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Radio New Zealand
“Insight”
March 17, 2002
Replayed March 18, 2002
(Transcript)
Return of ACC lump sum compensation for sexual abuse
Sue Ingram
Gordon Waugh
She
came home and sat in front of our - at our dining room table on a date that
is engraved in my brain. It was a Wednesday evening at 6.30 pm. She sat there
and said "I've been going to Auckland's
top counsellor, and she's been helping me to recover my memories of what
happened to me as a kid."
Sue Ingram
On 6 May 1992, Gordon Waugh's eldest daughter confronted him with her
allegations that he and other men had sexually abused her.
Gordon Waugh
My daughter went along to the
police and laid a complaint, but that complaint was quite astonishing because
it revolved around allegations of indecent assault by me alone.
Sue Ingram
And what happened to that
police investigation?
Gordon Waugh
The police interviewed all of
us and decided that there was no evidence on which to base a charge. So they
closed the case.
Sue Ingram
To this day Gordon Waugh does
not know what exactly motivated his daughter. He does know the claims shattered
his family, and that his daughter benefited financially.
Gordon Waugh
She made a claim on ACC and
was paid many thousands of dollars.
Sue Ingram
ACC lump sums were withdrawn
in 1992, but from April the first they're back and Gordon Waugh is among
those who fear their reintroduction will lead to an explosion of sexual abuse
claims resulting in huge payouts.
Extracts from parliamentary debates:
[?]: I'm not certain that NZ First at this point in time is going to
support this passed...
Jenny Shipley: This, Mr Speaker, will be a huge test for this new
government and say that in this attempt you will either fail...
Michael Cullen: ... present employers scheme will be developed and
reinstated and there may be some limited possibilities within that.
Sue Ingram
the Accident Compensation
Corporation is never far from the headlines and since its launch in 1974 it
has gone through a number of changes. One of those was in 1991 when the incoming
National govt announced the abolition of lump sum payments. Just over 10
years later Labour has reintroduced them. Mervyn Castle is the president and
senior advocate for SPAV – the Society for the Promotion of Accident Victims.
Mervyn Castle
The reintroduction was part of the Labour party's pre-election
platform on ACC. In part they're reintroducing that which was taken away by
the '92 Act.
Sue Ingram
Lynley Hood (LH) has written
about ACC in relation to sexual abuse counselling in her book on the
Christchurch Civic Creche case A City Possessed. She says the author of the
original scheme, Sir Owen Woodhouse, was against lump sums.
Lynley Hood
When ACC was originally set up Sir Owen Woodhouse argued vigorously
against lump sum compensation because he said it encouraged people to
maximise their agony in order to maximise their gain.
Sue Ingram
The earlier lump sum scheme
included compensation for the loss of enjoyment of life, and for sexual abuse
claims this often resulted in a $10,000 payout. Gordon Waugh believes this
led to an explosion in sexual abuse claims which fuelled National's desire in
the early '90s to do something about ACC's burgeoning budget.
Gordon Waugh
ACC didn't begin reporting the
number of sexual abuse claims they were dealing with until about their 1988
report and in that year they dealt with only 221 cases. Looking down the
following years - in '89 it was 445, the 667, 1075, 2173, and then we get
into big numbers like in 1993 13,000 of them.
Sue Ingram
By the last year of the lump
sum scheme, 1991-92, more than 15,000 people were paid a total of $m245, much
of it for historical sexual abuse claims from women and men claiming
compensation for childhood sexual abuse. Politicians from both sides of the
house concede things went wrong. Gerry Brownlee, National's ACC spokesman -
Gerry Brownlee
This time round you, for example, won't get a lump sum for loss of
enjoyment of life, as I read the Bill, and I think that is where things
really went wrong previously.
Sue Ingram
The Minister for ACC, Lianne
Dalziel -
Lianne Dalziel
The $10,000 payment that existed for pain and suffering, loss of
enjoyment of life, became pretty automatic. So if people could establish that
they had been sexually abused, then the payment of $10,000 was automatic.
