COMMITTEE FOR SOCIAL DEVELOPMENT  

OFFICIAL REPORT
(Hansard)

Administration of Disability Living Allowance

22 May 2008 

Members present for all or part of the proceedings:
Mr Gregory Campbell (Chairperson)
Mr David Hilditch (Deputy Chairperson)
Mr Mickey Brady
Mr Fred Cobain
Mr Jonathan Craig
Ms Anna Lo
Miss Michelle McIlveen
Ms Carál Ní Chuilín

Witnesses:
Mr Brian Cullen (Department for Social Development)
Ms Lesley Morgan (Department for Social Development)
Mr John Nevin (Department for Social Development)

The Chairperson (Mr Campbell):
I welcome Messrs John Nevin and Brian Cullen and Ms Lesley Morgan to the Committee. I remind everyone to switch off their mobile phones, as they interfere with the recording. You are here to brief us on the administration of disability living allowance (DLA). If you wish to make a few comments, we will ask questions later.

Mr John Nevin (Department for Social Development):
Thank you for the opportunity to address the Committee. DLA is a very important benefit in Northern Ireland, and 117,000 people claim it.

The Chairperson:
How many people claim it?

Mr Nevin:
One hundred and seventeen thousand.

The Chairperson:
I read somewhere that 170,000 people claim DLA.

Mr Nevin:
I apologise; you are right — I got my figures wrong. Some 170,000 people claim DLA. As DLA is an important benefit, it has been subject to several studies by the Northern Ireland Audit Office (NIAO) over the years. In fact, one study on the end-to-end appeals process is nearing completion, and we look forward to the results of that.

Disability living allowance is a tax-free social security benefit. It is paid to people who are under 65 who have an illness or disability that necessitates help with getting around or help with personal care or, indeed, help with both. It provides a contribution towards some of the extra costs faced by severely disabled people as a result of their disabilities.

One of the complexities of the benefit is that it is not based on a person’s condition, but on how the illness affects them in their day-to-day life; therefore it requires a high degree of judgement and interpretation of detailed medical evidence by decision-makers. As the briefing paper states, there can be 12 different outcomes to a claim for disability living allowance. Therefore it is very important to train the decision-makers, because our emphasis is on quality and on getting things right rather than on dealing with a claim quickly. Decision-makers receive a comprehensive 12-week training programme, which is specifically aimed at disability living allowance requirements.

They have access to online medical guidance that gives them information on the likely effects that medical conditions can have on people’s lives, their care and mobility needs. Medical officers who have experience with disability and with training in the legislation are also available to help decision-makers to arrive at proper decisions. When they have finished their 12-week training, decision-makers are assigned to mentors who are experienced decision-makers for a further six weeks, which helps to ensure that they have a full understanding of the training and the legislation and that there are, as far as possible, no gaps in their knowledge of the benefit.

As I am sure you are aware, doctors visit people in their homes to help to assess the degree of disablement from which they suffer. Those doctors have had training on disability living allowance and on specific needs beyond what they would normally have as GPs.

Our main aim is to strive for quality. In order to do that, we have, over the years, introduced special measures in the branch, including the formal establishment of a disability living allowance quality council. The council is headed by one of the senior managers in disability and carers service and includes key players from other areas. A standards assurance unit measures the accuracy and equality of claims and decision-making; it is a member of the forum because of its expertise on the benefit. It can provide feedback and advice on disability living allowance and on the nature of mistakes and where they happen. The quality council analyses the information that is gained from monitoring so that we know the areas where training needs must be tackled.

A quality-control team in the branch also provides advice and guidance to decision-makers on difficult or complex cases. A one-hour team slot is set aside every week throughout the agency to advise staff of changes in instructions, and, if any trends or particular types of mistakes have been discovered through monitoring, to help them to learn and to ensure that accurate decisions are made.

Management checks are carried out during the evidence-gathering stage to ensure that, from the outset, required evidence is sought from relevant sources so that claims are processed quickly and that quality decisions are made. The senior medical officer in the agency carries out disability-education awareness seminars; for example, on conditions that cause difficulty for decision-makers such as traumatic brain-injury cases and fibromyalgia.

As well as internal matters, we conduct a special forum with the voluntary sector that meets quarterly and at which its representatives can raise concerns with us about decisions and how the benefit is administered. The forum consists of the Citizens Advice Bureau, Advice NI, the Law Centre, and Disability Action. Those organisations have dedicated contact points in the branch where they can raise queries with us so that we can resolve issues before they go on for too long.

I mentioned quality and accuracy standards. During the past five years, we have made considerable improvements in the accuracy of cases. The number of correct cases has risen from about 88% in 2003-04 to 97% case accuracy in monitoring in 2007. That case accuracy of 97% can be converted to a financial-accuracy level, as regards the amount of money that was paid out after monitoring, which, in 2007 was 98·8%.

