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Dáil Éireann debate -
Friday, 7 Nov 2014

Vol. 857 No. 2

Social Welfare Appeals Bill 2013: Second Stage [Private Members]

I move: "That the Bill be now read a Second Time."

This is a very short Bill with one purpose, which is to expedite the social welfare appeals system. I propose that the maximum period for an appeal should be 60 working days, which is 12 weeks, except in very exceptional circumstances.

The Minister of State is aware of the 2012 report of the Free Legal Advice Centres, FLAC, which examined the social welfare appeals system in detail. It highlighted a number of difficulties with the existing system, of which delay was just one. In its report FLAC pointed out that in 2011 the success rate of social welfare appeals was 43%. I understand this figure has since crept up to more than 50%. The information available to me is that in the period from October 2013 to September 2014 34,000 cases were taken, of which 19,000 cases succeeded, which is approximately 56%. This means more than half the decisions taken by the deciding officer at first instance were incorrect. The latest figures available to me also state that at present the average length of time to process an oral hearing is 29.3 weeks, which is approximately seven months, and a summary decision takes 21.8 weeks, which is approximately five months. These are the average figures; individual cases can take much longer. I know of cases that have taken a year or longer.

Taken together, these delays, along with the high rate of incorrect decisions at first instance, mean that many people may be deprived of their legitimate social welfare entitlement for a very lengthy period. In certain instances a person may apply for a supplementary welfare allowance to tide him or her over. The way it is supposed to work is that somebody who makes an appeal shows evidence of this to the community welfare officer, who is supposed to make a payment to tide the person over. My experience is that this is not automatic. I have come across several instances in which people have been refused supplementary welfare allowance for one reason or another. If a case centres on habitual residence, a supplementary welfare allowance will automatically be refused.

During the lengthy waiting period, people are affected in two ways. Some of them are literally destitute and depend on the assistance of family and friends to tide them over. In many cases these family and friends can ill afford the payments themselves. It has also been my experience that while people are waiting for an adjudication on their entitlement to social welfare they experience great anxiety and distress. I have come across cases in which people's health was affected by the delay encountered on an adjudication of entitlement. With this Bill, I am seeking to shorten this period of uncertainty and, sometimes, destitution.

Changes could be made within the system itself which would alleviate the situation. If 56% of appeals are successful - I acknowledge that some of these successes were as a result of a review by the deciding officer - what does this say about the decision-making process at first instance? I have some familiarity with the courts system. If a particular judge was being overruled 56% of the time there would be consternation. Surely it is not beyond the capacity of the Department to improve the decision-making process at first instance. If my figures are correct, they show that the number of successful appeals is increasing, which indicates that the position is getting worse rather than better.

A common experience of Members who phone the appeals office is to hear that the file has not yet been handed over by the deciding officer. This accounts for a considerable portion of the delay. We are speaking about individual human beings who may be kept waiting, so it is difficult to speak about averages, but I understand that on average it takes a deciding officer approximately three months to hand over a file to enable the appeals office make a decision. This is indefensible.

It is no exaggeration to state that the 2012 FLAC report is a brilliant piece of work and a model of lucidity. Recently I read an interview with the novelist Ken Follett who extolled simplicity in writing. He stated that if anybody had to read one of his sentences twice he had failed in his task. We can say this about the FLAC report. It is clear, comprehensive and compelling. It examines the social welfare appeals system in detail and signposts very clearly the need for a number of changes. Some of the changes proposed certainly would involve a cost to the Exchequer, but others are simple and straightforward, could be done at no cost to the Exchequer and would immensely improve the system.

When the Minister of State responds, will he indicate how aware the Department is of the report and what, if any, action has been taken on foot of its recommendations? The evidence suggests that not much action has been taken.

Among the proposals made is that the appeals office be put on an independent statutory basis so as to remove the view that it is simply part and parcel of the Department of Social Protection. Another allied recommendation is that appeals officers be recruited through the general recruitment process rather than from within the Department as this reinforces the image of the Department adjudicating on itself.

