Thursday 20 August 2009

why do we need a new clinical framework?

soon after the election, the new government decided to change the composition of the ACC board. we've got a different group of people deciding who gets money for health services, and it seems that their priorities are not around sexual health. we've had the cuts to the auckland sexual abuse help line. and now, there appears to be a move that will result in cuts to counselling services to victims of sexual violence and abuse:

Sean Manning, President-elect of the NZ Association of Psychotherapists, adds that “ACC is in the business of addressing the effects of trauma, but the proposed process where a victim of sexual abuse will have to tell their story to three people before getting help, will actually be damaging. If you want to put people off asking for help, this is a good way to do it. It is a shocking way to deliver a supposedly rehabilitative service.”

“Other than an implied criticism that there are clients who are receiving ‘too much’ counselling we have yet to hear clearly from ACC what it is they believe isn’t working under the current system. Instead we’re seeing a set of changes hurriedly imposed that we predict will impact negatively on clients who are already distressed by experiencing difficulties with getting cover, unreasonable delays and the impacts this has on safe practice,” says Adrienne Dale of the NZ Association of Counsellors.

it's well worth reading the full press release, as there are some major concerns raised in it. as with the closure of the pay equity unit, there has been no consultation regarding this change. there has been no opportunity to have a discussion about the impact of the new clinical framework; there appears to be no research or evidence on which the changes are based.

all of which makes me wonder, who in the current government is standing up for women? who is advocating for services that are of crucial importance to women? there appears to be a total vacuum. for all the cries there used to be of "nanny-state" in the previous 3 years, we now have silence when the government is actually behaving in a dictatorial manner that is detrimental to the well-being of its citizens.

one final point. it's hard to see this as anything but another move to prepare ACC for privatisation. which will make it even more difficult for victims of sexual violence and abuse to obtain the professional services they need, because private providers will expect you jump through even more hoops before they'll accept your claim.


Anna said...

I'm glad you wrote this, stargazer. I feel gravely concerned about the whole ACC situation, but I know so little about it that it can be hard to follow what's going on or reach an informed opinion.

Anonymous said...

The research ACC have based this decision on ( suggests that the current practice of an indefinite number counselling sessions are not good for the survivor. Of course the NZ Association of Psychotherapists is going to be opposed to this! It’s disappointing that you’re putting the financial wellbeing of psychotherapists before the mental wellbeing of victims of sexual abuse.

ACC is in a terrible state. Nick Smith has categorically ruled out privatisation (yet you keep raising the spectre), but ACC is unsustainable in its current form without major taxpayer/levypayer funding. You can't continue to treat it as a black hole for money, immune from financial accountability, even where scaling back can be shown to be beneficial to the users of the scheme.

Dr. Gudrun Frerichs said...

A county with a social environment in which children are killed regularly by their caregivers and in which 15% of its population experiences sexual abuse at some point in their lives surely has a problem.

Cutting counselling funding for mainly female survivors of sexual abuse (approx. $2m in 2008 or $19m for all entitlements incl. compensations) is a travesty considering they didn't ask to be abused whereas countless males voluntarily follow their recreational interest i.e. rugby, which costs ACC 60m a year. But we don't hear about they need cutting down on that, don't we?

The problem is that a lot of people are completely ignorant of the complex problem of sexual abuse and chose to remain in that state. It plays perfectly into the hands of pedophiles, rapists, and other sexual predators.

namaste said...

The cost of sexual abuse to New Zealand society was estimated in 2001 to be $2,465m annually and in 2009 ...?

ACC‘s own injury statistics for counselling/medical fees are about $2m for 2008.

A further total of about $17 m for all other entitlements - weekly compensation for those rape victims who were assaulted whilst working and independence or lump sum allowances for those whose lives have been independently and rigorously assessed as being more than 10% permanently affected by rape.

Costs for running the Sensitive Claims Unit are about $30m.

The cost of administering the SCU therefore far exceeds the service it is supposed to fund.

Interestingly when you go to the ACC site Anonymous suggests you will find this information has been moved.

Does this reflect a culture of unresolved institutionalised secondary PTSD in the unit and ACC?

How therefore might the estimated 1 in 4 women and 1 in 8 men sexually abused before the age of 16 (and the others after this criteria) in New Zealand feel when the impact of these changes roll out in mid September?

The changes ACC intends to make will revictimise many of the estimated 600,000 survivors in this country as Stargazer suggests and further impact on generations of their children and the country.

These changes are made on evidence purchased by ACC which supports their bias and contradicts international and national studies and two decades of professional practice by clinicians.

There has never been an indefinite amount of counseling sessions available for the survivor through the SCU. The amount of sessions have been rigorously accounted for by regular reports and independent assessments since the inception of the SCU.

The only black hole in this situation is ignorance and fear; these changes treat survivors as though they are the problem.

Anonymous said...

Anon - I had ACC-funded counselling after I was sexually assaulted. I had an hour session every week for almost a year.

Had I not been able to have those sessions (and have them for as long as I needed to have them) I wouldn't have survived.

So don't talk about putting 'psychotherapists' before victims of sexual abuse.

ACC funded rape counselling saves lives.

namaste said...

I agree with you ACC counselling saves lives and the survivors of sexual trauma are going to be the ones hurt by these proposed changes.