Aengus Ó Snodaigh (Dublin South Central, Sinn Fein) | Oireachtas source

I tabled two of these amendments, which are consequential on the proposed change. I do not have a major problem with the definition of "medical assessor" but my problem is that this change will facilitate the use of employment agencies instead of hiring medical practitioners directly. On Committee Stage, I reflected the practice in Britain when agency staff were introduced and the health service went outside public practice. A standard was set for medical assessors to achieve reductions in payments. A report in The Guardianabout this, which I quoted, stated that this led to the death of a number of people because they were assessed as being fit for work when they were not. That put stress and pressure on them and forced them back into work when they were not ready. It needs to be ensured that what was done in Britain will not be replicated here. The Minister of State gave us an assurance that this is not the intention but, in the past, the Minister for Social Protection has sought support, for instance, for the re-employment of social welfare inspectors in the social welfare appeals office. We did not oppose that because the intention was good, which was to address a huge backlog of cases, and it was timebound. However, it involved a contract directly between the Department and the individuals in question for 11 months. That led to a reduction in waiting times. Nobody wants to exacerbate the current situation. There are not enough medical assessors and there is a significant delay in social welfare payments dependent on medical assessment.

It is difficult to figure out why hiring someone through an employment agency rather than through a recruitment drive or via direct contracts with the Department would be better. It will result in an increased cost to the Exchequer because normally employment agencies charge a premium of between 15% and 20% on top of the remuneration of the staff they provide. If the salary is €100,000 a year, this means it will cost the State €120,000 a year. I am concerned that the Department is going down this route, especially since most medical professionals can access the Internet to find work through agencies. In addition, quite a number of doctors who are the basic equivalent of a medical assessor leave the country every year. I may be wrong but this is an attractive job in that people can take up contracts for a short duration while backlogs are addressed.

In the long term, we have an ageing population. This will result in increased demand for assessments under the carer's allowance scheme, for instance. People who apply to care for elderly relatives will have to go through this process because an assessment must be made that the relative is in need of full-time care. Given advances in medical technology, people are living longer with complicated disabilities where previously they would only have survived for a few years. This is resulting in more medical intervention at an earlier stage and, therefore, the State is incurring increased social welfare payments on medical grounds, which will continue to increase in the future. There has been a significant jump in recent years as people who cannot afford the care required have become aware of the payments that are available and how to access them.

Nobody denies the need for medical assessors and, therefore, my proposal is to delete the reference to employment agencies because my problem is that we will impose an additional cost on the Exchequer. We should support the other amendments to ensure people are not put under undue stress because of delays in processing applications for disability allowance, invalidity pension, domiciliary care allowance and so on.

The other issue with bringing in agency staff is they will have to be trained to be medical assessors but they could disappear in the morning, although no more so than somebody employed directly. However, usually somebody who goes to the trouble of being employed directly has a little loyalty.

At the moment we have a significant problem with medical assessments, which has not arisen of late but has been there for a while. On appeal over 50% of those assessments are overturned. They are not all due to a bad assessment. Many are due to additional medical documentation. However, it is still a high number, which means that work must be done to ensure staff, whether the current medical assessors or ones employed in future through this contract system, are fully aware of everything required, take their job as seriously as they can and give it as much care as they can. The medical assessors cannot do that if they are under pressure to move things along as quickly as possible. That is the pressure they are under because the in-pile on their desks is getting bigger and bigger. They need help, but the employment agency part is a bad move.

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