Abuse In Orphanages

New Zealand's government is hardly the most corrupt or ill-intentioned in the nation. But there, as is the case almost everywhere, going back to at least as far as the Old Testament, orphans get a raw deal and are frequently abused. 

More than 30% of people in care in New Zealand from 1950 through 2019 were abused and many more were neglected. I suspect that as horrible as this is, that it is worse in many other countries (probably including the U.S.).

The mix of problems in New Zealand is multi-faceted. 

Most children in care were Maori (i.e. indigenous Polynesian), even though New Zealand is currently only about 18% Maori, usually in cases where they were removed from their families, putatively, for abuse or neglect. It is a fair guess that Maori children were also on the receiving end of a disproportionately share of the abuse suffered by children within the system. This has echoes of the notorious residential schools in Canada and the U.S., long ago, in addition to the other issues with abuse in orphanages without ethnic bias and issues of the treatment of indigenous people thrown in.

The culpability of New Zealand’s Catholic, Methodist and Anglican churches is also predictable and has been mirrored in Canada, the U.S., and the U.K., as well as many other places. Partially related is the religious affiliation of Maori people, of whom there are about 1,075,000 in the world (mostly in New Zealand, but with about 1/6th in Australia and about 21,000 elsewhere):

Given the total population, 0.1% corresponds to about 500 to 1500 people, and 0.2% corresponds to about 1500 to 2500 people.

Of course, while this is dismal, surely a large share of children in care in New Zealand genuinely were victims of abuse and neglect before the government stepped in and removed them from their families.

New Zealand deserves credit, at least, for a thorough investigation, for apologizing, and for resolving to take action. It is also worth noting that New Zealand apparently has a "no-fault accident compensation system" that makes sense as basically a more seamless version of a system where everyone has casualty insurance (it is discussed at the end of this post).

More than 200,000 people are estimated to have been abused by state and religious organizations in New Zealand that had been entrusted with their care, according to the final report from a landmark independent inquiry released on Wednesday.

The abuse included sexual assault, electric shocks, chemical restraints, medical experimentation, sterilization, starvation and beatings, said the report from the Royal Commission of Inquiry Into Abuse in Care. Many of the victims were children who had been removed from their families and placed in state, religious or foster care.

“For some people this meant years or even decades of frequent abuse and neglect,” the report said. “For some it was a lifetime; for others it led to an unmarked grave.” . . .

The inquiry, established in 2018 by the New Zealand government, involved interviewing nearly 2,500 survivors as it examined orphanages, foster care systems, mental health facilities and other forms of care that were charged with supporting 655,000 people from 1950 through 2019. The inquiry’s leaders described it as the widest-ranging examination of its kind in the world.

The report noted that most children in care were Indigenous Maori, even though the group makes up a minority of the country’s overall population of five million people, and said that “Maori were often targeted because of their ethnicity.”

Beyond the 200,000 people estimated to have been abused, the report said countless others had suffered neglect. . . .

The inquiry found that even when abuses by government and religious leaders were discovered, the leaders “were rarely held to account for their actions or inactions, which emboldened them to perpetrate further abuse.”

Among the inquiry’s 138 recommendations were calls for public apologies from the pope, the archbishop of Canterbury, and New Zealand’s police commissioner and its top civil servant. It also urged the government to overhaul the country’s no-fault accident compensation program to provide tailored support for survivors of abuse.

The report prompted New Zealand’s Catholic, Methodist and Anglican churches to promise change. “We will ensure that action follows our review of the inquiry’s findings,” Steve Lowe, president of the New Zealand Catholic Bishops Conference, said in a statement. “We owe it to survivors,” the Anglican Church said in another statement.

The report follows decades of complaints from survivors. “Survivors repeatedly called for justice but were unheard, disbelieved, and ignored,” according to the report. “Significant resources have been used to deny survivors their voice and to defend the indefensible. This must stop.”

From the New York Times (July 24, 2024).

The core forward looking recommendations of the report are here and focus on creation of a single national regulatory system for both secular and religious care systems.

National No Fault Accident Compensation

According to an article in a medical journal that is very opposed to the tort system of medical malpractice:

In 1974 New Zealand introduced a publicly-funded accident compensation scheme with the goals of minimising the incidence and impact of injury. 

The scheme provides assistance with the cost of treatment and rehabilitation for all personal injuries, regardless of fault, and in exchange bans suing for compensatory damages. Medical injury has always been covered under the scheme. Consequently, in New Zealand there is no culture of suing doctors for damages and doctors pay comparatively low medical indemnity fees of around £790 per annum. Doctors are held to account under separate processes including the Medical Council of New Zealand’s competence and fitness to practise processes, an independent patient complaints system, and a separate disciplinary process. 

The patient complaints system was introduced in 1994 on recommendation of a 1988 government report that found wanting the prior accountability processes in an environment where patients were unable to sue. In New Zealand, patient complaints are not a demand for financial recompense but a demand that an individual be held to account for perceived wrongdoing. A patient may lodge both a claim for treatment injury compensation and, regardless of injury, a complaint against a practitioner.

