Dáil Éireann Debate, Wednesday - 26 September 2018
55. Deputy Willie O'Dea asked the Minister for Employment Affairs and Social Protection the rationale for the changes to the illness benefit form; if her attention has been drawn to the difficulties and disruption this is causing for general practitioners and applicants; and if she will make a statement on the matter. [38895/18]
View answer56. Deputy John Brady asked the Minister for Employment Affairs and Social Protection when the decision was made to change the forms for illness benefit; the consultations that took place prior to the changeover to new forms; the status of processing times for the payment; and if she will make a statement on the matter. [39077/18]
View answerAs the Minister will be aware, a problem was created by the Department with regard to people applying for illness benefit, which caused a great deal of anxiety and stress for those people, not to mention the people expected to adjudicate on them, namely, the medical profession. How did this problem arise and has it been resolved?
I propose to take Questions Nos. 55 and 56 together, if that is okay with Deputy Brady.
That is fine.
My Department recently introduced redesigned claim and medical certificate forms for use in the illness and injury benefit schemes. The purpose of the redesign was to facilitate a new process within the Department whereby forms would be scanned rather than manually keyed into the new IT system. Claims received on the new forms and certificates are being processed into the payment system on the same day as they are received. That is a significant improvement on behalf or our clients. The introduction of the redesigned form was discussed with the Irish Medical Organisation, IMO, in advance. The IMO advised its members, one month before its introduction, that they should co-operate with the use of the new forms.
The Department subsequently communicated directly with general practitioners, GPs, as is our responsibility, shortly before the introduction of the redesigned forms. Given the confusion that has arisen over the last couple of months, we have to accept that we should probably have communicated directly with the GPs more quickly than we did. We accept that and we apologise.
The majority of the certificates in the claim forms that are now being received each day by the Department are the new scannable versions. These claims are being processed without any delay. However, some GPs have continued to use the old forms after the changeover date. To facilitate the continued payment of the illness and injury benefits to our clients, my Department has, to date, considered to accept those old forms. While their continued use causes delays to our processing times, my Department is doing everything possible to ensure that customers are paid as quickly as possible. There is currently a backlog of two days in processing the old forms and certificates.
The introduction of these and other initiatives is the subject of ongoing discussions with the IMO. A framework and timetable have been agreed with the IMO, during which intensive discussions are planned. New processes will not be introduced until these discussions are concluded and advance notice, including details of any changes to payment arrangements, will be provided to the individual GPs directly from my Department. It is important to note that the Department has had a long and positive relationship with GPs for many years. We are committed to working hard to resolve any outstanding issues which cause concerns among our GP partners.
I record my immense gratitude to the people in the illness benefit section of my Department. They worked tirelessly, including coming in at weekends, to ensure that the clients, who rely on the weekly payment and have no other form of income, did not have to wait due to a delay. We had to find a work-around IT system because had already moved to the new system and the old system was therefore not working. I say genuinely, and do not think it can be understated, that they worked their socks off to ensure the service we give to our clients is as good and reliable as it always is. I, for one, am exceptionally grateful for their commitment.
Since we are taking Questions Nos. 55 and 56 together, Deputies O'Dea and Brady have equal time, but their time is doubled, so they both have a fair crack at the whip.
I want to be associated with the Minister's remarks about the staff in the Department. The Minister said that the IMO was consulted. The Minister must be aware that the IMO only represents approximately 18%, fewer than one in five of practitioners who have to certify people for illness benefit. If I heard her correctly, the Minister also said that individual GPs were informed shortly before the new forms went out. My information is that the prescribing GP simply got all these new forms with a whole lot of different information and different questions from what had hitherto been the case and was simply told to get on with it without any consultation or discussion. I think the Minister has accepted that this is not a proper way to do business.
What percentage of GPs are using the new forms at present? Are there residual difficulties as a result of the fact that the full transition has not taken place?
I want to be associated with the Minister's comments about the staff dealing with the illness benefit forms. The reason they had to come in and work those extra hours, however, was the unmitigated disaster and mess that was created by the officials and by the Deputy herself, as Minister, in unilaterally introducing these new forms on 6 August without any proper consultation. It is interesting that she said that one month before the introduction, the IMO was consulted and informed that it should co-operate with the use of these forms. That is exactly what the Minister said, and that is certainly not consultation. I also heard her apologise to the GPs. That must be welcomed. She needs to extend that apology to the people. We are dealing with some of the sickest people in the State such as cancer patients and terminally ill people who, unfortunately, were caught up in this complete mess. The National Association of General Practitioners, NAGP, to which Deputy O'Dea alluded, representing the vast majority of GPs, has tried to engage with the Minister and the Department in this entire process and has been completely ignored. Has there been or will there be engagement? It is critically important that one of the organisations that represents the vast majority of GPs has not been consulted, negotiated with or simply spoken to.