We concentrate on quality and on getting the decision right and on paying the right money to those who need it, and we have evidence that we have made considerable progress in the past three or four years.

The Chairperson:
Thank you, Mr Nevin. You know that the number of people claiming the benefit greatly heightens public interest in the issue, and you have outlined some of the complexity.

The Committee asked:
“Over the last five years, what percentage of applicants who were unsuccessful in their applications for DLA lodged an appeal? This information should be broken down into components and rates.”

The response was:
“The Department’s Statistics and Consultancy Branch, which has responsibility for data capture from the Disability Living Allowance computer system, has advised us that the data held is a snapshot at any given time showing only those people currently receiving the benefit. Statistics and Consultancy Branch does not hold data on disallowances/unsuccessful applicants, therefore, we cannot ascertain how many unsuccessful applicants went on to make an appeal. Because Disability Living Allowance has 12 potential outcome determinations, with the exception of those awarded the highest rate of both components, an appeal can be made against any of the other 11 possible outcomes and the computer system we use to pay this benefit, which is owned and used by the Department for Work and Pensions, does not capture this level of detail.”

That answer reflects the complexity of the problem. In layperson’s language, will you explain how to establish the numbers and percentages of people who lodge an appeal after being refused DLA, regardless of whether the appeal succeeds?

Mr Nevin:
Mr Cullen will comment on that. We did try to answer in layman’s language.

The Chairperson:
It did not work.

Mr Nevin:
Obviously not. Explaining the issue of appeals from a DLA point of view is difficult, partly because appeals in relation to other benefits are often solely against a disallowance; with DLA, however, people can get an allowance but appeal for a higher rate. Furthermore, our statistics branch does not retain data on the number of appeals heard over disallowed cases. Mr Cullen will elaborate.

Mr Brian Cullen (Department for Social Development):
The system that our statistics branch uses for analysis pays the benefit into claimants’ bank accounts. Entitlement work is done offline. The computer system collates the names of customers, their benefit entitlement, and details of bank accounts to be credited. The statistics branch cannot access information on the number of people whose claims are allowed or disallowed, nor can it provide a further breakdown of those figures.

On the issue of appeals in general, every outcome decision is open to appeal, and it is wrong to assume that people appeal only against being refused benefit. There are 12 permutations, ranging, in monetary terms, from the highest level of £113 a week, to the lowest rate of either component, which is £17·75 a week, or — in the worst-case scenario — no entitlement at all.

The Appeals Service captures information on appeals and tribunal outcomes, such as whether the customer has won a higher payment.

Therefore, if the tribunal awards a rate to someone who has no entitlement, whether the lowest rate or the highest, that is considered a successful appeal. Equally, if someone with a current rate of benefit, whether the lowest or the middle rate, is awarded a higher rate on appeal, that, too, is regarded as a successful appeal. However, if the tribunal upholds the Department’s decision in a case, whether a disallowance or a current rate of benefit, that is classified as an unsuccessful appeal.

In cases where benefits are already being paid, the tribunal might decide that an individual is entitled to a lesser amount. Nevertheless, that means that we got it wrong, since we had been too generous in our determination. The tribunal has the authority to remove or reduce entitlement, which is also classified as an unsuccessful appeal. Only three types of data are captured: successful, unsuccessful or disadvantageous. The Appeals Service captures those data and feeds them to us. However, it is not possible to carry out an individual analysis of each of the 173,000 cases to which Mr Nevin referred.

The Chairperson:
There are 173,000 recipients of DLA entitlements. Is it possible to establish how many people in any 12-month period applied for DLA?

Mr Cullen:
There are 60,463 activities in any given year. An activity can be a fresh claim application or a renewal application; some people are awarded DLA for a restricted period because their condition might change and they will later have to reclaim. Claimants who receive the current rate of benefit can at any time report a deterioration or improvement in their condition and ask for a supersession to have their case re-examined or a previous decision reconsidered.

The Chairperson:
Do those 60,000 claimants encompass all groups?

Mr Cullen:
Yes.

The Chairperson:
Of those who were not entitled to DLA last year, how many are fresh applicants in the current year?

Mr Cullen:
There were 21,796 fresh applications.

The Chairperson:
Is that a consistent year-on-year figure?

Mr Cullen:
There have been about 21,000 to 22,000 applications in each of the past five years. In 2003-04, there were 23,000 applications, which was the highest number in the past five years; in the following two years the figure fell to 22,700 and 22,100. In the last full year, the figure was 21,796, of which 47% were successfully awarded benefit.

The Chairperson:
Has the total number of recipients remained constant or increased in the past five years?

Mr Cullen:
The live flow usually increases year on year; however, there are on-flows and off-flows, and it is wrong to make a correlation. If 21,796 people claim benefit — say 22,000 — and 50% are successful, it is wrong to say that that will add another 11,000 to the 173,000 because, depending on the nature of the condition, we might decide to restrict awards, so a certain percentage of people will come off benefits as a certain percentage comes on. In the last published figures, on 31 August 2007, there were 173,000 on our live load.

