[Marc]

Work and Income provided another reply to an Official Information Act request by a person who wishes to not be named. There are two more PDF files attached below, which are part of a response from 06 March 2013. The information is on designated doctors, Regional Health Advisors, Regional Disability Advisors, Medical Appeal Boards, also processes used and training of designated doctors. As usual they have withheld some information, which in some cases is for the familiar "excuses" or reasons (especially section 18f of the O.I.A.).

The response letter from Debbie Power dated 06 March shows at least a table with expenses paid per annum for the setting up and conducting of Medical Appeal Board hearings from 2005 to 2012. There was a large increase since the financial year 2009/2010, which reveals that there must have been a substantial increase of appeals, when compared to the years before then. That means more clients were not accepting WINZ decisions based on designated doctor recommendations.

The figures for MAB expenses are for the following years (page 2):

2005 / 2006: $ 129,569
2006 / 2007: $ 135,872
2007 / 2008: $ 91,665
2008 / 2009: $ 196,412
2009 / 2010: $ 610,092
2010 / 2011: $ 690,646
2011 / 2012: $ 449,582

There are also figures for annual expenditure on "designated doctors", covering 2005 to 2012 (page 3):

2005 / 2006: $ 2,845,371
2006 / 2007: $ 2,957,330
2007 / 2008: $ 1,161,185
2008 / 2009: $ 449,176
2009 / 2010: $ 580,381
2010 / 2011: $ 451,785
2011 / 2012: $ 413,854

(I am not listing the extra "host doctor" expenses the Ministry of Social Development paid to client's own doctors for completing medical reports that were requested by "designated doctors", which they also pay for). The expenses seem to be covering only the ordinary fees paid to such WINZ commissioned doctors.

At first sight one would think that there has been a drop in medical examinations by "designated doctors", which is true. Until about 2007/2008 WINZ used to ask for medical examinations by designated doctors for virtually every new application for the former invalid's benefit, or for required reviews of existing claims for that benefit. As the last Labour government decided that it is better to rely on client's own doctors for invalid's benefit applicants and recipients in the first instance, and only involve "designated doctors" for reviews later on (where deemed "necessary"), they did away with case managers asking for "designated doctors" examinations or assessments for all new invalid's benefit applications.

Since then "designated doctors" have mostly been used for "second opinion" reviews and re-examinations of persons applying for that benefit. But sickness beneficiaries continued to be examined and re-examined as usual. Consequently a drop in examinations resulted from that policy change only, but since then the expenses paid, and examinations made, appear to have been rather stable (until mid 2012).

I have no newer figures, so it is not clear, whether the new approach that has been brought in mid this year has resulted in more "designated doctor" examinations or not. As from February next year apparently outsourced, contracted, supposedly "independent" and more comprehensive work capability assessments will be introduced, it is not quite clear, what the role of "designated doctors" will be from then. They may still be used in some cases, or perhaps some will become part of the chosen "experts" that will on an ongoing contract basis be doing these new assessments then.


The O.I.A. response also confirms that from August 2008 to October 2008 MSD conducted 'training sessions' for "designated doctors" across the whole country (see page 3 to 4), and it lists what "training material" was officially used then. The mentioned "scenarios" have been attached to comment 4 further above (1 to 7). To question 12 the letter answers that there was continued training provided - besides of "ongoing engagement with medical practitioners" - and sessions were run, when "significant changes' were "implemented". No details about such sessions and what was covered are given.

But some figures were mentioned re those further training sessions:

2008 / 2009: $ 26,710
2009 / 2010: $ 533 (?)

It is stated the costs related to "appointment fees" that MSD paid, but other costs are apparently not included. In papers covering planning and preparation of the training in 2008 (perhaps see PDFs under comment 17 and also further above) there was though mention of help with travel, accommodation, some food and beverages, as well as "education credits" to be paid. Further information has been withheld under section 18 (g) of the O.I.A. (see page 4). Information on "all reports" on "designated doctor" training were also withheld by Debbie Power!


Then there are at least some range figures for the salaries of Regional Health and Disability Advisors:

$ 57,300 to 78,807 per annum for RHAs and RDAs is a range of incomes paid to them, that is given.

