Getting it right, putting it right: Improving decision-making and appeals in social security benefits (1335-i) Public Accounts Committee 19 Nov 2003

Q18 Mr. Gerry Steinberg (City of Durham): When I read the report, it did not really surprise me. Some of the worst cases that I get in my constituency post bag and at surgeries are people who have been turned down for benefits. You sometimes wonder how the decision has been made for some of the people who have been turned down for benefits. Clearly those who have made the decisions do not know the facts. Funnily enough I had one case last Saturday morning which I shall mention in the course of asking a few questions. You mentioned Figure 10 on page 16 and looking at these figures, there are no surprises, they are the results you would expect. You would expect Attendance Allowance and Disability Living Allowance to be quite bad. I wonder why it is so bad. I know you attempted to say a very subjective sort of decision is taken, but if enough evidence is given and if a person gets the correct medical report, I cannot really see why it is as bad as you claim it to be. Why does this benefit cause such a particular problem and have so many wrong decisions made on it?

Sir Richard Mottram: It is a combination of two sets of quite complicated things. Firstly, you are not assessing the medical condition, you are assessing the impact of the medical condition on the need of the person and the people who are taking the decisions inside the Disability and Carers Service are having to apply complex rules, complex law in relation to that. Secondly, as the report has brought out, perhaps we could do better in how we assess the medical evidence, for example. Obviously we need to do better on evidence gathering, particularly in relation to the medical side, and, in cases of doubt, on having a dialogue with the customer.

Q19 Mr. Gerry Steinberg (City of Durham): You are a kick off the backside of 50% of decisions being wrong. That has to be very, very worrying indeed, particularly for the people who are being turned down and who look, on the face of it, to be very genuine cases. Let me give you an example from my surgery. Obviously you cannot comment on the case, but the general theme of the case is quite common. A woman reaches retirement age, in fact 65, and she is looking after her son for whom she is receiving Attendance Allowance. The son is 39 years' old and can virtually do nothing for himself; he is totally dependent upon his parents. The father is in his 70s. She had been receiving Attendance Allowance up to that stage. The only circumstance to change in this case is that the woman reaches 65, applies for Attendance Allowance to be renewed and it is refused. She still has to look after the 39-year old son, who is severely disabled, the chores are probably getting worse as she is getting older and the only thing which has changed is that she has reached 65, has applied again and has failed to get the benefit. This does not alter the fact that the son is still disabled and is unable to look after himself and needs a lot of assistance. The assistance which they were receiving, which they needed before she was 65, has now stopped, yet she is doing exactly the same tasks. Furthermore, it seems to me that it also disadvantages those people who are less articulate; not the most articulate of people are told to appeal. They are worried into appealing or not appealing, as the case may be, so they just struggle on and do the best they can. I looked at the case and wondered why on earth the benefit had been stopped. Why has it been stopped?

Sir Richard Mottram: Obviously I do not know the individual details, but perhaps I could ask Don Brereton to offer a possible explanation, which is an illustration again of the complexity of the system and I quite understand why people find it difficult to understand this because of the interaction of different benefits. We can certainly think of one reason why it was stopped, but we may not be right of course.

Mr Brereton: From the way you have described that case I think you are talking about Carer's Allowance here; it was called Invalid Care Allowance and it is now called Carer's Allowance, which is available when you are spending 35 hours or more looking after someone with severe disabilities. At the age of 65, if you are eligible for some state retirement pension, under the rules governing these benefits, it is taken that these two benefits are actually for a common purpose, that is to sustain income when you are not working. The view is taken - and this is across the benefit structure - that there would be double provision if you paid both state retirement pension, which is to provide income in retirement since you are not working, as well as a benefit which was designed to provide you with an income when you are not working when you are of working age because of your care needs. I am sorry that is complicated.

Q20 Mr. Gerry Steinberg (City of Durham): I understand what you are saying.

Mr Brereton: At the moment it is a matter of law.

Q21 Mr. Gerry Steinberg (City of Durham): Presumably in this case they would already have been receiving the old age pension because the husband was in his 70s; presumably they had been receiving pension. Are you saying they were awarded this benefit until the next time they applied for it and once they had re-applied for it, they had gone into a pension situation and therefore it was stopped.

Mr Brereton: It was effectively reduced as a result of their own retirement pension. That is what I would assume from the details you have given us this afternoon.

Q22 Mr. Gerry Steinberg (City of Durham): If that is the answer, I find it incredible that two old people who have to look after a son who is 39 years' old and who is totally dependent upon them suddenly find themselves worse off. I shall pursue that at a later time. Staying with Figure 10, when I was looking at this particular chart what caught my eye was that the figures for 200-01 and 2001-02 were pretty similar; there was no great discrepancy, except in the short-term benefits. Why short-term benefits specifically?