The Chairperson:
Let us keep this simple. There are 173,000 claimants at the moment: what was the number five years ago?

Mr Cullen:
I do not have that statistic in front of me.

The Chairperson:
There are 173,000 recipients in the system and approximately 20,000 applications each year, roughly half of which are likely to be successful.

Mr Nevin:
There are roughly 23,000 new applications each year.

Mr Cullen:
Forty-seven per cent were successful in the last full year.

The Chairperson:
I am trying to understand the scale of benefit entitlement. By how much is the number of applications increasing and how many fresh people are coming into the system? How does that affect the administration of the system?

Mr Nevin:
In September 2003, there were 155,000 DLA recipients; in September 2004, there were 162,000; in September 2005, there were 167,000; in September 2006, there were 170,000; and in August 2007, there were almost 174,000 recipients.

The Chairperson:
Has the Department been able to work out what percentage of the population of Northern Ireland is theoretically entitled to apply for disability living allowance?

Mr Nevin:
Research shows that about 18% to 20% of the population in Northern Ireland suffers from a limiting health complaint. That does not necessarily mean that all those people are entitled to disability living allowance, but it gives an indication of the potential pool of applicants.

For example, there are people with cancer who are receiving treatment, but their lifestyle is not sufficiently —

The Chairperson:
I am sorry, but I am not talking about medical conditions; I am asking about the number of people theoretically entitled to apply for disability living allowance. Are people over 65 entitled to claim?

Mr Nevin:
There can be no fresh applications from the over-65s.

The Chairperson:
Therefore it should be possible to determine the number of people over 65 who live in Northern Ireland who can be removed from the mathematical equation.

Mr Nevin:
Yes.

The Chairperson:
If there are 1·7 million people in Northern Ireland, 250,000 of whom are over 65 — I do not know the exact figure, but I am sure that the Department could establish it — the number of people who can theoretically apply for DLA, whatever their condition, is about 1·4 million. Can other categories be removed from the equation? Can a claim be made for a very young child?

Mr Cullen:
One can claim from birth, Mr Chairman. There is a three-month qualifying period before one is entitled to claim, but if a child is born with a substantial disability, a claim can be made at the outset and we would make an award in advance of that three-month period.

The Chairperson:
I suspect that the number of applications for very young children is quite small.

Mr Cullen:
For the purpose of benefits, a child is classified as anyone under 16. A high number of children with disabilities claims benefit; however, we cannot break it down by age profile.

The Chairperson:
I would like to simplify the matter: we are talking about a potential applicant pool of approximately 1·4 million to 1·5 million people under 65 who could theoretically apply for disability living allowance. The number of successful applicants is increasing by about 5,000 per year, is that right?

Mr Nevin:
That is correct.

The Chairperson:
What sort of administrative problems does that present?

Mr Cullen:
The same resource requirement is needed whether a claim is successful or not, and that requirement relates to the volume of applications and not to their outcome. Once entitlement has been established, the maintenance on a claim is limited, with the exception of a customer writing to report a change in their condition, bank details, general practitioner and so forth.

Ultimately, most of our resources are targeted at determining claims and applications. At present, 53% of claims are unsuccessful, but we still have to go through the same determination process of evidence gathering that we would for a successful claim.

I have a rough understanding of where you are coming from — although correct me if I am wrong — in wanting to understand the percentage of the population in Northern Ireland eligible to claim. Statisticians, through commissioned research, estimate that roughly one in 10 of the population receives disability living allowance.

The Chairperson:
Does that statistic include the proportion of people who cannot apply for DLA because they are over 65?

Mr Cullen:
No; it covers people who fall within the age-band criteria.

Mr Nevin:
A total of 173,000 — approximately 10% — of the 1·7 million people in Northern Ireland receive DLA. However, if the over-65s are excluded, the remaining recipients represent 12% to 13% of the 1·4 million people who are entitled to receive DLA.

Mr Cullen:
There is an alternative and equivalent benefit — a form of attendance allowance — available to people over 65, which mirrors the DLA entitlement conditions, with the exception of the mobility programme.

The Chairperson:
At the moment we are just looking at DLA.

Mr Brady:
Whether you like or not, our concerns have been instigated by the inconsistency in DLA decisions; I have been dealing with that issue since the introduction of DLA in 1992.

An example of such inconsistency is where two children with Down’s syndrome, one of whom will get an indefinite award while the other will get a two-year allowance.

I am aware that you look at how each applicant’s condition affects them, but it is the inconsistent decisions that I find hard to reconcile. Another concern with DLA administration is that of commissioners’ decisions over the years. I am not quite sure how they are factored in.

Another issue is periodic reviews. I was involved in a consultation in the mid-1990s when periodic reviews were introduced to ensure that people received their entitlements. However, from then until last year, I did not meet one person in the advice centre where I worked who had their circumstances periodically reviewed and subsequently allocated more money. I am not saying that it does not happen; I am just saying that that has been my experience.

