(Byner: In what can only be described as a scandal, WorkCover is bringing in medical experts from interstate at a cost of $439 an hour, flights and accommodation extra. Specialists are paid $139 for reading the first 12 pages of case notes plus $8.50 for any extra page that they might read. Independent opinion of this practice is that it’s a way of chasing an outcome favourable to WorkCover, not the injured worker … I can reveal today that WorkCover has proposed to freeze medical fees for doctors treating WorkCover patients in this state. Doctors have already refused in many cases to treat WorkCover patients because of the burdensome paperwork and the inadequate remuneration for what is a very complicated job sometimes … this is employers’ money that WorkCover is using to bring in higher guns from interstate. Many WorkCover clients are so strapped for cash, they have to rely on food hampers from charities while this corporation pays fees that are beyond even those charged by top lawyers in the Supreme Court. We should be scandalised that WorkCover is prepared to spend exorbitantly trying to avoid paying benefits and go to as many as seven medical opinions when you or I would be refused Medicare benefits after the second or certainly the third. All of this from a WorkCover whose finances seem to be completely out of control … the statistics on workers who are proven to be rorting shows only a small percentage of proven rorters. The great bulk of people injured at work simply want to get back to work asap. The State Government has to investigate this outrageous process otherwise we have another State Bank style fiasco in the waiting. The Motor Accident Commission sets reasonable precedents for charges and fees when dealing with road accident victims who require surgery. It therefore beggars belief that WorkCover cannot do the same. Now Dr Andrew Lavender … tell us more about this.) … what’s happening is of course, that we’re concerned that isn’t available expertise in South Australia … obviously in the vast majority of situations there should be doctors in South Australia who could provide an opinion to WorkCover and that our concern is bringing people from interstate is firstly, is it with a predetermined outcome in mind? That is, are we looking at bringing in people because we may get a more favourable opinion to WorkCover as compared to the injured worker? (Byner: Well you said in the news yesterday that was what you really suspected.) Yeah … the second issue is … if we can’t get … if this isn’t the case, then are we bringing in people because we just can’t find doctors in South Australia willing to provide the WorkCover services and … why freeze WorkCover payments … if that’s the situation? (Byner: So what is your question to Minister Holloway, who by the way, apparently can’t be found?) … my question is … in terms of providing medical treatment to injured workers, why are we looking at potentially freezing fees for doctors in South Australia when we already have difficulty getting many doctors to see WorkCover patients? And secondly … the earlier we can get treatment, the more doctors who are willing to see WorkCover patients, the more comprehensive our approach to the injured worker, the quicker we’re going to get people back at work and participating in the community. (Byner: So you are suspicious that the reason interstate doctors are being brought in, you called them yesterday, ‘hired guns’ … ?) Yeah … I said … potentially they’d be hired guns if that’s the reason they’re coming in and certainly that’s a concern … if you look at the expenditure and it’s $3m for I think 47 different visits, that actually equates to around $60,000 for each attendance … that seems a large sum of money and certainly, we would have thought, you would buy a lot of medical opinions in South Australia for those sums. (Byner: … thanks for joining us.)

