Phil Hogan
Question:13 Mr. Hogan asked the Minister for Social Welfare if he will be taking any steps to reduce the backlog in social welfare appeals; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Social Welfare Appeals.
Phil Hogan
Question:15 Mr. Hogan asked the Minister for Social Welfare if his attention has been drawn to the backlog that exists in respect of appeals for unemployment assistance and disability benefit in particular; the action he intends to take to remedy this situation; and if he will make a statement on the matter.
Eamon Gilmore
Question:18 Mr. Gilmore asked the Minister for Social Welfare if he will provide additional staff for the Social Welfare Appeals Office in view of the disclosure in the annual report of the office that it takes from four to five months to dispose of an appeal; in view of the conclusion in the report that many of the unsuccessful appeals were as a result of a failure to provide the claimant with adequate information on the original decision, if he intends to introduce any new procedures to ensure that maximum information is available; and if he will make a statement on the matter.
I propose to take Questions Nos. 13, 15 and 18 together.
Each year over one million cases are decided by deciding officers, the first decision making level in my Department. Of this number about 18,000 cases, 1.8 per cent, are appealed to the independent appeals office which I set up in 1990.
In his annual report for 1992, published in September 1993, the chief appeals officer drew attention to the number of appeals awaiting determination and the time taken to dispose of an appeal. His report shows that the social welfare appeals office received 17,610 appeals during 1992 and that the number of appeals awaiting determination at the end of that year was 7,053.
Last autumn I appointed two additional appeals officers to the social welfare appeals office. A subsequent vacancy in the appeals office arising from the retirement of an appeals officer has also been filled. I am pleased to say that these increased resources have resulted in a rapid reduction in the number of appeals on hand. Despite the fact that the number of appeals registered in 1993 exceeded 18,000 the number of appeals awaiting determination at the end of the year had been reduced to 5,317. I am pleased to say that this improvement is being maintained and that since the beginning of this year the number on hand has been further reduced to 4,551. I am confident that there is scope for this trend to continue over the coming months resulting in a reduction in the time taken to process appeals.
Deputies will be pleased to know that I recently set up a new social welfare decisions advisory office to provide better information and advice to customers about how their entitlements are worked out under the social welfare law. The new office will provide advice and guidance to deciding officers. There are some 700 deciding officers who determine entitlements in my Department. Deciding officers are appointed by statute and their powers are set out in the Social Welfare Acts. They are independent in the exercise of their duties and responsibilities.
The new office will also have the responsibility of improving communication of the decisions to customers. I am particularly keen to see the introduction of individual personalised letters for customers explaining each decision and how it was made in relation to their own individual circumstances, especially where a claim is being disallowed. The requirements of natural justice will be at the centre stage in improving information for the public. The new office will help customers to understand better the reasons for the decisions in their cases.
Will the Minister agree that for any person dependent on social welfare payments a four to five month delay is unreasonable and unacceptable? Will he further agree that the ongoing delay in dealing with appeals is putting undue pressure on the supplementary welfare allowance scheme? Is he aware that one of the key recommendations of the FLAC study in relation to the unsatisfactory nature of the supplementary welfare allowance scheme was that the undue delay in dealing with appeals by the independent appeals office was putting pressure on the supplementary welfare allowance scheme?
It is clear from the figures I have given that the social welfare appeals office is doing a good job. The proportion of appeal cases is 1.8 per cent. The number of appeals awaiting determination at the end of the year had been reduced from 7,053 to 5,317 and has been further reduced to 4,551. Since decisions of this kind can involve substantial reassessment or reinvestigation of means from claimants' holdings, obviously there will be some cases which will take a considerable period. In some instances the information is not supplied. It is clear that the backlog is being reduced. I agree with Deputy Allen it is important that the burden be taken from the supplementary welfare allowance scheme, otherwise it will not be available for people who need discretionary payments.
The annual report of the appeals office pointed out that of the order of 42 per cent of all people who appealed subsequently had their claim either fully or partially restored. Will the Minister not agree that such a high figure indicates that wrong decisions are being made at a fairly high rate and that the correct information is not being given to claimants when they make their claim? Will he agree that serious steps need to be taken — not so much at the appeals level, although steps have to be taken there — to ensure that staff dealing with claims in the first instance are fully apprised of the rights of claimants so that they are not put through a process of appeals which can take up to four or five months and have to live on supplementary welfare allowance in the meantime?
Appeals on unemployment assistance account for 44 per cent of all the appeals and are the single biggest element.
Forty-two per cent of claimants subsequently have their claims restored, fully or partially. These people are on elementary income and are deprived of it while waiting for an appeal to be processed. They have to live on supplementary welfare allowance in the meantime. There is something seriously wrong.