We accept that we cannot change the legislation; however, we can question the administration and its inconsistency. I recently came across a case where a 1998 examining medical practitioner report on a person who suffers from the progressive condition of osteoarthritis was quoted in 2000. I am not sure how the two can be reconciled.

I have also found that favourable GP reports for claimants are often ignored, whereas unfavourable ones are quoted ad nauseam. Those are personal observations from my dealings with the issue over many years.

Another administration issue relates to the treatment of people with mental-health problems. Commissioners’ decisions have said that an examining medical practitioner should not assess people who have mental-health problems unless they have some knowledge of the illness. However, the opposite often happens: examining medical practitioners who have no experience of working with mental-health problems examine people who have severe mental-health problems.

Are all those issues factored in?

You spoke about accuracy; however, the accuracy to which you refer is the accuracy that you apply to your criteria in administrating the benefit, not necessarily the legislation. I could go on about that all day.

I am aware that the design for the DLA form won an award a few years ago. I am not sure who gave the award, but it certainly was not someone who had applied for DLA. The problems with that could be looked at and streamlined with proper medial evidence and consultation.

The disability handbook is frequently quoted to DLA claimants. However, it is often inconsistent with what is quoted by the Department.

The North has a high percentage of people per head of population who have a disability. The area where I live has one of the highest incidences of MS in the world, which has been documented by the Mayo Clinic. There are also high incidences of ME and fibromyalgia. There are commissioners’ decisions that are consistent with what you said about looking at the effect and not the cause of an illness.

Unfortunately, in my experience, that seems to be ignored. Therefore, huge issues must be considered; however, I do not want to go on about it all day.

Mr Nevin:
Without wanting to sound facetious, Mr Brady has covered quite a few points and, although I will try to answer them all, I apologise if I miss any of them out in my response.

We appreciate the work that the Assembly does, as well as the help that we get from the voluntary sector, constituency offices and public representatives, although it may not always appear that way. Professor Eileen Evason, who is well known in the field of welfare rights and voluntary work, recognised that people working in the welfare and voluntary sectors tend to deal with people who are dissatisfied and have complaints as a result of mistakes that we have made. I do not claim that we are perfect — far from it. Therefore, those who contact their representatives have had problems. There are probably too many such people.

Accuracy monitoring is carried out by an independent unit in the branch. That unit follows the guidance that we have been given through the commissioner’s decisions, and has found that 97% of cases are dealt with accurately. That means that, of the 170,000 case papers, we recognise that 3% of them — approximately 5,000 — are wrong.

Believe it or not, over recent years, the statistics show that over 50% of cases that are reviewed in the periodic enquiry result in the claimants’ benefits being increased. Those people will go to their representatives because they are probably reasonably happy; therefore, I accept that Committee members, as elected representatives, may not have met many — if any — such people.

We have attempted to improve the general accuracy and equality of the amount of disability living allowance. The regulations state that an award should be indefinite when there is no evidence to indicate that the conditions will remain satisfied. Mr Brady mentioned reviewing, on the basis of 10-year-old evidence, the case of someone who suffers from osteoarthritis. That should not have happened; that evidence should not have been used. However, using that case as an example, osteoarthritis is a degenerative condition. When the person initially applied for disability living allowance, he or she may have qualified only for the lower-rate mobility component and, possibly, not for care. Those conditions are likely to continue to be met as long as that person remains alive; so that would be an indefinite award. It is likely, however, that after, say, between three and 10 years, that person’s condition will deteriorate.

We have worked with our statisticians to identify such cases that — to use Civil Service-speak — have a high propensity to change; that is, for example, cases where someone suffers from a degenerative illness. The conditions for that claimant’s receiving a benefit will continue to be met; however, those conditions may have deteriorated to the extent that the person becomes entitled to a higher rate of benefit. We review such cases, over 50% of which result in the claimant’s receiving an increased benefit.

Mr Brady:
Is the periodic review therefore instigated as a result of a desire to increase a person’s benefit? My understanding, — and I have been told by the Department — is that periodic reviews are chosen at random by the computer from the list of people whose benefit award is indefinite. We were told that cases for review are selected at random. If that is not the case, that should be made known in the public domain.

Mr Nevin:
To explain the background to that, in 1990 a review of benefits by the Audit Office found that there were too many indefinite awards in NI, compared to the number of such awards across the water. The Department examined that and, five or six years ago, I became involved in that review. At that stage, we decided to ask our statisticians to target cases that were likely to change. At the beginning, that amounted to over 80%. At that stage, the ratio of reduction to increase was 51% to 49%. Those figures remained until the last couple of years. The purpose is not to increase or decrease awards; it is to ensure that the correct award is paid.