(Byner: Now Ann Bressington, you have a vested interest in this … tell us what it is?) … I have been involved in donating food parcels for injured workers who can’t afford to put food on the table or are going without medication because they just aren’t receiving the entitlements that they’re supposed to be getting. But I think … the commonality of language that Dr Lavender just used to the same as people in the legal profession who work on WorkCover cases who called these interstate [un clear] hired guns as well and have also indicated that they are very pro WorkCover which means anti injured worker. And regardless of what Julia Davidson says about why they are flying in these doctors, I think people are highly suspicious [unclear] to get the outcome that WorkCover … want. (Byner: A bit of logic would suggest that if that is not the reason, then you wouldn’t freeze the money you give to local doctors if you are having trouble finding them, that you have to go interstate. So something smells.) Well that’s exactly right … WorkCover has been a blight on injured workers now for almost three decades … the name of the bill, the Compensation Rehabilitation Act is a farce because this isn’t about compensating and rehabilitating injured workers and if Mike Rann was serious about reconnecting and re-engaging with the community, then I suggest this is a good place to start because we have injured workers who are losing their homes, who aren’t able to feed themselves or their families … people’s lives are being ruined because of the decisions of this statutory authority and it’s time to rein them in. No more reviews, no more inquiries. The Legislative Council finished a twelve month inquiry into WorkCover just at the end of last year. Now it’s time for the Minister to take up the reins of his portfolio and rein this statutory authority in … force it to work in a moral and ethical manner as well as a legal manner. (Byner: …the Motor Accident Commission has an arrangement with doctors for injuries not dissimilar to those that you might expect from an injured workplace and there’s kerfuffle about it and yet WorkCover has a totally different system that seems to cost a lot more money and … it’s the poor employers who pay this.) Well that’s right … and it’s not as though this WorkCover fiasco isn’t fixable. It is fixable and there were a number of amendments offered to the Legislative Council from Mark Parnell and myself when this legislation was being debated and one of my amendments was to limit the number of assessments that injured workers should be required to have. (Byner: … you or I, if we have a medical problem and need a specialist, Medicare will give us a couple of opinions … but once you go past about three, they’re going to say, “We’re not going to pay for this”.) Well that’s exactly right and why does an injured worker … need to have seven assessments? (Byner: How often do they do seven?) Well I’ve heard of at least a dozen cases … and over a period of time that the injured worker should be engaged in treatment. They’re off having assessments from one end of town to the other … it’s happening quite regularly … I know that other MPS have heard of similar cases. But why do we need to have seven assessments for an injury? (Byner: So what are you calling on Paul Holloway to do?) … I want to know … that the injured workers that these interstate IMEs have assessed, how many other doctors have they actually been required to see before they’ve seen the interstate IME? And what was the outcome of the report from the interstate IMEs compared to the reports of the other assessments that they’ve had? And that should clear up any muddy water we have as to whether these guys are hired guns or not.

(Byner: Rosemary from the Work Injured Resource Connection, good morning.) … I was kind of surprised yesterday when I saw the story on the front page. I knew the story was coming out and I knew it was time that the wider public knew what was going on within the WorkCover system. To answer your question how often do case managers send injured workers to IMEs, the answer … is as many times as they want to. There is no set limit. If they want to send somebody to an IME two or three times a month, they can. Nobody steps in… unless an injured worker complains to myself or to a Parliamentarian we don’t know what’s going on. (Byner: It seems to me that the Government have got to have a good look at this corporation … I think there are precedents in other areas of accident and injury which are not dissimilar to the sorts of problems that WorkCover face.) The injured worker that was mentioned in the article yesterday … who saw the IME in March, the one who flew down from Queensland, Ms Davidson said they only IMEs when there isn’t another IME available. That injured worker had his appointment made in January, almost 9 weeks before he actually saw the IME and in that time he could have seen a local orthopaedic surgeon and had treatment and been back at work. (Byner: The numbers will bear out what’s going on here.) They will. The trouble is, we can’t get the truth out of the corporation … most people tell me that all I do is bang on about WorkCover but it’s costing absolutely everybody in this state, not just the employers, but every time you go into a coffee shop and buy a hot chocolate … you’re paying WorkCover levy for that. (Byner: Oh absolutely. Rosemary, thank you for joining in this morning … we did request the Minister, Paul Holloway but we’re told they couldn’t find him.)

(Byner: Hello John Darley.) … I just thought I’d tell you about a person that I spoke to last week who was an injured worker being dealt with by WorkCover Corporation and EML. They’d been sent to … 27 doctors before EML got the answer they wanted and on one occasion they were sent to five doctors on one day. Because each doctor was running a bit late, the person didn’t get to the last doctor in time and so WorkCover Corporation threatened to cancel the claim. (Byner: But that’s not the patient’s fault … what kind of treatment is that?) I know … this is the problem with WorkCover Corporation and EML … fortunately there was an amendment that I put up two years ago, there had to be a review of the WorkCover legislation commencing no later than the end of this year. My tip is, the Government will have to rewrite that legislation. (Byner: … John Darley, you’re a good man mate and thank you for calling in this morning. That’s amazing, 27 different doctors … the doctors run late, gets to the last appointment and they threaten to cut off his benefits because he didn’t see the last doctor. What kind of rubbish is this? What kind of social justice is this? What kind of social inclusion is this? What kind of economic management is this?)