Sue Ingram
Lianne Dalziel is keen to
point out the differences between the new legislation and the old lump sum
scheme.
Lianne Dalziel
We've introduced lump sum compensation for injuries where there is a
certain threshold of injury reached and, of course there's a higher level of
lump sum compensation for those that have had a significant impairment. So
it's a scale that applies to the level of impairment. So in fact we haven't
reintroduced lump sum compensation for sexual abuse in the way that it
existed before. You have to actually reach a very high level of permanent
impairment in order to access lump sum compensation.
Sue Ingram
The extra cost of the lump
sum scheme has been costed at 50 to 60 million dollars. Dr David Rankin is the
general manager of ACC's relationship with the health sector.
Dr David Rankin
All research that we can identify internationally clearly indicates
that there is a moral hazard for any insurance company that implements lump
sums. We believe that our processes that we have in place now are far more
robust than they were prior to 92. We expect there to be pressure on our
scheme costs with the implementation of lump sums and that pressure has
already been costed and indicated to the govt.
Sue Ingram
Dr
Rankin says he doesn't know how much of the extra cost will come from sexual
abuse claims. For sexual abuse claimants there will be certain criteria they
have to meet to access lump sums.
Dr David Rankin
The injury, or the date of last exposure, must occur after the first
of April. Secondly, the injury must be stable, or two years must have passed
since the date of last exposure. And thirdly people must be subject to an
incapacity assessment that demonstrates that they have suffered more than 10%
impairment.
Sue Ingram
The cutoff date of April the
first means that claims of historical sexual abuse will not become relevant
under the new legislation for a considerable amount of time. However, just
like the old lump sum scheme a claim of sexual abuse still does not have to
be proven, a caveat which dismays critics. Author Lynley Hood -
Lynley Hood
It'll be like putting out sign saying: Get Your Free Money Here.
Sue Ingram
Senior Psychology lecturer at
Victoria University, Maryanne Garry -
Maryanne Garry
It's better than a lottery ticket. At least when you go in the lottery ticket
you gotta spend some money, you gotta at least spend some time scratching and
doing all this kind of stuff, and then saying - oh, I wonder if I got the
jackpot here? This time what you have to do is, you have to say: You know,
this happened to me. The end. You have to go at some paper work. You have to
go into counselling. We know. We have evidence that years ago, when this
policy was in effect, it produced some very unsavoury behaviour among people.
Why is it not going to do that now?
Sue Ingram
Gordon Waugh -
Gordon Waugh
It's simply going to cost the taxpayer a lot more money for no good
reason.
Sfx - phone ringing -
Female voice: Help foundation, Marion here.
Sue Ingram
At the Wellington Sexual Abuse Help
Foundation manager Marion Kliest says if proof was required huge numbers of
people would be put off from coming forward for help.
Marion Kliest
What would be required of people coming, - um, walking through this door,
anyway, is enormously difficult. If they knew that they had to take the
issues, or name their abuser, if they could do that, or go through the
justice system, then we wouldn't see people at all.
Female voice
Have a seat, just whichever one takes your fancy - When you rang in
here, you would have spoken to Cecile or Marion on the desk here and they
made a few notes as a result of talking to you, so I know a little bit about
why you've come - but, how can I help?
Sue Ingram
Lyn Hamilton is a trained counsellor and divides her time between a
private practice and the Wellington Help Foundation. She says there are many
reasons why people don't come forward after being sexually abused.
Lyn Hamilton
Shame, guilt, fear, lack of trust, betrayal by significant other
people in the past. So for people to actually come through our doors, let
alone make that first call on the phone means they've already come a
significant way. It takes a lot of guts to do that.
