Ms Catherine Cox:

I thank the committee for having us. Today I will talk specifically around carer-related social welfare payments and the medical eligibility criteria, in particular, carer's allowance, carer's benefit and the respite care grant. We were part of the domiciliary care allowance, DCA, review process over the past two years and we are happy that the changes made have brought about considerable improvement, particularly for parents caring for young children with pervasive developmental disorders, PDDs, such as autism. We have been part of that process and are happy that we have worked closely with the Department on that.

I refer to the issues facing family carers on the ground. The fact that 50% of carer's allowance appeals are successful causes us concern and while it shows that the Department is honest in the appeals process, the problem lies with the fact that not enough information is being sought or given at the application stage. We are working with the Department on this. The application form is 24 pages and that is the amount of space that is given to put in the care duties the carer is providing. That is far too little and we would like to see the introduction of a daily diary that family carers can fill in. This would prompt them to fill in the details of the person for whom they are caring and the issues they face relating to supervision, personal care and whether there are actions the person being cared for takes that would put him or her or others at risk. We are also working with the Department on this. The diary will also deal with medication and the therapies the person is receiving, which will give a more holistic picture of the level of care being provided. In the absence of a face-to-face assessment, the person looking at the form can see at a glance that high levels of care are required.

We believe that question No. 10 on the medical form is flawed. I will not go into this as it is quite technical but we have outlined this in our submission.

Family carers who care for an adult with PDD, an intellectual disability or mental health illness face another problem. The form is strong in capturing information about somebody with a physical disability but it does not capture the issues faced by somebody with a mental health disability. In other words, it leans heavily towards physical disability and it is very much a medical model rather than a social model. For example, a person could be caring for somebody with a mental health illness or an intellectual disability who does not understand money or who cannot use public transport or travel on a bus or who may be vulnerable in relationships or vulnerable to addictions or may have suicidal thoughts or aggressive. None of this is captured in the current application form, which is weighted towards older people and those with a physical disability. This, in turn, proves burdensome for carers who must provide extra reports, which is costly and time consuming. It also places an additional burden on the Department because cases are appealed and it takes more time to review them. In the interests of fairness and consistency, we ask that the DCA review be extended to review the carer's application form. We acknowledge that the Department is reviewing the improvements to the DCA and it wants to do that to make sure the changes working well for everybody. We would like carer's allowance to be reviewed as soon as possible.

The medical assessment presents another difficulty for carers. Carers express extreme frustration when their GP has submitted and signed off that a person requires full-time care but this is often ignored by the medical assessor who does a paper assessment. We understand and sympathise with those views. We ask for a change in current practice in order that there would be a single integrated medical assessment process which would look at health, income support and education. It would cover all those rather than having separate assessments. We ask for them to be combined. It would be more efficient but also more humane to the carers applying for the payment.

While we acknowledge the processing time for applications improved dramatically in 2013 when the gap reduced from 26 weeks to 12, we have noticed over the past 12 months that it has begun to increase again. We ask that this be looked at. We acknowledge the Department is working to improve that.

We welcome some initiatives by the Department in recent days. It has introduced a process whereby if an application comes in and the officials feel the medical information is not sufficient, they will go back to the carer and seek more information before they stop the payment. That is a welcome improvement in the system.

We have highlighted many of the issues I have highlighted to the Department and we are working closely with officials, particularly on the daily diary. We feel that would improve the position of family carers and the Department is keen to work with that. We discussed that at the recent annual forum for carers and there seems to be a positive move towards introducing something like that. We welcome the improvements to the DCA process and those improvements should be spread out to the carer's allowance and carer's benefit processes.