§ 1. Mr. David Heath (Somerton and Frome)What estimate he has made of the proportion of appeals against medical assessment leading to refusal of benefit that are upheld by the independent appeal tribunal. [150480]
§ The Parliamentary Under-Secretary of State for Social Security (Mr. Hugh Bayley)For all appeals held between 1 October 1999 and 30 September 2000 that 2 concerned decisions on benefits involving a medical assessment, appeal tribunals upheld 54.9 per cent. of the original decisions.
§ Mr. HeathI am grateful for that information, but rather disappointed by it. In 1999, the hon. Gentleman told me that in 1997 he inherited a figure of 59 per cent and that, although it had decreased to 48 per cent., it was still too high. It appears that it has risen again. If nearly half of all appeals are being upheld, many people are being wrongly assessed, and that figure does not even include people who do not have the ability or opportunity to take their case to an appeal. Does he agree that it is about time that we had a system that gave disabled people a proper medical assessment and got decisions right in the first instance rather than on appeal?
§ Mr. BayleyI share the hon. Gentleman's view that we want to get every decision right first time, and I should like fewer decisions to be changed on appeal. However, he must agree that since disability living allowance was introduced, about half the cases that are taken to appeal result in a different decision. In many cases, that does not mean that a different rate of benefit is awarded—simply that the benefit is paid for a different period, which is usually longer.
I also agree that we want to ensure that high-quality medical evidence is given. The hon. Gentleman knows that the Government have taken a number of steps to improve the quality and consistency of decision making, through better management of the doctors whom we use and better training of them. In February last year, we introduced a procedure to allow an appeal tribunal that is dissatisfied with the quality of the medical evidence given by the Department of Social Security doctor to raise its concerns with our chief medical adviser. We welcomed that important innovation and, since then, tribunals have raised five cases in which there have been concerns about such medical evidence.
§ Mr. Denis MacShane (Rotherham)Is not the key word "quality"? Every MP deals with heart-rending cases 3 of appeals that are turned down or doctors' assessments that are not considered satisfactory. Equally, however, we have a responsibility to constituents who are concerned about any working of the system that might result in an abuse. We need quality and strictness so that we are fair to both sides of the benefit appeals system.
§ Mr. BayleyThe Government have introduced a number of reforms to the decision-making and appeals system which are intended to make decisions more consistent. Together with the Royal College of Physicians, we have introduced a diploma in disability assessment medicine to set a benchmark of high standards that we want our doctors to meet. We have also introduced better and more consistent training for them. That used to be organised ad hoc by a senior doctor in each medical boarding centre. We now have a national programme of training, which adheres to a national syllabus, that is delivered by trained trainers. We hope that that will make the improvements that all hon. Members want.
§ Rev. Martin Smyth (Belfast, South)We appreciate the Minister's answer. Is he disappointed or surprised that only five cases have been referred on the basis of their medical details? Medical assessments are part of the problem. We are told time and again that the adjudicating officer makes the mistakes, but on appeal we discover that poor medical responses have been at fault.
§ Mr. BayleyClearly, there are cases of poor medical reports. However, those are written far less frequently than many hon. Members might suspect given the amount of attention that such a report attracts. I do not want a high or low number of complaints. I want people, including the chairmen of appeal tribunals, to have somewhere to go if they believe that a poor medical report has been written, in the knowledge that their appeal will be thoroughly investigated. If that means that remedial action has to be taken with the doctor, such as retraining or tighter management, or, in the most extreme cases, if we have to stop using that doctor's services, then that is what will happen.