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
We are now in public session. The topic for discussion is social welfare appeals. When we were setting our schedule of meetings for this year, members looked for this meeting to examine the system for appealing social protection decisions, in particular, the length of time involved. Members have been provided with some documents from the Free Legal Advice Centres which is anxious for us to note its work on the appeals situation. I am pleased to welcome officials from the Department of Social Protection to discuss the matter with us. I welcome Ms Geraldine Gleeson, chief appeals officer, Mr. Ken Kelly, appeals officer, and Mr. Brendan O'Leary, appeals officer.
I draw the witnesses' attention to the fact that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence in regard to a particular matter and they continue to do so, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing ruling of the Chair to the effect that they should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable. I now invite Ms Gleeson to make her opening remarks.
Ms Geraldine Gleeson:
I thank the members of the committee for giving me this opportunity to address them on the issue of social welfare appeals. The issue which members wish me to address today is the delay being experienced by appellants in the processing of those appeals. In my opening statement, I will outline the current position with regard to processing times and the number of cases on-hand, and also outline the likely outturn for this year.
As members are aware, the number of appeals submitted to the social welfare appeals office, SWAO, has increased dramatically since 2008 with the number of receipts doubling from an average of 15,000 a year to 35,484 in 2012. While this number is high, to put it in context, there is now on average in excess of two million claims made for payment across the range of social welfare schemes on an annual basis. Members will also be aware that as a result of actions taken in the SWAO to address this increase, including the assignment of additional appeals officers whose numbers have increased from around 17 to 40 and improved processes, the number of cases finalised has risen from an average of 13,500 to 32,558 in 2012. Nonetheless, because of the increase in the number of appeals, our customers have experienced significant and unacceptable delays in the time taken to conclude appeals.
As of 2012, there are two aspects to the delays being experienced. One is that the processing time for appeals covers all phases of the appeal process, including many elements which are outside the control of my office. In the current economic climate when all areas of the Department are under pressure, the reality is that an appeal case may experience several delays along the way. Delays can be experienced when the appeal is sent to the Department for a submission from the deciding officer who originally decided the case or in the medically based schemes where further examination by medical assessors is required and where most of them would get a second go at the cherry. In some cases where means might be the issue, there might be a subsequent investigation by a social welfare inspector. Each of these areas carries its own possible delay. The schemes which have the highest waiting times are the medically based schemes. I have provided members with a table showing the breakdown in processing times for these schemes between the Department and my office. I have picked the past six months of 2012 because that is when our own processing times began to significantly improve. I have also provided figures for January of this year. What the table shows is the appeals office significantly improved its processing times. For example, the first column which deals with carer's allowance shows that in 2011, the time taken in our office was 19.6 weeks. In 2012, the time taken was 13.2 weeks. The same is true for disability allowance so members can see that the time taken in the appeals office has diminished while the times for the Department have gone up. I will address the reason for that in a minute.
My office is liaising on a regular basis with the Department with a view to improving these processing times. I understand that the Department is actively involved in clearing backlogs on a number of these schemes. I am sure some members have been briefed on this. They include carer's allowance, invalidity pension and disability allowance. My understanding is that good progress is being made with these backlogs with the invalidity pension backlog fully processed, the carer's allowance backlog on target to be processed by the end of March and the disability allowance backlog on target to be processed by the end of June. The clearing of this high volume of initial claims has resulted in a large increase in the level of appeals at a time when all available resources in the Department are involved in claim processing. The Department informs me that as the backlogs are reduced, more resources will be focused on appeals with the intention of reducing delays within the Department.
Some delays have also developed in the processing of medical assessments and reviews due to a combination of factors including the increased workload for medical assessors and the reduced availability of medical assessors due to retirements. The Department is addressing this issue and I understand it recently ran a competition to establish a new panel of medical assessors. Three new medical assessors were appointed from this panel and have been working since November 2012. It is expected that a further eight medical assessors will be appointed in the near future.
The second issue relating to processing times was the very significant disparity between the time taken for a summary decision and an oral hearing. For example, in 2011, the average processing time for a summary decision was 25.1 weeks whereas for an oral hearing it was 52.5 weeks. This was a result of the operating model within my office whereby files were assigned to an appeals officer who either decided the appeal summarily or returned the file to be listed for an oral hearing, most likely by a different appeals officer.
This gave rise to an inherent delay because the file was placed in a second queue to await an oral hearing.
Under a new model which has been in operation since January 2012, where an officer is assigned a caseload, he or she will either decide cases summarily or conduct oral hearings, if they are warranted. This has rebalanced processing times between oral hearings and summary decisions. In 2012 the average length of time to deal with an oral hearing was 39.5 weeks, while for a summary decision it was 27.8 weeks. The overall reduction in this regard is 10.2 weeks.
The number of cases in hand at the end of January was 19,465. As of today, there are 1,000 fewer cases in hand. The figure of 19,465 is approximately 2,000 more than the number of cases in hand at the end of 2011. The reason for this is that receipts in 2012 rose as a result of the merging of the community welfare service with the Department's appeals service. In addition, the number of cases finalised in 2012 was down by a small margin, some 1,400. The reason for this was twofold. In the first instance, eight officers retired up to the end of 2011, which gave rise to a huge loss of experience in 2012. Also, between turnover and additional resources, 25 of our current complement of 40 appeals officers had less than 18 months experience at the end of 2012. Throughout last year the experience and capacity of these officers have increased. This is evidenced by that fact that of the 32,558 cases finalised in 2012, 12,835 were finalised in the first six months, while the other 19,723 were finalised in the second six months. In January this year the number of cases finalised was 3,746 as compared to 1,986 in January 2012.
With regard to the likely outturn in 2013, it is expected that the number of cases finalised will be some 6,000 higher than 2012. This is based on the results for the second six months of last year. If the number of cases received this year is the same as last year and if 39,000 are finalised, the balance in hand will drop to approximately 15,000.