$ 42,491 to 58,425 per annum are paid for so-called "Health and Disability Coordinators" (working and liaising with GPs and other health professionals - for WINZ and MSD!).

Please see details re these positions further above (described in attached PDFs and also in one or two "links" to online information.

Information on the incomes of Dr David Bratt as Principal Health Advisor, and Anne Hawker as Principal Disability Advisor was WITHHELD for PRIVACY reasons!


Work and Income Board members receive the following "fees" per annum:

$ 58,500 for the CHAIR,
$ 26,500 for other members, all per annum (for a nicely paid "part time" occupation they basically have).

This board supports the Chief Executive of MSD in implementing the "investment approach" to their future processes and policies.


The second PDF document attached here contains statistical data on benefit recipients per category per quarter from 2000 to 2012, which can only give limited information on "movements" and impacts "designated doctor" examinations and recommendations did have. There is no information on movements and why they may have occurred.


Comments:

At least this gives some insight into what has been going on, while other information is as usually being withheld. Sadly it is making it very difficult for ordinary citizens and outsiders to get a transparent impression of how WINZ and MSD conduct themselves, and more "digging" in this regard is needed and being worked on!

Attached File(s)

•  MSD, O.I.A. reply, design. doctors, MABs, training, reviews, stats, D. Power, Dep. C.E., 06.03.13.pdf (2.51MB)
  Number of downloads: 2
•  MSD, O.I.A. reqst, D. Power, Dep. C.E., benefit recipients per category list, 2000-2012, 06.03.13.pdf (509.77K)
  Number of downloads: 2

[Marc]

In a submission the New Zealand Medical Council sent in to Dr Bratt, and which was dated 25 Sept. 2013, the Association expressed concerns about the Ministry's and/or Dr Bratt's plans for bringing in new, supposedly "independent" assessors. It can be found online on the internet and downloaded via this link:



http://www.nzma.org....s-Providers.pdf

It is titled:

'Independent Work Ability Assessments - Providers'


The submission is addressed directly to Dr Bratt and starts with "Dear David". The following are bits out of it, which clearly shows the dissatisfaction that the NZMA has regarding what is being planned:

"In order to formulate our response to MSD, we have consulted with our General Practice Advisory Council, Specialist Advisory Council and the NZMA Board. We note that the request for feedback by MSD was made on 12 September with a deadline of 20 September. We are disappointed with this very short consultation period and trust that you will give consideration to our submission even though we have not been able to meet the requested time frame."

"The NZMA is fully aware of the health benefits of meaningful work and we support, in principle, the aspiration of assisting people with health conditions or disabilities to return to work, to the extent this is appropriate and in the best interests of the individual patient. However, we have two major concerns relating to the draft document on IWAA providers. These concerns are outlined below.

Our first major concern relates to the inclusion of ‘vocational practitioners’ among the range of practitioners identified by MSD as being suitable to provide the assessments. Our understanding is that ‘vocational practitioners’ may have no healthcare background at all and are not registered medical practitioners. Rather, their primary qualifications are in Career Development. Given that the target population for these assessments includes patients with mental health conditions (40%), musculoskeletal system disorders (15%) and people with a range of other conditions such as cardiovascular disease, chronic respiratory diseases, diabetes, cancer and nervous system disorders, the NZMA believes there are significant risks in engaging the services of non-healthcare workers to review medical information and discuss recommendations on condition management or treatment.

We submit that the role and importance of front line general practitioners appears to have been underplayed in this proposed list of assessment providers; this group of medical practitioners (not just those general practitioners with qualifications in occupational medicine) are well placed to understand a patient’s health-related and other barriers to employment, and we believe they have useful experience to offer MSD in relation to the objectives of this assessment.

Our second major concern relates to the duality of a role in which a seemingly independent assessor is paid by MSD to undertake an assessment of an MSD client but then also provides advice and recommendations on the management for the individual concerned. To avoid a conflict of underlying motivations, we believe that better practice would entail some sort of firewall between these two roles. Such a separation of roles would also be consistent with what occurs in other spheres (e.g. assessments in the military and for members of sports teams).

