Roy Heather: Injury Prevention Rehabilitation and Compensation Amendment Bill (No 3) — Third Reading 
Roy Heather: Injury Prevention Rehabilitation and Compensation Amendment Bill (No 3) — Third Reading 
[Volume:625;Page:20339] 
HEATHER ROY (ACT) 
: 
 ACT New Zealand is opposing the passage of this bill for a number of reasons. Firstly we are very concerned about the costs we think will result from the implementation of this bill. Secondly we are very concerned that it goes no way towards rectifying the inequality that results where people who suffer an injury and people who suffer an illness despite the fact they may end up with the same condition are treated financially very differently. Other parties have said they would like to see some choice in competition in premiums and so would we. Thirdly we are very concerned about the continuing trend of this Labour Government to introduce amendments in the Committee stage in the form of Supplementary Order Papers. They often contain quite significant amendments and of course they have not had the ability to be scrutinised by a select committee or have public submissions. We certainly oppose that practice. 
Several clauses in the Minister’s Supplementary Order Paper 365 seem to be ambiguous. Many of the members who spoke in the Committee stage were unsure about the implications of new clauses 26A 28A and 29A. Despite repeated requests of the Minister to address the questions she did not take a call. All of that would indicate perhaps that she had something to hide. Certainly the intent of those amendments is not clear. So ACT opposes those clauses for that reason alone. 
I think it is a worrying trend. It tries to shortcut the democratic process in this country—a very robust system if followed. We are very reluctant always to see these things happen and we voice that objection for the future. 
Our objections have not changed significantly following the Committee stage. The minority view that ACT put forward in the Health Committee and in the report back still stands and we will be opposing the third reading with those objections in mind. 
We are very concerned about the increased cost that we think will result from the removal of the rarity and severity definitions in relation to medical misadventure. At the moment the levies come from the earners account and non-earners account roughly on a fifty-fifty ratio. We asked officials from the Department of Labour to try to outline for us the costs they thought would result from the implementation of the bill. We also asked the Minister for a regulatory impact statement and although we were told on several occasions that this would come— 
Hon Member 
: Should have it. 
HEATHER ROY 
: That is right. The legislation has to have it but we are still waiting for the regulatory impact statement despite the fact we are now at the third reading. Again the Minister was very reluctant to address this issue and did not seek a call in the Committee stage even though she was asked repeatedly to do that. 
The Department of Labour as I said has undertaken to look at what the additional costs will be. The Accident Compensation Corporation (ACC) actuaries looked at the legislation and determined that possibly another 1000 additional treatment injury claims could be expected each year and they estimated they would cost on average $9000 per claim. The officials totted that up and said we could expect an annual cost increase of $8.69 million and a one-off transitional cost of $12 million. But when asked how confident they were that these figures were accurate they said that it was very difficult to obtain data upon which to base claim number predictions and costings. So the answer I guess when we summarise it is they are really not sure what the additional costs will be. That is or should be a great worry to the taxpayer. 
Many health professionals contacted me over this bill particularly people who are responsible for assessing for ACC—such as medical practitioners—saying they were very worried about the explosion of costs they believed would happen. They felt there would be a proliferation of claims. Claims are allowed retrospectively as well as from the date on which the legislation takes effect. They were worried that the estimate of the number of claims that would come forward was very light and the estimate of the cost per claim was also very light. These people work at the coalface and deal day to day with claimants for assessment and see the end result. I think they are in a very good position to try to predict what will happen with the implementation of this legislation. 
We believe that claims will be made for conditions that are not foreseeable and the bill certainly does not prevent this. These claims may not be the fault of any party involved but rather the unintended but statistically predictable consequence of normal treatment. I do not think we want to be going down this road. We have to accept that there are consequences unintended or not of normal treatment and often they are not foreseeable. If they are not the fault of any one party I think there is being built up in this country an expectation that somebody will pay when something goes wrong whereas previously people did undertake and accept a certain degree of risk. 
ACT in opposing this bill is not arguing that ACC coverage should depend on fault. In fact we believe that in theory there is some merit to the changes to the medical misadventure provisions but on balance our objections outweigh the positive aspects of the bill. So that is the reason we have decided to oppose it. 
I mentioned previously that the scheme operates at the boundary between sickness and accident and this makes it very vulnerable. In fact many patients talk of the unfairness that exists. They make claims believing they are valid but miss out when the ACC assesses their condition and says they do not qualify because an accident or an injury cannot be proven. This often causes a lot of tension between a patient and practitioner and we believe that this tension may well be exacerbated by this bill. 
It will be in the interests of patients and health providers to classify complaints as treatment injury with those new provisions. Although I do not believe that anybody sets out to collude or to try to circumvent the system to everybody’s benefit I think it is just human nature often to allow this to happen. So things may well now be classified as a treatment injury whereas previously a patient would have to make a complaint about the health practitioner before the issue was looked at. The removal of the disciplines could mean that that boundary between illness and injury will in practice depend on highly subjective decisions with a loss of the integrity of the scheme that at the moment I do not think it really has. 
Although the intention of the bill is to remove the necessity to prove fault it is possible that those changes may result in a proliferation of complaints against medical professionals for reasonable but unintended consequences of treatment and that would be a great shame. 
Just to conclude I would like to say that ACT like the National Party and as the New Zealand First Party also indicated believes that choice of insurer for both individuals and employers is essential. We would like to see a return to the choice that existed for that very brief period in 1999. We think the indications were of a very good system but obviously the very short period of time the competition was allowed to exist for meant that teething problems highlighted some of the initial difficulties. If those teething problems had been given an opportunity to be ironed out we believe that in the long term cheaper premiums and lower accident rates would have been achieved. That would have been of great benefit to everybody. Choice and competition with insurers private insurance involved and competing with public insurers would be ideal. We certainly believe that the private industry has a right to compete for that insurance cover.