Speech to ACC’s Injury Prevention Partners' Conference
Shifting ACC to a greater focus on injury prevention
Good morning. It’s great to be here today, with so many of you who have been contributing over a long period of time to ensure fewer New Zealanders lose their lives or are seriously injured in accidents.
We all know the impact on someone’s life from injury, and the importance of doing everything we can across government to ensure the investments and people are in place to prevent as many injuries as possible.
Today is an important time in the history of injury prevention in New Zealand. If you look at the bigger picture with regard to ACC, there have been a number of changes over the last five years.
We inherited a scheme that had a $4.8 billion hole in its accounts in one year alone, and we’ve turned that around to take the scheme’s assets from $10 billion to $31 billion. All the levied accounts are now fully solvent, and we’re in a position where we have excellent board leadership under Paula Rebstock, and excellent executive leadership under Scott Pickering.
There’s also a range of other work being done. For example, I currently have work underway to ensure the roughly three per cent of people whose claims are declined have access to fair processes to challenge decisions. This is so that everybody gets the assistance they’re entitled to under law.
ACC has also embarked on a major project, called Shaping Our Future, to improve service across the organisation.
Now that we’re in a position where public confidence is rising, the scheme is fully funded and we have around $2 billion of levy cuts, ACC can start to invest more in injury prevention and ensure this is informed by a good evidence base and strong and enduring partnerships.
Increased investment and improved strategic priorities
If you look at the history of injury prevention, in the past ACC has tended to fund small scale interventions over relatively short periods of time. Often, these didn’t result in the cultural or behavioural change that needs to occur.
We know we can be successful in significantly reducing injuries in certain areas. One example is road safety.
Through a coordinated approach across government and a range of agencies, from NZTA to the NZ Police, we have seen a continued, overall reduction in the road toll.
This is because we’ve focused on a range of factors that influence injuries, such as speed, alcohol, road design and better support for young drivers.
So I’m very pleased that the ACC board has put in place a new approach for injury prevention.
They now have a strategy which has clear priorities to drive reductions in the incidence and severity of injuries, and they’ve increased their injury prevention spend - from $30m last year, to $50m this year.
To reach this goal, ACC has identified a targeted level of investment over a five-year horizon. This allocation has been identified based on factors such as the likely impact on the outstanding claims liability, and the Government’s priorities.
Improved data and partnerships
It’s pleasing to see that ACC is working more collaboratively with other agencies, like the Ministry of Health, to share information and forge partnerships at a government level that will stand the test of time.
However, we know that in many areas, such as reducing children’s injuries, it’s not just the Government that has a role to play.
Often there are other organisations that have the ability, the institutional knowledge and the wider relationships to deliver injury prevention programmes, and also be the genesis of ideas for those programmes.
So what we will see from ACC is a commitment to initiatives based on good data, and long-term strategic relationships.
I’m going to walk you through some examples where work is happening across agencies and beginning to make a difference. These are reducing family and sexual violence, reducing children’s injuries and reducing the number of falls in New Zealand.
Reducing family and sexual violence
In my role on the Family and Sexual Violence Ministerial Group I am working alongside my colleagues, led by Ministers Adams and Tolley, to ensure government agencies, including ACC, respond better to family and sexual violence.
We are taking a hard look at how agencies work together and what improvements can be made right across the system.
Earlier this year, I was pleased to launch ACC’s new Integrated Services for Sensitive Claims, which sees a more holistic approach to ensuring survivors of sexual abuse receive the right services, in their own time and on their terms.
This is about providing a range of services much earlier to reduce the impact of trauma and prevent re-victimisation. Recovery forms a really important part of the wider sexual and family violence system response.
Young people are a focus in this area. It’s worrying that our youth are the most represented in ACC’s sexual violence numbers. As part of the Ministerial work programme, I’m leading a strategy aimed at tackling youth sexual violence.
ACC’s healthy relationships programme for high school students, called Mates and Dates, forms a core part of this strategic action.
I’ll continue to work hard at joining up the elements of the system and working collectively with my colleagues to address our unacceptably high sexual and family violence rates, and the harm they cause.
Reducing children’s injuries
The vast majority of ACC’s 349,000 claims for children last year were for minor cuts, scrapes and bruises, with a small number – less than one per cent - for more severe injuries. But we can’t take comfort in statistics, and numbers alone don’t begin to reflect the distress caused to many children and their parents.