(Byner: … David of Mount Barker … you’re a GP, good morning.) … my addition to this discussion is that I’m old enough to remember when WorkCover was introduced in South Australia … there was a deputation of senior physicians and surgeons who went to see the Minister … to tell the Minister that this is just not working and the same system had been working in Victoria for two years and was already in trouble. The senior Minister said to this deputation, “You bastards [and I quote him]. You bastards are only looking after your hip pockets”. And it was evident from the beginning that the whole system was run by amateurs and it’s got steadily worse. (Byner: … thank you for calling in today. I think the worry is … you’ve got other organisations who deal with serious injury, not dissimilar to those that happen in the workplace. They seem to have a situation where they’re not getting this huge burdensome debt going to … tens of millions. So clearly there is a big difference between the way they work with the medical profession, the same specialists … and WorkCover. The problem is not the medical profession, the problem is WorkCover. Minister, are you prepared to roll your sleeves up and do something about it? You need to, sir … )

Let me tell you what Ann Bressington is doing and God bless her. She donated a thousand dollars for food parcels … last month. She says it’s time for the Government to clean up the legislation and hold EML and WorkCover to account … she goes on to say, “While it may be legal to use fly-in medical examiners, it is not moral or ethical conduct under the legislation and it must be changed to regulate the money that they’re paid” … I go back to a very simple proposition … for anybody else in the mortal world, two or three opinions is about where you go … so where do we get off at 11 or 12 or 20 … because if you did that to Medicare, you’d have a major investigation asking you and probably the doctor, why are you sending this person to all these different specialists? Can’t you see Medicare doing that to WorkCover? “Oh, we’re looking for an outcome we like”. That’s not a conversation you’re going to hear, but you know what, the Minister can fix it if he chooses to do so.

(Byner: We have the CEO of WorkCover … has called in. Good morning … Now I have a question which is probably at the core of all this and that is, do you believe that we have more fraudulent people in this State claiming WorkCover than there are in other parts of Australia?) Absolutely not and workers fraud is a very, very minor issue for us … (Byner: Alright well then why are we seeking many opinions on the same patient for the same problem when if you or I did it, even in a motor accident claim. I think once we got past about three there’d be some very serious questions asked.) I think that the question that you ask is a really important one and it’s one of the reasons that the Government in it’s legislation has introduced independent medical panels so we would normally seek one independent medical examination if we were unclear about someone’s medical status perhaps too but over time what the scheme will start doing is referring individuals to the independent medical panels where there will be three doctors. Nothing to do with WorkCover, it’s a medical panels SA as an independent set up and they will make a decision about a worker’s condition and they don’t just look at whether the individual has capacity for work but they’ll also look at whether the injury is work related or whether the treatment that’s being paid for is appropriate. (Byner: Julia it seems as if the Australian Medical Association are of the belief that you’re bringing in hired guns from interstate at a very expensive cost to get an outcome that you’re shopping for. … Let me read you an email … from somebody that is actually at the core of this. I wont broadcast their name on air. They say, to add another dimension to the WorkCover, the Attorney-General’s Department which includes the Public Trustee is self insured. He says the apples do not fall far from the WorkCover tree. He then says, when they received a medical assessment while considering the validity of my workplace bullying WorkCover claim, the findings did not suit management’s position so they wrote to the medical assessor, querying his findings and sought in writing a different opinion. How do I know? I have that letter. But Ann Bressington accuses your corporation of not seeking one or two or three but many opinions until you find the one that you want.) I would dispute that. (Byner: Can you prove it? Can you dispute it using proof and what proof would you furnish?) What I can do … is say that if an individual is concerned about the use of independent medical examination in relation to their individual case what they should. … (Byner: No what I have said is the number of people doing the same assessment, not an independent assessment but the number you would send them to. We’re hearing figures here of 7, 8, 11.) No I can give you some facts. … Over the last 4yrs we used 510 local doctors to do independent assessments for us. (Byner: Why do you want to freeze the money you pay them when you’re paying interstate people to come in to do the same job?) No let me just explain. We’ve used 510 local people and 47 interstate people. … We only use interstate people when we can’t get local people to do the assessment quickly enough or if we haven’t got the local expertise. We’re in regular dialogue with the Australian Medical Association about this issue. (Byner: Well let me tell you, the way they’re talking this morning and yesterday seems to contradict what you’re saying right now.) Well I can only give you the facts … but I am concerned if an individual feels that a medical assessment is inappropriate… (Byner: Hang on … that’s not what’s been put today or indeed in the paper yesterday. What is being put here