I thank Ms Gleeson for her presentation. I have regular dealings with the social welfare appeals office and take the opportunity to thank the staff of that office for the courtesy I am always shown.
In the context of the table Ms Gleeson provided, it is disappointing, despite all the work that has been done, that matters have not really improved with regard to the period between the making of an initial application and an appeal. In some instances, they have marginally disimproved. I take the point that some of this is outside the Department's control. I am aware that officers in Limerick dealing with appeals related to supplementary welfare applications still have not received some of the material they require. This is despite the fact that the appeals in question may have been made between six and eight months ago. That is outrageous, particularly in the context of making a basic payment. As Ms Gleeson is aware, supplementary welfare is designed to tide people over while they are waiting for something better to come along or for a decision on their social welfare claims. It is unacceptable that people are being obliged to wait six to eight months for payment because the Department simply has not furnished the relevant information to the appeals office.
I am glad that the processing times between the holding of oral hearings and the making of summary decisions have been reduced. However, as I understand it, there is still a difference of three months in this regard. According to statistics provided by FLAC for 2011, the success rate in oral hearings was 48%, whereas that in the case of summary decisions was only 25%. FLAC recommended that appellants be informed of this and encouraged to seek oral hearings. It has been my experience that appellants are being informed that if they seek such hearings, it will be months before they are held, which is something of a deterrent. Rather than deterring people or advising them to take a course of action which may lessen their chances, we should advise them on the possibility of achieving greater success through oral hearings. Will Ms Gleeson provide an indication as to when the gap in time between the holding of oral hearings and the making of summary decisions will be completely closed? In other words, when will there be a similar timescale for the two?
In the context of the Department not sending on material in respect of invalidity pension and carer's allowance claims, etc., as stated, I deal with the relevant staff on a regular basis and do not believe what is happening in this regard has anything to do with their competence or ability. There are simply too few such staff. A follow-up to the Croke Park agreement is being negotiated. My understanding was that one of the fundamental terms of the original agreement was that staff would be readily deployable. In other words, the Government is supposed to be in a position to take staff from places where they are not exactly worked and redeploy them to areas where existing staff have too much work in hand. This does not seem to have happened to any great degree in the Department of Social Protection. This provision should be entrenched in the follow-up to the Croke Park agreement. There has been a great deal of public debate about people who work in certain areas and payments for overtime, working unsocial hours, etc. From the point of view of customers, namely, those the public service is supposed to serve, a fundamental provision in this regard should be contained in the follow-up to the Croke Park agreement. This is part of the original Croke Park deal which has not been implemented.
Some time ago FLAC made submissions at a meeting we attended in the Mansion House and one of the points it made - I do not say this in a critical way - was that, under Article 6 of the European Convention on Human Rights, the social welfare appeals system was required to be fully independent. It is not, of course, fully independent because it is actually part of the Department of Social Protection and there is no security of tenure for appeals officers, etc. Another important point FLAC made was that there was not equality between an appellant and the Department in the event of an appeal. For example, social welfare appellants are not entitled to civil legal aid to assist in his or her appeal. This is despite the fact that he or she will be up against someone on the other side who is an expert. More importantly, there appears to be a problem in that the social welfare officers who represent the Department at appeal hearings have access to more information than appellants who do not have full access to the information on their cases which is in the possession of the former. That seems fundamentally unfair. However, I will not belabour the point.
I thank our guests for the work they are doing. I do not doubt their bona fides for one moment, but when I consider the totality of the situation in respect of someone on carer's allowance whose application is refused in the first instance - as is the case with many individuals - and who then makes an appeal, I am aware that the duration of the process has been reduced by four weeks. However, it still lasts for over eight months. The position on disability allowance applications is much the same. The situation with regard to invalidity pension applications has worsened because the period has lengthened from 35 weeks to 39. I appreciate the work our guests are doing, but there is still a long way to go.
Go raibh maith ag na hoifigigh as an méid a bhí le rá acu.
I find these sessions both useful and informative in the context of the data provided. I have dealt with a number of social welfare appeals on behalf of constituents and fully understand the complexity of the cases which come before our guests and why there may be delays in individual cases. I am also aware of the workload involved.
I have always found the officials I have dealt with to be courteous and helpful to appellants which is not to say that decisions are always favourable. There will always be those whose appeals are not allowed.
There are a number of issues to be addressed in relation to appeals. The first issue for the Department is the scale of appeals, which is stark. Another issue is the startling statistics on delays in processing appeals. Many appeals decisions are favourable to appellants. While I am not suggesting the Department should not uphold appeals, it indicates an underlying flaw in the initial processing of applications. People who make applications are not being assisted with complex forms. To this day, there are forms in which you insert your name, address, PPS number, age and grandmother's maiden name, the last of which I had to ascertain for my father-in-law recently. That information is already on file and on a computer already. It is daunting for people who do not often engage with services or who are semi-literate. They should be able to give their PPS number at a social welfare office and have those details come up unless there has been a change. A grandmother's maiden name will not have changed. They are simple things but the system is complex. The initial application process must improve. If it does, the Department will find it is not overturning decisions on appeal. I have argued with the Department that before an application goes to appeal, it should be flagged that people can apply for a review first. A simple thing like a phone call from a deciding officer to say he or she has not been supplied with a particular letter whether as a result of an oversight or because it has not been obtained from a hospital would reduce the costs to the Department.
I am worried about the figures before the committee. I acknowledge that there has been a great deal of progress. The Department has outlined the reasons for delays in medical assessments with three new medical assessors having been appointed while one is on maternity leave and eight more are to be employed later this year. Hopefully, those appointments will address the five key medical claims. The figures supplied to the committee show that there are 37 schemes in total, of which 23 involve average waiting times of more than 40 weeks. Of those, nine involve waiting times of more than a year. If one rules out the medical assessments, seven schemes have waiting times of more than 50 weeks and 15 of more than 40 weeks. It is not just the medical end of things that needs to be addressed. I remember that when the Department made a previous presentation to the committee we were told that the additional staff rehired for one year were supposed to do the devil and all and they did for a while. The progress made in 2011 was, however, undermined in 2012. What changes will we see for next year?
