Oireachtas Joint and Select Committees

Wednesday, 20 February 2013

Joint Oireachtas Committee on Education and Social Protection

Social Welfare Appeals: Discussion with Department of Social Protection

1:30 pm

Ms Geraldine Gleeson:

I will deal with the questions in chronological order. Deputy O'Dea asked about SWA and a delay in papers being sent to our office from the community welfare service. Deputy Ó Snodaigh also referred to delays in SWA. My office prioritises SWA appeals. Once the submission is received, any SWA case is prioritised so that there is no delay from our perspective. As to the reason for that delay happening on the SWA side, which is quite different to the medical schemes, the community welfare service and the Department were being integrated throughout last year. As a result, duplication has been corrected but I understand there have been difficulties in some pockets. One of the benefits of the integration is a reduction in SWA appeals. Before the community welfare service appeals service joined our service, there were approximately 8,000 appeals relating to SWA. Last year, the figure was approximately 4,000. There seems to be better co-operation on the ground between the community welfare service and the Department but I accept that there are pockets where difficulties arose. Those difficulties crystallised in delays in sending us the papers. I understand these difficulties are being worked through and we are following up on those cases which have been delayed.

The Deputy also raised the issue of FLAC, that appellants should be informed there is a better chance of success at oral hearing. The other side of this point is somewhat of a criticism that the number of summary decisions increased. That is the case, certainly. The number of summary decisions have been at 40% of the decisions taken in a given year but this number is now 60% of the total decisions. However, the key point is that when 40% of decisions were summary decisions, only approximately 18% to 19% were favourable decisions. Now that figure, overall, is 30%. What is more instructive is in what I term the subjective schemes, the medical schemes, where the issues are less objective because these are not means cases or contribution cases. The qualifying criteria can be quite subjective. The level of positive summary decisions rises significantly. In the summary decisions on DA, 46% were positive; 41% of the summary decisions on carers were positive; 39% of the summary decisions on domiciliary care were positive. These figures are much higher than the average figure. In an effort to be more efficient and to dispose of cases summarily when we can, more emphasis was placed on ensuring that if one was 99% certain that one would make a positive decision in a case, there was probably no need to take it to oral hearing to hear that extra 1% of evidence. In that scenario we have pushed the level of positive decisions. I am not as concerned as may have been the case in previous times. I am very happy to say that the number of positive summary decisions has risen. It is a complex issue which must be monitored and we will do so.

The Deputy asked about the timescale. An appeals officer will be in charge of approximately 100 cases. He or she will dispose of those which can be decided summarily and the remainder will be taken to oral hearing. By definition, the summary cases will be disposed of more quickly. The key difference is that the timescales will become far more similar as they have done over the past year. This is due to continue over the next year, as the experience of the officers develops. More experience results in more confidence in disposing of cases summarily.

Deputy Collins raised the matter of the Department's failure to send the medical scheme papers. I referred to this in my opening statement. The Department has great difficulties at the minute. To a certain extent, I can understand that it is concentrating on the backlogs in the initial claims because those people have had no bite of the cherry. However, given the significance of the delays for the appellants in my office, three of us meet regularly, the assistant secretary who has charge of the illness schemes, the chief medical officer and myself, to ensure that in so far as possible this is progressed. The assistant secretary in charge of the medical schemes has given timescales for when the backlogs will be processed. In the interim he has devoted more resources to clearing the appeals. The difficulties on the medical side are more protracted because although the chief medical officer will be assigned more medical assessors this year - no more than in the case of our office - the time taken to train them can have an impact. It is vital that the three of us keep meeting in order to keep up this the agenda. I will give a brief example. At the last meeting I was promised 1,600 cases very quickly over the next three weeks. But for that meeting, we might not have made that progress. It shows that co-operation is working.

Deputy O'Dea asked about the free legal aid report and the independence issue. There is no doubt that my office operates independently. In fact, the process is statutorily independent in that the statute sets out the role and duties of an appeals officer. The courts have agreed over the years. I do not think there has been any concerted criticism over the years that the office did not operate independently. I can understand why FLAC raised the matter. In general, the criticism has been that there could be a lack of confidence in the office if it were not seen to be structurally independent. That lack of confidence has not emerged as a criticism up to now. My own view is that whatever way it is looked at, it will be costly to become structurally independent. For example, who would be the appeals officers in a structurally independent body? Would these not still be experienced departmental officers, be they on redeployment or whatever? Having spent the money on setting up an independent body, will we still be open to criticism that we are too close to the Department? Many issues need to be considered. My own view is that people need a flexible and accessible service. That flexibility exists in the system as it currently operates, probably because we are still part of the Department. Any appeal is subject to many reviews within the process.