is that people are being sent to different doctors for the same ailment diagnosis. That is quite different to what you are suggesting and furthermore there are people who are afraid to come forward because they are worried that if they do, something will happen to their claim that is not in their favour.) If anyone is afraid to come forward to us then all I can suggest is that they go the Ombudsman, the WorkCover Ombudsman who is an independent investigator … (Byner: Why have you frozen the money that you will pay local doctors, Andrew Lavender told us this, this morning, not an hour ago, when you are paying top dollar for these specialists and even huge fees.) Let me be clear. We pay exactly the same rate to interstate doctors as to local doctors. (Byner: $439 an hour?) Yeah … we pay the same rate. Our preference is to use local doctors. (Byner: And the reason you don’t is, that you cant find one?) No we either can’t get the access to them, so there may well be a local doctor but we don’t want to wait for 3 months or however. (Byner: Did you know that there are surgeries contacting us today saying that they haven’t been paid for sometime by WorkCover?) A colleague of mine just told me that you’d had somebody phoning in doing that and if anyone has got concerns about not having being paid they should call us on 131855 and we’re happy to deal with their issues. (Byner: Well here is another one. A caller rings in to say that they were told in December that they would go to a 5 doctor panel. Now the end of May, no paperwork’s been put to the panel and when it does hit the panel it will be another 60 days wait at least. In the meantime the caller is not getting paid. Is that good enough?) I can’t comment on an individual case … (Byner: If that scenario was to happen … is that satisfactory?) I’m not responsible for Medical Panels SA so I don’t know how quickly they. (Byner: No, no, no but you’re responsible for the paperwork that gets there.) Well we would refer a case to Medical Panels SA as soon as we possibly could but I’m happy to look into any individual cases if anybody would like to phone and give us further information Leon. (Byner: Alright so from your point of view there is nothing untoward about anything that we’ve discussed this morning about bringing in interstate specialists, the cost of doing so, the fact that Andrew Lavender … has said that you have frozen the fees that you are prepared to pay to local doctors and it appears that there are many doctors you don’t pay in a timely manner?) From my point of view I think it’s appropriate for us to use the local doctors where we can, which is what we’d do. On the occasions where we can’t get access to local doctors we will go interstate. We pay them exactly the same rate that we pay local doctors and we have a very good track record of paying… (Byner: Do you pay them $8.50 to read an extra page after 12 of a case note?) We have very detailed fee schedules. … and those have been negotiated with the Australian Medical Association over the years and we believe them to be a fair rate of pay in line with what doctors get paid in the rest of the market and sometimes the Australian Medical Association has a different view that it would like it’s doctors to be paid more but we have to do what we think is appropriate and affordable. … (Byner: So let’s get this clear, after about three second opinions anything under that … if it got to 7, 8, 9 or 10 you think that’s fine?) No … when I first spoke … If there starts to be significant differences of opinion in relation to someone’s medical condition, that we now have Medical Panels SA and we would now refer the case over to Medical Panels SA. That’s something which didn’t exist historically and historically there would have been numerous doctors giving opinions on things and I remember when I was looking at the argument in favour of establishing independent medical panels, we had cases where we had 15 or 16 opinions. Now none of us think that’s sensible. Neither you nor I would wish to have all those different examinations so Medical Panels SA have been set up as an independent authority to actually bring together three or four independent doctors to make a final decision on someone’s situation and over time we would see more and more cases being referred to Medical Panels SA which I think is an improvement for everyone. … (Byner: I think it’s a worry when a statutory officer of the parliament of this state … writes to the media, and I quote, “It is not uncommon for injured workers to be sent to numerous doctors until the report is written that WorkCover are looking for.” That is dreadful.) I’m not sure what you’re referring to there. (Byner: The amount of doctors that have been put on people to get many expertise.) In relation to an individual case I would agree that we should minimise the number of doctors that are actually reviewing an individual case but sometimes these are complex issues and … the introduction of medical panels will allow complex cases to be referred to Medical Panels SA. (Byner: When you have a doctor who assesses a WorkCover case, what would you say should be a reasonable time for which they should be paid? … ) … We have a standard of paying people within 30 days and we pay a lot more quickly than that in fact. Historically we’ve actually paid between 4 and 7 days. You may or may not be aware, we’ve just been implementing a new IT system and we wrote to the medical profession advising them that there could be some minor delays in processing. We’ve only had four medical practices raise with us their concern and we will deal with an individual practice situation during this transition paid period on a one on one basis. So again if anyone wants to phone me if they’re concerned they’re not getting paid, they can call me on 131855 but we have a very good track record or paying doctors. (Byner: … thank you.)

