Vol. 699 No. 1
82 Deputy Olwyn Enright asked the Minister for Social and Family Affairs the number of dental applications made on behalf of multiple customers without their knowledge; the action she will take in this regard; and if she will make a statement on the matter. [1674/10]
Changes to the treatment benefit scheme were announced in the 2010 budget. From 1 January 2010, treatments available under the scheme are limited to a free optical and dental examination together with the treatments previously available under the medical appliance scheme, namely hearing aids and contact lenses required for medical reasons. People who at 31 December 2009 were undergoing a course of treatment or who had applied for approval to commence treatment will have their applications for dental benefit processed under the rules that operated prior to 1 January 2010.
In the period immediately after the changes were announced in the budget, there was a sharp increase in the number of inquiries from customers and from dentists on behalf of customers seeking approval for dental treatment. From the level of correspondence received from some dentists, it was clear they were submitting bulk applications on behalf of their patients. Claims involving many hundred customers were received from eight dental practices. These applications were supplied in alphabetical order as if downloaded from a database.
On checking with a number of customers, it became evident that many of them had not approached the dentist to seek treatment nor had they authorised the dental practice to submit an application on their behalf. The dentists concerned were contacted and agreed to withdraw the inquiries and resubmit them in the proper manner.
In order to avoid any repetition of the problem, a letter was issued to all dentists clarifying the procedures to be followed in submitting eligibility and approval inquiries. These procedures include the need to ensure that the patient had given approval for the inquiry to be made and the need to provide a confirmed appointment date and contact number for each customer. This was difficult in some cases because the customers had passed away. It has been noted that since the letter issued, the majority of inquiries have been submitted in the correct manner. Inquiry applications received without all the relevant information are being returned. A number of dentists have been in contact with the Department since the issuing of the letter to advise that they submitted inquiries in error, to ask for them to be withdrawn and to advise that they will submit a revised list of inquiries in the correct manner. It is estimated that over 150,000 eligibility inquiries for dental treatment were received in the period between budget day and 31 December last. The inquiries in question are being processed. It strikes me that dentists were very busy in the ten working days between budget day and the end of the year. Priority is being given to confirming patient eligibility. Officials will perform spot checks on inquiries to ensure that they were submitted properly and with the consent of patients. Any breaches of the guidelines will be reported to the Office of the Data Protection Commissioner for appropriate follow-up action.
I welcome this example of vigilance on the part of the Department. Does the Minister know how many dental practices attempted to submit lists of patients without such applications having been signed by the patients in question? How did the Department realise that dentists seemed to be submitting patients' names without their consent? Was the alphabetical order issue the main one in this regard? Will any sanctions be applied in cases of this nature? Have the applications been returned to the people in question? Has everyone on the list been contacted by the Department to make them aware that their dentists submitted this information?
This phenomenon came to light when applications were submitted in bulk and in alphabetical order. In some cases, all of the forms were signed with the same signature. That may have been erroneously done by receptionists. When departmental officials conducted cross-checks within the system, they found that some of the customers who were anticipating getting treatment in the future were actually dead. When some of the people on the list were telephoned on foot of those spot-checks, they said they had not been to the dentist recently. In some cases, people who had not been to the dentist for a couple of years were on the list as having been approved for future treatment.
They could come back from the dead for treatment, like certain people do on voting day.
I mentioned in my reply that the bulk of the claims to which I refer came from eight dental practices. In fairness to the officials in the relevant section of the Department, they copped on very quickly to what was happening and started to contact the dentists in question. By the time they contacted the third dentist, the word had got out and he was expecting the telephone call. Two professional groups of people — opticians and dentists — were affected by the decision that was announced on budget day. When I met the opticians, I found they were particularly keen to retain the examination, which is the best way of identifying real problems. As a result, the examination was retained and there has not been a word from the opticians since. They are getting on with their work in a professional manner. By contrast, the dentists conducted an enormous campaign, involving postcards as well as radio and television advertising. They were well within their rights to do so. A number of dentists are making an awful lot of money from the system. Eligible people who properly made their appointments and submitted their applications will, of course, continue to be treated in the first few months of this year. It is important for professional bodies like those we are discussing to realise that these cuts were made with difficulty.