Mr Brady:
With regard to logistics and bringing forward, if, in the periodic review, the case of a person with a condition that is likely to worsen is entered into the computer, will that case be picked out in five years’ time?

The Chairperson of the Committee for Social Development:

Some sort of DGI or something?

Mr Nevin:
I asked that question in preparation for today because I thought that our system could possibly be improved. The system does not allow us to bring cases forward three, four or five years ahead. Our data on the impact of benefits, how they change and how decisions are passed were given to the statisticians and fed in. A code is assigned to any benefit awarded which reflects the nature of the person’s complaint that most contributes to that award. Statisticians take that information into account.

Conditions that will deteriorate — for example MS, osteoarthritis or fibromyalgia — can be flagged up fairly well; they can be identified and pulled out. Equally, where people have conditions that are likely to improve, those cases can be identified from the system. We had agreed with the Audit Office on a programme, through the periodic enquiry, to tackle those cases with the highest propensity to change, and there are approximately 28,000 of those. We were examining about 2,000-3,000 of such cases each year, and the Audit Office asked if that could be extended. We wrote to cases in that pool that were less likely to change, asking the recipients of DLA if there had been any change in circumstances. We hope, over a period of three or four years —

Mr Brady:
In the case that I am talking about, of osteoarthritis, there was an award — a low award — but it was in a supersession where DLA 434 was sent out and completed, with medical evidence as to the worsening of the condition.

There was a recent case where someone who was said to be in the top 10% of people with rheumatoid arthritis — the person is actually undergoing a form of chemotherapy, which should be some indication that he or she has a serious condition — and the medical evidence from the specialist and GPs was clear that the condition had deteriorated rapidly. It had spread to the spine, yet that person was turned down. I refer to that kind of inconsistency.

Regarding the periodic review, when we were involved in the consultation in the mid-1990s, we were told that it was being done in a better way here because it had been made such a mess of in England. That is why the voluntary sector was called in — to make sure they got it right. Unfortunately in my experience, that simply has not happened, but that is the personal observation of someone who has worked in that field for the last 26 years.

The Department needs to stand back and look at big issues around the whole administration of DLA. I make the point that accuracy means applying your criteria. I do not say that everyone who applies for DLA should get it; that would be nonsense. There are people who receive DLA who, I am sure, should not. However, genuine cases of particular conditions that would receive DLA, were the criteria applied, are not.

That is the problem. You referred to people who receive DLA after a periodical review. That is great, but the people I refer to are not just dissatisfied. People who have genuine conditions, supported by medical evidence, have had their DLA reduced. That is despite the fact that, in many cases, the condition has become worse.

The complexity of the benefit system has been illustrated by yourselves and by the questions that the Committee members have asked. Ultimately, however, the decisions are made by civil servants without the necessary medical knowledge. Members referred to senior medical officers. I have read appeal papers that were returned because a condition may or may not improve. If someone has a broken leg, they hope that that will get better. However, some complex medical conditions are dismissed by the decision-makers — and therein lie many of the difficulties.

Mr Nevin:
I know that Mr Cullen is champing at the bit to speak. Over the years, the Department for Social Development has improved the consistency of correct decisions; however, I accept that there are cases when the Department does not get those decisions right. Those constitute approximately 3% of the case load, although that means thousands of cases.

The Department draws some comfort from the report that was produced by the president of appeals tribunals. Mr Maclynn last reported on 2005-06, when he said that the decisions in relation to DLA were of a high standard. The right decision was made in 98·4% of the cases that went to appeal. That is not to say that some cases were not overturned because of different interpretations, where new evidence was considered by the tribunals, or where, having seen the person, the tribunals decided that a change should be made.

The Department was given some consolation from the consistency and the correctness of the decision-making in accordance with the law. Obviously, we cannot discuss individual cases; however, if members have examples of individual cases, Brian Cullen will be very happy to consider those.

Mr Brady:
With respect, Mr Maclynn’s figures would be more accurate if it was known how many people had their request turned down and did not appeal that decision. Presumably, he only deals with appeals that go through his office. It is perhaps the case that quite a few people who were turned down did not appeal because they did not think that it was worthwhile. That is another issue that should be considered.

Ms Ní Chuilín:
My question concerns the periodical review. Mickey Brady referred to categories of conditions that may or may not improve: a form of random selection exists even in those cases. I do not deal with many constituents who have the expertise to appeal their DLA decision. I do not hear of many people who successfully appeal their decision and receive more money as a result.

My question relates to lessons that could be learned from DLA decisions that were successfully overturned after appeal. I am alarmed to hear that that figure is so high. Are any mechanisms in place to undertake a review and to learn lessons about how decisions are made?

I am aware of a case in which one of my constituents had various mental-health problems. The doctor who undertook the assessment told him to catch himself on and give himself a shake. That is not conducive to making assessments. That doctor had medical training, but no training in empathy or understanding of mental-health conditions. The decision did not go in favour of the claimant. However, that claimant won the appeal and was awarded DLA. That is a clear example of a process from which lessons could be learned.