Finally, we suggest that it would generally be more appropriate for MSD to liaise with the patient as well as their general practitioner when formulating an assessment of their work ability. Where independent assessments are required, we suggest that these are best undertaken by a general practitioner who is not the patient’s own general practitioner. While we appreciate that MSD is keen to avoid an over-medicalised model, we believe that general practitioners and other health professionals (e.g. psychiatrists or psychologists where mental health concerns dominate) are best placed to undertake assessments that focus on how a patient’s health condition or disability impacts on their potential for employment."


Comment:

Wow, how revealing is this now? Clearly the NZMA is well aware of what MSD are trying to do, and they are very concerned about what they have been planning. So while the public at large can only find this one submission on MSD's plans via the internet, there is much of a lack of transparency otherwise. Who else may have made submissions, and of what types? Does anybody know whether there is any other information available on this, and what MSD and WINZ will finally do when bringing in "independent assessors", and who will be used to "staff" them, or perform in those roles?

I am shocked about this lack of transparency, and that there is apparently NO PUBLIC DEBATE ON THIS. It is extremely worrying what is going on here!

Attached File(s)

•  NZMA, sub-WorkAbilityAssessments-Providers, to MSD, Dr Bratt, 25 Sept. 2013.pdf (192.52K)
  Number of downloads: 2

[Marc]

There are signs that the medical profession is getting concerned that their members (particularly GPs, i.e. general practitioners), some of whom are of course working as "designated doctors " for WINZ, or assessors and "specialists" for ACC, may be losing their reputation for professionalism and independence. Recent publications give reason for this to be the case. Both the Royal Australasian College of Physicians, and there it is the AFOEM (one of their faculties), as well as the Medical Council of New Zealand, have late last year published new statements of apparently high importance.

It seems that these professional institutions and organisations have taken some note of concerns that have been raised by various persons, last not least the writer of this post. They have now indeed seen a need to take actions and defend the profession, their members, and certain controversial policies, which particularly the 'Royal Australasian College of Physicians' (RACP) and their 'Australasian Faculty of Occupational and Environmental Medicine' (AFOEM) have started developing, publishing and promoting since 2010. This includes their policy statement on ' The Health Benefits of Work'�!

That particular policy statement was developed with the help of Professor Mansel Aylward, promoted by Dame Carol Black, and pushed for with the help of Dr David Beaumont (President Elect of AFOEM, formerly working for ATOS Healthcare, the ASSESSORS FOR DWP in the UK!!!). Another one who supports the same policy drive is of course the Principal Health Advisor Dr David Bratt, who has worked for the MSD since 2007. He is of course the man who likens "benefit dependence" to "drug dependence "!

After launching their ideologically coloured policy and consensus statements, and follow-up ones, the AFOEM (led by Dr Beaumont!) have now apparently got a bit worried about their daring claims. Hence they now saw a need to specify what kind of " work" is supposed to be " good"� for people's health. They have come up with a statement on ' What is good work?'�!?

See the details from their further statement on this from October 2013:
http://www.racp.org....rk/latest-news/

Download the poorly explained, unconvincing and bizarre publication they released on that:
http://www.racp.org....ldname=filename

Here is a further statement to governments, employers, businesses, insurers and the likes:

http://www.racp.org....ldname=filename

But that aside, they still stand for this, and try to justify what they said before, and what the high calibre “experts” that pushed for all this, still firmly adhere to:

http://www.racp.org....A247F80DC4F363C


And here is also what the 'Medical Council of New Zealand' considered necessary to remind their members of in September 2013:

http://www.mcnz.org....fication-v4.pdf

" Background
1. As a doctor you are expected to sign a variety of medical certificates that range in purpose from confirming sickness to certifying death and are required by receiving agencies, which include employers, insurers, ACC and government departments.
2. This statement outlines the standards that you must follow when completing a medical certificate1. It may be used by the Health Practitioner 's Disciplinary Tribunal, the Council and the Health and Disability Commissioner as a standard by which your conduct is measured. A certificate you have completed may also be challenged in a New Zealand court and you may be called upon to justify your decisions. "�

" Professional obligations
3. Certificates are legal documents. Any statement you certify should be completed promptly, honestly, accurately, objectively and based on clear and relevant evidence.
4. Your obligation is to the patient and to the law. Issues like the type of certificate being completed or who initiated, or pays, for the consultation must not influence your assessment and findings.
5. You must not complete a medical certificate for yourself or someone close to you."

