Open Letter
Barri Leslie
Blue Spectrum Counselling

Confidentiality Concerns Re ACC SCU

Attn: Adie Dale,

Executive Member

New Zealand Association of Counsellors (NZAC)

ACC Portfolio

Dear Adie,

Re: CONFIDENTIALITY FOR ACC SCU CLIENTS . . . A PROFESSIONAL ETHICAL ISSUE

Recent discussions amongst ACC approved counsellors / psychotherapists / psychologists and supervisors in North Shore City, Auckland, have highlighted a number of concerns about new ACC SCU processes, the first we have addressed is CONFIDENTIALITY.

For a client who applies for ACC SCU Counselling, then signs a 167 form and later goes over 30 hours, their personal details are presented to:

1. Often clients first tell a GP who fills out an ACC 45 application for a Sensitive Claim.

2. Then they present to a counsellor who gathers more detailed information about the sexual abuse/rape and the consequences and writes an ACC 290 report.

3. Both the ACC45 and the ACC290 are read by a Claims Assessor at the SC Unit, who if the claim is accepted assigns a claim number.

4. From this point all contact information plus the Claim Number is available to any of 50 Customer Service Representatives at the Call Centre in Hamilton.

5. As further statistical information about the client (e.g. numbers of counselling hours or any compensation paid) is entered into the computer system cumulatively it is available to 10-12 Customer Service Representatives selected from the above 50 who are given some extra training.

6. Additional information including details of the sexual abuse/rape events required in counsellors' reports are available to their appointed case manager, (plus all other case managers if their appointed c.m. is away, plus new c.ms as the staff turns over frequently).

7. If the client wants to have more than 13-14 hours counselling the clinician must write a detailed ACC 291 report which also is required to be read and discussed with the clinician's supervisor. Traditionally supervision has involved discussing clinical issues while protecting the anonymity of clients. However in this situation supervisors inevitably now know the names and many personal details of clients, as they must read and sign off the report.

8. If a client wants to go over 30 hours counselling, their whole file is passed one of two another case managers who oversees either North or South Island complex claims, and they sometimes consult with their team leader,

9. Also if claiming over 30 hours the whole file is passed on to a Peer Reviewer in Wellington to read and assess progress.

10. Over 30 hours the client is also likely to be required to meet for at least an hour with a Data Assessor to review the events, their consequences and client/counsellor progress. This is often re-traumatising for the client for a number of reasons.

This means that not less than 3 and potentially 58 persons (plus more given the high staff turn-over), with a wide range of training and commitment to confidentiality have access to identifying information about clients.

Two concerning accounts from counsellors in North Shore City:

Counsellor 1: My client rang [ACC] today to inquire about an application she has put in. The person in the call centre told her that her case manager is on the phone and whether she could help her. After the client gave her claim number, the call centre person was able to access the computer file and everthing that was ever written about her. She told the client "Your case manager sent you a letter today - do you want me to read it out to you?". Which subsequently she did. The client broke down and collapsed in my practice room and it took her 3 hours to get enough control over her legs in order to leave safely for home.

This is an example of 'respectful treatment of service user'. The letter should not even be sent to her without ensuring therapeutic support in dealing with it.

On another note: ANYBODY could have given her claim number and would have received the information about the claim! Confidentiality and privacy down the drain.

Every day I think "This is the worst, it can't get any more terrible" but it can. Obviously. Every next day proves me wrong.

Counsellor 2: I rang ACC SCU with a general inquiry about entitlements for clients making disability claims. I asked first at the call desk thinking I might get a satisfactory answer rather than trying to get through to a case manager.

The answer got a bit complicated and the person on the phone asked my client's name. I gave the name but said I didn't have the DOB or address with me as it was just a general query and I was ready to drop it . . . then she said she had two clients with that name up on the screen . . . one in New Plymouth and one in Auckland. I said my client was in Auckland but I didn't know her DOB although she was an older woman.

She then went on to say this client had had some funding already. I said, No I didn't think my client had ever had any SCU cover other than counselling. Yes she has, said the person on the phone, and I can tell you exactly how much . . . at this point I thought it was all going too far, so I said, Don't you have any requirements for maintaining confidentiality, to which she responded quickly, Yes, I meant, I could tell you what she's been paid, but I won't.

I have only previously used the phone desk to get a claim number, using the client's name, DOB and address (which is bad enough . . . an incestuous family member would know that information) but this time I only gave the client's name and vey general other information. Although I introduced myself by name and as a counsellor from Auckland, I could have been anyone. Also it seems I could have accessed information about the client in New Plymouth.

From Barri Leslie BA(SocSc), Dip.Ed. MNZAC Blue Spectrum Counselling 1st Floor, 3-5 Auburn St, Takapuna, NSC, Auckland, 1309 Ph 09-488-0340 Fx 09-912-9008 Email: barri@pl.net

Copies to:

Ada Crowe (NZAC)
Robin McGill (NZAC)
David Rankin
Gail Kettle
James du Plessis
Dr Andrew Moskowitz
Kim McGregor
Sue Murray
Janice Giles et al

Rt Hon Helen Clark,
Georgina Beyer,
Sue Bradford,
Deborah Coddington MP,
Helen Duncan MP,
Hon Ruth Dyson,
Ann Hartley MP,
Sue Kedgely MP,
Hon Annette King,
Dr Muriel Newman, MP
Hon Murray McCully,
Hon John Tamihere,
Metiria Turei MP,
Hon Tariana Turia,
Hon Margaret Wilson,
Pansy Wong MP,

Editor editor@scoop.co.nz

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