The second table in the presentation document circulated to the committee shows that significant progress has been made in the appeals office to deal with the backlog in invalidity pension and disability allowance appeals. The figures suggest, however, that there has been an increase in delays within the Department itself. There has been a substantial increase in the delay in carer's allowance which has gone from 19.8 weeks to 34 weeks. The delay is also increasing in relation to invalidity pension within the Department while it is coming down in the appeals office. On foot of the recession and the severe resultant distress, a lot of people have raised with me the issue of the supplementary welfare allowance, which is an emergency payment. If it is refused, an applicant has absolutely nothing. While the waiting time for a summary decision is not too bad at 17.6 weeks, the waiting time for an appeal is 22.9 weeks. While the delay may sound good by comparison with delays in other appeals, it means a family or a person will be basically destitute for that time. Can that be addressed? They are people who do not have another payment on which to rely.
I do not know if the Department has experienced the same thing, but I find increasingly that where an appeal has been allowed, there is a delay by the Department in implementing the decision. If an appeal is allowed on 1 January, it is sometimes the end of January before an appellant receives a payment. It is even longer in some cases where people apply for backdated payments to which they are entitled. In some cases, it has been a number of months. I do not know whether it is a fault of the Department or the result of another backlog.
I raised with the appeals office previously that one of the delays in processing files results from the need to physically transfer the files. Has progress been made to transfer files electronically to ensure that the consideration of a file can begin more quickly and that the process starts immediately where a medical assessment is required and even before an assessor can fully consider it?
A great deal was covered by Deputy Ó Snodaigh and I am not sure there is much more to ask. I thank the witnesses for the report. Progress has been made on appeals but there are still many difficulties in terms of having experienced staff who can deal with cases sensitively and properly for people who are unwell. Is the moratorium still in place on staffing for the appeals office? It appears to be the key problem including in relation to the medical panel. I was on to the appeals office during the week to discuss a case in respect of which the files must be obtained from the Department which will take months. It is crazy that the appeal has been lodged in the computer and is ready to go but we are waiting for the information to come over from the Department. Is there any way that can be changed?
There are strange issues. Where a person applies for domiciliary care and disability allowance, most of the work will already be done, but there are still difficulties in obtaining the domiciliary care approval and the matter goes to appeal. I have a case where a 16 year old has had an appeal in D'Olier Street since last year. I cannot understand what the problem is and why a decision cannot be made more quickly. The information is already on file from when she applied for domiciliary care in the first place but extra information is needed. I cannot understand where a case is ongoing why there is such a lengthy wait for an appeal given that the information is already there. I understand where it is a new application.
Deputy Ó Snodaigh made the point that many people appeal rather than apply for a review which they do not realise is available and which can be dealt with more quickly. I will leave it at that as many of the points have been covered already.
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.
I shall commence by saying the nice things first. I thank the delegation for attending. I compliment the staff who work in the appeals office. Whenever we ring them they are always informative, courteous, return our calls and inform us what is happening.
They are the nice remarks.
The witness referred to the waiting and processing times. Unfortunately, the reality on the ground does not reflect those times. I dealt recently with an appeal for a carer who was waiting two and a half years for a decision on her carer's allowance. That is certainly not reflected in these figures. The average processing time for the invalidity pension is 48.7 weeks. That is nearly a year. It is very hard to tell somebody that their claim is being dealt with when they are waiting a year for a decision on the application. It is just not good enough for the people concerned. We can bandy figures around here and dress them up to look as attractive as we wish, but the fact is that a person must wait a year for a decision on an invalidity pension.
The witness also referred to the supplementary welfare appeals. I am encountering many problems for people who are living on supplementary welfare allowance while waiting for appeals for invalidity, disability or other social welfare benefits. That allowance is not recognised as a payment for things such as third level grants. People cannot get the third level grant because they are on supplementary welfare. It is not recognised as a payment. We must sharpen up and sort things out for these people. Their children are waiting for a payment to go to college, while they are living on supplementary welfare allowance. Again, it is not good enough.
With regard to the oral hearings, according to the figures 53% of people who have oral hearings get a favourable result, as opposed to a rate of 30.6% for people who do not have an oral hearing. Obviously, the oral hearing is the way to go. I know, from dealing with this, that there is great compassion and fairness among the appeals officers, which one does not get from a written report. They listen to the people's stories about what life is like for them. It is a little like how we are listening to the survivors of the Magdalen laundries. On a piece of paper it does not cut ice in the same way. The witness answered the question about waiting for the files from the Department, but, to be honest, it is a disgrace. Once a decision has issued on illness benefit or whatever, the Department is finished with the file and should give it to the appeals office. What is the waiting for? What more work does the Department have to do with it?
I took the time to meet the chief medical officer in the Department of Social Protection to discuss the delays in the medical based schemes. Since that meeting, things have improved dramatically for me. I understand the system better and can guide my constituents. However, they are the people who come to see me. What about the people who do not? I had four cases and instead of going to the appeals office I sought a review. All four cases were successful. The chief medical officer is now using those four cases for training purposes within the Department to show the type of people who should not have slipped through the net.
Can the witness recommend to the Department, with regard to the medical based schemes, that a more detailed medical history be sought on the application forms? That is where all the medical based applications are failing. They do not provide for a sufficiently detailed report, and when a detailed letter is later sent from a doctor or consultant the Department changes its mind. If the medical report was more detailed in the first instance, the Department could avoid many appeals. Can the appeals office make that recommendation? We have certainly made it, but the Department is obviously not listening. In addition, the applicants' general practitioners, GPs, are getting fed up with having to issue letters every day for the Department of Social Protection. They are beginning to brush people off saying they have already provided a letter and report when people seek a more detailed report. A girl rang me today about her appeal. She has been waiting for two years and has approximately 12 letters from doctors, four from the same GP who is getting absolutely fed up of the whole business. That is the reality on the ground.