"Implications of certificates
6. You must be aware that completing a certificate has implications for the patient, yourself, and the agency receiving the certificate.
7. Studies have shown that patient, family and cultural factors may influence how doctors complete certificates. Certificates may have financial implications for the patient and the recipient through benefits, employment and compensation payments and failure to complete a certificate appropriately may have a negative impact on the patient, the patient 's family
or the receiving agency. You need to be aware of these influences and recognise that you may be susceptible to them.
8. Completing a certificate may also directly affect the safety and security of others. Certifying a patient to undertake work when he or she is unfit may place the patient or the patient' s colleagues at risk.
9. Because a certificate has implications for the receiving agency, that agency might contact you for more information. You should therefore have a conversation with the patient about the information you are permitted to disclose if you are approached. "�

There is a bit more to that statement (incl. footnotes), which can be found via the link above!

So they also warn their members that the Health and Disability Commissioner will ensure rights of sick and disabled are met. If that was really so, some doctors may be concerned and take heed. But as we know better, I think this is more a "message" to the public and media, to pretend they really fear the HDC may hold them to account, which he/she has historically only done very rarely and usually only in very extreme, serious cases:

http://accforum.org/...y-commissioner/

Personally I would rather advise people to take doctors to court than go there!!! But we know about the "catch 22" situation with the law usually expecting health and disability end consumers to first take any complaints to the HDC Office.

Closing Comments:

I think the new additional statements by the AFOEM and MC of NZ are just poor attempts to justify the former somewhat misguided, flawed policy and consensus statements from 2010 and 2011. When the selectively chosen "science" and "research" all that is supposed to be based on (incl. the twisted "bio psycho social model" as Aylward and Waddell interpret it) is in itself questionable and lacks sufficient basis, then policy based on it cannot be taken that seriously either. I am sure that much more needs to be sorted out here, and besides of the RACP, the AFOEM and MC, the persons ultimately responsible for all this, including certain government politicians and administrators, need to do a thorough rethink and back off this madness. It is absurd to claim that "worklessness " is the main issue, and that "work" in "open employment" is the solution to it all! Perhaps they should rather look at poverty, social injustice, marginalisation, social stigmatisation and sundry other areas, that may be the real contributors to poor health. They should also accept that mental illness and musculo skeletal conditions are not simply based on sufferer's " illness belief".

[jocko]

I have never seen this before. Well done marc. Excellent research.Some of the designated doctors are "good guys" we must remember. I see my own mentioned and another who has battled for people well above the call of duty.
I took a review for a local lady. It was held in Nelson before 3 doctors at the WINZ building. I took the review on my own without the lady I represented. She won ok but they turned down another case that was even more deserving than hers so they are rubbish as far as I am concerned.

[netcoachnz]

Check out https://fyi.org.nz/ for other Official Information Request findings.

[jocko]

It all comes down to two new catchy terms "Austerity Measures" and "Bail Out."The new politically correct terms for robbing the poor, in this case the disabled poor, to help the rich. The sick and disabled are providing the bail out money world wide. The insurers lost the money on the market and now they are pulling this bullshit to recoup those losses.
This fucking money is our fucking money. It is there to support us at times like these. It is there so that communities like mine can survive when the big operations close or are mothballed. People receiving genuine ACC and WINZ support are a very important economic factor in the regions like Northland and the West Coast.
These people on their low incomes come here with their meagre resources and buy property and live here because it is less expensive than elsewhere. There are a lot of disabled/disenfranchised workers in these poorer regions simply because they can not afford to live anywhere else. A lot of them work part time and support the economic community. They build, they own houses and cars that need maintenance, they eat, their kids go to school. They are a very important part of the economy in these poorer regions. It is their young fit and healthy kids that provide us with the hardworking coalface production workers we need when the mines get going and things pick up and we go through our boom periods.
It is the steady income stream from these disabled/disenfranchised workers that helps maintain the infrastructure in our poorer regions. All these Austerity measures do is pour petrol on the fire of recession. The disabled never operated South Canterbury Finance or Merryl Lynch with its world collapsing toxic debt. Yet it is their resources that are being used to assist the people who created the problem?

