asked the Minister for Social Welfare the cognisance her Department's medical referees take of the detailed reports of family doctors and specialists who are attending the recipients of disability benefit; and if these are given serious consideration by medical referees before compiling their final report.
Ceisteanna—Questions Oral Answers - Reports of Family Doctors.
24.
In the course of carrying out examination of claimants to disability or injury benefit medical referees examine claimants with particular regard to the cause of incapacity which has been certified by the claimant's medical certifier.
In this connection they review the history of the illness and take account of previous illnesses. They consider in particular all the certifier's and consultant's reports including the results of any clinical investigation given.
Full consideration is given to the reports by the medical referees who find them extremely helpful in compiling their final reports on the claimant's fitness for work.
Is the Minister satisfied that the Department's medical referees, who now number 25, take account of the detailed reports of the family doctors and specialists who attend those people? Why is it that so many are being deemed capable of work who are still under the constant care and attention of their doctors and continuing to see, on a regular basis, the specialists or consultants who are attending them and where, in some cases, operations to remedy defects in the long term are being contemplated? These advices and reports seem to be disregarded and the claimants are deemed capable of work. It seems irreconcilable with the statement the Minister made.
Where a medical referee examination is decided on the certifier is notified and advised to furnish a report. These reports and the history of the claimant and any clinical requirements are received in an estimated 10 per cent of cases and in the course of examinations claimants are requested to give a general account of past illnesses and the history of the present illness. Any report furnished by the certifier will help to put the illness in perspective. The medical adviser considers that such reports from family doctors and the details given in some cases of clinical tests are very useful for examination purposes, particularly in view of the technical nature of the illness which claimants might not be able to describe. The medical adviser is satisfied that due weight is given to such reports and that they are taken into account in arriving at a decision.
The Deputy referred to cases of people waiting for operations. It is not always the case that everyone waiting for an operation is unfit for work while waiting. Waiting for an operation is not, in itself, an illness. I admit that most people waiting for an operation are suffering from some illness that has to be rectified but, of itself, a certificate stating that somebody is waiting for an operation does not mean he is ill.
Do the medical referees take into account the type of occupation which claimants may have had prior to their becoming ill and availing of disability benefit? Are physical examinations undertaken by referees specifically geared to the determination of the assessment of the illness which is described?
Approximately 80,000 claimants are requested each year to attend a medical referee examination and some 50,000 of these are examined; about 14,000 or 26 per cent are deemed to be capable of work in the first instance. In the event of an appeal, these are normally re-examined by a different medical referee who may or may not confirm the first medical opinion. But approximately 75 per cent of people who appear before medical referees are continuing in benefit.
I asked the Minister was the occupation of applicants who appear before medical referees taken into account? If a person is deemed capable of working that assessment must relate to the occupation he had. I have a particular case where an applicant who was receiving an invalidity pension from the UK for a particular condition was examined by a medical referee of the Minister's Department and he decided that the applicant was now capable of work. The report was duly sent to the Social Security Appeals Tribunal in Newcastle-upon-Tyne. Before that tribunal the medical referee's report on this man who was aged 46 years stated quite clearly that the man was capable of work though he could no longer work as a labourer. Is that man, at 46 years of age, now going to become a highly skilled worker, or a clerical worker, or a computer controller because the medical referee has decided, in Ireland even though he is obtaining a UK invalidity pension, that he is capable of working? Can the Minister not see that this is quite outlandish?
The Deputy's point is a difficult one to answer but, generally speaking, the concept of being capable or incapable of work is used in a very general way. It would be very difficult to operate any system whereby one would have to relate the capability of a person to, strictly a particular kind of work. In legal terms people are sometimes advised, in common law cases, to seek light work, and we find there is really no such thing as light work. All considerations are examined in these cases, but the fact that a claimant is incapable of doing his or her particular job, but is capable of doing 101 other jobs, would not automatically mean that that person could remain indefinitely on disability benefit.