Changes to ACC

For many years, New Zealand has had a 'no-fault' personal injury insurance scheme that has been the envy of the rest of the world. Funded by levys on things such as income and vehicle registration, it has compensated everything from broken bones and sore backs to the families of suicides, and victims of sexual assault. It is a cornerstone for funding private accident and emergency clinics, physiotherapy practices and a host of other rehabilitation and counselling services.

In recent years, ACC has actively funded Injury Prevention programmes, including the Safe Communities project that employs me. Most branches have Injury Prevention Advisors, who work alongside agencies engaged in road safety, workplace safety, alcohol-related harm, and falls prevention.

ACC (accident compensation commission) is a business arm of government, and run by a politically appointed Board. The new National Government has signalled that the huge financial deficits sustained by ACC must be curtailed, and the move is towards an insurance model: where the responsibility falls on the victim ie the higher the 'risk' of a claim, the greater the premium. For example this will see ACC levys on big motorcycles increase substantially, despite the fact that motorcyclists will argue that it is motor cars and other vehicles that cause most of their accidents.

While the big increases in premiums are being debated in the media, there has also been significant changes in the funding for injury prevention. We have been advised that ACC will cease funding for Tauranga Safe City from 30 June 2010. Funding for counselling for victims of sexual assault has been made much harder to receive. But one change in particular really raises my ire.

Falls for older people are life-changing events - they can lead to permanent disability, loss of confidence and are the largest cause of non-medical deaths. ACC funds three programmes to help prevent/reduce falls: The Otago Exercise Programme (OEP); modified Tai Chi; and Vitamin D for all rest home residents. Quietly and below the radar, ACC are now progressively axing OEP, and reducing entitlement to Tai Chi. The Vitamin D supplement remains untouched as it is very cheap and gives a good "return on investment."

The Otago Exercise Programme (OEP) is an individually tailored exercise programme for people 80 years or older (65 years for Maori) who meet the criteria, that is delivered in your home by a trained nurse or physiotherapist. It has been shown to reduce falls by 35% (ACC's website). It will be completely gone by December 2010.

Modified Tai Chi classes are for people over 65 years old who have had a fall, or are assessed as being at risk of falling. Classes are taught each week in a group setting. Initial research shows that Tai Chi reduces falls by 47%. Entitlement (frequency and duration of the programme) will be significantly reduced under the new ACC regime. In the picture, a group are demonstrating their Tai Chi in downtown Tauranga at the Tauranga Safe City 'launch' in 2006.

Both of these programmes are proven to be very effective. They address critical issues of strength, and mobility, flexibility and balance. In the case of Tai Chi, they are hugely beneficial in a social context. A cynical assessment would suggest that the decision to withdraw and reduce these falls prevention services reflects the diminishing value of older people in the community, and effectively transfers the responsibility and costs to the health sector. It is outrageous that these internationally recognised therapies are being terminated or reduced.