[Marc]

jocko, on 21 January 2014 - 10:34 AM, said:

It all comes down to two new catchy terms "Austerity Measures" and "Bail Out."The new politically correct terms for robbing the poor, in this case the disabled poor, to help the rich. The sick and disabled are providing the bail out money world wide. The insurers lost the money on the market and now they are pulling this bullshit to recoup those losses.
This fucking money is our fucking money. It is there to support us at times like these. It is there so that communities like mine can survive when the big operations close or are mothballed. People receiving genuine ACC and WINZ support are a very important economic factor in the regions like Northland and the West Coast.
These people on their low incomes come here with their meagre resources and buy property and live here because it is less expensive than elsewhere. There are a lot of disabled/disenfranchised workers in these poorer regions simply because they can not afford to live anywhere else. A lot of them work part time and support the economic community. They build, they own houses and cars that need maintenance, they eat, their kids go to school. They are a very important part of the economy in these poorer regions. It is their young fit and healthy kids that provide us with the hardworking coalface production workers we need when the mines get going and things pick up and we go through our boom periods.
It is the steady income stream from these disabled/disenfranchised workers that helps maintain the infrastructure in our poorer regions. All these Austerity measures do is pour petrol on the fire of recession. The disabled never operated South Canterbury Finance or Merryl Lynch with its world collapsing toxic debt. Yet it is their resources that are being used to assist the people who created the problem?

Yes jocko,

It is all part of the agenda, of trying to get blood out of a stone, to turn more of the so far considered work impaired potential "slaves" into further "slaves" to work for a living, to help governments give tax cuts to those that are already mostly doing fine. It is the "trickle up" agenda, the shift of resources and wealth from the bottom to the top. Have a read of an Oxfam report out today, and it tells us something. As for governments, particularly the ones favouring their already mostly well to do clientele, and those getting big donations from business donors, urged and reminded to look after who has the dollars and power, they do what we know already. They are always on the look-out, to see what other governments do, so they can perhaps "learn" something, to also do themselves. That is what happened with ACC reform, now with welfare reform, and with labour law and other reforms here in New Zealand. They saw what they have done in the UK, and hey, they love it. Now the Australian government is after years of "boom" looking to cut where it hurts the poor, to "afford" looking after their prefered clientele, the middle and upper middle class, and certainly the upper class:

http://www.smh.com.a...0121-315go.html

The Abbott government is preparing Australians for an overhaul of the welfare system, with Social Services Minister Kevin Andrews indicating too many depend on the government for their incomes. "More than five million people now are in receipt of one form of welfare or another," Mr Andrews told ABC radio on Tuesday." To mount his case for tough changes to welfare, Mr Andrews is using a new "10-year review" given to the government by the Department of Human Services. Mr Andrews said the review shows that more than five million Australians, or about one in five, now receive income support payments. The subject of welfare reform is close to the heart of Prime Minister Tony Abbott. In his 2009 book, Battlelines, Mr Abbott wrote that one of the Howard government's most significant achievements was "slowing the rise in the number of people claiming the disability pension".

But the Prime Minister is keenly aware of the dangerous politics surrounding any changes to welfare payments. Mr Andrews chose his words carefully in his interview on ABC radio on Tuesday. Mr Andrews said that the welfare changes would not happen "in the immediate future" but rather in the "medium to long term". Australia needed to avoid becoming a welfare state like "nations in Europe", Mr Andrews said.
"People who need welfare, who deserve welfare, will get welfare," he added. Mr Andrews cited the "incentives" being offered by the Abbott government to encourage welfare recipients "who are capable of working" to get jobs."

Comment:

Now have we not heard this kind of stuff before??