Once a person enters the appeals process they get many reviews along the way. The deciding officer will examine it first. A medical assessor, a different one than the one who examined it originally, will take a look at it. If it is still not favourable it will come to us. If it is decided by us, and it is not favourable, in many cases we will get more evidence from the person and, in some cases, another lot of evidence. All of these scenarios are accommodated. Even if it means that somebody satisfies maybe at a later date, for example, a case of habitual residence condition, HRC, my office has the flexibility to do that. An independent office would be very constrained when it came to examining the original decision and the evidence that was before the officer originally. Some of that flexibility could be lost. Obviously independence is not a matter for me, I am merely expressing my views on it.

With regard to equality between the appellant and the appeals office, reference was made that the deciding officer has access to more information. My only response is that we notify every appellant that he or she has the right to seek his or her file and any paper that was before the deciding officer. Each and every appellant is told that. The FLAC report contained a survey of advocates and quite a high number of them did not regard getting files as very beneficial. They felt that the files did not greatly elaborate on the reason for the decision. If I have missed anything Deputies can raise them with me again.

Deputy Ó Snodaigh mentioned difficulties with the initial processing because people had to fill out forms and state a grandmother's maiden name and so on. I am not here to advocate for the Department but it is moving close to improving the matter. One can now apply online for some schemes and a lot of the data held by the Department will populate the form. That means people will not have to resubmit information that is already held by the Department.

The Deputy mentioned that a review is available. We have spoken about the matter before and it was interesting. I shall outline how our system works. A person lodges an appeal which is sent to the deciding officer to make a submission which is a review by the deciding officer. In some cases a person could secure a review before he or she lodges an appeal. Whether that review, where it goes back for a submission and a review, should be included in the time taken for the appeals process is a matter that should be examined. In the UK it does not form part of the time. In the UK there is an option for reconsideration and the time for the appeal only starts once a reconsideration by the initial decision maker has concluded. We could examine that option here. The UK option is more transparent for the appellant. Here we could add it all in and inform people how much time will elapse rather than divide the time up between the Department and the appellant.

Deputy Ó Snodaigh also referred to 37 schemes and the fact that many of them have a waiting time of over 40 weeks. I accept his observation. The schemes that cover a large number of people, and are not the medical ones that I spoke about earlier, have a shorter waiting period. The waiting period for the jobseekers' scheme and the social welfare allowance are a bit better. Some of the schemes that have a very long waiting period relate to a small number of people and the issues can be quite protracted. For example, inspectors might have to trace contributions that a person feels that he or she should have in order to calculate the contributory State pension. There might be issues about whether an occupational injury payment can be made. I accept the waiting times and I know that they are very long. We have improved the waiting times for schemes with a large number of participants but we need to do more.

The Deputy referred to my January 2013 figure on carers. I probably should not have included that tabular statement because a month can be unrepresentative. The figure only refers to one month. My previous tabular statement spans a year. I accept the Department's time in that month increased oddly for the carer's allowance. We got quite a number of cases cleared by the carer's allowance unit. The delay was crystalised in one month because those cases were decided.

Deputies Ó Snodaigh and Collins asked whether we needed more staff. One always likes to have more staff. I regularly meet the Secretary General and on each occasion we review staff numbers. Obviously I would be happy if we got more staff. We did get more staff and we increased our numbers from 17 people to 40 people. In my opening statement I tried to convey how much time it takes to broaden the experience of staff. That measure came to fruition during the second part of last year when we finalised nearly 20,000 decisions. This year we should finalise close to 40,000 decisions. If we can do that this year then we have enough staff. We could reduce the backlog to 15,000 and reduce processing times. Given the number of appeals that are being lodged, we have 15,000 cases on hand which is the same percentage that used to be on hand over the years. The Secretary General of the Department and I will keep staff numbers under review. For the moment we probably have enough staff. I base my comment on our current number of staff and their level of experience.

I was asked about physical files. We have not made much progress. However, we have been involved in feeding into a review that is being conducted by the Department into medical assessors, the social welfare inspectors and ourselves. All of them must deal with clients or customers, out in the field, who need a physical file and must compile and submit a report.

We are examining the best way to provide for the sharing of digital documents. As I said on the last occasion, the only potential fly in the ointment is that a number of documents are lengthy, especially the medical cases. I would like the sharing of digital documents to work and the medical service will be the first to do so. I prefer to have a physical file when I have an appellant and the appellant's representative or legal representatives in front of me. In such cases working from a screen could prove difficult but the matter will be kept under review.

Deputy Collins asked about a moratorium on staff recruitment. There is no moratorium but staffing levels are kept under review. I hope that there are no setbacks. I hope that this year will show that the current staffing of the office is sufficient. I think I have answered the questions on departmental files and reviews.

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