Another recommendation is that the appellant be automatically given a copy of his or her social welfare file. Currently, an appellant whose appeal progresses to an oral hearing must, if he or she wishes to know the deciding officer's submission, request his or file under FOI legislation. In my opinion and the view of FLAC, appellants should be automatically entitled to this information.

Another recommendation is that urgent cases be prioritised or, alternatively, that an interim payment be made to persons experiencing destitution in the event of excessive delay. While free legal advice is available to social welfare appellants, FLAC recommends that civil legal aid also be available, which obviously would result in a cost to the Exchequer. FLAC also recommended that terms of reference be drawn up for appeals officers. I am not aware if this has been done.

A number of other, largely procedural, proposals are made, including that the appeals officer carry out an audit of his or her procedures to ensure optimum use of resources and that staff in the Department of Social Protection, where appropriate, direct people presenting with problems to organisations that can help them such as citizens' advice centres and NGOs. It is also recommended that an appellant be given access to any previous decision which may be relevant to his or her case, with, of course, the appropriate anonymity. In terms of precedent, such a system operates in the courts.

Another recommendation is that oral hearings be granted when requested unless there is a compelling reason to the contrary. In my experience - I am not aware of statistics in this regard - while this was previously the case, the number of cases in which oral hearings are being refused is increasing, which is a serious matter. By way of statistics, the number of successful appeals decided by way of oral hearing far out-numbers the number of successful appeals decided by way of the summary process.

Other recommendations include that appeals officers, similar to deciding officers, hold quarterly meetings and that regular training be provided for appeals officers. All of these are simple and straightforward recommendations, the vast majority of which would not result in an additional burden on the Exchequer but would immensely improve the system for the benefit of appellants. We are speaking in this instance about people whose circumstances are such that they have applied for social welfare benefits and are, therefore, among the poorest in society. In many cases, they will experience several months of anxiety and uncertainty and, in some cases, great poverty, while awaiting a decision on their case. The system should be as user-friendly as possible for the people concerned who are a disadvantaged sector of society.

I look forward to hearing the Minister of State's response on shortening the appeals system or, at least, the provision of some certainty for the unfortunate people stuck in the appeals system awaiting a decision on their cases and also on the recommendations contained in the FLAC report of 2012.

I welcome the opportunity to discuss the social welfare appeals system. I acknowledge that there has been an understandable level of concern about appeal processing times in the past few years and appreciate that this is what prompted Deputy Willie O'Dea's proposals. Appeal processing times are always a matter of concern, particularly when they impact on those who are most vulnerable in society. I hope that in setting out the very significant progress made in this area in the past two years I can allay Deputies' concerns.

First, I would like to speak about how the appeals system works and why, by its very nature, it takes time to finalise an appeal. The process has a statutory basis in primary and secondary legislation; appeals officers are required to be quasi-judicial in performing their functions, and the office operates independently of the Department, which is one of the proposals made by Deputy Willie O'Dea.

The processing times, as reported by the appeals office, include all stages of the process, including the time taken by the Department in reviewing a decision. It is worth spelling out how the process works.

When an appeal is received in the appeals office, it is registered and the processing time is measured from that date. As required by regulations, the appeals office then notifies the Department that the appeal has been lodged. This notification requires that any file or document relevant to the appeal be forwarded to the appeals office and also requires a submission from the deciding officer on the extent to which the facts advanced by the appellant are admitted or disputed. At this point in the process the Department reviews the original decision.

Social welfare legislation provides that where a decision is on appeal, a deciding officer may only revise the decision if the revision favours the appellant. Therefore, at this stage of the appeals process, the decision is reviewed to decide whether it should be revised in favour of the appellant. This part of the process can take some considerable time. However, it also demonstrates the flexibility of the overall system. For example, in the case of schemes which relate to illness, disability or caring, the time taken by the Department will almost always include a review of the case by a different medical assessor from the one who initially examined that case. In many cases, there may even be a third review, in respect of which additional information is submitted. In cases where the issue involves a means test or other conditionality requiring investigation, a further visit by a social welfare inspector may be warranted. All of this activity takes time, but it also affords the appellant many opportunities to strengthen his or her case. By way of example, 21% or 8,062 of the 38,421 appeals finalised in 2013 were revised by the Department in favour of the appellant during this stage of the process.