I do not say that consultants should be sent out to deal with different conditions; however, when people apply for DLA due to mental-health difficulties, surely a simple suggestion is that the person who undertakes that assessment should at have a background in mental health.

Mr Nevin:
I do not know about individual cases and cannot comment on them.

Ms Ní Chuilín:
I do not expect you to.

Mr Nevin:
The doctors who are employed by the Department are managed by the senior medical officers in the branch. However, that is not to divorce the agency from its responsibility. Complaints are dealt with by the senior medical officer and the director of our medical service.

We try to learn lessons. In complicated cases, including mental-health ones, presenting officers go to tribunals. We ask them for feedback, especially where decisions are overturned. From a learning perspective, the difficulty is that we are not privy to the reasons for the tribunal’s decision. We can make some inferences from the questions that the appellant and the presenting officer were asked.

We have been in touch with the president of appeals tribunals to reach an arrangement to receive feedback on cases that are overturned. Under our proposal, the tribunals would give us quick feedback on cases that they monitor. That is necessary because, although we try to use the information in the president’s report, that usually takes a year or more to publish, and some cases are between two and three years old by then. Therefore, the learning is not current. If an arrangement is agreed, we hope that the tribunal will tell us its experience of where the cases were wrong, so that we can tell our decision-makers what needs to be examined. Hopefully, that will improve the quality of their decisions.

Ms Ní Chuilín:
It is very hard for anyone to learn lessons when he or she does not receive the information necessary to understand the reasons for decisions, and to make decisions more transparent.

A section on the form does not leave much room to write about, for example, mobility restrictions due to mental-health problems, or the emotional or physical impact of more than 30 years of conflict. You said that there are more DLA claimants here than in Britain. Our society is poorer and unhealthier, and has a particular set of circumstances. Is there room for that to be fed in centrally?

I am glad that to hear that a proposal has been submitted to help you learn lessons because, unless you have the ability to examine your mistakes and use them to help you make better decisions, we will continue to have these conversations with old data.

Mr Nevin:
Brian knows more about the mechanics of the form than I do. However, in an attempt to improve the application form and make it easier for people to complete, it is subject to continual review. The current form was subject to extensive consultation with the disability lobby across the water, and Brian spoke to the disability lobby here when the form was introduced.

With regard to mobility and mental health, if someone can walk, but requires mental support to do so, there are spaces in the form to explain that. The form is under review, and changes in its design will take representations into account.

The Chairperson:
I ask everyone to be concise when asking and answering questions. Although I realise, and accept, that we are discussing a complex subject, we are in danger of running severely over time.

Mr Cullen:
Members raised the issue of how we learn from complaints, appeals, and so forth. The robust mechanisms in the processes enable us to do that. The first lesson is internal to the Department. The first stage of any dispute, before it goes to an appeal, involves an individual’s request that a decision be reconsidered. A different decision-maker examines the case to ensure that the Department had sufficient evidence to justify its original decision. If the second decision-maker deems the original decision to be incorrect, he or she can revise it accordingly. A mechanism is in place, whereby the reasons for overturning or changing a disputed decision are — in every single case — fed back to the original decision-maker.

As a manager, dealing with disputed decisions can be resource-intensive. I must ask whether an incorrect decision was made because of a mistake based on the available evidence, or whether the customer raised new issues and provided supporting evidence. In such cases, the Department can better educate customers on the evidence required to prove their entitlement to the benefit.

As Mr Nevin mentioned, the main source of feedback from the appeals service is in the form of reports by its president, which highlight why cases were overturned. In his most recent report, for 2005-06, only 1·6% of decisions were found to be incorrect. The reason for changes to the remainder was that the tribunal received evidence that had not been available to the decision-maker.

Members probably wonder why that evidence was not available to the Department, or why it was not requested. The constraints of data protection mean that only questions relevant to the benefit claim can be asked. In over 70% of cases, the Department writes to general practitioners about received claims, and a standard report asks the questions deemed relevant to the benefit. In contrast, when the tribunal hears the case, it is standard practice in Northern Ireland for it to receive all available GP records, which are taken straight from the GP’s surgery and made available to the tribunal. However, it is not within our gift to have those records, because we would be in possession of information that was not necessarily relevant to the benefit claim and might be of an extremely personal or sensitive nature.

The Chairperson:
There will be a series of questions from members, but we will have to follow up in writing to the Department, because we will not cover all the necessary ground today.

Mr Cobain:
It worries me when I hear Ministers on television saying that they will cut the number of people claiming benefits for A, B, C, D or E over the next couple of years, because, in Northern Ireland, the number of fresh claims is down by 20% — which could be considered a success — and the number of appeals is up by 20%. The officials know more about the subject than I do; if I were in their position, I would be worried by an increase of 20% in the number of people winning appeals.

