Dr. Devesh Singh:

I agree that there are a lot of questions but they are pertinent and I appreciate them. What is of interest to me is that a lot of the questions are the same type of questions that we face as medical assessors. I intend to give the committee the medical assessors' feedback from the perspective of the questions posed. If there are any administrative-related issues then my colleagues will address them.

Deputy O'Dea asked pertinent questions. The difficulty in getting claims processed and desk assessments were two of the issues he raised. He sought clarification on how desk assessments could be perceived as providing an objective opinion. The matter was raised by several other Deputies and speakers today along with queries about the role of the medical assessor and deciding officer. From my own perspective, I have found it reassuring that the Department has not placed a cap on payments and no quota on the number of applicants for this benefit. That means if every application medically qualified then all of the applicants would be paid and it would not matter if the whole population of the country applied, so be it.

When it comes to difficulty in getting claims processed, I agree with Members. There is an ongoing process to improve the application process, the assessment process and communication. However, there is a complex process between the medical and administration elements. It is not only medical criteria that an applicant must satisfy. He or she must satisfy other non-medical criteria such as a means test and natural residence which takes a considerable length of time.

Desk assessments can be reasonable and objective way of assessing medical applications. However, and I must reiterate, this is based on the quality and comprehensiveness of the medical information available to the medical assessor. The committee must understand that what I have heard today is the same experienced by GPs in their day to day practice that initial applications are deficient, limited or restricted. Reaching the right conclusion is also a struggle for us as well. I have heard that a lot of applicants hold back information which does not do them any favours. I take this opportunity to ask Members to convey to their constituents that applicants should do some good for themselves and the best chance is to give everything bit of information to us. It would save on time, costs and mental stress faced by applicants.

I will move on to Deputy Ó Snodaigh's remarks. Communication with medical organisations has been an ongoing process. In the last couple of years we have realised that we could do more and we have been addressing that. There is no formal mechanism or platform for us to engage with them, but we do so at every opportunity, mostly when we find when processing an application that we need more clarification. This happens nearly once a week and we make attempts to ring them and communicate directly. The process is sometimes limited by the availability of the general practitioner. My experience is that the doctor is often in a consultation and one must leave a message and wait for them to respond at the end of the day. It is an ongoing process. In terms of official contacts, the chief medical adviser has taken every opportunity to present the perspective of the medical assessment process at various medical conferences and forums. For example, on 5 February, he presented to the national GP tutor network. Opportunities and platforms like that help a great deal to get the message out.

The Deputy also asked whether the claimants' doctors get a payment for providing reports, which they do. The Department spends at least €18 million to €20 million per year just getting reports back from GPs. That is a significant amount. In fact, last year it went up to €21 million.

The form for the report is designed to give us enough information to make the decision, if it is filled in correctly and comprehensively. There are two things we must ascertain, namely, the severity and duration of the condition. Much of the time, it is the duration we are looking for. For example, if somebody has severe back pain and has an MRI, which might show pathology, this might improve in a couple of weeks or months with treatment. The duration is the information that we do not always get. However, the form is reasonably well designed to provide the information we need. I agree that the forms are lengthy. There are many pages in the initial part of the form covering administrative and general information. Why are half the appeals successful? I cannot answer for the appeals office, which is a quasi-judicial and independent part of the Department, but I gather that if claimants are providing more information to the appeals office, that would dictate a difference of opinion.

Senator Moran's first question related to the large number of disability allowance applications that are turned down. She stated that over 13,000 applications were turned down out of a total of 27,000.