Where a decision is not revised, the file with the relevant appeal submission is returned to the appeals office and added to the files awaiting assignment to an appeals officer. To be fair to all appellants, the assignment of appeals and the arranging of oral hearings are dealt with in chronological order. The only exception is in respect of the supplementary welfare allowance scheme. Deputies will be aware that where a claimant has been refused a claim for social welfare and is appealing that decision, it is open to him or her to apply for supplementary welfare allowance in the interim. If the application for supplementary welfare allowance is subsequently refused, the appellant can also appeal that decision and the supplementary welfare allowance appeal will be prioritised for attention within the appeals office as soon as the appeal file and submission are received from the Department.

When a case is assigned to an appeals officer, he or she will examine the documentary evidence presented in order to determine if the appeal can be properly and fairly decided on a summary basis. Where it is considered that an oral hearing of the case is required, it is estimated that the logistics alone involved add a further six weeks to the process. The venue must be booked; the case must be scheduled with other cases to be heard at the same location, and sufficient notice must be given to the appellant and witnesses. At any time during this process, up to and including the hearing of the case, an appellant may submit additional information, which, as I said, affords him or her the opportunity to strengthen his or her case.

I would now like to turn to the issue of processing times. The Bill was initiated by Deputy Willie O'Dea on 13 March 2013. As I said, I appreciate that during the years 2010 to 2012, inclusive, and into early 2013 there were unacceptable delays in the appeals process.

The background to this was the dramatic and unprecedented increase from late 2008 in the number of appeals received in the appeals office. Prior to 2009, the average number of appeals received per year was in the region of 15,000, but by 2012, annual appeal receipts had more than doubled, peaking at 35,500.

The number of appeals received remains high. In 2013, the appeals office received 32,777 appeals, or the second highest annual number of appeals received since the office was established in 1990. The dramatic scale of this increase placed considerable pressure on the appeals office. However, significant effort and resources have been devoted over the last few years to reforming and improving the overall effectiveness of the appeals system and improving appeal processing times for appellants. An extra 15 appeals officers were appointed and ten former community welfare service appeals officers joined the appeals office in 2011, bringing the total number of appeals officers to 41. In addition, a new operating model was introduced in the appeals office aimed at improving the efficiency and effectiveness of the appeals system and eliminating delays at various stages of the appeal process.

On the basis of these reforms and the increase in resources, there has been a dramatic improvement in the processing times for appeals. For example, the time taken for an appeal involving an oral hearing has dropped from 52.5 weeks in 2011 to 29 weeks at the end of October 2014, which is a reduction of nearly six months. The time taken for an appeal determined by way of a summary decision has decreased from 25.1 weeks in 2011 to 21.6 weeks in 2014. These times are still improving. For example, the average time taken for an oral hearing last month was down to 26.4 weeks and the time taken for a summary decision was down to 18.7 weeks. By way of comparison, the time taken for an oral hearing in 2007 was 30.3 weeks and the time for a summary decision was 14.2 weeks. Nonetheless, there can and will be further improvement at every stage of this process. However, it is worthwhile to consider the comparable processing times for the Social Security and Child Support Tribunal in the UK. Appeals in that process took an average of 30 weeks to clear as at June of this year. This measurement does not include the time spent with the Department for Work and Pensions in reviewing the case. If the time spent with the Department in this jurisdiction is discounted, the figure for the time taken to process an oral hearing in 2014 falls to 17.3 weeks, while a summary decision takes 11.6 weeks. It is worth noting that the English appeals system is more inflexible in that the tribunal deals only with the decision that was made at a point in time and based on the evidence that was submitted at that point in time. This demonstrates that we compare very favourably with the UK with regard to processing times.

Deputy O'Dea proposes that where appeals are not processed within the specified 12-week deadline, a decision allowing the appeal would be deemed to have been met. This timeframe simply does not take account of the fact that it is a two-stage process, which includes the initial review by the Department and consideration of the appeal by an appeals officer either on a summary basis or by means of an oral hearing. As I mentioned earlier, the logistics alone of setting up an oral hearing adds six weeks to the process. Further, the proposal would mean that even where the underlying conditions for receipt of the social welfare payment were not met, an appeal would be allowed simply on the basis of elapsed time. This would clearly not be tenable and would be a misuse of public funds. The proposal would lead to a situation in which it may be in an appellant's interest to delay an appeal beyond the statutory deadline in order to achieve this result.