Sir Richard Mottram: Funnily enough, when I saw this table I asked that question as well. I think the answer is, although I say this with a certain nervousness, having appeared before the Committee a number of times, that almost certainly the figure for 2000-01 is too high. It has not been misprinted in the report, but our feeling is that performance in that year was probably not that high and there was a debate over performance in 2001-02 - without going into the technicalities - a discussion about what number should be reported. We chose the lowest number. I suspect that in one case it came out high, in the other case it came out low.

Q23 Mr. Gerry Steinberg (City of Durham): It is obvious to me from the report that the additional evidence which is given during an appeal means that a lot more cases are actually approved. It does seem to me that if a person attends the appeal rather than submitting a written appeal, they have more likelihood of succeeding.

Sir Richard Mottram: If a client does?

Q24 Mr. Gerry Steinberg (City of Durham): Yes. Why do you not make it clear that they have more chance of success if they appear in person rather than doing it by letter.

Sir Richard Mottram: We do.

Q25 Mr. Gerry Steinberg (City of Durham): You do?

Sir Richard Mottram: We do.

Q26 Mr. Gerry Steinberg (City of Durham): You actually make that clear to them.

Sir Richard Mottram: Yes, we do.

Q27 Mr. Gerry Steinberg (City of Durham): Do you make it clear that they have the right to have somebody there as well?

Sir Richard Mottram: We do.

Q28 Mr. Gerry Steinberg (City of Durham): You do. One of the things which the Chairman mentioned worries me intensely and that is the ability of a person to make an appeal. I am sure we all have cases in our constituencies and I quote a case again where a woman came to me who had had her Jobseeker's Allowance stopped because they deemed her fit for work. She was a woman in her sixties, she was a cleaner in a working men's club and her job was to get on her hands and knees and brush and scrub, move table around, move chairs around and generally do a very manual job. She had a very serious operation, a colostomy, and she could no longer work. She then had that operation reversed and still did not feel able to work. She made an appeal and she lost her appeal; she applied for Jobseeker's Allowance and she lost it. I am not saying whether that decision was wrong or right, but I also had in my surgery at the same time a man who just thanked me very much for my help because after two years of arguing he had just received Jobseeker's Allowance. He was a very articulate man, he had been in education. I am not making any comment on whether he was disabled or whatever. This lady was a cleaner in a working men's club who clearly was not as articulate. He gets it and she does not. Is it not worrying that the more articulate you are, the more chance you have of getting the benefit: the less articulate you are, the less chance you have and that is not taken into consideration. You did say that you let them know that a third party is invited, you let them know it is far better to appear in person and frankly I am not convinced.

Sir Richard Mottram: You are not convinced that we do that or that it would make a difference?

Q29 Mr. Gerry Steinberg (City of Durham): Yes, I am not convinced that you do that and I am also very worried that the more articulate you are the more chance you have of being successful, despite the disability or the illness you may have.

Sir Richard Mottram: I have one example here of the advice we offer people and if I show it to you, you will say it is buried on page 32, but I will just read it out. It says that if you attend an oral hearing you will have the advantage of being able to deal with any questions or issues which may arise. The Appeals Service is actually neutral on this, just to be clear, so I am talking about the advice of the department. The Appeals Service is part of the department but separate from us and all the support provided to the judiciary is completely separate from us of course. We, in our guidance, encourage people to appear in person by implying that it will give them an advantage. The Appeals Service is neutral on this matter. On whether you are articulate or not articulate, I really cannot help. Obviously there is an issue. All that we try with our staff is to encourage them, and no doubt we can do better on this, to understand the challenges - and we can describe some of the work which is done here - that our customers face, be sympathetic to those challenges and to work with people in ways which help them. Certainly when I go round the country I see good examples of this. No doubt every member of the Committee could quote a bad example at me. We are a very big organisation; we could obviously do a lot better. The aim of our organisation, the purpose of our decision-making, is to treat everyone equally within the framework of the law. Obviously this is a big issue for us, but I cannot guarantee that articulate people do not do better because in all sorts of ways they probably do.

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Q104 Mr. Gerry Steinberg (City of Durham): Following up on the Invalid Care Allowance, is it means tested?

Mr Brereton: The Carer's Allowance has restrictions on it in terms of where your income is coming from. If you were working, for example, there would be restrictions on the amount of work and the amount of earnings. It is not means tested in quite the same way as some of the other benefits, but there are restrictions on how much you can earn.

Q105 Mr. Gerry Steinberg (City of Durham): The point is that you clearly said if somebody receives an old age pension, they cannot receive two benefits. What happens if somebody was on Invalid Care Allowance and then they got a private income? Would the Invalid Care Allowance stop?

Mr Brereton: I do not think the Invalid Care Allowance would be affected by a private income.