Australia's National Rape Hotline Run By Insurance Company, Who Demands All Sorts Of Private Info

Australia is providing a fairly stunning case study in how not to set up a national hotline for sexual assault, rape, domestic abuse and other such situations. It has a service, called 1800Respect, which lets people call in and be connected to trained counselors from a variety of different call centers around the country. However, as Asher Wolf informs us, a change in how the system will be managed has created quite a shit storm, and leading one of the major providers of counselors to the program to remove itself from the program -- meaning that it will likely lose government funding and may go out of business entirely.

The issues here are a bit convoluted, but since its inception, 1800Respect has actually been run by a private insurance company, Medibank Health Solutions, who partners with organizations who can provide qualified counselors. One of the big ones is Rape & Domestic Violence Services Australia (RDSVA). While it already seems somewhat troubling that a private insurance company runs the "national" rape and domestic violence hotline -- it's even more troubling when you find out that the company views the service as a profit center:

Earlier this year Medibank healthcare and strategy group executive Andrew Wilson told The Australian that the services offered, which include BeyondBlue, Nurses on Call and After-hours GP as well as 1800 RESPECT, are an active part of their business.

"We have put a stake in the ground and said we'd like to double the operating profit of this part of the business in the next three years."

Over the past year, Medibank changed how the service was run, having the first line of people responding to calls doing more of a triage effort to figure out who really needs to talk to a counselor and who can just be pointed to information. Medibank claimed this was to better serve callers' needs -- and to enable more people to reach a counselor, but there have been lots of concerns about this.

And it came to a head a few weeks ago, when RDSVA, whose contract with 1800Respect was up, announced that it was leaving the program entirely, in part because part of the new contract demands from Medibank would have involved having to hand over all of the confidential notes it had on callers.

The new 1800RESPECT contract written by Medibank required Rape & Domestic Violence Services Australia to handover all client file notes resulting from the past six years of counselling for the 1800RESPECT service. We firmly believe that this would breach client confidentiality and contradict Australian privacy legislation.

This requirement causes even greater concern due to Medibank's position that they will not evoke communications privilege to protect client confidence. Medibank have also provided limited guarantees for the protection of counselling notes if Medibank were to be sold. It is the view of Rape & Domestic Violence Services Australia that this requirement of the contract cannot be met legally or ethically.

The concerns about Medibank are hardly theoretical. Just a couple years ago the company had a major security breach, sending all sorts of details on Australian military personnel to China.

RDVSA also notes other problems with the contract, including requiring that all notes be kept in an online service from Medibank, that RDVSA says it evaluated for its own needs and found that it was not sufficient. And then there's stuff about call recording, and whether or not those recordings will be protected from being accessed in a lawsuit:

Rape & Domestic Violence Services Australia is deeply concerned that the new contract would require counsellors to sign an agreement directly with Medibank for their counselling calls to be recorded. Callers to 1800RESPECT may now experience not only the written documentation being provided to the Courts but they may also experience release of the voice recording.

Sexual assault and domestic violence services have worked over many years with government to establish communications privilege to protect client's therapeutic records from being misused in legal proceedings. Medibank holds a position that it will not engage in communications privilege actions when client files are subpoenaed.

There's more to it as well, but especially when talking about information as sensitive as sexual assault hotline calls, which may create very real risks of more violence or even death for those who choose to call, the entire setup here sounds horrifying. The focus of such a hotline shouldn't be turning it into a larger profit center for an insurance company, but rather 100% focused on helping those calling in -- and that includes protecting their privacy.