Significant progress made in the past two years means that the time taken for completion of the process has now decreased considerably. As of October this year, we are now below the norms that existed before 2010. As I have outlined, the appeals system in place has a number of stages and allows for reviews, appeals and further information to be submitted at any stage of the process. This favours the appellant, who would otherwise have to repeat the application process unnecessarily. This process carries an inherent delay in terms of finalising an appeal but it is also a very flexible and accessible system. For all the reasons outlined, a statutory timeframe for the completion of the appeals process is not tenable and I will be opposing Deputy O'Dea's Bill.

We must try to achieve a quicker turnaround time. I want to maintain a process in the system whereby additional information can be added at any stage, as it would be wrong to have to push people back to the beginning. There may be a disadvantage to the proposal in this respect. I can see the very strong justification for the introduction of the Bill, especially if we recall the waiting times that have occurred. I will certainly take on board the report of the Free Legal Advice Centres and the issues raised by the Deputy with respect to terms of reference and oral hearings. The office acts independently. I thank the Deputy for raising the issue today, as it has been an opportunity for Deputies to contribute to the debate.

I support the intention of the Bill, but the Minister of State is opposing the timeframe, which is too narrow. Nevertheless, the intention is to address a problem within the social welfare appeals section. It is not just a problem with social welfare appeals, as the issue is with the initial decision in many cases. For example, consider the number of appeals upheld, especially in medical cases. These would include applications for carer's and disability allowance, as well as invalidity benefit. There is a range of social welfare payments on which an assessment is made by a deciding officer based on medical evidence. Considering that the number of appeals upheld can be 40% or more in these cases, we know there is a problem in the system. Other social welfare applications that go to appeal might see 10% or 15% upheld. The problem lies in medical assessments and the examination of documentation produced by an applicant. When the application is made, not all the medical documentation might be present or clear. I know this because I have seen some documentation supplied by doctors to clients. If the information is unclear, rather than making a decision of refusal, a deciding officer would be better served by asking an applicant to get his or her doctor to fully explain the issue. In medical cases, the deciding officer would be a medical practitioner in the Department. These officers must go on the documents in front of them, but they are not stupid; if somebody has had a body part amputated, he or she will know the condition will not get better. There have been strange decisions concerning visible medical problems whose existence has not been accepted by a deciding officer. In such cases, the person involved would experience the stress, strain and turmoil that is often involved in making an appeal, as well as the subsequent delay.

That is the biggest problem with medical appeals. Often, the allowance is needed quickly. This is particularly true of people who will be dependent on a carer. It is not necessarily the carer's allowance that is in question. In order for a carer to be granted carer's allowance, the person being cared for must be in receipt of disability allowance or an invalidity pension. Where somebody has been struck down by an illness that is not properly explained by a doctor, God forbid, there may be a delay in granting these allowances to him or her. If the person appeals, it can take more than six months before a decision is made by the Social Welfare Appeals Office. If it is granted at that stage, the carer may then apply for carer's allowance and end up in the same rigmarole. There is a need for a more linked-up approach to medical documentation. It is not always the fault of the Department of Social Protection or the Social Welfare Appeals Office.

I acknowledge the major progress made in recent years. The length of time for appeals has been cut in half in the past five or six years. Some of this is related to the letter sent out in the first instance. I have made this point to the Minister on a number of occasions. The letter refusing an allowance in the first instance is not very clear on what "review" means. When better documentation or other facts that could change the decision can be provided, the case can be reviewed rather than ending up in the Social Welfare Appeals Office. If that were made clearer in the letter, it would be better. The review is buried in the third paragraph, telling people that they can apply for a review if there has been a change in circumstances or if further documentation is available. The same paragraph deals with how people can deal apply for a social welfare appeal and sets out the deadline. People do not understand what a review means. It must be made clearer to the applicant. This might cut down the number of appeals and the length of time people are without payments. In many cases, they have the documentation and can go back to the doctor or consultant or tell the Department of Social Protection that the problem is that there is a waiting list to get a letter from a consultant. It is one of the biggest scandals that people must wait five, six or seven months for a letter stating their condition. A press of a button in the hospital is all that is required. I know the pressure that outpatient units are under, but if they could issue a letter to support a person with a disability it would serve the cause of the hospital because it would relieve some of the stresses and strains that people are under, and this might make their recovery quicker.

