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Posted 22 March 2005 - 10:14 PM

22 September 2004

Catherine Parkin
Health Committee Secretariat
Bowen House
Parliament Buildings
Wellington

Submission

To the Parliamentary Select Committee on Health;

Injury Prevention, Rehabilitation and Compensation Amendment Bill No 3




My name is ****** ********

My interest in this legislation is the area of interpretation of standards. In particular in respect to amendments proposed under Clause 3 (1) of the above Bill.

First let me introduce myself

I have for some time suffered with an very disabling form of post herpetic neuralgia - which in layperson terms is the nerve pain, which comes after shingles. I also suffer with angina and, as well, I receive regular monitoring for a tendency to hypertension.

From an early time I have found that acupuncture is one of the few options available to me for relief from pain and to improve my ability to live normally. My doctors have generally been very supportive in my receiving acupuncture as part of my overall programme (see attached referral letter for me to receive acupuncture treatment, provided by Dr N Haribhai).

My other area of background is that I am on a disability allowance and so have sought cost for my acupuncture through my Social Welfare disability allowance. I have in the past received "acupuncture" from a doctor who was offering the service but found that it had little or no effect compared with the acupuncture I receive from my more fully trained acupuncturist.

In early 2003 at considerable inconvenience and personal stress my case for recovery of some or all of my acupuncture cost was taken all the way to the Social Security Appeal Authority. As a result, since April 2003, to quote the Work and Income, "in a decision based on your personal circumstances (which) does not indicate a change of general policy" I have subsequently received a modest part recompensation for acupuncture under Social Welfare.

The current situation is therefore that I receive only a fraction of what my acupuncturist reasonably is entitled to charge me but if I were receiving the acupuncture" from a "registered health professional" (with little or no training and qualification in acupuncture) I would derive a far greater dispensation. Clearly this is an absurd situation that leads to my next point - and the reason I am writing in respect to the current legislation.


During 2002, as part of my ongoing struggle to get proper recompense for the acupuncture I was receiving from a trained and qualified acupuncturist, I came into possession of a letter written by the then Minister for Disability Services Hon Ruth Dyson. (see attached) That letter is dated 7 December 2001 and may throw some light on the reason why payments for acupuncture services under Social Welfare remain so determined and also why the area of interpretation of acupuncture standards in the present legislation is so important.

To quote the Minister from her letter dated 7 December 2001,
    "Work and Income NZ has no means of ascertaining the validity of qualifications unless the practitioner is a registered doctor, physiotherapist or other health professional. The integrity of the benefit system, funded by the taxpayer, must be maintained. The Ministry cannot make payments to clients to cover the cost of treatment or services where the practitioner has an unrecognised, uncertain, or unverifiable qualification to provide the service
My acupuncturist informs me that as well as any qualification an acupuncturist gained from theft original place of training as a provider in the other area of disability services -namely ACC- he or she is also required to be fully assessed towards the National Diploma of Acupuncture (NDA).

The problem for the committee members to consider is that the Minister should be telling her fellow parliamentarians there is no acupuncture standard when a simple phone call to NZQA can confirm that the NDA was already in place and registered under NZQA since August 1998, i.e. 39 months prior to the Minister's letter.

I submit that the determination of acupuncture services under Disability Services demonstrates that the determination of acupuncture services under ACC needs to be made only after proper reference to what constitutes an appropriate standard.

In the case of Disability Services this appears to remain an outstanding area which Parliament urgently needs to consider.

I am aware that there is already an acupuncture standard in place. Until reference to what constitutes an appropriate acupuncture standard is properly determined I am therefore against any amendments proposed under Clause 3(1) of the Injury Prevention, Rehabilitation and Compensation Amendment Bill No 3.

I wish to appear before the committee and my daytime phone is (04) 5278886.

Yours sincerely



******* ********* *****


17 July 1998 PENICILLINASE SENS PENICILLINS

Thank you for seeing the above patient re Disability allowance regarding acupuncture treatment.

Mrs ********* suffers from severe postherpetic neuralgia for the past few years. She is on medication for it.
The pain she experiences impairs her quality of life considerably.

To help alleviate her pain from the postherpetic neuralgia she has acupucture treatment. This is an accepted form of medical treatment for chronic pain.
Postherpetic neuralgia can occur for a few years, so it is hard to predict when the pain will cease.

In Summary, Mrs ************s disabilty is the severe pain she experiences from postherpetic neuralgia The treatment for it is acupuncture as welt as medical treatment, with which she is compliant.
This has helped alleviate the severity of the pain and is decreasing the effect of her disability on her daily life, thus improving her functioning. Acupuncture is a valuable part of her pain management and my concern is that she will not cope with the pain without it.

Should you have any queries do not hesitate to contact me.


Many thanks for your assistance. With kind regards
Dr N haribhai., White Lotus Ltd.


Office of Hon Ruth Dyson

Minister for Disability Issues
Associate Minister for Accident Insurance
Associate Minister of Health
Associate Minister of Social Services and Ernployrnent
MP for Banks' Peninsula

7 Dec 2001
Sue Kedgley MP
Parlianient Buitdings

Dear Sue

Thank: you f'or your letter of I Novenber 2001, addressed to the Minister of Social Services and Employment, the Hon Steve Mahaey, regarding Disability allowance payments from Work and Income NZ. Your letter has been referred to me as' the issues raised fall within my portfolio responsibilities,

In your letter, you note that Work and Income NZ pays Disability Allowance costs for acupuncture if performed by a registered medical health practitioner. You further state that there is no requirement for these practitioners to have any training in the use of acupuncture, nor any recognition of the training and qualifications that any non registered health practitioners may have in this field

I agree that this may appear to be an anomaly. However, Work and Income NZ has no means of ascertaining the validity of qualifications unless the practitioner is a registered doctor, physiotherapist or other health professional. The integrity or the benefit system, funded by the taxpayer, must be maintained. The Ministy cannot make payments to clients to cover the cost of treatment or services what the practitioner has an unrecognised, uncertain, or unverifiable qualification to provide that service.

As you are aware, Disability Allowance is a supplementary payment available to people with a disability or special health need, to reimburse extra costs associated with their medical condition. It is a requirement that these payments are renewed periodically, that a medical health professional confirms the costs claimed are directly related to the health condition and that those costs are verified by, the production of receipts. If a client's health costs change, they can apply to have them included in their Disability Allowance.

Thank you for' writing. 1 trust my reply answers your question.
Yours sincerely
Hon Ruth Dyson
Associate Minister of Social Services and employment.
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