Mr. John McKeon:

We must be very careful in attributing and extrapolating even the net figure to be representative. The surveys are carried out at a particular point in time.

If one were to calculate a 95% confidence interval, which we have started doing in our fraud and error reports, as the Comptroller and Auditor General knows, the rate of fraud and error for invalidity pension, for example - Deputy Cassells also mentioned other schemes - would be somewhere between 0% and 3%. The average at that 95% is 1.5%. However, when one has that range, one cannot extrapolate that it is, even at the net level, that high, so I would be cautious about quoting large figures as being the real cost. When it comes down to it, if we were to review every single claim all of the time, my belief is we would be closer to the lower boundary of that 95% level, closer to 0% than to 3%, so we must be careful about that.

Having said that, Deputy Cassells asked a question about the variability in the fraud and error between the various schemes. There are two main things that contribute to the variability. One is whether the scheme is an assistance-based scheme or a contributions-based scheme. In assistance-based schemes the payments are contingent on and subject to the income a person might have, so there is an extra variable, whereas contributions-based schemes are based on the historical level of contributions. One can establish the historical level of contributions at the point of play very precisely. Therefore, the person qualifies and it is very unlikely that there will subsequently be a change in their entitlement. After having submitted a means assessment, a person's income may change during the course of his or her claim. If that income change is not notified to us, it will result in either a fraud or an error. In most cases we attribute this to error because there is no definitive evidence that the claimant deliberately withheld the information. The standard in section 302 of the Social Welfare Consolidation Act is very high in this regard. In order to attribute something to fraud, it has to be wilful, deliberate and knowingly withheld information, so it is in fact almost beyond a reasonable doubt. Therefore, in most cases we attribute it to customer negligence or customer error, and they are the main distinctions.

Deputy Cassells raised a question about the medical reviews. As outlined by the Comptroller and Auditor General, we have not conducted all the reviews at a time that the medical assessor, when he or she assesses a claim in the case, might be relevant. It is important to note two things in this regard. First, the indication that is given by a medical assessor at a point in time when a medical claim is submitted is one of the indicators that we take in order to review and select a claim for review. There are other indicators relating to the age of the person, the duration of the claim and the prior claim history, so there are a number of triggers which inform our decision to take a claim for review. One of them is the medical assessor's review. The fact that a medical assessor says he or she thinks a certain claim should be reviewed in one year, two years or three years does not necessarily mean that that claim will be prioritised for review above another claim, which might have another trigger, such as the age of the individual or his or her prior claim-----