Regina Doherty (Meath East, Fine Gael) | Oireachtas source

I propose to take Questions Nos. 70, 71 and 74 together.

My Department has experienced significant difficulties in processing illness benefit payments in recent times which, regrettably, have impacted on people in a manner that has correctly been described as unacceptable. This is a matter of great concern to me and my Department. I am extremely disappointed and embarrassed by our failure to maintain the usually exceptionally high standard of service provided by the staff of the Department.

The root of the difficulty lies in the transfer of the illness benefit scheme to our new core business objectives information technology, IT, platform on 4 August. The transfer had a number of objectives, including moving the illness benefit payments from a very old IT platform which is approaching end of life to a newer platform which already manages most of my Department’s other payment schemes. We wish to realise cost savings by eliminating the need for labour intensive data entry and enabling the re-use of existing data already on the business objectives platform. It was hoped that the transfer would facilitate, in due course, with the co-operation of general practitioners, GPs, the move from submission of paper medical certificates by people to one whereby an ecertificate is transmitted electronically from the GP to my Department and the move away from certification each week by a GP to a system whereby a single certificate is provided to cover the entire illness period.

The system change worked effectively for approximately 80% of those who claim illness benefits but a several difficulties arose which affected payments to a significant number of people.

The redesign of the medical certificate enabled the forms to be scanned rather than manually entered into the system. However, approximately 50% of GP practices initially continued to submit old form medical certificates which led to long delays in claim processing on the new system in early August. The delays were overcome by the Department implementing an automatic certification process to ensure that people, including those whose GPs were not submitting the correct certificates, were paid. Although the process ensured that people received their payments, it resulted in approximately 15% of recipients receiving a split payment in the period from September to November. People who received split payments were not underpaid as a consequence of this approach; the total amount paid to them was in accordance with their entitlement. However, they did not expect the payment to be split.

During this time, my Department deployed additional staff to process old form certificates received from GP practices. This allowed us to cease the auto-certification process in mid-October and the issue of split payments has since been largely resolved. Approximately 75% of medical certificates now being received are in the correct format and the remaining forms are being processed manually on the day they are received.

The removal of the auto-certification process has belatedly exposed some underlying deficiencies in the design and operation of the new illness benefit system. The main issue identified relates to the transition from a payment-in-arrears approach to a current-week payment approach, that is, from a system whereby people are paid their entitlement the week after the submission of a certificate to one whereby they are paid during the week of certification. This leaves very little tolerance for late receipt of certificates once a claim is in payment, which is causing significant uncertainty for people. The new system has very tightly defined rules which must be satisfied before a claim and a certificate can be accepted and processed. Although these rules are valid in principle, they are leading to payments being delayed for reasons that would not have been applied under the legacy system.

My Department has taken three main steps to resolve these issues. We have deployed additional staff to process the tasks and respond to inquiries arising from the tight application of scheme rules by the new system. We have developed some new IT routines or work-arounds that, in effect, build in a seven-day buffer to address the payment gap issue and automate the processing of tasks to ensure a faster flow-through of payments. We are reviewing the design rules in the system, including the payment in the current week rule, and will modify the system to afford greater flexibility in processing of claims and certificates. In addition, my Department continues to engage with the medical profession regarding the implementation of e-certification and single closed certification. We hope that these measures will lead to an improved delivery of services. My Department has allocated additional managers to take responsibility for the programme of work I have set out. The management team includes a full-time assistant secretary and additional staff at principal, assistant principal and higher executive officer level.

As a consequence of these measures, people who are due a payment and whose certificates and claims are in order should now receive their payment entitlements. Payment volumes were restored to normal levels last week and are being monitored on a daily basis to ensure that they remain at that level. Any further issues that may arise will be quickly identified and further remedial action may be taken to address them.

It is important to note that there are always cases - and there were always such cases under the old system - of people’s payments being legitimately stopped or paused for a variety of reasons. Such issues will remain and are normally dealt with via our helpline number.

In addition to the system issues, my Department sincerely acknowledges that it did not communicate effectively with people in advance of the new system coming into effect or in the immediate post-implementation period. Although my Secretary General wrote to all those in receipt of illness benefit some weeks ago to apologise for the difficulties they were experiencing and to advise of the supports available, I accept that communication was too little, too late and of limited comfort to those unduly distressed.

Our experience with the illness benefit transfer has been a salutary reminder of the longer-term impact of short-term remedial actions. Such actions, even those taken with the best of intentions, may have unanticipated issues or failures and must be carefully thought through before implementation. In order to ensure that lessons are identified and learned from this experience, I and my Secretary General have commissioned an independent review of the project to be undertaken by a retired Revenue Commissioner. I expect that it will be delivered to me by the end of the year and its findings will inform our approach to future system and process changes.

As I have stated, my Department sincerely regrets the distress it has caused to recipients of illness benefits in recent months and we will endeavour to ensure that nothing like this happens in our Department again.

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