Unemployment assistance appeals account for the largest proportion of the total. The steps taken have resulted in the backlog being reduced. It must be borne in mind that we are talking about 1.8 per cent of all cases; a huge volume of applications is processed without any difficulty. One of the problems is that the legislation appears to be restrictive; social welfare officers do not have the same discretion as supplementary welfare officers. In the case of the self-employed it is sometimes difficult to determine whether a person has an income which can give rise to problems in making an assessment and Deputies come across such cases frequently. As an appeal is processed more and better information is provided. Consequently, a solution is found. By the time a case reaches the appeals office all the information needed to make a decision in favour of the applicant is available. We are trying to ensure that people receive good information and that is the reason for establishing the decisions office. I hope it will be of help in making decisions much earlier before a full appeal is heard. That is the practical way to proceed. That office has now been set up and will provide the information people need. Training will also be provided for deciding officers.
Does the Minister agree that the most satisfactory form of appeal is the oral hearing and that while he may produce figures to show that the appeals process is speeding up oral hearings are not? What proposals, if any, does he have, to reduce the length of time an applicant has to wait for an oral hearing? I can cite many examples where people had to wait between six to eight months in connection with an application for unemployment assistance which is usually at the bottom of the list. I am sure the Minister agrees that is totally unacceptable.
Yes, but one would need to examine each individual case to discover the reason for the delay. It may be that land transfers and other difficulties can lead to delays. It would be far better if a decision was made before the stage of holding an oral hearing is reached. That is what we are concentrating on to try to ensure better decisions are made and to reduce the number of cases where an oral hearing is held. In general, I agree with the Deputy; we are trying to streamline the system under which many appeals are heard and a large number of decisions made. The number of outstanding appeals has now been reduced. We are going further and trying to ensure that better decisions are made in the first instance.
The Minister referred constantly to deciding officers but I put it to him that the report to which I have referred, the 1993 report of the appeals office, states that over 42 per cent of all appeals resulted in a revised decision partially or fully in favour of the claimant. This is a horrendous figure given that a person is deprived of the income on which to survive from week to week. There is a need to ensure that adequate information is provided to a claimant when they make their claim.
That is the area on which we are concentrating to improve the quality of the information provided to clients and the quality of decisions taken in the first instance, on health matters for example. If a person is not happy with the decision of a medical referee the matter can be referred to a second medical referee. It may be that adequate information is not provided to the person concerned who is not properly prepared——
They are never told how they should prepare.
I agree; this is what the decisions office will be concerned with — the quality of the decision and the quality of information provided to claimants before an appeal is heard. For instance, if a person is asked to attend a medical referee it is important that they are given a clear indication of what they should do.
While I welcome the reduction in the number of appeals outstanding there is a problem, particularly in cases where it is decided on medical grounds that a person is capable of work and has to attend a second medical referee. Unfortunately, the medical referee is expected to be an expert on all aspects of medical care but he is not. The problem is that people are advised by their general practitioner and their consultant that they are not fit for work but the medical referee says that they are. This is unsatisfactory and unfair. We come across such cases far too often. I appeal to the Minister to find some way of having an independent arbitrator who would decide. I know of one man who is anxious to return to work to complete his pension contributions but his medical advisers will not allow him to do so even though the appeals officer says that he is fit for work. These are genuine cases and the people concerned feel hard done by. While I welcome the reduction in the number of appeals outstanding people are being affected. This is unsatisfactory.
It may be that a company will not allow a person to return to work on medical grounds because of its insurance arrangements; yet, a person may be fit for work after a lengthy period of illness. This gives rise to the question as to whether the person is suitable for the work. This can be hard to fathom or understand; I have come across such cases. One would generally expect a consultant's report to be definitive. That may not be true in all cases but, in general, when an adequate consultant's report is presented it should carry the day for the person involved. However, on some occasions it does not and I have had similar experiences to those outlined by Deputy Wallace. That is where the independent appeals office comes into play. The person involved is no longer dealing with a medical person but with an administrative appeals officer who will consider the matter from all sides to determine whether the complaint is legitimate. A back problem is one of the most frequent complaints. In general, a consultant's report should have a major influence on the decision.
If the Minister believes that he is innocent, is the performance and, more importantly, the attitude of medical referees monitored? Very often people are treated in a discourteous and abrupt manner, sometimes not even allowed to put their case in the manner they wish. I know a lady who was forced to attend a medical referee on crutches last summer. Even though it was physically obvious that she was unfit for work she was disqualified from receipt of disabilty benefit. I am sure the Minister is well aware of what I am talking about.
Qualified medical people are appointed to make decisions as medical referees.
Does the Minister not give them instructions?
They make medical decisions.
Does the Minister not instruct them to be as harsh as possible?
I do not, never. When the Deputy has experience on this side of the House sometime in the distant future he will realise——
In the not too distant future.
(Interruptions.)
Gemma Hussey has been briefing the Deputy.
The Deputy might as well dream by day and by night.
(Interruptions.)
Please allow the Minister to answer as I want to proceed to questions from other Deputies.
That is not the way we operate. The medical referee makes an objective medical decision.
The Minister should not mislead the House.
If we are not happy with a decision we refer this matter to a second medical referee and if we are not happy with the decisions of either of those referees the matter is referred to the independent appeals office. I deal with those issues in the same way as Deputy Connor, as a practising public representative. I am familiar with the process from both ends. If we did not leave it to the medical referee to make the decision there would be no point in appointing such referees.
Does the Minister write to himself?
No.