Sue Ingram
Counsellors say the
cornerstone of reaching those who have sexually abused is sympathy and that
any disbelief can get in the way. But Maryanne Garry, a senior lecturer at
the School of Psychology
at Victoria University, believes the process
should be more rigorous.
Maryanne Garry
If I were to go to an insurance company and say look this thing
happened to me, now you can give my $15,000. I actually think it's within
their right to try and verify, even the tiniest hand in the back of the room
that shoots up and says - Are you sure? I actually think they're perfectly
within their right to do that.
Sue Ingram
Author Lynley Hood is also
critical.
Lynley Hood
ACC in any other area of their work will want confirmation when
anyone says they've been injured. They will want proof that they did fall off
a chair and break they leg or whatever.
Sue Ingram
ACC believes it's right to be
very lenient on the criteria it uses for sexual abuse cover. Dr David Rankin
-
Dr David Rankin
It's an extremely traumatic episode for any person to lodge a claim.
It requires courage to talk about, to disclose that it's happened, often to a
gp that you don't have a lot of relationship with. And so the number of
people who are prepared to lodge a claim is relatively small compared to what
the NZ sexual abuse incidence rate appears to be.
Sue Ingram
Being confident of that rate - the
incidence of NZ sexual abuse - is not so easy though. Much quoted is the
Otago Women's Health Study carried out in 1991. Lynley Hood in A City
Possessed reports that the survey finds that the percentage of
retrospectively reported child sexual abuse was 32%, which she cautions about
taking that at face value.
Lynley Hood
There are all sorts of problems with these surveys. They all vary according
to the population studied and the definitions of sexual abuse. And also
they're all dependent on retrospective self-reporting, which is notoriously
unreliable.
Sue Ingram
The confusion is evident even at ACC,
where Dr David Rankin consults the corporation's therapy guidelines for Adult
Survivors of Child Sexual Abuse written by Kim McGregor in 2001.
Dr David Rankin
Last year we published Therapy Guidelines for counsellors dealing with sexual
abuse and that guideline quoted statistics that up to 35% of NZ female
population has been sexually abused at some stage in the life.
Sue Ingram
What is that based on?
Dr David Rankin
- New Zealand Women's Refuge - ahhhm --- mumble. The Otago Women's Health
Survey found that 25% of women reported experiencing sexual abuse that
included physical contact before the age of 16 years and 16% before the age
of 12 years.
Sue Ingram
Some of the confusion lies
with trying to compare sexual abuse rates from different age groups, and
across different definitions of abuse. However, where a direct comparison can
be made, the figures still don't match. The Otago study states that nearly
20% of the women in the survey reported sexual abuse involving at least
genital contact before they turned 16. In the ACC manual which quotes the
Otago Study the figure for that same cohort is 25%. Anyone querying the
figures is often criticised for suggesting that there is no sexual abuse.
Lynley Hood -
Lynley Hood
Of course I'm not saying that it doesn't happen. I'm just saying that
any complaint has to be taken seriously, of course. But there's no reason why
you should believe it without question.
Sue Ingram
Gordon Waugh, who was wrongly
accused by his daughter of sexual abuse -
Gordon Waugh
Sexual abuse does happen. It's endemic
in many societies. It's endemic in NZ society. But the simple fact is that
none of us know the prevalence of it.
Sue Ingram
Already off the back of
recent publicity, the number of people making a claim with ACC for sexual
abuse has increased 5 fold. [Sfx of letterbox thud] In January a Christchurch law firm called Wakefield Associates
distributed 1 million leaflets to households around the country.
Male Voice Over
Victims of sexual abuse have a legal right to ACC financial compensation. You
may be entitled to a lump sum of up to $25,000 and ongoing payments valued in
excess of $150,000.
Sue Ingram
The publicity caused
sensitive claims to ACC to increase from around 100 a week to 500. Despite
coming before the April the first cutoff date. Dr David Rankin from ACC -
Dr David Rankin
The claims that have been lodged are valid claims, and we will
process them for cover. But they won't be eligible for a true lump sum under
the new legislation. What the Wakefield Associates group have said is that if
your claim is accepted and you've already been to counselling and had
treatment, ACC will backdate that counselling, and may also backdate your
independence allowance, which will be paid to you as initial upfront sum.
