Oireachtas Joint and Select Committees

Thursday, 7 December 2017

Public Accounts Committee

Comptroller and Auditor General 2016 Report
Chapter 16: Regularity of Social Welfare Payments
Chapter 17: Management of Social Welfare Overpayments
Chapter 18: Department Reviews of welfare Schemes, Social Welfare Appeals Process, Social Insurance Fund

9:00 am

Mr. John McKeon:

I understand why it is done but it is probably taking it a step too far to say that the fact that a medical assessor believes a medical review should be done in, say, two years means that there is a plan to do it in two years. The plan is to select claims for review based on a number of risk factors, one of which is the medical assessor's review. It is not the determining factor. It is a very important determining factor but it is not the only one. Furthermore, regarding the medical reviews, we have come through a period in the Department when the rate of new claims for medical schemes has increased very dramatically year on year. This can be seen in our expenditure results. As I said in my opening statement, when we have a choice to make between allocating resources to control activity and serving the customer in trying to get his or her claim into payment as early as possible, we generally put the resources into serving the customer. This meant that we did not have all the resources that we could deploy to do reviews. Medical schemes are among the least risky when one looks at the figures, so I think this is the right thing to do.