Balmain Rape Crisis Centre in crisis
By ALEC SMART
A rape crisis centre in Balmain will have to undergo multiple staff redundancies and faces likely closure over a dispute on client privacy.
The Rape & Domestic Violence Services Australia (R&DVSA), a not-for-profit NGO in Balmain, provides trauma counsellors for rape victims calling the 1800RESPECT phone number.
Medibank Health Solutions, Australia’s largest private health insurer, has been managing the 1800RESPECT traumatic help telephone service since it was introduced in 2010. In August Medibank announced it would implement changes, which would require R&DVSA to breach client confidentiality by turning over records.
“In early August we announced a new arrangement,” Medibank confirmed, “with a panel of organisations to provide the trauma specialist counselling component of 1800RESPECT (approximately 30% of calls to 1800RESPECT are for trauma specialist counselling). Four not-for-profit sexual assault, domestic and family violence organisations were invited to join the panel.”
However, despite R&DVSA having to lay off staff to implement the changes, they were reluctant to share the very personal information of their clients with the private health provider, compiled over years of trauma counselling.
Medibank was unwilling to allow the confidential documents to remain under the care of R&DVSA.
A stalemate ensued, until R&DVSA eventually announced it was severing its relationship with Medibank when its contract expires on October 28.
Karen Willis, Executive Officer of R&DVSA revealed that Medibank would not negotiate on the client privacy issue.
“It’s a done deal.”
When asked how it is likely to impact upon the service, she replied, “That’s the end of our service, so the NSW Rape Crisis Centre [in Balmain] will go. We’re now in the process of making about 70 women redundant.
“We’ve requested funding for the redundancy, because Non-Governmental Organisations are required to not accrue for redundancy. We’ve got leave entitlements, and so on, but not redundancy. We don’t have the close to a million dollars needed to pay those redundancies; as any NGO, you don’t. The government gives you money; you spend it on services; that’s the whole idea.”
Medibank Health Services issued a statement, saying, “We had hoped that R&DVSA would be part of the service but we respect their decision and wish them the very best. We appreciated the opportunity to have worked with them in the past, recognising the critical importance of addressing sexual assault and domestic and family violence in Australia.”
The NSW Minister for Health, Brad Hazzard, was invited to intervene in the privacy issue, but seems reluctant.
“We’ve had discussions with a representative from his office,” Karen Willis of R&DVSA confirmed, “and also Minister Goward [Pru Goward, NSW Minister for Family and Community Services]. I don’t expect them to publicly oppose the Federal Government, that’s not what they’re going to do.
“I did hope that they will make presentations to their colleagues and say, “Hey, come on, these are State-based services that we need to keep in place.”
“Minister Goward was very clear that NSW Rape Crisis must continue to be able to provide services. So we’re hopeful that they will make representations to their federal colleagues.”
“Until October 28, the contract we currently have with 1800RESPECT we will see to the end and continue to provide services.
“After that: Medibank has established a new model where they will do a triage and then they will send clients out to three other providers.
“We were invited to be a part of that, but it would have meant a 75% reduction in funding so we still would have had to make 50 women redundant.
“There were also a number of key things that, from our perspective, were just unethical in the extreme. One was that we would be required to hand over the last six years of counseling notes to a private health insurance company. That’s 77 individuals’ file notes and hundreds of thousands of occasions of service that Medibank just expected us to hand over to them and there was no way we were going to do that.
“There was also the counseling model that they were proposing. They said the counselors would have to abide by it, and when we said ‘Can we have a copy of it?’, it turns out is hasn’t been written yet!
“They were giving themselves four weeks to write a trauma counseling manual. It took us two years to write our first one and then we’ve revised it since, and each time it’s taken a year. It has been internationally recognized as best practice in providing telephone trauma counseling, but Medibank can do it in four weeks.
“We have grave concerns for the quality of that document.
“The 1800RESPECT will continue, it will just be a different model with different providers so people will still be able to ring the service.
“But things like handing over the file notes: when women contact us – mostly women, although about 17% of our calls are from men – our view is that they trust us with their information and we have an absolute responsibility to protect that, come hell or high water, and that’s exactly what we’ll be doing.”
“All records relating to a call can potentially be subpoenaed,” Medibank stated, “including the written file notes which all counsellors working on the service (including the specialist trauma counsellors at R&DVSA) are required to maintain.”
R&DVSA countered, “We have a commitment that if a defence lawyer subpoenas those files, we will always use communications privilege to oppose that. On the other hand, if one of our clients makes a complaint to police, we will provide a police statement, not the file notes, with the relevant information.
“Firstly, there’s that inherent trust that we’ll be breaching, and secondly, there’s also some legal ramifications we’d be breaching as well. We believe we have an absolute ethical responsibility to abide by and we believe it is part of the client-counsellor relationship.”