This is one of the budget cuts of which people are not yet terribly well aware. It seems extraordinary that the Minister has changed the rules in a manner that drastically cuts the entitlements of those who have been paying into the social insurance fund for 25, 30 or 40 years. A lot of trouble is coming down the track in this regard. The word has not got out terribly well yet. As people try to make appointments with dentists and opticians, they are starting to discover that the Minister has interfered with their entitlements to this extent. I would like to ask the Minister about the specific abuses that are the subject of the question before the House. What was the largest number of claims to be made by an individual practice during the period between budget day and the end of the year? Does the Minister have any penalties at her disposal? What sanctions can she impose on practices that have engaged in this kind of abuse?
People have been making their contributions into a fund that is now in deficit.
It is not their fault.
I know it is not.
They have paid their social insurance contributions.
When we made decisions in advance of last month's budget, we had to ascertain how best the fund could be protected. We do not intend to retain these changes on a permanent basis. My aim is that they will be in place for just one year. We have maintained the two most critical elements of this scheme. The examination can highlight basic difficulties in addition to a myriad of much more serious diseases. We have protected the basic scheme while changing the eligibility criteria. We hope those changes will last just a year. As I have said, some 150,000 names were submitted in total. I am aware that one or two individual dentists submitted hundreds of names, which is quite significant. I do not have the exact numbers to hand.
What sanctions are available to the Minister?
The first sanction is that somebody can be reported to the Office of the Data Protection Commissioner. The use of people's information without their permission is quite a serious offence. The Department may consider the possibility of striking individual dentists from the panel, if it is felt they were deliberately trying to defraud the system. The relevant section of the Department is trying to work through the 150,000 names to determine the degree of eligibility in each instance. We will see if anything else comes to light as a result of that.
Does the Minister intend to take action against any of the practices?
As this is just the third week of January, we are still in the process of taking a look at the names.
Were the dentists involved in communication with each other?
I want to make some progress by calling the next question.
83 Deputy Seymour Crawford asked the Minister for Social and Family Affairs if she has carried out a review on the way inspectors are estimating income for the self-employed and for farmers; her views on whether current income is not being accepted by some inspectors; and if she will make a statement on the matter. [1525/10]
Jobseeker's allowance and farm assist are means tested payments. In each case, social welfare inspectors interview claimants and make the inquiries necessary to ascertain their means. Historically, self-employed people were assessed on their income in the 12 months prior to claiming, and decisions were made on that basis. This has proved an effective measure of means during periods of relatively stable economic conditions. However, it has always been open to each applicant to make a case showing that his or her income in the coming 12 months was likely to be reduced in light of personal or economic circumstances. The Department's inspectors and deciding officers take account of such arguments and, in assessing means, exercise their best judgment as to the likely income such a person would receive in the 12 months following their claim.
In light of the changed economic environment, and recognising that the system of using past year earnings as a basis for assessing means was no longer as equitable as it had been, the Department issued a circular in May 2008 advising inspectors of the need to recognise that, in general, less work would be available in the current economic environment and, as a consequence, the income of a self-employed person may be reduced. A further circular, on self-employment process improvements, was issued in December 2009. It advised inspectors to deal efficiently and effectively with means tested cases that contain an element of self-employment. Inspectors were advised that each case should be examined on its merits and that they should apply their knowledge of local conditions to arrive at a fair assessment of the income from self-employment for the coming 12 months.
Some 88% of farm assist claims and 93% of self-employed claims that were decided on in the period between January and December 2009, inclusive, were awarded. If a self-employed person's situation changes after he or she has made an initial claim for jobseeker's allowance or farm assist, he or she can apply to have his or her means reviewed. In addition, if the individual is dissatisfied with the means assessed, it is open to him or her to make an appeal to the social welfare appeals office. I appreciate the need to ensure that claimants who have been self-employed, and whose income is significantly affected by the economic downturn, receive their full entitlements in a timely manner. I assure the House that we are doing our best to ensure that this is achieved.
I am sorry to have to raise this issue again. I brought a number of cases to the Minister's attention last year. For example, I spoke about a self-employed person who went out of business last August. His ten workers have received their entitlements, but he has not yet received a single penny.
A question please, Deputy.
How can I ask a question without explaining what I am asking about?
The Deputy will know that one minute is allowed for supplementary questions.
This situation has not yet been resolved. The man in question is living entirely on the basis of the support of his family. His wife has applied for carer's allowance. When I spoke to officials in the carer's allowance section of the Department, they said they would re-examine the case without reference to the appeals process. That did not happen, unfortunately. Both the man and his wife are without assistance. I am also familiar with the case of a young farmer——
Go raibh maith agat.