There is another matter. When a medical based application is turned down by the Department on a medical ground and an applicant appeals the decision, the Department does not carry out the means testing part of the application. An applicant who goes through an appeal on medical grounds and is successful will think: "That is great. My disability or carer's allowance has been approved." However, they then discover the means testing has not been carried out. That might mean the application will be turned down again and might necessitate another appeal on the same application. The Department should carry out more tasks in tandem. It should carry out the means test along with assessing the medical section.
Perhaps the witness will address those issues.
The witnesses are very welcome. I acknowledge the improvements but it does not make for easy reading. Like Senator Moloney's experience, I met a woman recently who had been seeking invalidity pension for one and a half years before approaching me. She believed the entire country was down on her. With the help of the Oireachtas line, we got a response for her within approximately six weeks and it was positive. I do not understand why the system could not have been successful for her. The witnesses might explain that because people are at their wits' end with these delays.
What percentage of applications across the various schemes are granted without going to an appeal? The witness referred to it but perhaps she would go through it again. How many of those applications are granted on appeal? I deliberately ask Ms Gleeson this question because I think the new policy of management for managing budgets is to put everything to appeal. I have grave concern about that. We are driving people mad. They are totally frustrated. Some people are being put on the bread line because of this. There is a hostility among the public because of this type of treatment. The hostility is wider than this issue, of course, but it is not good. What would improve things for Ms Gleeson? I realise she is doing her best with the meetings and I acknowledge the improvements she outlined. However, if she discussed what would improve matters we might be able to help.
Ms Gleeson said something that I do not understand. She said there seems to be better co-operation between the community welfare officers and the Department. She is in the Department as well. How does she not know what the reason is? I ask her to clarify what she means by using the word "seems".
Another trend I have noticed relates to the domiciliary care allowance for parents with disabled children in the home. When they put in the application and it is refused they are told that unless they have new evidence they should not get back to the Department. They might not have new evidence but the case might not have been presented well the first time. It is wrong that they are just rejected. Will Ms Gleeson comment on that? I wish her well, but huge improvements must be made.
I welcome the personnel from the Department of Social Protection. As I have said time and again, statistical information is fine but it is not the reality on the ground. Can we get a breakdown of the overall processing times county by county? The times might be different from county to county. It was interesting to note in the Ombudsman's report last year that approximately one third of the complaints to the Ombudsman related to the Department of Social Protection, and many of those cases were successful following appeal to the Ombudsman. Is that an indication that a more transparent interviewing process is required at the local office? Would this not reduce much of the bureaucracy and the number of cases going to appeal?
Appellants are very vulnerable and have very little income. I see little joined-up communication between community welfare officers and the Department of Social Protection. People are often told to go to the community welfare officer to receive an interim payment, but they do not always receive it. They are left very vulnerable and depend on the goodwill of relatives and friends to support them and give them food. Like other members, I have dealt with cases in which people have had to wait nearly 12 months for an appeal to be heard. This is not good enough. Self-employed persons are particularly vulnerable through no fault of their own. They might have invested heavily in a business that went belly-up when the economy went into recession. Their cases seem to take longer than others to be processed.
Let us consider the circumstances of those who require the farm assist payment. If there is an old house in the farmyard, as was traditionally the case, it causes untold problems as it is regarded as a second home. The question is asked why it is not rented or income is not generated from it. Such houses should be condemned by the HSE as not fit for human habitation. They might have been the houses of farmers' parents who might have lived into their 80s and 90s and they might not have great sanitary facilities, yet the Department of Social Protection cannot understand why they are not habitable. It classes such houses as habitable and states they should be generating income. This causes untold problems for farmers who are trying to obtain the farm assist payment. Perhaps this issue might be examined in a humane fashion. There is a great lack of assistance to help people with their appeals and I would really appreciate it if something could be done in this regard.
Let us consider the oral hearing system. When an officer comes from Dublin or elsewhere to a region, how many cases does he or she deal with each day? People are left waiting for several months for an oral hearing. This is not good enough and it is not a question of a shortage of staff as very few cases are dealt with on a given day. Perhaps the process might be speeded up. In some instances, it is 11.30 a.m. before an appeals officer arrives. He or she may take one case before lunch and perhaps two afterwards and that is it for the day. This is not good enough because people are suffering as a result of the delays.
There is a problem with forwarding files with additional information to various Departments. Additional information may not be forwarded to the Department from the local office and the applicant only discovers this when someone makes a telephone call on his or her behalf. Alternatively, he or she discovers the information has been lost in transit. These matters niggle people and I would welcome Ms Gleeson's comments. It all contributes to bureaucracy and a system that leaves vulnerable people in dire poverty.
If I have another question, I will revert to the delegates. There are strange happenings in the farm assist scheme.
Ms Geraldine Gleeson:
I will go through the questions in chronological order where they do not overlap.
Senator Marie Moloney has made the point that we have given average processing times and that they do not reflect the reality. The Senator knows of a case in which the waiting time was two and a half years and of an invalidity case in which the waiting time was over one year. I accept absolutely that it is an average processing time and that there will be people on the wrong side of it. I notice that we receive many parliamentary questions about individual cases. When I am clearing them, I see what is going through. In recent months files with my office have almost invariably been assigned to an appeals officer. While there would have been a delay in my office owing to cases being put in the press until they were assigned, there is very little delay in my office in that regard now. However, I accept the Senator's point absolutely that, notwithstanding this, people are left waiting for unacceptable periods, for various reasons. The main way forward is what we are doing, that is, working very closely with the Department to ensure that as we reduce our processing times, it will reduce the time during which cases are within its remit.
It has been stated appellants cannot get a third level grant and that they are in receipt of supplementary welfare allowance because they are waiting for a primary payment. I do not know why that is.