I do not know whether Deputy O'Dea is aware of the long-standing relationship - it has existed for many years - between my Department and GPs. We rely on them not only for illness benefit, but also for carer's benefit and a variety of other schemes. They are an invaluable resource to both the people they serve and to the Department. We have never, ever told anyone to get on with anything, so I do not know who is giving Deputy O'Dea his information but it is not quite accurate. Our relationship with individual GPs is based on individual contracts. There are no representative bodies with which we negotiate or mediate. We deal directly with our GPs. However, out of respect for the long-standing framework that has existed in this country, of which Deputy O'Dea is well aware, and which was established by Fianna Fáil many years ago, and perhaps to flag potential issues we ourselves within the Department would not have seen, we did have discussions with the IMO. Those discussions were fruitful and, notwithstanding other issues and other new efficiencies that will be discussed over the coming months, the IMO instructed its GPs that they should move ahead with the new, more efficient process being enabled by the Department to ensure the efficiencies provided by the GPs and the Department result in expedited claims and payments for the clients who rely on them. This is exactly what happened for all the GPs who used the new forms that were scanned in. Normally one must wait a week and get paid a week in arrears on an illness payment. People are now getting paid on day two. There are huge efficiencies, and I am very grateful to all the GPs who have come on board. I apologise to the Acting Chairman for rabbiting on. To answer Deputy O'Dea's question, I do not have a percentage, but the vast majority of claims coming in to us daily are on the new scannable forms.
The Minister asked me whether I am aware of the relationship between her Department and the GPs - yes, I am - and who informed me that the GPs were told to get on with it - the GPs did. Given her Department has such a wonderful relationship with GPs, this is a pretty shoddy way to treat them, with respect. As Deputy Brady has said, there is an organisation that represents over 80% of GPs and has sought to consult directly with the Department, and for the life of me I cannot understand why the Department chooses to consult with an organisation representing 18% of GPs and refuses point-blank to consult with an organisation representing 82% of GPs. The Minister referred to "the vast majority" in response. The vast majority would be well over 50%. The information I got - and I got it in writing - is that, as of yesterday, 80% of GPs are still relying on the old forms and doing photocopies, etc.
That information is incorrect.
That is the information I have and I will communicate that correspondence to the Minister after this-----
Yes, but I assure the Deputy that it is incorrect-----
I will let Deputy Brady in and then I will let the Minister reply.
It was stated that the aim of introducing these new forms was to improve efficiency for GPs and the Department, but efficiency has gone out the window. It appears to me that the only reason these forms were introduced was to make the process more efficient for the Department, certainly not for patients. This is what we see. I mentioned cancer patients and terminally ill people who are being caught up in this complete debacle. It is not the first time the Department has made a complete mess of changeovers, of introducing new schemes and so on. We saw this last year with the dental examinations that were introduced without any consultation with dentists or any organisations and the mess this created at the time, and that is a fact. The Minister can shake her head.
The Deputy makes the facts up as he goes along.
I want to ask a couple of specific questions. How many people are still waiting on an illness benefit claim to come through because of this mess? What is the current processing time for new applications?
I thank both Deputies for their co-operation. I ask the Minister to conclude on this.
Public policy on discussions or consultations with professional organisations such as those representing GPs has, since about the mid-1970s, been to engage with one representative body rather than try to negotiate or communicate with multiple bodies claiming to hold the mandate for that particular group of people. The Deputy cannot say on the one hand that one organisation represents 80% of the people it represents when, on the other, another organisation claims more or less the same thing because both sets of details cannot be true. In the case of GPs, the representative body which is affiliated with ICTU and has been for many years is the IMO. The NAGP is a relatively new body which is not affiliated with ICTU, and the Department's understanding is that its membership is less than that of the IMO. Nevertheless, the Department is happy to take input from the NAGP and has had some contact with the organisation and will consider any input we receive from it regarding any efficiencies it might like to see in our system and our offering. We will, however, continue to hold substantive discussions with the IMO as it is the body that is recognised as holding the representative rights for all GPs.
If Deputy Brady wants to make stuff up as he goes along, that is his will, and it is probably a practice that is well engaged by Sinn Féin. The reality of the matter is that the new forms and the new system have brought far greater efficiencies than were ever there before. When we used to get an old form and it had to be manually inputted, people would have to wait perhaps five or six days for their illness payments. Now when the form comes in it is scanned in on the same day and the client gets the payment the following day. I do not know in what world Deputy Brady does not think that is a better system. In our world, however, we think that having efficiencies is a good thing, not only in the Department, which ultimately saves the Department money and allows us then to spend that money elsewhere. Perhaps in Deputy Brady's world it is not a good thing.
If implemented and consulted on, that is absolutely a good thing.
Improving services for our clients is also a very good thing, and that is what we will continue to do on both this scheme and across all schemes in which we can provide improvements and efficiencies.
I point out to the three people in the Chamber - the Minister and the two Deputies - that we have run seven minutes over time. They were entitled to double the time because there were two questions. I will not allow that to continue so I ask all Members to stick to the rules of the House. I am only implementing the rules. I ask Members to do their best. I know it is a very serious issue and I do not wish at all to block or stop people from trying to explain a point.