Robert Brokenshire has rung in to say he has been discussing with cross benchers … other members of the Upper House, the possibility of a select committee into these matters to prevent a Government cover up. He said there are too many constituents contacting MPs … all sides of the parliament. For this not to be true he believes doctors are waiting a long time for payment. He says it’s common knowledge. Julia Davidson says, no. there might be one or two cases but we’re prompt. So basically, you’ve got a series of accusations and a series of denials but the real meal is in the numbers and the numbers ought to be made public and a few FOI’s would probably be quite appropriate or are we going to argue that we cant do that because this is privacy or there are commercial interests here. Well there can’t be because there is only one person doing it.

(Byner: Well today we’ve got a little more on this WorkCover story that blew out in the media … this is what we now have … I got a note here from Ann Bressington, which I’ll read to you verbatim … she says, “The no fault mentality of WorkCover system has permeated SafeWork SA, with many constituents, who’ve been injured due to negligence of their employers, expressing their frustrations to me about employers not being prosecuted. If it were not for WorkCover’s system these workers would be able to hold their employer accountable through a civil action in court” - which by the way you can do interstate - “Members of the legal profession state that prosecutions for workplace safety breaches are almost non existent, even though there are 89 occ, health and safety inspectors.” Obviously they must be doing that thing we call monitoring … “Queensland’s prosecution rate of negligent employers outstrips what’s happening in South Australia on a per capita basis”, according to Ann, but listen to this, “On medical panels”, she says, and I quote, “I have been informed from a reliable source that approximately 190 long term injured workers have been identified to be forced off the system by a medical panel come July 1. These injured workers were encouraged to take an absolutely unsatisfactory redemption, with the threat that they would be summoned before a medical panel and they would find some capacity for work, hence forced off the system.” Now, only a Minister can answer this, but the Government don’t want to provide him – that’s Mr Holloway. She goes on, “Injured workers living on less than the minimum wage. Numerous workers are being forced to live on less than the minimum wage, in some cases less than $300 a week due to either the injured worker who was on or close to the minimum wage while at work, having their weekly maintenance cut by 10% after 13 weeks and 20% after 26 or the injured worker having a prior redemption for a different workplace injury. Retraining, one of the most frequent complaints I hear”, says Ann Bressington, “is that WorkCover ignores the need or refuses to provide retraining. Many injured workers due to their injury and the likelihood of reoccurrence are unable to return to their prior employment and as such require retraining in a different field of employment if they are to re-enter the workforce and despite being willing to spend tens of millions on independent medical examiners and on lawyers they consistently deny workers’ retraining opportunities. One worker was so frustrated at EML’s inaction on his own initiative sought out retraining opportunities and found an applicable course, but WorkCover refused to pay the small fee involved. Return to work – this is not accurate as people who leave the scheme, either through frustration or who’ve been redeemed or kicked off the system, have been recorded as return to work statistics.” You know what really I don’t like is these patronising commercials on radio and TV and these silly little award nights they pat each other on the back for getting people to work … yet the reason that we had the unfunded liability that was so bad is because we weren’t very good at it. “Exit fees” … you’ll love this one. “Businesses who attempt to leave the WorkCover scheme have to pay exit fees that can cost hundreds of thousands of dollars to millions of dollars. Lin Fox $30 million – this is on top of all those administrative steps that have to be put into place before an application is considered. The claim is that when they move to self insured WorkCover are left with the injured workers, which self insures of SA deny. There is currently a disallowance motion for this regulation