Katene Rahui: Injury Prevention Rehabilitation and Compensation Amendment Bill — First Reading 
Katene Rahui: Injury Prevention Rehabilitation and Compensation Amendment Bill — First Reading 
[Volume:658;Page:7441] 
RAHUI KATENE (Maori Party—Te Tai Tonga) 
: 
 When Sir Owen Woodhouse presented the results of the 1967 royal commission report on workers’ compensation he summed them up by concluding: “Injury arising from accident demands an attack on three fronts. The most important is obviously prevention. Next in importance is the obligation to rehabilitate the injured. Thirdly there is the duty to compensate them for their losses.” They were simple goals arising out of an admirable commitment to principles such as community responsibility comprehensive entitlement complete rehabilitation meaningful compensation and administrative efficiency. The important challenge before Parliament now some four decades and more later is to assess whether these goals are still relevant whether they have been achieved and how successful the scheme has been in following them. 
Seven years after the Woodhouse report the Government of the day created the Accident Compensation Corporation (ACC) introducing what would later be described as a revolutionary model for cost-effective rehabilitation and compensation. The essence of the exchange negotiated by the State was that in return for giving up the right to sue all New Zealanders had the right to a new universal 24-hour no-fault coverage against injury along with associated rehabilitation and compensation services. For the last 35 years New Zealanders have been contributing to injury accounts that variously cover employers the self-employed earners non-earners and motor vehicle and medical misadventure. 
Part of the process of change introduced by the Injury Prevention Rehabilitation and Compensation Amendment Bill is the proposed increase to three of the levies: the work account levy the earners levy and the motor vehicle account levy. The justification is apparently an increase in the number of claims and rising health costs. Yet conflicting information seems to question why these levy changes need to occur. The recent ACC annual report suggests that claims have stabilised. In fact there was a 7 percent decrease in the last financial year. The annual report also points out progress in the rehabilitation of workers. The goal was to have an 88.5 percent rehabilitation rate 9 months after injury. The achieved rate was 87.5 percent. One percentage point hardly seems worth making a fuss about. Why would we want to review a scheme that has been lauded as a world leader on the basis of a one percent difference? What could be the rationale for a bill reforming accident compensation? 
The Maori Party has raised one major issue before in this House and consistently throughout the term of the previous Government and the current Government and it demands reform. That issue is the significant difference in the rate at which Maori and the general population claim for accident compensation services. This difference appears to be most marked for non-earners the young and the elderly who are arguably the most vulnerable New Zealanders. The difference in rates is even more inexplicable given that Maori are overrepresented in injury statistics across all ages and in all areas. In fact injury is the leading cause of death for Maori aged 30 and under and most of those deaths are preventable. The March 2008 report of Statistics New Zealand revealed that Maori have significantly higher injury rates by occupation with 155 injuries per 1000 fulltime-equivalent workers compared with 111 for Pakeha. It is higher particularly in occupations such as agriculture fisheries manufacturing and trades. There are also significantly more injuries in lower-paid occupations where Maori are overrepresented. 
Meanwhile ACC figures continue to show that Maori make fewer claims to accident compensation and are less likely to receive compensation entitlements. ACC has tried to do something about this by establishing formal channels such as the Maori advisory board Te Roopu Manawa Mai to exchange valuable ideas and information. It also introduced a Code of ACC Claimants’ Rights which contains eight rights encouraging positive relationships between claimants and ACC as they work together for the claimant’s recovery. Although ACC undertook initiatives to improve access through information programmes and better engagement with Maori communities these programmes have not demonstrated significant success in closing the delivery gap. Access for Maori has been consistently lower than for other groups. The data that is available demonstrates that Maori receive treatment at a lower level than non-Maori and where services are accessed they are accessed later and claimants exit programmes earlier. A similar record applies in the area of injury prevention. 
If any amendments are to be made to the Injury Prevention Rehabilitation and Compensation Act 2001 to reduce levies and Crown costs one would think that the broader question of eligibility for accident compensation support would be high on the change agenda. The absence of data around the business significance of Maori claimants could be something the corporation addresses as a priority going into the future. For example if we were to plan for a given level of improvement in access for Maori such analysis might estimate what the impact might be on ACC’s bottom line. Before we even begin this exercise we know intuitively that because Maori are a small population group and constitute a small group of claimants it is unlikely that Maori will be considered a high-value market segment to provide a financial incentive for private insurers to develop Maori-responsive business strategies such as the use of rongoa Maori or mirimiri treatments in the context of a rehabilitation regime. 
The Minister for ACC Nick Smith promoted the context for the changes outlined in this bill as the need to return to a position where accident compensation is both affordable and fair. The goal of being affordable and fair sets up a spectrum ranging from institutional racism at one end to cultural competency at the other. Under the bill Maori in high-risk occupations will pay higher levies. High-risk occupational areas have significant numbers of Maori workers and the bill provides for a matching of risk environments with levy rates so the cost of cover can be expected to increase. Across the board a possible result will be employers structuring employment relations to shift responsibility for risk to employees along the lines of the independent contractor model. There is reason to expect that this model would eventually apply across the board. Preliminary analysis of the changes also reveals that they will disproportionately impact on vulnerable workers and low-income families as the bill decreases access to cover and decreases the level of compensation to these claimants. 
At the other end of the spectrum is a scenario in which the accident compensation scheme values cultural competence. Professor Mason Durie describes cultural competence as being “about the acquisition of skills to achieve a better understanding of members of other cultures”. Culturally competent care involves practitioners establishing and maintaining positive relationships through improving their understanding of tikanga Maori and effective communication. The end goal of course is to achieve better health care outcomes for Maori. Cultural competence is a major focus for the Maori Party. We campaigned on it. We have consistently spoken of it across the health and social sectors and this bill is no different. 
There is another dimension to our decision to vote for this bill’s being referred to select committee to let the people have a say on accident compensation and that is the potential for Maori entrepreneurship and enterprise to rise to the opportunity for innovation. In 2007 ACC undertook a risk-profile review with groups within the Ngai Tahu umbrella resulting in a considerable annual levy reduction. The Federation of Maori Authorities has also been interested in pursuing dialogue around levy rates and the possibility of a Maori consortium leading a corporate arrangement with ACC possibly focusing initially on specific industry sectors such as forestry fishing construction and farming. 
For all of these reasons—and for more reasons that will no doubt arise from submissions—we agreed to support the introduction of the bill and its referral to a select committee so that people can express their views. We want to hear about people’s experience with the scheme. Among others we want to hear from workers and their whanau who have suffered an injury health workers and providers of rehabilitation services. We do this so that the accident compensation scheme can once again be a world leader; so that it can be affordable fair and culturally competent; and so that it can remember always to focus on the best interests of the community.