They've labelled that a lump sum, but it's not the same as a lump sum under
the new legislation.
Sue Ingram
But they're correct in saying
that's what might happen?
Dr David Rankin
They are correct in saying that some people will be eligible for a
significant cheque when the payments start.
Sue Ingram
ACC is also undertaking its
own promotions campaign about the lump sum scheme.
Female Voice
This is poster that we developed with the Women's Refuge as part of
our partnership with them. We've got a million dollar partnership with them
for over 3 years, and what they said to us what they wanted was a poster that
would clearly set out how to make a claim and where to go for help. So that
was what we developed.
Dr David Rankin
Any media publicity or attention to this sensitive claims process
covered by ACC always generates an additional number of claimants. People who
have tried to suppress and get on with their life listen to media reports, or
read media reports, and decide that it's time they got treatment. That's a
good process. If we can assist them in living a better life, that's what this
scheme is all about.
Sue Ingram
Has the publicity tapped into a pool of genuine sexual abuse victims,
or encouraged people with an eye on the money? The Minister of ACC, Lianne
Dalziel takes offence at the suggestion of a gravy train -
Lianne Dalziel
I have met the parents of young people who have been abused - physically,
sexually, emotionally. I have met older people who lives have been ruined by
sexual abuse, and to suggest that $10,000 payment is a gravy train I think is
deeply offensive to many of those women. I think it's unfortunate that there
are those who would really allege that people would make up that level of
abuse in order to gain $10,000. It's just ridiculous.
Sue Ingram
So of those who come forward,
how is it possible to determine whether the claims are genuine or not. Dr
David Rankin from ACC says the corporation has put a robust system in place.
Until recently there were 900 registered ACC counsellors around the country.
900, until ACC made them register.
Dr David Rankin
They have to fill out a very detailed application form documenting
their education requirement, their attitude, approaches to dealing with
people of different ethnic background, their experience in sexual abuse
counselling, and they have to have the support of the professional
association they belong to. We do a police check on everybody to make sure
they don't have a criminal record. And we look at the volumes and outcomes of
the counselling they have been engaged with ACC for in the past. That process
has eliminated about 1/3 of our counsellors, so we now have about 600
counsellors who have been through that more rigorous process.
Sue Ingram
In A City Possessed about the
Christchurch Civic Creche case, author Lynley Hood raises concerns about the
standard of counsellors dealing with sexual abuse claims.
Lynley Hood
They are trained to believe whatever the claimants say, and are paid
to treat the claimants for sexual abuse. So the whole system is skewed
towards believing and treating sexual abuse, regardless of what the
claimant's problem actually is.
Sue Ingram
Dr Rankin says there have been a mixed
bag of standards within NZ.
Dr David Rankin
ACC is committed to raising the standard to a level that assures us
that the counselling we purchase is effective.
Sue Ingram
Your implication is that some
of the concerns over the training and the standard of counsellors in the past
may have been justified.
Dr David Rankin
There are many issues that make ACC nervous about a counsellor's
continued competence. One of those is the volumes of claimants that they
counsel. A counsellor that only deals with a very small number of sexual
abuse claimants every year cannot maintain the skills that are required for
effective counselling. We also recognise now that formal training in
counselling does give counsellors greater skills than those that have perhaps
not been through formal training. The competency requirements for counsellors
will always be a dynamic issue. I believe we will always find out more and
more about what constitutes effective therapy and as we make those findings
we will adjust the criteria required for a counsellor to be funded for
counselling for ACC.
Sue Ingram
So during the 90s counsellors might have been getting it wrong.