I understand the intention of the Bill and support its progression to Committee Stage, where we can tease out this legislation, rather than having a back-and-forth debate today. At the very least, we should consider a timeframe. With regard to the asylum seeker process, which is a debacle, the Minister of State at the Department of Justice and Equality, Deputy Aodhán Ó Ríordáin, is examining whether a timeframe can be implemented so that people have their human rights respected and an early decision can be made. If decisions are put off, people do not have the right to a proper service. It is not yet at that level in the Social Welfare Appeals Office, but sometimes it is due to a complication of the system or the fact that an applicant does not have access to documentation or does not understand all of the forms.

I presume other Deputies have had the same experience of being asked what people should do with social welfare appeal forms. One of the initiatives undertaken by FLAC is a guide to the social welfare appeals system. We can tell people that this is the mechanism of how to make an appeal or ask for a review. It is framed in this way so that it is clear to people what is sought and what conditions apply. If people think there have been hard done by, they should have access to the social welfare file through a freedom of information request. They can then check to see whether account was taken of all of the documents supplied. It is an extra burden on the Department of Social Protection, but people are entitled to their files. Perhaps many people do not understand this point, but they are also entitled to their medical files. If they apply for the medical files at the same time as the social welfare file under freedom of information, they might be able to speed up the appeal. Perhaps this can be addressed by allowing the Bill to go to Committee Stage for a more detailed perusal.

I thank both Deputies for their contributions. I will re-examine the useful suggestions made by Deputy Ó Snodaigh. Deputy Willie O'Dea spoke about training. A total of 13,000 individual training days were delivered to staff in 2013. We are actively working on this. He also suggested that examples of the Department's decisions be published to provide a better understanding of the process. I do not have the note to hand but, as far as I know, examples are published in the annual report. I am saying that off the top of my head so I will need to go back and look at it.

Although over 50% of cases are overturned on appeal, this does not mean the original decision was wrong in each case. The Deputies know there are many occasions on which people come to our offices and we find out that information was left out of the appeal submission. That shows the flexibility of the system. There is no cut-off date for information to be submitted and it will be accepted at any stage. That can add to the length of the decision.

The Department is working hard to make improvements. We are trying to implement better information gathering at the initial claim stage, which will lead to better decisions. There should also be better explanations for the reasons behind decisions, which will make it easier for customers to understand the decisions and reduce unnecessary appeals. We are actively working on that point. Improvements in review processing times will be examined. Decisions made and notifications to the citizen could be in better or clearer English, because people have different levels of literacy. Official forms can be quite challenging for all of us. I will look at that.

Oral hearings are always granted when requested unless there is a compelling reason not to do so.

Applicants are always told they may get their file from the Department. Deputy Ó Snodaigh touched on that in his contribution that people are aware of it but that sometimes even when they get the file, it is of no great assistance. That was pointed out in the FLAC report also. There are regular meetings of appeals officers to try to ensure continuity across the system.

It is in all our interests that we drive down the length of time this takes as much as possible. Deputy Ó Snodaigh suggested that this go to a committee. I do not think the proposal needs to go to Committee Stage but an exchange, possibly at a committee, would be interesting because many Deputies have experience, sometimes much more than myself, because of the volume of constituency queries received. There is a wealth of experience which could be tapped into by the Department and sharing those experiences could mean a better and faster decision for the applicant.