And this is also what is going on:
http://www.theguardi...lf-of-the-world

[Marc]

jocko, on 21 January 2014 - 10:12 AM, said:

I have never seen this before. Well done marc. Excellent research.Some of the designated doctors are "good guys" we must remember. I see my own mentioned and another who has battled for people well above the call of duty.
I took a review for a local lady. It was held in Nelson before 3 doctors at the WINZ building. I took the review on my own without the lady I represented. She won ok but they turned down another case that was even more deserving than hers so they are rubbish as far as I am concerned.

As for "designated doctors", yes I do not rule out that some of them will follow their conscience and remember that they are bound by the Code of Ehtics of the New Zealand Medical Profession, but too many are making wrong, at times appalling recommendations. Any doctor who volunteers to work for and with WINZ will be confronted with what Dr David Bratt thinks, and what he presents them in his many bizarre, biased "presentations", and they will be told not to trust beneficiaries with health issues, which creates suspicion, which is then only a step away from being biased. I know from experience that some GPs are having a personal bias anyway, and a somewhat dim view of people being on benefits for longer periods, for health reasons.

The new "research" from professor Aylward, and a few others, which is indeed highly controversial and selectively done, puts a new "spin" on it all, which even many doctors fall for, thinking they are actually doing the "right" thing by classifying sick and disabled as capable of work, but they then leave them to deal with WINZ, who have their agenda, which may be very much less "supportive" and "sympathetic", based more on "cost savings".

I can only appeal to all facing designated doctor or other WINZ commissioned "examinations" and assessments, to be extremely careful, and to bring along a witness, if possible!


Here by the way is the NZMA website page, with access to the 'Code of Ethics' that medical practitioners are bound by. Sadly - at least at times - some seem to be forgetting this, or they have their own, subjective and inappropriate "interpretation" of it:
http://www.nzma.org..../code-of-ethics

[jocko]

Amazing how all of this rhetoric and dogma aimed at the disabled/unemployed only surfaces at times when the stock market crashes and the insurers drop their bundles.

[Marc]

I HAD TO SEE WITH DISTRESS, THAT THERE APPEARED TO HAVE BEEN ATTEMPTS TO "CORRUPT" TEXT IN THE COMMENTS IN THIS THREAD!!! IT IS EXTREMELY WORRYING WHAT IS GOING ON, AND IT APPEARS THAT SOMEONE IS TRYING TO DISCOURAGE PERSONS FROM INFORMING OTHERS ABOUT WHAT IS REALLY GOING ON AT MSD, WORK AND INCOME AND IN THE "DESIGNATED DOCTOR " MEDICAL FRATERNITY! THAT IS UNLESS THERE ARE SOME SYSTEMIC ISSUES WITH THIS FORUM WEBSITE, WHICH THOUGH SEEMS A BIT HARD TO BELIEVE. APOLOGIES TO INTERESTED READERS FOR ANY DETECTED - BUT NOW CORRECTED - TEXT FLAWS THAT MAY HAVE OCCURRED TO VIRUS OR OTHER ATTACKS!

[Marc]

There is an interesting post revealing how MSD are making a lot of effort to keep information about the effects of welfare reform withheld from the public:

http://publicaddress...ng-its-welfare/

"How is Government evaluating its welfare reforms, and why aren’t we allowed to know?"

By Michael Fletcher, published 29 June 2014.

Read it on 'Public Address', under the heading or column 'Speaker'!

[Marc]

I see QFJ has made some references to "Designated Doctors" in a new post on this forum:

http://accforum.org/...ed-the-process/

I read it and find it interesting how Designated Doctors also sit on Medical Appeal Boards, and not seldom are there more than one hearing appeals by WINZ clients, who may have disagreed with a decision made by a case manager, that was based on a designated doctor "recommendation". Of course not the same Designated Doctors sit on the Board, but they will all have been "trained" by MSD's well known Principal Health Advisor, Dr David Bratt. So much for the "independence" of a Medical Appeal Board, appointed by MSD's "Coordinator", paid by MSD and made up by medical practitioners and some other health professionals "trained" by MSD.