Although medical injury has always been covered under the scheme, the compensation of medical injury has not always been without fault for doctors. Prior to 2005, patients could obtain compensation by proving medical error. Because all findings of error were reported to the Medical Council, compensation could bring disciplinary repercussions for doctors. Fear of punishment and/or reputational damage discouraged some doctors (and some patients) from participating in the compensation claims process, unfairly restricting access to compensation for injured patients. This situation was rectified in 2005 under the ‘no-fault’ legislative reforms. The reforms extended eligibility to all injuries caused by treatment and replaced the prior reporting duties with a new duty to report ‘risk of harm to the public’ to the ‘authorities responsible for patient safety’. These changes freed doctors to participate in the compensation claims process with little fear, and improved information flows within the system.

The program explains itself here:

Our no-fault scheme covers everyone, including visitors, who are injured in an accident in Aotearoa New Zealand. It can include events that result in mass casualties, and covers children, beneficiaries, and students. You’re covered if you’re working, unemployed, or retired.

There are some limits to the support we can provide. These limits are set by Parliament, which makes laws about what we can and can’t support.

If you're injured in an accident, make sure you go and see your doctor or health provider first. They can make a claim for you. Claims can be made up to 12 months after your injury. We may still consider claims made after this time if there’s a good reason for the claim not being made sooner. 

What is no-fault cover?

No-fault cover means it doesn't matter what you were doing when you were injured or who was at fault. We'll cover you, as long as the injury falls within our legislation.

The cover we provide helps pay for costs to support your recovery and get you back on your feet. It includes payment towards medical bills, treatment, help at home and work and help with your income. 

Physical injuries we cover

A physical injury is when there is actual damage to your body. This includes: 

• sprains or strains - such as the ankle, back, knee or shoulder sprains
• wounds - cut, broken or bruised skin
• burns
• fractures
• dislocations
• dental injuries
• hearing loss
• concussion and loss of consciousness
• maternal birth injuries which occurred on or after 12:00am on 1 October 2022.

We cover most physical injuries if they're caused by: 

• an accident
• sexual violence

We can cover injuries or conditions that happen over time and are caused by the type of work you do. This is known as gradual process conditions. We have to establish if your work tasks or workplace environment are causing your condition.

We can also cover injuries that are long-term, permanent or that happened at birth. 

Injuries caused by treatment

Sometimes getting treatment can cause an injury. We can cover a treatment injury if: 

• the treatment directly caused your injury
• a registered health professional was treating you
• it's not a normal side-effect of your treatment.

We can also cover injuries caused by treatment for an injury we've already covered. 

Conditions that come on gradually from work

We can cover injuries or conditions that happen over time and are caused by the type of work you do. This could be things like: 

• tendonitis from overusing muscles or heavy lifting
• deafness caused by noise at work
• infections or diseases from exposure to certain environments. 

Serious injuries and disabilities

We can cover injuries that cause long-term effects and disabilities including spinal and traumatic brain injuries (TBI), such as concussion.

Find out how we're working to reduce the number, severity, and impact of TBIs:

Reducing traumatic brain injuries 

Mental injuries we cover

If we accept your claim for a physical injury, we can also cover mental injuries resulting from that injury. For example, post-traumatic stress disorder after a physical assault.

If your physical injury is caused by medical treatment we may also be able to cover a resulting mental injury, even if the physical injury isn’t covered.

We also cover mental injuries if you've experienced, seen or heard a traumatic event at work such as working in a retail shop when a robbery takes place. This is even if you haven't been physically injured. 

Sexual abuse

We provide support for anyone in Aotearoa New Zealand, including visitors to the country, who has experienced sexual abuse and assault. We may also be able to help if you're an Aotearoa New Zealand resident and have experienced sexual abuse while travelling overseas. It doesn't matter if the event happened recently or a long time ago.

If you've experienced sexual abuse, use the Find Support website to see the organisations that have therapists who can support you. This support is fully funded and you can start whenever you're ready. There are also services available for your family.

If you're having trouble getting in touch with the right therapist, contact us. We'll help you to make an appointment. 

Dental injury

We can pay for dental injuries caused by: 

• an accident
• sporting injury
• as a result of medical or dental treatment.

We don’t pay for: 

• damage to your teeth or dentures due to normal wear and tear, eg chewing or biting
• damage to your teeth due to decay or gum disease
• damage to your dentures while you were not wearing them
• treatment that was done by someone that’s not a registered dentist, eg a dental technician.

Your dentist will help you to make a claim if you have an injury we cover.

Injuries causing death

We give financial help if someone dies as a result of: 

• an accident
• a work-related disease or infection
• a treatment injury we're covering
• a self-inflicted injury (in some circumstances). 

Maternal birth injuries

If you have experienced an injury while giving birth on or after 1 October 2022, we may be able to help with your recovery. We have guidance on what's normal and what's not.

This is essentially "no-fault" automobile insurance and worker's compensation on steroids and has a lot to be said for it in some form. The tort system does a poor job of compensating people with smaller injuries, and people who have suffered from bad outcomes and accidents when fault is less clear cut. The tort system is also slow, uncertain, and involved immense transaction costs.