I pay particular credit to the staff who work in the appeals office. Since the recession, there has been an unprecedented increase in the number of appeals - I gave the figures earlier - and that reflects the high unemployment rate. The number of appeals has reduced and the length of time it takes for an appeal to be heard has reduced significantly. That is due to the civil servants who work in the Department. I did not want to finish without mentioning the trojan work done by, and the level of change and reform in, the Department to bring the figure down by more than 50%, which Deputy Ó Snodaigh rightly pointed out. That is exceptional at a time of grave economic difficulty. I thank Deputy O'Dea for raising the issue and the Deputies for their contributions.

I thank the Minister of State for his response and Deputy Ó Snodaigh for his support. I join with the Minister of State in complimenting the staff in the Department of Social Protection and the appeals office, with whom it is always a pleasure to deal. They are very courteous and helpful people.

I will make a couple of general observations, none of which is directed personally at the Minister of State. There was a reference in his speech to what is happening in the UK. We are coming up to the 100th anniversary of 1916 and we have been an independent country for almost 100 years. I think it was the late John Kelly who described this constant tendency to look at what is happening in the UK, of emulating the UK and of measuring ourselves against the UK as malignant "Paddyism", with which I agree.

The Minister of State was correct in saying the Bill was initiated on 13 March 2013 and that the situation was worse then. I acknowledge the improvements that have been made and the extra staff who have been appointed but it highlights something else. I recall in the run-up to the general election and during the preparation of the programme for Government great play being made of the so-called democratic revolution and how this Dáil would be revolutionised. One of the central parts of that revolution was that Deputies would be able to bring in their own legislation. Normally, when a Deputy brings a Private Members' Bill before this House, it is to deal with a fairly immediate problem. This Bill was proposed 20 months ago in a particular situation and it is now being introduced. That says more about the claims that this particular parliamentary reform would be revolutionary than anything I could add.

In fairness, it reflects the hard work of Deputies in bringing forward Bills.

Of course it does but the point is that when they are introduced 20 months after they were produced, it says something about how the system has changed.

A huge number of Bills have been brought in not only by the Deputy's party but by many others.

Deputy Ó Snodaigh made the point that 60 days may be too short a timeframe. With the resources etc. available to the Department, that may very well be correct. I am not caught up with 60 days. What I am trying to deal with is the situation of some unfortunate who has been turned down for social welfare. The statistics from the Department show that in more than 50% of cases, he or she may have been wrongly turned down. If he or she goes to appeal, he or she will go to his or her local public representative to say that he or she was months applying for carer's allowance, disability allowance or whatever but now he or she has gone to appeal. He or she will ask how much longer he or she must wait. What I want to do is to give the person some element of certainty and that we can say it will not go beyond a certain period of time. I still think that is valid. Some of these people do not get supplementary allowance, so they will be literally living from hand to mouth. What is being adjudicated on is whether the person is entitled to social welfare in this country. That will be a very big thing for the person, probably the most important thing in his or her life. We want some element of certainty to reduce that worry and stress and that a person will know that a decision will have to be made within a particular timeframe.

The Minister of State mentioned that there are various steps in the process, with which I agree. Perhaps the Department, as an alternative or on its own initiative, will produce a circular which fixes a maximum period for each process, for example, the process whereby the deciding officer must prepare his or her observations and send them on to the appeals office. If there was a specific timeframe for each of those processes, it would certainly help.

The Minister of State said that when somebody looks for an oral hearing, he or she will automatically get one but that has not been my experience. I ask the Minister of State to look at that because if somebody requests an oral hearing, it should be automatic.

Will the Deputy send us an example?

I will do that. I also ask the Minister of State to take on board Deputy Ó Snodaigh's very good suggestion that the right to a review be clearly set out because people have come to me who think they must go straight to the appeals office and they are amazed to hear they can actually go back to the deciding officer to have their case looked at again. That is not clear on the form. I am glad some of the administrative changes proposed by FLAC have taken place.

While I will press the Bill, I nevertheless acknowledge the improvements that have been made. I seriously urge the Department - this is not political - from the point of view of the people we represent, on whose behalf we speak, who are the poorest section of society and who are waiting for their social welfare entitlement to be adjudicated on, to continue the improvements made and to try, if at all possible, to bring some element of certainty for those people.

Question put.

In accordance with Standing Order 117(1A), the division is postponed until immediately after the Order of Business on Tuesday next, 11 November 2014.

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