Ms Geraldine Gleeson:
It has been stated an oral hearing is the only way to go. I repeat what I said about what I call the subjective schemes, the medical schemes. This is where most of the focus by anyone who is inquiring is directed. We are making positive decisions on a significant number of these cases by way of summary hearing. I hope I get that message across.
On the point that an oral hearing is the only way to go, an appeals officer is often the first person to meet the appellant on his or her journey. Even in medical cases, one does not see the medical assessor or deciding officer. The fact that the appeals officer is the first person one meets makes a difference because the person will present his or her case more cogently in person than he or she can on paper. The experience of the appeals officer comes into play when he or she examines the medical evidence from the appellant's general practitioner or consultant. He or she examines the appellant's account of the difficulties that arise. An experienced officer can see whether he or she is likely to make a positive decision in a case. All we are saying is that we do not want to bring such cases to an oral hearing. In general, I do not favour saying to people that they can request an oral hearing if they like because it could give rise to an unreal expectation that they will receive one. In some cases, there is clearly nothing to be gained from it. I refer, in particular, to means and contribution cases. Generally, where an oral hearing is requested, we grant it, unless we find we can make a positive decision in the case at the level of summary hearing.
I was asked about the delays in receiving files. A couple of issues arise. The delays are encountered in the medical schemes.
The delay is due to the fact that it has to go to the medical assessor for a different-----
It is not just in the medical schemes. I particularly referred to the cases where they were not waiting for medical evidence only. If we telephone, we are told they are waiting for the file from the Department. That is the line we get much of the time.
Ms Geraldine Gleeson:
The other big schemes include the jobseekers' schemes. Although there may be in individual cases, in general, there is not a long delay in getting files from local offices. I will come back to the issue about the community welfare office, but the main delays lie with the medical assessor. That is the first part. The second relates to the fact that the Department is working on digital documents. Unfortunately, in preparing a case for us, these must be printed off and pulled into a file, which results in a delay. As I said, much effort is going into speeding this up.
We can make recommendations on the forms and we do all the time. For example, we made recommendations on domiciliary care allowance and, in particular, the level of information being given to people who are turned down and the wording of the disallowance. There was a huge improvement in the wording after that recommendation was made.
The main development in regard to forms which is very welcome and which I have mentioned concerns the MR99 form designed for the medical schemes. It looks for the appellants' comments. For example, in the case of domiciliary care allowance, it asks about the interaction with the child, communication and all of the difficulties encountered on a day-to-day basis. It also asks for the person's own account. Appeals officers find this extremely useful.
Ms Geraldine Gleeson:
It has been included for 18 months perhaps. One of the problems is that in the schemes which are digital, a bar code reader has to be developed to process applications automatically. As they are being dealt with manually, such readers are not as widespread as they should be, but they are certainly working on making them widespread. We are certainly very much in favour of them and they can only help an appellant's case.
I refer to disability allowance and making the medical assessment but not the means assessment. That came about because social welfare inspectors were under huge pressure in investigating means. It was being found that many cases would be investigated for means but were turned down on the medical evidence. The decision to do it this way was a very practical one to ease the pressure on the inspection branch. I fully accept that in these cases where it means a second bite at the cherry, it is very difficult. When they do this, they make it very clear to the person concerned that we have only made a decision on the medical aspects of the claim. This is something that will be reviewed when there is not as much pressure on inspectors. The other point is that those involved in this area did not make a desk assessment of means until recently and they have moved significantly. Where they are making a desk assessment, they do not wait.
Senator Fidelma Healy-Eames asked what percentage of cases were granted initially and what percentage were granted on appeal. Of the number who make an appeal, 50% are successful, but of that 50%, half are successful because the applications were reviewed by the Department.
It would be good if it could be supplied to us because we cannot know if the Department is working successfully. If the majority of cases end up being appealled, we will know there is a problem at first stage. Some 50% of appeals are successful.
Ms Geraldine Gleeson:
Some of our local offices are operating the Intreo system, about which members will have heard. What is happening in the offices is that they are operating as a team when a person comes in through the door; there is complete co-operation at the initial stage which is cutting down the number of SWA claims. There is much co-operation, but that is only in Intreo offices, but they are being rolled out progressively.
In terms of the issues involved, there are pockets around the country. There would have been issues about the level at which a decision-maker was available in the community welfare service. In some areas the decision-maker would have been the community welfare officer but in others, particularly for a negative decision, it would have been the superintendent. I think that was an issue which emerged following the integration. In the pockets where the decision-maker used to be the superintendent, there were some delays. As I understand it, most of the issues involved have been ironed out and things are working much more smoothly but delays developed and that was the reason.
Ms Geraldine Gleeson:
As I said, to try to deal with this, the assistant secretary who is in charge of all the medical schemes, the chief medical officer and I meet on a regular basis. There is close liaison to identify where the road blocks are, why they are happening and whether there is anything we can do to speed up the process. That is why I say there were improvements resulting from that interaction.
Yes. A person should get something when he or she is facing destitution. I have spoken to people from the Society of St. Vincent de Paul who tell me it is a serious problem and that they must try to supplement people with food and so on when they are waiting for their appeal to be processed. That is not good enough in this day and age and it is a serious problem in some parts of the country.
Ms Geraldine Gleeson:
The Deputy asked for a breakdown by county. We do not have the figures to hand, but we can get them for him. My colleague, Mr. Kelly, has pointed out to me that under the new model, files are assigned by county. We would have to get a separate file to organise the results of appeals by county. We have done this previously. I accept that the cases of self-employed persons take longer, as such cases often involve getting a set of accounts and there might be delays with the accountant. We have noticed that there is generally an investigation by an inspector. That takes time, by definition, because an inspector has to go out.
The Deputy also spoke about what was seen as a second home when a farm assist application was being considered.
It would be impossible to separate it from the farmyard in order to sell it to somebody else. There is no reasoning. People are being denied farm assist payments because houses they are in no position to sell are being classified as second homes.