There is a new Bratt "presentation" that has surfaced, which is available via this link:

http://www.gpcme.co....%20Training.pdf

Otherwise try the attached file, if that does no longer work:
 Fri_room6_1400 Bratt Designated Doctor Training.pdf (267.88K)
Number of downloads: 5

It shows how the new approaches used under the new welfare regime, emphasizing the peculiar "health benefits of work" (propagated by Mansel Aylward et al), are now firmly communicated to WINZ Designated Doctors! The UK welfare approach is here to stay, it seems, and WINZ clients, same as ACC claimants, face more "rigorous" examinations and assessments, expecting sick, injured and disabled to work.

Have a look at it, it seems that Bratt and MSD have become quite aware of some certainly justified critcism, hence the emphasis to the Designated Doctors he "trains" and "mentors" to be careful with their report to WINZ - see page 20!!!

Also does he make a remark on page 23, re complaints to the Health and Disability Commissioner!

It appears they have a "discrete" arrangement with the HDC, which some may call in simple words "collusion"!?

Most certainly some posts here have hit a raw nerve, I presume.

[MG]

Well done Marc: your research tallies with my own. I understand MSD is well down the road towards its goal of implementing an ATOS/UNUM medicolegal assessment model very similar to the well-loved ACC version. No suprises there, as Prof DF Gorman now sits on the boards of both MSD and ACC (and feeds from both taxpayer-funded troughs simultanenously). Your reference to "collusion" between MSD and the Health and Disability Commissioner may be explained by the fact that Gorman was a member of the panel that picked the current Commissioner (a faceless nonentity from within the ranks of the Ministry of Health bureaucracy). Doubtless, Gorman got paid for that too.

[Sparrow]

And of course, Paula Rebstock, ACC chairman is on both the ACC and WINZ boards.

Conflict of interest???

[Marc]

Yes, if WINZ go down that way, they may truly be caught out one day, as the very nasty NZ department that blindly copies a lot from the outdated, endlessly amended, non-workable Work Capability Assessment that many in the UK now consider abolishing, and replacing with something more real world based. Perhaps, just perhaps, despite of UK Labour maintaining a very murky position towards the WCA in its present form, if there may be a change of government, there may still be a chance of some improvements further down the line, eventually?!

Maybe it is just my desperation, maybe, still a bit of desperate hope, that something more like this kind of stuff may be what the future can hold:

https://www.rethinkingincapacity.org/

That is unless the people behind this think tank research will also be bought out and hired by corporates, by the DWP bosses and policy makers, and simply end up being used and abused, like others before, to reshape their ideas to serve the interests of those that ultimately hold the power.

Cost saving, cost saving, investment approach, outsourcing, privatising, and so it goes, I fear.

[MG]

What about the Convention on the Rights of People with Disabilities? For reasons that escape me, the last Labour government incorporated it into domestic law back in 2008 (just before we gave it the arse card). As a result, decision-makers must apply its provisions. FWICS, no one within ACC or MSD knows, or cares, much at all about the Convention. OTOH, the Judges seem to be paying a bit more attention to NZ's international human rights obligations these days. The CRPD is even more relevant because, as I said, it's been incorporated into domestic law. I reckon this could be a fruitful line of argument to develop in ACC and WINZ cases.

[Marc]

MG, on 04 April 2015 - 01:36 AM, said:

What about the Convention on the Rights of People with Disabilities? For reasons that escape me, the last Labour government incorporated it into domestic law back in 2008 (just before we gave it the arse card). As a result, decision-makers must apply its provisions. FWICS, no one within ACC or MSD knows, or cares, much at all about the Convention. OTOH, the Judges seem to be paying a bit more attention to NZ's international human rights obligations these days. The CRPD is even more relevant because, as I said, it's been incorporated into domestic law. I reckon this could be a fruitful line of argument to develop in ACC and WINZ cases.

MG you are of course right with your stern criticism. But we know that what they (the government) are doing is just endless verbal diarrhea and BS, that is to even put it mildly. Effectively doing things for long term sick, injured and disabled costs money and resources, and the present government showed its priority years ago, by giving tax cuts that effectively favoured the better income earners above the rest, who were hit with higher GST, to make up for some of the loss of tax income.