Dr David Rankin
We have no evidence to indicate that people that went to counselling
in the 90s received less effective counselling. We do recognise that there
may have been a risk. We are unable to quantify that risk, nor have we
endeavoured to.
Sue Ingram
Lyn Hamilton from the Wellington Sexual Abuse Help Foundation is one
of those who has had to reregister.
Lyn Hamilton
There was quite a bit of resentment about the amount of work that we
had to do in order to comply with this. And an understanding that it's
important that we be answerable and that we live up to whatever current
standards there are and that those are maintained, and I think that the
criteria are rigorous. In my experience it's been robust right from the
beginning. I don't feel that it's more rigorous than it has been, simply that
there's a standardisation process occurring across the board.
Sue Ingram
And Marion Kleist, manager of the Wellington Help Foundation, says
there have been other factors which have put off counsellors from
re-registering.
Marion Kleist
The low rate of remuneration would be a big issue for lots of people,
and I think there are high compliance costs associated with doing ACC work. I
think there are lost of counsellors and psychotherapists and therapists out
there who actually don't need the hassle of having to deal with the ACC
compliance. I think that's a tricky issue, because I think ACC have to have
some compliance. We don't argue with that. But I just think that for lots of
people they don't wish to undertake that any more and they can get plenty of
work without having to do that. It's not as if working with people who have
been sexually abused is easy work anyway. Why do it if you don't have to?
Sfx - phone ringing.
Female Voice
Good morning, Terrace Medical Centre.
Sue Ingram
The process of claiming an
ACC lump sum for sexual abuse is likely to begin at a person's GP. Their
local doctor can assess their mental state and refer on to a therapist. If
sexual abuse is disclosed or suspected ACC will pay for 2-4 counselling
sessions while an initial assessment is made. The counsellor then advises ACC
whether more treatment is necessary. To help, ACC last year produced some
Therapy Guidelines. They are 43 pages long and cover the stages a client may
go through in a counselling process for sexual abuse. Maryanne Garry, an
expert in memory and senior lecturer at the School
of Psychology at Victoria University,
is scathing. She says the guidelines provide a perfect means to build false
memory.
Maryanne Garry
What we've got is - on p.18 - adults survivors rarely enter therapy
with a specific goal of working through unresolved child sexual abuse and you
can be fairly confident most issues your client will wish to work on that may
appear to be surface issues will be related to the effects of childhood abuse
or its context. Some survivors will have no conscious memory of their history
of childhood sexual abuse it says on page 19. On p. 20 - it's no unusual for
clients to initially at least deny aspects of some of all abuse experiences,
or to minimise the effects of abuse. So what you've got here is - so you've
got people who aren't remembering this thing, but you are the counsellor have
the skills to suspect that something's going on where you have to help them
remember. So this manual takes you through steps. The first thing is you have
to educate people about what childhood sexual abuse does, and you have to
tell them what the symptoms of csa experiences are like. All of this acts as
suggestive material to people. It gives them sort of like a - think about a
scaffolding - just a framework, a little skeleton on which they can hang the
details they might use in trying to remember something, and when you try to
remember something people engage in activities like - you might talk to other
people and say - does this sound plausible to you? Or they might imagine -
that's another common strategy - so they shut their eyes and they imagine -
what they're doing is just building, hanging information that they're creating
on this scaffolding. And before you know it, it's not unlikely that people
are going to come up and remember full blown experiences that never happened
to them at all.
Sue Ingram
Katherine McPhilips, a
clinical psychologist and clinical manager at the Auckland Sexual Abuse Help
Foundation believes it would be hard to fake the mental trauma or Post
Traumatic shock that would result from sexual abuse, but she says if a
client's problem is due to another cause they will be sent somewhere else.
Katherine McPhilips
We tend to refer those clients elsewhere if the dominant problem is
not sexual abuse because our organisation relies heavily on ACC funding. So
if the dominant problem is not sexual abuse then ACC will not fund the
counselling for those clients.