When we look more closely at frequency, severity and cost of child injuries, these areas emerge:
- injuries in the home (which includes family violence, safe sleeping, driveways and dogs)
- motor vehicles (including quad bikes)
- treatment injury (ie birth injuries)
- injuries playing sport.
Unfortunately, child fatalities from injury follow the same trend. But many of these injuries and deaths are preventable, and changes in behaviour are achievable, so there’s much work to do in this area.
Later this morning I will be launching a very important campaign aiming to prevent child death and serious injury.
ACC is partnering with the health sector to lift New Zealand’s performance in preventing falls among our aging population.
The Steady as you Go initiative helps older people avoid falls through exercises that improve balance, leg strength and general fitness. It’s a programme that has been well received by the target audience and has recently been extended from Otago to Tauranga and Whanganui.
Another example sees ambulance and health alarm representatives provide added-value advice to their customers. They do this by helping them identify and remove hazards in the home that could cause falls.
If we combine initiatives such as these with others, such as improving nutrition for our senior citizens, then in a “system” sense we will begin to get synergies and multipliers that will lead to an overall improvement in well-being.
In other words, the secret is taking a holistic approach that not only reduces injuries but also improves the health of the nation. This approach can be applied beyond the older population to other sectors in society too.
Supporting ACC in injury prevention
As Minister for ACC, I am taking a leadership role in certain areas, particularly where I can see that agencies themselves haven’t taken a clear lead.
There are some areas where legislative change may be necessary to make a significant difference. But it’s also important to work across portfolios, and I’ll be working with colleagues to ensure we get a holistic, cross agency approach.
The reduction of children’s injuries is a good example. Another is the reduction of older people falls.
I was pleased recently to launch a range of initiatives with the Hon Maggie Barry, Minister of Senior Citizens. This included injury prevention initiatives and general wellness information, provided to new SuperGold cardholders.
As I’ve just mentioned, a key goal here was helping older people become healthier, which in turn helps prevent falls and the injuries and severity of injuries that can result from them.
So over the next two days there’s going to be some intensive discussion about getting the best out of partnerships.
At the heart of partnering, agencies and organisations need to have shared understanding of the problems, common objectives and most of all a willingness to work differently.
If we look at the key areas you’ll be focusing on – and I’ve mentioned some of these already – from the Government’s and ACC’s perspective, here’s what they are.
Workplace is a key area. Here, the focus is on putting together a three-year action plan, working across manufacturing, construction, agriculture and forestry, with the ambitious but achievable aim of reducing workplace injuries by 25% by 2020.
To reduce falls, there will be a continued focus on improving services for older people and analysing further opportunities to broaden our reach to other target populations, such as those of working age.
Road will involve continued work within the Safe System framework, which emphasises the interconnection between safer roads, safer speeds, safer vehicles and safer road users, and will continue to build it’s great work with NZTA and the NZ Police.
Treatment Injury will see a focus on reducing preventable treatment injuries and exploring ways to connect treatment injury into existing initiatives in the health sector to improve overall quality and safety.
The Community portfolio is a new portfolio, tasked with improving capability in community channel management and strengthening community partnerships. There will be work on programmes that are strongly cross-portfolio, like the consumption of hazardous amounts of alcohol and injuries in children under the age of 14.
Sports will see a focus on two main areas – organised sports and recreation.
Finally, as I’ve already highlighted, reducing violence will focus on the primary prevention of family violence, sexual violence and suicide. The violence portfolio aims to champion safe interventions that target young people aged 0-25, and forge long-term partnerships with others who are interested in violence prevention
Thank you again for the work you do, in agencies, communities and in businesses and workplaces throughout New Zealand.
We all know the dramatic impact that injuries can have on people’s lives. We know too that accidents and injuries can occur anywhere, at any time.
ACC has come a long way in the last five years. It is now more stable financially, more transparent and has a much longer-term view.
Looking ahead, we will see an increased injury prevention spend, supported by an improved strategic focus, a better evidence base and the development of longer, stronger partnerships. I will also work to lead change and ensure ACC works better across agencies.
All of this means that in my view, we will shift ACC from an agency focused on helping people through injuries, to an agency focused on helping prevent injuries from happening in the first place.