As for "disability", the "disability strategy", the UN Convention on the Rights of Disabled, that is stuff that is largely now swept under the carpet. All they do is some "monitoring", and occasionally releasing some cheap scate, nonsensical "campaigns", to raise some awareness, or to make a few of the more ignorant feel good. Hey, they are doing something, is what people are meant to think. Then there are "surveys", and releases of "reports" telling us little new.

I have repeatedly visited this website, which you must have also, and it shows the lack of REAL action:

http://www.odi.govt....2014/index.html

http://www.odi.govt....ts-in-2014.html

http://www.odi.govt....2013/index.html


It is similar with the hollow claims by MSD and WiNZ, that they offer "support" for mentally ill, to get "assisted" into suitable work. After a number of OIA requests and responses, all that has been established is, that the additional "support" exists only in "more active case management" and referrals to outside, private service providers, paid nice fees to try and shift "clients" into whatever kinds of jobs.

Endless propaganda, little or no extra expenditure, little real efforts, and endless more pressure for the affected to bloody well shut up, and move on, get a job if you can, or otherwise be "grateful" with what you get. That is the wonderful "investment approach". As the wider public do not see all this as a priority, not even the ratings driven and advertising earning media give a damn.

The UN Declaration certainly deserves more emphasis and should be used to raise awareness, but most in the public do not care much about what the UN says or does, especially if it may cost them more money in taxes they pay. Government knows it, and so the opposition, and it is not a priority, apart from the rare question in Parliament that may be asked re all this. As for how this UN declaration may work with being used in ACC legal cases, yes, that is territory that must be tried and tested, for sure.

[MG]

New Zealand's medicolegal assessment regime gets several, unfavourable, references in the attached report, from DEMOS, a respected British think tank.

Attached File(s)

•  Demos on UK WCA 2015.pdf (490.27K)
  Number of downloads: 6

[Marc]

MG, on 11 April 2015 - 11:41 AM, said:

New Zealand's medicolegal assessment regime gets several, unfavourable, references in the attached report, from DEMOS, a respected British think tank.

Yes, you are onto something rather interesting there, MG!

I understand they will spend up to the next three years to do further research into work ability assessments and alternatives to the UK's WCA (which was also to some degree the further development of what Aylward had once dreamed up). I see Aylward et al be shifted onto the archive shelves of history soon, some researchers are starting to present something a bit more sensible, and then it is up to the politicians to decide what to do.

With that I fear we will still see major challenges ahead, as slashing, cutting and cost saving is too tempting, than actually do the right thing, for the long run.

But let us wait and see.

Listen to this interview also, it shows the problems scientists face now, being pressured by politicians and business to deliver and support what they prefer, rather than adhere to proper science:

http://www.radionz.c...acks-on-freedom

[Marc]

So MSD have finally released their current WINZ Designated Doctors list (as of about 20 March 2018):


https://nzsocialjust...on-20-03-18.pdf

https://nzsocialjust...sd_20-03-18.pdf

For a redacted version of an older Designated Doctors list, which was made available by MSD to an OIA requester in August 2012, you can click this link to view a PDF that was created from the same data then contained in MSD’s ‘Designated Doctors Master List’:
https://nzsocialjust..._20-08-2012.pdf


But this all happened only after someone involved the Ombudsman, who took ages to get MSD convinced they better release it!

More on all that is found here:
https://nzsocialjust...e-nz-ombudsman/


Also of interest is an OIA response by MSD of 3 Feb. 2017, containing some bizarre comments.The PDF with the authentic response by MSD, only partly anonymised and dated 3 Feb. 2017, can be loaded by clicking this hyperlink:
https://nzsocialjust...actitioners.pdf

The same OIA response by MSD is also available on their website, via this link:
https://www.msd.govt...actitioners.pdf

It is interesting to read all that, when they were reluctant to release the 'Guide for Designated Doctors' for years, which strange was available in 2011. Now they released the same 'out of date' version, after the Ombudsman stepped in:

The ‘Guide for Designated Doctors’ document released by MSD under the OIA on 8 Nov. 2017 can be found by clicking the following hyperlink:
https://nzsocialjust...ctors_final.pdf


How bizarre, how bizarre. Have a read and form your own views on all this.