This is a very grey area and needs to be examined, as some flexibility is needed. The current approach is causing serious problems. People on jobseeker's allowance are being advised to apply for a farm assist payment as a more appropriate payment. When the problem I have mentioned prevents them from getting a farm assist payment, all of their payments are discontinued, even though they used to have a genuine entitlement to a payment. Having agreed to change to a different payment, they are debarred from receiving any payment. Perhaps the Department will examine the matter.
I thank the officials from for coming to this meeting. I appreciate the presentation they have made and the excellent quality of their answers to our questions. We do not always have that level of insight and openness from delegates. The level of detail provided can sometimes be a little skimpy, but it has been helpful today. I acknowledge the importance of the work of the appeals officers which has a significant impact on people's lives. It must also be acknowledged that the number of finalised cases has increased by 140% since the middle of the last decade. That is important.
Like other members, I encounter a substantial volume of people at my clinics and in my office who are frustrated by the delays they encounter as they use the system. Perhaps this problem is not mentioned in the media as much as one might expect. The people who are using the system are isolated, rather than being part of a collective group. Approximately 60% of those who use the SUSI system are in the appeals system. We have heard a great deal about SUSI, but we do not hear as much about the long delays encountered by many people after they have been dealt with in the SUSI system. There is a sense of isolation among the users of the system.
It has been suggested there is not necessarily a problem with the local offices. Can we get a county-by-county breakdown of waiting times? If the waiting times of applicants in some counties are much higher than the national average, is a system in place to flag the problem and tackle the issues in question?
I understand that when payments are reviewed and stopped, priority is given to cases involving disability and invalidity payments in order that they can be reviewed as quickly as possible. Is that accurate? If it is, would it be possible for that approach be extended to all payments? In that context, I would like to mention an issue I have come across in my office. If a person whose payment has been stopped pending a review decides to submit an appeal, he or she has to wait a long time, which is a difficulty. The officials might be able to clarify the matter and give me a little more information on it.
The arms of the State need to be responsive to the needs of citizens. When people need the State to step in and assist them, they expect it to respond and help within a reasonable timeframe. The impact that a shock event such as illness, an accident or the loss of one's job can have on a person's life should never be underestimated. That is bad enough, but it is very difficult for people to have to wait for the best part of a year for assistance. It is not good enough for citizens who have worked hard and paid taxes for all their lives - honest people who have always done everything by the book and tried to do the best they can - to be refused something they believe they are entitled to and then have to wait a long time for State assistance.
Has the social welfare appeals office made projections for reductions in appeal times for the years beyond 2013? While I acknowledge the work done to date, I emphasise that we need to reduce these waiting times further because they are far too long. We need to ensure the system is as efficient and as responsive to users' needs as possible. I would be interested to find out more about the projections for 2014. Are there ambitious targets for that year and the years beyond it?
I welcome our guests and thank them for their presentation. As Deputy Griffin said, their comprehensive answers are much appreciated. On my own behalf and that of my staff, I genuinely thank the social welfare appeals office for the service it gives to public representatives. I acknowledge that it is unfailingly courteous and helpful.
I was struck by the figures mentioned with regard to invalidity pension and disability allowance. In both cases, the social welfare appeals office seems to overturn decisions with extraordinary frequency. The figure is 51% in one case and 46% in the other. One in two decisions is likely to be overturned. I am curious to know whether lessons are being learned. When Ms Gleeson spoke about the connection between the appeals office and the Department, she referred to their independence. What lessons are being learned? Do the appeals office and the Department share knowledge? If half of decisions are being overturned by the appeals office, there is something very wrong. I am interested to know what steps are being taken to learn from this unnecessary duplication to try to avoid it in the future.
I am aware that public representatives are and must continue to be a constant pain in the neck with our parliamentary questions, etc. Those are my words rather than those of the officials. As public representatives, we demand much of the social welfare appeals office's time and command many of its resources. We certainly use up much of the time of staff with our constant barrage of queries. By the same token, we could be a much more useful resource. The 166 Deputies and 60 Senators offer a great deal of assistance when we meet the clients of the appeals office, but I suggest we could be given more information, advice, direction and guidance. That suggestion is probably more relevant to the Department than to the appeals office. The officials who are present can respond to it, if they wish. I was going to ask whether the officials knew what percentage of their files had representations in them. I am not sure whether they have information on the inquiries made by public representatives. I imagine that a large percentage of the files have been the subject of representations.
Public representatives could be a useful resource if we were given more constructive information, guidance and assistance. As the first port of call for people considering appealing a decision on an application for a social welfare payment, we could be put to better use.
On the running of the social welfare appeals office, how many staff worked in the office in 2000 when it processed in the region of 17,000 applications per annum? The office aims to process 40,000 cases per annum and I understand it currently employs 40 staff. Is that correct? What is the budget for running the office? On the basis of a back of the envelope calculation, if 40 staff are expected to deal with 40,000 applications, each staff member will process approximately 1,000 appeals in the course of a year.
While my final question may appear a little trivial, it relates to a bugbear of mine and reinforces my argument for providing Members of the Oireachtas with information and guidance that they could pass on to constituents. Does a letter from a consultant have superior status to that from a general practitioner or is that an old wives' tale. If it is a myth, I am guilty of perpetuating it because I encourage constituents to obtain a consultant's letter. Does the social welfare appeals office take a formal position on this issue?
Ms Geraldine Gleeson:
Yes, although I should clarify that these are average figures across all appeals, in other words, they relate to every case that is closed. This will include revised decisions which refer to cases that are revised by the Department, as well as those which are not revised and come back to the social welfare appeals office. The figure for time spent in the Department in respect of carer's allowance appeals is correct.
An analysis of the table suggests that if the joint committee wishes to address concerns about delays in processing appeals, it is pointless inviting a delegation from the social welfare appeals office to come before us. The office has demonstrated that it has made considerable progress in processing appeals, whereas the Department is moving in the opposite direction. The presentation also indicates that 69% of delays in processing invalidity pension appeals can be attributed to the Department, while the equivalent figures for carer's allowance, disability allowance and illness benefit appeals are 60%, 58% and 49%, respectively. If one was seeking to establish a process to improve processing times, one would tackle the largest problem, that is, delays in the Department.