The Chairperson:
The same thought struck me just as Mr Cobain was asking the question. Is it possible to establish a reason for the difference in success rates between Northern Ireland and GB, not only in the reduction of fresh claims that Mr Cobain highlighted, but in the huge disparity in the number of reconsiderations and appeals? In 2007-08, for example, the Northern Ireland success rate for reconsiderations was 21%: less than half of the 44% rate in GB.

Mr Nevin:
Our explanation is that our original decision is correct in approximately 97% of cases. The more evidence that is received, the more it reinforces the quality of the original decision.

The Chairperson:
Sometimes, Planning Service officials use those criteria to assess planning appeals, and they can be difficult to substantiate.

Mr Nevin:
I appreciate that, Chairman. The fact is that 21% of decisions are changed on reconsideration. I would be worried if none was changed, or if only 5% or 10% were changed.

The Chairperson:
My point is that, assuming that the criteria are the same, the success rate of appeals in GB is more than double that of NI. Why is that?

Mr Nevin:
As I said, we have looked at that. Our original decisions are correct, and, therefore, few of them will be subject to change upon reconsideration.

The Chairperson:
Does that mean that your counterparts in GB are incompetent?

Mr Nevin:
I hesitate to say that.

The Chairperson:
I am sure that you do.

Mr Nevin:
We may not always be successful, but, in the majority of cases, we try to get as much evidence as we need at the beginning. As I said, if no cases succeeded on reconsideration, I would be concerned. To be honest, I would also be concerned if the success rate of reconsideration was around 40% to 50%, because that would call into question the quality of the original decisions. I am not acquainted with the GB cases, so I cannot comment on that Department’s standard of work.

Mr Cobain:
Talking of appeals, do you worry that the number of cases successfully appealed — meaning that the original decisions were wrong — has increased by 20% in the last five years?

Mr Nevin:
At 30% —

Mr Cobain:
Does 20% not worry you?

Mr Nevin:
A 30% success?

Mr Cobain:
The number of people who win appeals has increased by 20% in the last five years. Does that worry you? Does that suggest a trend of original decisions being wrong? You mentioned the quality of service; however, over the last five years, there has been a trend of more people winning appeals.

Mr Nevin:
More appeals have been successful. The actual trend shown by the president of appeals tribunals’ annual reports is that the accuracy of the decision-making in appeals has improved. As we said earlier, it has increased to, 98·6% or 98·4%. The cases that the appeals tribunals overturn usually involve new evidence, although in some cases the tribunal takes a different view of the same evidence that was considered by the original decision-maker. That is why we wish to have feedback from the Appeals Service.

Mr Cobain:
Do you not know what that feedback is?

Mr Nevin:
No, we do not know much of it yet.

We are concerned about the figures. However, I would be happier with 25% of successful appeals. If the appeals system was not working, and people were not winning appeals, others might think that appealing was not worthwhile, as Mr Brady said. If people knew the statistics, and if they were aware that they had a one-in-four or one-in-three chance of gaining something by appealing, they would be encouraged to exercise their right to dispute the decision.

The Chairperson:
You talked earlier about presenting officers. Was the Department’s intention to have presenting officers attending 100% of DLA appeal hearings? Has that occurred yet? If not, do you know the actual percentage?

Mr Cullen:
It is around 40%.

Mr Nevin:
We had hoped to achieve 100% attendance. However, there are several appeal centres and a wide spread of hearings. Hearings can take place on the same day in several centres, and they are not co-ordinated, so they might occur in Derry, Newry and Enniskillen at the same time. Hearings are also extremely resource-intensive.

We drew up criteria for the cases that we would attend. Some DLA cases are regarded by experts as being less complex than others.

The Chairperson:
I presume that all the circumstances that you outlined were equally applicable five years ago. Are you saying that, five years later, a presenting officer is not present at 60% of appeal hearings?

Mr Cullen:
In 2002-03, presenting officers were present at slightly under 20% of appeal hearings; in 2003-04 the figure was 42%; in 2004-05, 47%; in 2005-06, 42%; and in 2006-07 it was 35%. Until August last year, presenting officers were present at 27% of appeal hearings.

Whether presenting officers attend appeal hearings is subject to the availability of resources, and whether a case is considered to be complex. Findings from previous tribunals prove that sometimes the presence of a presenting officer has no bearing on the outcome of the tribunal. A decision is made by a panel. The role of presenting officers is that of amicus curiae. Their job is to state the facts, not to say whether an appeal should be successful.

The Chairperson:
Let us be clear: the Department did not set a target of presenting officers being present at 100% of tribunal hearings, because it was thought that such attendance would not make any difference. Departmental officials thought, rightly, that it is appropriate for a presenting officer to be present at every hearing. You said that in the past year, presenting officers were present at only 27% of appeals. That is a decrease from approximately 40% in previous years.

Mr Cullen:
That is the figure for April 2007 to August 2007, which is the latest available information. The figure for the entire year will change. For 2006-07, the figure was 35%.