Sue Ingram
ACC says it has employed
counsellors skilled in determining whether the mental injury reported is
directly a consequence of sexual abuse.
Dr David Rankin
We require those counsellors to submit detailed reports and progress
notes on their counselling's going, and in a few cases, a v few cases, the
counsellors will write to us and tell us that they believe that the initial
reported incident did not occur and the mental injury that is now being
reported is not the consequence of sexual abuse. That's a rare event.
Sue Ingram
After having ACC accept a
sensitive claim a sa claimant will then have to have counselling until a
trained health professional assesses whether their mental trauma has
stabilised. This will be at a maximum of 2 years, but could happen much
earlier. If stabilised the amount of permanent impairment, or in ACC jargon,
residual damage, can then be assessed for a lump sum. Minister Lianne Dalziel
-
Lianne Dalziel
There will be an initial period of counselling, a reference then for
a psychiatric report, and then ongoing commitment for counselling for
probably 2 years before we would - and that doesn't nec mean that counselling
would be right throughout that period, but it means that in about 2 years
time when things have stabilised, that's the point that we would look at lump
sum compensation.
Sue Ingram
To be eligible for a lump sum
the residual damage must be judged to be over 10%. But assessing mental
stability and residual damage is no easy task. Katherine McPhilips -
Katherine McPhilips
That's a very tricky question to answer with mental impairment and I
guess from somebody who works on the counselling and therapy side of it - I
find that v difficult to judge. I don't know to be honest, because from a
counselling/therapy side of it, of course, we believe that healing is always
possible given the right conditions.
Sue Ingram
ACC accepts it's a difficult area. Dr David Rankin -
Dr David Rankin
It's extremely difficult to judge mental impairment. We have a v
limited number of people that are skilled in that process, and we've been
through a v exhaustive process of determining how we should determine
impairment for mental injury.
Sue Ingram
Once assessed, as sliding
scale for a lump sum payment comes into effect.
Dr David Rankin
The numbers range from $2,500 to $100,000.
Sue Ingram
That $2,500 would be for 10%?
Dr David Rankin
10%. It's a sliding scale. Once you get towards 80% it quickly
reaches $100,000, and at the 80% it is $100,000.
Sue Ingram
The numbers at the top end
sound big, but Minister Lianne Dalziel believes that people who aren't
genuine claimants would not be prepared to go through the counselling system.
Lianne Dalziel
I've talked to a lot of counsellors who work with the victims of
sexual abuse and they tell me that there are many stages in the counselling
process, that it's just - I know there would be some who would have in the
past for the sake of $10,000, it was pretty much assured. Maybe they could
see that that was something they could do. But in the vast majority of cases
how could you just go through that week after week after week and maintain a
pretence of such a high level of distress.
Sue Ingram
Marion Kleist from the
Wellington SAHF also says she can't see why people would claim sexual abuse
without genuine reason -
Marion Kleist
(laughs) I can't imagine why anybody would want to come and claim for
counselling for something that hadn't happened to them. There's nothing to be
gained from that particularly. In terms of the lump sums, well, time will
tell.
Sue Ingram
Time will tell. Despite the
extra claims the publicity has generated, it won't be for at least two years
before lump sum payouts for sexual abuse claimants will be able to be
evaluated. Until them the two camps remain far apart.
Katherine McPhilips
When we're working with somebody, there's not just what they tell you
in words, there's what they tell you in their whole life story, what their
body language tells you, all sorts of ways that we're looking for congruency
between what they say and how they present. So it's so it’s not as easy as it
might be thought to actually make a false claim.
Gordon Waugh
At the end of this there is a
huge organisation within ACC, the Sensitive Claims Unit, costing the taxpayer
millions of dollars. The counselling claims also cost many millions of
dollars, and you cannot have that sort of taxpayer funds - any taxpayer funds
- being paid out on the basis that there is no evidence for. You've got to
have some evidence.
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