Ms Gleeson has indicated that the office is now working more closely with the Department and has held a couple of meetings with officials. In terms of trying to tackle this issue, a full-time, cross-functional, interdepartmental project team needs to be established in the office. The chief medical officer, the assistant secretary and the social welfare appeals office are much too busy to rely on infrequent meetings to address this issue. A permanent project team must be established to work on this issue if the delays are to be tackled. This team must prioritise the main source of difficulty, namely, the Department.
With regard to carer's allowance appeals, the two tests for carer's allowance are, first, that the applicant is providing full-time care and, second, that the person being cared for needs full-time care. The second test is carried out by medical assessors. Are the medical assessors qualified doctors? I have examined a number of the decisions the assessors have made and compared them with the condition of the applicants which I have personally observed. Some of the decisions that, on medical grounds, the person being cared for does not need full-time care are unbelievable. They suggest a serious medical assessment is not carried out in many cases and that some form of paper exercise is carried out by a person who is either not qualified to assess medical evidence or simply does not care. It appears the assessors have a quota to fill and once this has been done, they are not concerned about other applications. This is a major problem.
I met someone with cancer who is physically incapable of moving and experiencing associated mental health issues. The interpretation of a medical assessor in this person's case was that full-time care was not required. This is not acceptable. I continually advise persons in such circumstances to reapply for the allowance as it is the only avenue open to them. However, this approach adds to the workload of the office. I have serious concerns about medical assessments in the case of many social welfare payments.
The flow charts highlight that approximately 7% of appeals are withdrawn. On what basis are they withdrawn? Does this occur when people emigrate, find employment or experience another significant change in their circumstances?
The table on appeals outcomes shows the following categories: "Allowed", "Partly Allowed", "Revised DO Decision", "Disallowed" and "Withdrawn". The term "DO" refers to deciding officer. In the case of revised DO decisions, are the outcomes generally favourable to the applicant? If one combines the percentages pertaining to the outcomes shown for the first three categories - "Allowed", "Partly Allowed" and "Revised" - the figure indicates the extent to which initial decisions were wrong or the deciding officer was not fully aware of the details of the application. Is that correct?
Ms Geraldine Gleeson:
To respond to Deputy Griffin's question on the variations in waiting times on a county by county basis, I understand the Deputy was not referring to the medical schemes. Every nine to 13 weeks we examine the files that are with local offices to identify if there are blockages in a particular area. We have a system with each of the local offices, whereby they are sent a reminder in the case of certain files. This system works well because there are so many offices that the numbers in a particular office are relatively small. This means that when one puts pressure on a local office to provide certain files, it is able do so. The system in this regard is different from that for medical schemes which are all bunched together.
The Deputy referred to disability allowance and invalidity pension appeals in the context of reviews rather than initial applications and raised the issue of priority. I assume priority is afforded within the medical assessment side in order that if a decision is reviewed, these appeals receive priority. That is the correct approach. These schemes do not receive priority in my office. The only scheme that receives priority is the social welfare allowance scheme.
Every appeals officer will agree that a higher bar is set in a review case, by which I mean that where someone's payment is being stopped, we will hold the Department strongly to account to ensure it shows there has been some improvement in the condition of the individual concerned. If we do not see such an improvement, that would be the basis on which we would allow a case. While we do not prioritise such cases, a higher bar is set for cases in which a person who has had the benefit of a payment on the basis that he or she had a certain condition and subsequently has that payment removed following a review. To uphold such a decision, there would have to be a clear understanding of the reason the payment was removed, which means one would need to see that there has been an improvement in the condition of the person since the payment was granted.
On the issue of projection beyond 2013, as I often state, the appeals process, by definition, is lengthy.
That is particularly the case where it is an oral hearing. In the good years the oral hearing would have taken around six months for the total process. Certainly, we would hope to get back to that. The reason it takes six months is for good reason as there are steps along the way. There is the review by the deciding officer, the review by the medical assessor back to us, and now an oral hearing must be scheduled. We examined this some years ago and decided that adds at least eight weeks to the process. If an appeals officer decides it must be an oral hearing, he has to wait for the oral hearings for that county, he has to schedule them and there must be a premises. He must give three weeks notice to the appellant and notice to the witness. There are a lot of logistics that go into setting up a hearing. To answer the Deputy's question, we would hope to get back to an average of six months for an oral hearing.
Ms Geraldine Gleeson:
The summary decisions in the past would have taken half the time of an oral hearing because under the old method, every case was vetted. If it was decided summarily, it went back into a second queue for oral hearing. What that was doing was picking the low-hanging fruit and getting rid of it quickly. When summary decisions were made then, the disallowance rate was far higher. In other words, they were easy cases to decide and they were got rid of more quickly, but it is counter-intuitive. In other words, one is speeding up the cases for people who are less likely to succeed.
With the new model, summary decisions will be slower for two reasons. First, we are not picking them off and fast-tracking them and, second, we are deciding more of them on a positive basis, which means the case must get a deeper analysis. I think my colleagues, Mr. Brendan O'Leary and Mr. Ken Kelly, would agree when I say that under the old model, if one was vetting a case and something appeared to be more complex, there would always have been the temptation to put it out to oral hearing. Under the new model, one must take it to oral hearing oneself. Therefore, one will be very clear before putting it down for oral hearing. That is one of the other reasons the number of positive summary decisions has risen.
I have given all that information to explain that the processing times for a summary decision will not go back to what they were, which was half the time of an oral hearing. They will continue to take less than the time for an oral hearing. I do not have a problem with that because I think the system is fairer.