The Chairperson:
On looking around the table, I detect that Committee members will want to investigate that issue in substantially more detail with the Department than we have done today.

Mr Brady:
It was interesting that you said that presenting officers, although useful, are not that important. A few years ago, the president of appeals tribunals, Mr Maclynn, subpoenaed presenting officers to attend hearings.

Mr Cullen:
Mr Maclynn subpoenaed presenting officers because, at that time, written submissions for cases were not being received. Detailed written submissions are now supplied, which is over and above what currently happens across the water.

Mr Brady:
There were cases in which no written submissions were available and no presenting officers were in attendance, although written submissions may have been available for other cases. My point is that the president of appeals tribunals places a lot more weight on the presence of presenting officers than does the Department.

The figures that were quoted for both Britain and here highlight the need for the reconsideration of all administrative procedures. The point was made earlier that legislation cannot be changed. The Department here works to the same regulations as exist in Britain. I would be shocked to be told that your accuracy was not as good, or better, than that in Britain. The same legislation is in place, therefore there has to be a reason.

Mr Nevin:
As Brian said, when the president of appeals tribunals said that he wanted presenting officers in attendance, written submissions were not being sent. At one stage, shorter versions were sent. Currently, comprehensive explanations are provided of the decisions that have been appealed, detailing the reasoning for that decision.

Mr Brady:
When I started working on appeals in the early 1980s, statistics found that, rather than going alone, someone had a 60%-better chance of winning an appeal if granny went along. With respect, written submissions are good and serve a purpose, but they are not as good as having a representative or a presenting officer in attendance.

Mr Nevin:
I accept that. There is logistical and administrative pressure in attending all appeal hearings, which has an impact on the preparation of new appeals.

Mr Brady:
I accept that. However, the Chairperson said that the figure of 27% is less than acceptable.

The Chairperson:
Forty per cent was not acceptable, and 27% is less so.

Mr Cullen:
That 27% is for a limited period only — from April to August 2007.

The Chairperson:
You said that before, Mr Cullen. However, percentage terms would not be affected by the period of time in which a figure is determined, because — whether it is six months or six years — a percentage is still a percentage of the total; it is not a quantifiable number. The Committee would be interested to see figures for the full year. Whatever way it is cut, if the Department’s objective was to reach 100% attendance by presenting officers from a 40% benchmark, it has certainly not made progress towards that.

Mr Cullen:
The current objective is not to be at the 100% stage, bearing in mind —

The Chairperson:
It certainly is not.

Mr Cullen:
The Department’s criterion is to send presenting officers to what are defined as complex cases. To date, the president of the tribunal has not raised any issues with regard to our level of attendance at hearings.

Mr Brady:
Do you think that the president has just given up? It is inclusive and parochial at the same time. I do not want Ms Morgan to think that she came to the Committee and wasted her morning entirely. The figures show that it takes 11·94 weeks for an appeal in Newry, because it is one of the busiest centres outside Belfast. A lot of appeals are going through. Recently, Newry has tried to offload some cases to Banbridge to save time. Is that accurate?

Ms Morgan:
That is correct. Several issues come into play. Our Newry venue is the third-largest in the Province, although Londonderry, too, is a big venue. We have issues around the fact that disability-living-allowance appeals require three tribunal members, as well as the logistics of getting three members together, one of whom must be a medical member — as I am sure that you are all aware.

A pool of 74 doctors is available, the majority of whom have surgeries and, therefore, are limited in the amount of time that they can give. Obviously, they cannot travel very far. As a result, only 33 out of that pool can go to Newry because of their other commitments. That must be balanced off against the fact that DLA appeals make up about 53% of our intake. Furthermore, we have to work with doctors in relation to incapacity benefit appeals, so balancing all of those areas can cause problems.

Moreover, with regard to Newry, there is a high volume of adjournments for DLA appeals in Northern Ireland — just over 24% — compared to 18 % in GB. However, there is a 29% adjournment rate in Newry, and those cases must be fed back into the system.

Mr Brady:
That has nothing to do with me, honestly.

Ms Morgan:
I did not say that it had. [Laughter.]

The Chairperson:
Is that due to the complexity of the situations?

Ms Morgan:
It is a judicial decision to adjourn cases, and I cannot comment on that. However, obtaining GP records is the reason given in the majority of cases. Many of the adjournments take into account the fact that GP records are needed in Northern Ireland, whereas that does not happen in GB.

The Chairperson:
The subject has had a fairly broad airing, and yet it is intensely complex and comprehensive. A great deal of ground has been covered and much still has to be covered. If Members are content, we will write to the Department covering a range of the areas that we have not been able to deal with today, due to the complex nature of the subject, and see what response we receive and take it from there. Are members content?

Members indicated assent.

The Chairperson:
Mr Nevin, Mr Cullen, Ms Morgan, thank you very much for attending