got from the case worker was a ‘woops, sorry’, and finally, she’s recently lost her job, due to not returning to work in time (after giving over 20 years to the company in question). She’s 64 years old, lost her husband aged 51, has survived breast cancer, and has osteoporosis. She has worked and paid taxes her whole life, and since emigrating to NZ in 1981, has worked every year but one until this injury. ACC have constantly made her feel guilty and indirectly suggested she somehow has to constantly prove this happened, and that she should be thankful for whatever she gets. The young, naive and unhelpful case workers have been unattentive, arrogant, and careless. She’s paid her taxes for decades and this is the way she is treated. She is now being forced to go to CV writing and ‘back to work’ courses, under threat of losing the bare minimal money she’s receiving, despite only being 10 months from retirement age. My Finnish wife has struggled to understand how a country can treat its citizens in such a way- to the point she didn’t actually believe me until I could prove this was happening. NZ is a place I’m now ashamed to call home.

    12. By Danny on Jun 26, 2012 | Reply

      My mother got hit by a van (“joe” we have ‘no fault’ accident insurance )on an unmarked pedestrian crossing, she was discharged after two weeks without consent by the public hospital in an undisclosed critical condition.
      She was then subjected to assault and battery. Both ACC & CCDHB refused to fund hygiene, mobility or pain management for the displaced and unfixed life threatening injuries.
      The doctors ACC made her see in this state also said that her severe brain injury makes her “hypersensitive” to the pain of unfixed displaced multi fractured spine,neck pelvis etc etc.

      ACC claimed in court they can close her file, this after refusing to purchase and provide minimum level of care, treatments and rehab. The MSD have been criminally managing since ACC “closed her file”.
      She has been given $200 per week to purchase the needed and already identified specialist inpatient care (which she would have to purchase overseas due to her treatment injuries here).
      ACC need to be changed from the top downward, all ACC staff are not evil and those that aren’t pathological would be deeply harmed by the ACC culture.

    13. By Jock Strapp on Oct 2, 2012 | Reply

      I recently ran into a clear case of medical malpractice through negligence in a New Zealand hospital that resulted in demonstrable injury. On reviewing what I might do about it in retrospect, I found that, legally, the answer is “practically nothing” except possibly obtaining some sort of compensation from the ACC on the basis that they might perhaps accept it as being a “Treatment Injury”.

      This seemed quite extraordinary until, on researching further, I found that New Zealand – in pursuing the admirable end of early 20th century concerns to establish an equitable compensation system for those workplace injuries where fault was not easily ascertained – had swallowed the (later significantly disclaimed and modified) theories of Patrick Atiya QC on the law of tort hook, line and sinker and had, in consequence, set up the ACC as the sole, monopoly provider of insurance for all personal injuries in New Zealand on an exclusively no-fault basis.

      Although there remains an option for a plaintiff to sue an at-fault party for punitive damages, the fact of the over-riding monopoly of the ACC on all accident insurance renders it largely ineffective and unlikely to provide either compensation for a plaintiff or deterrent to a defendant.

      Presumably, given its basic motivation, the ACC was originally formed under a Labour government? I wasn’t here then, but I wouldn’t be surprised if it was. Talk about gullible. Insurance providers and those commercial enterprises that weigh workplace and public access safety measures on any significantly cost-effective basis must have been laughing all the way back to the boardroom. Set up a monopoly under the full protection of the state and you get a state monopoly. Mussolini, like yourself also a journalist, had a word for that.

      You say, “ACC claimants have agreed not to pursue the route of suing for compensation in return for the state intervening, and providing an adequate level of compensation.” You omit to say, “Statute prohibits any competition for the ACC to operate in the commercial arena, so injury compensation claimants have no alternative but to lodge claims with the ACC except either not to claim at all or to attempt to claim through legal action that is, by virtue of the monopoly status of the ACC, both unlikely to succeed or to be adequate to the nature and extent of any injury (or consitute any real deterrent) if it does.”

      You say, “That kind of thing – the systematic denial of entitlements – is the core problem with ACC.” Whereas the core problem with the ACC is its statutorily-accorded monopoly position.

      A natural and almost inevitable consequence of that monopoly is that the corruption that almost invariably surfaces from time to time in almost any organization of ordinary human beings is, within the ACC, a bureaucratic corruption. Which is remarkably different from the sort of commercial corruption that would be found in a commercial organization? NOT. Just almost impossible to eradicate by any of the normal methods selection that drive bad systems of whatever provenance out of existence in non-monopolistic environments where any state players (often socially invaluable contenders in commercially competitive arenas) are without inbuilt statutory advantage except that of democratic accountability.

      Remove the “bonus” basis of corruption from the ACC and the emergence of other, equally iniquitous bases of corruption – almost certainly already present within the organization, if not yet so obviously predominant – will follow in short order. The “bonus” basis of corruption is only a symptom of the real systemic potential for corruption that exists, a priori, in any state-ordained monolith.

    14. By BDBinc on Oct 2, 2012 | Reply

      Jock strapp, ACC is not corrupt because it is a state ordained monolith.
      It could easily be 2 big private insurance companies owning & shareholding in NZ’s hospital, health and other services.
      Removing a bonus system that harms the accident victim is a reasonable suggestion, as why should we pay people for engaging in the unlawful denial of medical needs ?
      Why pay extra bonuses for crime?
      One should not use the disgusting state of ACC (and the health system) corruption to suggest that we privatize it.
      As Danny said, there are good people in the system but they are following bad leadership and unlawful processes and decision making.
      Most ACC employees and agents , if allowed to use their own free will, (without financial bonuses for crime and illegal operational mandates and pressure from above), would approve of medical treatment for all of ACC’s victims.

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