——with €6.50 of farm assist——
We do not have time to go through the Deputy's list of cases.
He got farm assist all right. He got €6.50 for himself, his wife and his children. We asked the Department to get the inspector to re-examine the matter.
The Deputy cannot simply ignore the Chair.
The inspector refused to do so. What is the Minister going to do about that?
Before the Minister replies, I ask the Deputy to have some regard for the Chair. The rules which exist for the asking of questions can be set aside if the House so decides but in the interim the Chair should be allowed to apply them.
Genuine issues arise in respect of self-employed people seeking unemployment assistance. We took these issues on board in recognising that the income a person earned over the preceding 12 months could not reflect what he or she could earn during the following year. This is why new circulars were issued to inspectors. Bearing in mind some of the concerns raised by Deputy Crawford on previous occasions, a substantial new circular issued to inspectors last month to ensure, for example, they did not take sole account of previous incomes. Accounts cannot be exclusively relied upon or considered in isolation from other factors. The circular tells inspectors precisely what they should look for and advises them to be cognisant of the fact that employment is unavailable. The projected net income for the succeeding 12 months should take account of the downturn and reflect diminishing trade on a proportionate basis. We are sending the message to our offices and inspectors that there is a cohort of self-employed people who may have earned a decent income 12 months ago but cannot at present expect similar remuneration.
The figures speak for themselves when I note that 88% of applications under farm assist were granted and that 93% of those who sought unemployment assistance were self-employed. I am aware the Deputy is interested in a particular case but the issues he has set out are not reflective of the success of the scheme overall.
I assure the Minister that the example I have set out is only one of many. What efforts will be made by the Minister to ensure that inspectors follow her directions? It appears that a few people are ignoring them. Is it fair that somebody should have been waiting since early summer for a result?
Inspectors have already received three circulars and they have also been brought together in a workshop so that the details of the scheme could be explained and their fair implementation ensured. We will continue to keep the matter under review.
84 Deputy Seymour Crawford asked the Minister for Social and Family Affairs the reason a person (details supplied) in County Monaghan in receipt of farm assist has had payment reduced from €15.90 to €2.10; her views on whether this is a serious income reduction for someone on such a low income; and if she will make a statement on the matter. [1524/10]
Arising from the changes made in the Social Welfare Act 2010 the rates of payment for both jobseeker's allowance and farm assist payments were reduced. Accordingly, the farm assist payment of the person concerned was reduced in line with these provisions with effect from 1 January 2010.
The person concerned applied for and was awarded farm assist with effect from 19 November 2008. In such cases, a social welfare inspector interviews the claimant and makes such inquiries as are necessary to ascertain his or her means. The person's means were assessed at €324 per week, derived from his spouse's income from employment and farm income.
Where a person's situation changes after making an initial claim for farm assist, he or she can apply to have his or her means reviewed. In addition, it is open to the individual, if he or she is dissatisfied with the means assessed, to make an appeal to the social welfare appeals office.
The person concerned requested a review of his means in November 2009 and a social welfare investigator duly reviewed his circumstances. However, based on the information provided by the claimant, there was no material change in the means derived from his farming enterprise and his wife's income from employment remained unchanged. Accordingly there was no change in his means. He was notified of this decision and of his right to appeal to the social welfare appeals office.
The Deputy will be aware that in light of the changed economic environment the basis for assessing means in cases where self-employment is involved was reviewed by my Department, which issued circulars in May 2008 and December 2009 advising inspectors and deciding officers of the changed economic circumstances and the need to recognise that, in general, claimants' self-employed income potential has reduced. Inspectors were advised that each case should be examined on its respective merits and that they should apply their knowledge of local conditions to arrive at a fair assessment of the income from self-employment in the coming 12 months.
I appreciate the need to ensure that claimants who have farm income and whose income is significantly affected by the economic downturn receive their full and fair entitlements having regard to the legislative provisions and means test that apply.
This man's wife earns a low income by working in retail four days per week and he owns a farm comprising 14 acres. I hope his application will be reassessed in order to take account of his actual income because the decision as it stands is extremely unfair.
Difficulties arise where the wife is also working because her income is also taken into account. We accept that somebody might need farm assist but the household income must be considered. This is a social issue because in the past the man was the main breadwinner but the roles have now reversed and men are being refused social welfare assistance because their household income is being earned by their spouses.
Written Answers follow Adjournment Debate.
