Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

To take up the point that Deputy Ó Cuív is making, at the start of the form there would be two to three sentences explaining what full-time care or full-time attention is. The difficulty is each of the schemes is different and illness benefit is not the one we have the problem with. If you look through the statistics from the Social Welfare Appeals Office, a substantial amount of decisions are either made preliminarily or where it had gone back to the office where the original decision was made and on review, the decision has been reversed because new evidence has come in. What tends to happen is that someone gets the form for the carer's allowance or disability allowance or invalidity pension, he or she fills out the form and brings it into the GP. The GP, at the end of a long day fills out a whole series of these forms, some of which are certificates for employers and others of which are letters that are needed for a medical card. They have a whole plethora of different forms but they are all looking at different aspects. The GP is even trying to remember who the patient is in relation to it.

I have asked the patient to jot down on a sheet of paper what their key issues are that are relevant to the various forms. I have found that when that is actually done, there is less chance of the medical aspect of the application falling down initially. That is grand if they happen to come into me or Deputy Ó Cuív initially, before they go through the process. Usually, what ends up happening is they come back to us and say we have been refused this, my mother is in a wheelchair and yet I have been refused the carer's allowance. She obviously requires full-time care, that is not an issue, but when you go back and look at the medical report that has gone in, you would have come to the exact same conclusion as the medical assessor in the Department. I have gone through it with families and have explained to them this is what has gone into the Department and that is not what the case is with this person at all. It is delaying the processing of these applications, it is leading, particularly in relation to the disability allowance, to the fact that the Department is falling so far short in relation to the target. I think Deputy Ó Cuív's proposal in one simple measure could make a significant difference in relation to this. The worst performing one at the moment is disability allowance.

It could be piloted with disability allowance - on the medical report in that - and a narrative could be put in that this is the test being put in relation to disability allowance. A simple, plain English narrative for the GP would help that. Ultimately, none of us wants to see applications going to appeal, either those that could be determined initially or those determined at review. It is always frustrating to get a black and white case and to have to submit it for appeal. Normally, we get it at review because it is obvious, but that delays the process. The fact that an official has to look again at an application, or send on the medical report to the medical assessor again, is delaying applications of first instance because they have to review existing forms that were previously submitted. If we can reduce that, it will change the statistics we are dealing with here and benefit everyone. It will make the Department more responsive in respect of them because it is getting the data it needs. That is the point that Deputy Ó Cuív is making. It is worth looking at it even in terms of taking one of those schemes initially and putting that through the process, engaging with the medical assessors within the Department, who know exactly what they are looking for, and maybe engaging with the IMO on it.

We can send out all the regulations and all the briefing material we like to GPs but it is not being read. I would hope that my GP is not reading it either. I would rather my GP read the latest research regarding health conditions and emerging health conditions than circulars from the Department of Social Protection. That is what I would like to see my GP reading if they are reading something at night. Let us make it easy for them. The witnesses might take that back and look at it.

Coming back to the point I made about SWA, having the statistics on the appeals office again gives us an indication of where the system is falling down. The report is presented in a way that the actual targets are not in it. The Department has assisted us in providing it in the supplementary information, and that is welcome. Again, the objective behind this report seems to be lost on the Department of Public Expenditure, NDP Delivery and Reform. I would love to know how many Members of Parliament, either TDs or Senators, have been involved in the engagement that the Department of Public Expenditure, NDP Delivery and Reform sets out regarding how it structures this report. The report is for us, yet it is not being presented in a manner that is of benefit to us. As I say, that is a criticism of the Department of Public Expenditure, NDP Delivery and Reform and the way it is presenting this. It is not a criticism of the outputs coming from the Department.