An Ounce of Prevention

David Lowe, the manager of employment relations services for the Employers and Manufacturers Association (Northern) argues for the splitting of ACCs ability to set levies and its control of rehabilitation. He argues that the ability of ACC to set its own rates reduces its incentive to be efficient with rehabilitation. 

I don’t really agree with him. ACC are generally quite efficient at long-term rehabilitation and they leave all short-term rehabilitation (for sprained ankles, cut fingers etc.) in the hands of the patient’s GP. I think this is a reasonably efficient way of doing things, although it does tend to lead to overuse of rehabilitation for relatively minor injuries. There is no evidence that people in New Zealand take longer to get back to work than in other countries.

One of the downsides of any attempt to privatise ACC is that other insurance companies may not have such lenient criteria for rehabilitation as ACC and may be substantially more hard-nosed about the benefits of rehabilitation for minor injuries. Some may consider this to be an upside, of course.

Lowe is much nearer the mark when he suggests combining OSH and ACC. It is clear that there is a great deal of incentive for ACC to help prevent accidents, yet their efforts in this regard are mediocre at best. Lowe correctly points out that this is partly due to the turf war between OSH and ACC, as their interests in injury prevention greatly overlap.

It is a mystery to me why a large part of ACC funding is not driven by prevention incentives. Currently, the fact that I have not had an accident requiring an ED visit makes absolutely no difference to my payments to ACC. A workplace can have an accident a week and yet pay no more per employee than a workplace (in the same industry) that has had no accidents for five years. There is therefore no incentive for workplaces to spend money on safety except to comply with OSH regulations. 

I recall standing at the Foveaux Strait Ferry dock while crew unloaded small containers of baggage via a small crane right over the heads of the passengers. I have walked through machine shops full of rapidly rotating machinery, past slippery spills of water and the occasional bolt lying in the floor. I have seen men grinding with their goggles neatly perched on top of their heads and their ear muffs draped around their necks. 

Abattoir workers let fly with sharp knives and no mesh gloves. Farmers allow their eight-year-olds to drive powerful quad bikes. Office workers routinely stand on wheeled chairs to retrieve files from high shelves or change light bulbs. Amateur sportspersons run onto playing fields with little or no warm up and even less protective gear.

New Zealand is a giant accident waiting to happen.

We cannot prevent all accidents, but, at the very least, we can make workplaces and, probably, sports places accountable  for preventable accidents. Not by fines levied after a long court proceeding, but by sharp increases in ACC payments for poor accident records. Although this would require increased admin costs, the savings in prevention of accidents would be enormous. Kiwis have a terribly cavaliers attitude towards accidents which is not improved  by the fact that ACC pays for nearly everything when you have an accident. Perhaps some financial incentive may improve our appalling accident statistics.

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