Ms Geraldine Gleeson:
Deputy Jim Daly asked what lessons are being learned in respect of the medical cases. Many lessons are being learned and we feed these back. Often in my annual report I set out issues that have come before appeals officers of which we think the Department should be aware. Also we meet with the Department's decisions advice area and tell them about issues that are coming up at appeal and particularly where there are problems and what might solve them. That is fed into the guidelines given to appeals officers.
Having said that, this is not an easy issue to solve, in the medical schemes there simply is a difference. The case is looked at by a deciding officer, mainly based on a medical assessor's opinion. The medical assessor does not see the person. That was an agreed approach by experts in the field on the basis that they are not a treating physician, are not diagnosing, and this would be the best way to assess them. That is the way it is done. They get the best evidence they can. One could argue that they are looking at it more clinically. When it comes to appeal, we are concentrating a little more on the care that is actually given. In any particular case, the care that is given can fluctuate for any number of reasons, even socioeconomic reasons. If one looks at a case on paper, a child requires X attention. That same child in one house might need more than in another, depending on the make-up of the household. There are any number of reasons.
People have often asked whether a medical assessor should decide and whether a medical person should appeal. One can look at this in many ways. This is the system in place. I think the medical assessors would argue that the submissions they get cover the socioeconomic aspect of the case, or certainly they look for them to do so. I think our experience would be that they do not always and often do not. That is probably the aspect that is fed in at appeal. I do not think that is necessarily a bad thing. Certainly, we would feed back our experience of that as it is gleaned at appeal hearings. The system is not perfect but I do not think there is a perfect system for that kind of situation.
One of the assistant secretaries in the Department has met many Deputies and Senators twice or three times since the Government was formed, because there would have been many new Members, to explain to them what is available, whom they might contact and what is the best approach. One of the aspects she would be trying to drive home is the TD helplines. I do not know what the experience is unless it is bad. Certainly we have a TD helpline in the office. It is a dedicated resource. The number is given to Deputies. The experience within my office and in the Department is that every assistance possible is provided. I include in this the sessions provided by the particular assistant secretary who brought along information people to help. It is an issue about which everybody is conscious and they would be aware that if a Deputy is given good information, he or she can help the client and they are clearer on the issues involved.
In regard to the number of staff, in 2000 the number of appeals officers during all those years would have ranged between 15 and 18. I do not know what the number would have been for any particular year. Therefore, a jump to 40 is significant.
In regard to doctors' letters versus consultants' letters, the appeals officers would confirm that more weight would be given to a consultant's letter for the simple reason that he or she is the expert in the condition that is presenting whereas a general practitioner treats more generally. He or she may not be treating in the children's cases. Often a consultant is treating the child and the general practitioner may know the child. A consultant's letter is certainly given the weight it deserves in the appeals system.
Can I come in on the issue of the consultants' letters versus GPs' letters? One of the significant issues coming across my desk is the length of time people must wait to get a consultant's letter, which adds to the delay. We have had contact from people who are under pressure and who have been waiting up to five weeks just to get a letter from a consultant. This adds to the delays. I know this is not something for which the Department is responsible, but there is a cost involved as well. Some people are being charged for a consultant's letter, although they have little or no means. They know a consultant's letter carries more weight, but the length of time it takes to get it and the cost associated puts even more pressure on them. Can that be taken into account by the Department when it is examining particular files?
I have a question, but I do not necessarily expect an answer now. When the Department gives us a breakdown by county report, can we have some more detail on how many of these cases are medical cases? Within the medical area, the domiciliary care allowance, for example, relates to autism. Can we have a more detailed breakdown, if possible, of the context of the appeals?
I am conscious that Ms Sylda Langford has been waiting a long time to come before the committee for the next part of the meeting, so I would appreciate it if we could wrap up quickly. There was a question about the project team and Deputy Ó Snodaigh also raised some issues.
Ms Geraldine Gleeson:
As I said, the three of us meet regularly to discuss issues. There is also a project team in the Department which concerns itself with the medical schemes. It is simply an effort to bring together all of the various areas of the Department that impact on the schemes, and it is chaired by the deputy secretary of the Department. I am on that team or committee and continually feed in these issues. Therefore, there is a focus on driving this issue.
There were certainly issues with the illness schemes, but huge work has been done around clearing the backlogs. To an extent, I understand the concentration on fresh applications, which have had no chance, but progress is being made. The major project team and our group of three work together and we are focusing our efforts on ensuring progress.
Deputy Ó Snodaigh asked about revised decisions. Any revised decision made by a deciding officer must, by definition, be favourable. They are not allowed revise unfavourably while a decision is under appeal. With regard to cases that have been withdrawn, the majority of these occur in the case of illness benefit. These cases are different from others in that they concern the only medical scheme where all claimants are seen by a medical assessor. Therefore, the person who has been cut off has been seen. When the person makes an appeal, he or she is seen again by a different medical assessor. At that point, a letter goes out from my office informing the person he or she has been seen by a second medical assessor, has been found capable of work, asking whether he or she wishes to proceed with the appeal and, if so, on what grounds. The person is given six weeks to respond. If there is no response after the six weeks, the cases are withdrawn, but would be opened again if the person comes back. Generally that does not happen. This accounts for the majority of withdrawn cases.
Ms Geraldine Gleeson:
They are full-time doctors and not recruited unless they have significant experience as medical practitioners. Often they have other qualifications also, such as paediatrics or psychiatry. They are well qualified. With regard to their decisions, I am sure if the chief medical officer was here, he would inform the Deputy he makes great efforts to ensure consistency across the medical cadre. That effort continues, but I suppose there will always be some inconsistencies and some cases, such as the Deputy described, will get through. One might wonder how on earth some are accepted, and we have come across such cases ourselves.
I will draw this part of the meeting to a close, but urge that members remain for the next item. This discussion has shown the value of constituency work and that members are informed on this issue because of engagement with their constituents on these issues. Ms Gleeson has given detailed and informative responses to the questions and, as a result, this meeting has been very productive. I thank her for attending the meeting.