Abuse claim oversight switch stuns providers

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Australian health insurer Medibank has won a bid to manage sexual abuse claims for the Accident Compensation Corporation (ACC).

The company, which is being sold by the Abbott Government in a share float expected to fetch up to A$5.5 billion ($6.1 billion), is one of 173 successful bidders to become "suppliers" of sexual abuse counselling - a new management layer that will contract with counsellors and psychologists who will remain the service "providers".

Other successful bidders include Active Physiotherapy, now called Active+, and Auckland's biggest doctors' network, Procare.

Counselling leaders are alarmed. Manukau counsellor Tania Blomfield, who co-chairs the national network of sex abuse counselling agencies, said she was concerned that "private sensitive information is going into databases outside of the sector".

"It scares me that they may be seeing this as a potential money-spinner," she said.

ACC has lifted funding from a standard $83 an hour at present to new rates which will stay about the same for counsellors with diplomas but will increase to about $100 an hour for those with master's degrees or $130 an hour for physiotherapists, or more for clinical psychologists.

But counsellors who go into the new integrated contracts will no longer be able to charge clients "top-up" fees of up to $90, and some could end up worse off if the supplier companies managing the contracts take a big cut for administration.

"From the client's perspective, which is what it's all about, this is going to be a lot better than the existing system, but the question is going to be how badly do the providers get screwed along the way," Ms Blomfield said.

Medibank NZ general manager Andrea Pettett said the company approached about 700 of the 900 ACC-registered counsellors and received indications of interest from more than 100 of them.

The company also operates the Healthline phone service for the Ministry of Health and is believed to be on a shortlist of three, along with Lifeline and a company owned by Procare and Christchurch doctors' network Pegasus, in another tender to integrate Healthline with other helpline services.

Sex abuse tender

Why are sex-abuse counselling contracts being re-tendered?
ACC's new "integrated contracts" include assessing clients' needs as well as providing counselling. Until now most counsellors have not had contracts but simply billed ACC for hours worked.

Why can insurance companies and physiotherapists bid?
ACC has opened up the criteria for assessments to allow clients to choose their assessors and counsellors. Until now ACC decided who did the assessments.

What will change for sexual abuse survivors?
They should get a more integrated service, fully funded by ACC. Counsellors in integrated contracts can no longer charge clients extra fees above the ACC subsidy.

Why are counsellors worried?
Some counsellors worry that insurance and physiotherapy companies won't understand privacy issues and other sensitivities in sexual abuse cases.