before the Legislative Council.” So, you know, we’ve got a system here it looks as if where a statutory authority is doing what it wants, when it wants and how it wants and the Minister has an hands off approach … go back through history, that was exactly what we had when we had the State Bank … it would be good for Ministers to face the music and maybe change the tune if they think it’s not the right one – that’s their bloody job. Ann Bressington, good morning and thank you for that briefing … if only a third of that’s true we need an inquiry, but we’ve already had one) We’ve had one – we’ve had a statutory authority’s inquiry that ran for 12 months, but I might state Leon that that inquiry actually only focussed on the bottom line sort of issues that WorkCover were facing, not on the effects that injured workers are suffering from this terrible, terrible system (Byner: … I know there are people in this government who are decent, compassionate people … surely this stuff has got to be railing on their conscious, it has to be) Well Leon, I would have thought that the night of the debate itself we would have seen some level of descent, but it was most frustrating to sit in that chamber, and speak for five hours mind you, but to watch both Labor and Liberal basically switch off while these stories were told, while these issues were raised. The medical panel issue … is quite devastating for injured workers because their decision’s final, there is no appeal process for that (Byner: Yes, but hang on the medical panel … if your letter to me is right, WorkCover case managers or their associates are using that as a tool to try to intimidate an injured worker into taking a redemption, lest something be found, that may or may not be right, but they can’t argue) Well, the medical panels can’t receive any independent medical reports from a constituent’s doctor or specialist that a person may be seeing privately, they only get the … files … the case history that EML want to provide to them … quite often they’re not going to be making … their assessment on a whole story (Byner: So Ann what can be done here?) It needs legislative change Leon … none of this can be bypassed, none of this can be fixed unless this government steps up to the plate, admits that this is too harsh, this legislation is unworkable for injured workers and agree to some amendments of these issues that I’ve mentioned with you today (Byner: All right. Ann, thank you).

(Byner: Iain, what’s your observation on what we’re talking about right now?) … Ann knows and the public now know that the Government … has promised another review of WorkCover, commencing in 2011 … there’s no reason why that review of WorkCover can’t commence today, if the Minister was so minded … that was certainly our policy, was to start the review immediately … whatever changes are made WorkCover they’re clearly not working … the unfunded liability hasn’t really tumbled … the injured workers would argue, they’ve certainly argued at public meetings that I’ve been at, that all that’s happened is they’ve had their benefits cut simply so employers can get a rate cut (Byner: … I’d love to put the Auditor-General in there to have a look at a claim that was made yesterday, and it’s not the only one, where for the payment of a $35 bill $40,000 was expended in order to justify paying the $35 … you wouldn’t need too many of those to understand why there is this very large amount of money that’s outstanding) … the issue with the monopoly claims agent brings a whole range of problems with it – the Liberal Party don’t support a monopoly claims agent because there is a lack of competition … so, you know, is a private sector monopoly any better than a public sector monopoly in that sense? (Byner: No) So we think having more than one claims agent is certainly one of the changes that should be brought to the system because it will bring pressures to bear to the system … after 8 years of Labor Government what have we got? We’ve got a workers’ compensation scheme that is out of control; the unfunded liability went up to about $1.1 billion; they’ve slashed workers’ benefits in a … bid to try and reduce the unfunded liability … whether that now improves the system who knows … the issue for the Parliament is whether it improves the finances of the system as competing with the argument as to whether it actually improves the for injured workers … it’s the balance of those two arguments ultimately the Parliament needs to deal with (Byner: Iain Evans, thank you indeed).