§ Mr. AshleyTo ask the Secretary of State for Social Security if there is any facility for claimants for the attendance and mobility allowances to be examined by a woman doctor or a doctor from a particular ethnic background.
§ Mr. ScottIf claimants for the attendance allowance and mobility allowance specifically request to be examined by a woman doctor or a doctor from a particular ethnic background, these requests are dealt with on an individual basis by the regional office senior medical officer. Every effort is made to meet the claimant's request but the ability to do so largely depends upon the availability of doctors meeting the requirements among the examining medical practitioners in any one locality who have been recruited and trained for the undertaking of such examinations.
§ Mr. AshleyTo ask the Secretary of State for Social Security how many examining medical practitioners for the attendance and mobility allowances are(a) women and (b) from ethnic minorities with language skills or a particular cultural background where this is relevant.
§ Mr. ScottThere are 4,863 examining medical practitioners who undertaken examinations on claimants388W for the attendance and mobility allowances. Of these 816 are women, and 908 are from ethnic minorities with language skills or a particular cultural background.
§ Mr. AshleyTo ask the Secretary of State for Social Security if he will tabulate the number of successful applications for review of the attendance allowance and break down the figures into those who sought review because they were dissatisfied with the original decision and those who did so because their condition had deteriorated.
§ Mr. ScottFigures for 1987, the latest year for which information is available, are in the following table.
Attendance allowance reviews 1987 Number of successful1 applications by reason for review Reason for review Number Dissatisfaction 19,190 Deterioration 23,933 Other 981 TOTAL 44,104 1 Successful reviews include those where an allowance is awarded for the first time, those where an allowance is increased from the lower to the higher rate and those where the period covered by a certificate of attendance needs is increased.
§ Mr. AshleyTo ask the Secretary of State for Social Security (1) what are the procedures for dealing with doctors who are not fulfilling their duties to claimants for mobility and attendance allowance satisfactorily;
(2) how complaints against examining doctors for attendance and mobility allowance are dealt with.
§ Mr. ScottComplaints against examining doctors for attendance and mobility allowance are dealt with by the Department's senior medical officer in the appropriate regional office. The doctor is provided with a copy of the complaint and of the report of the examination concerned and is asked to comment. The senior medical officer considers the complaint, the doctor's reply, any previous complaints made against that doctor and the SMO's personal knowledge of the doctor. The SMO then decides what action to take and arranges for a reply to be sent to the complainant.
Dissatisfaction with the work of an examining medical practitioner may arise as a result of complaints or during the course of monitoring his or her work. There are two main causes for dissatisfaction, inadequacy of the reports or a defect in the doctor's conduct, manner or behaviour. In the former case the unsatisfactory reports are discussed with the doctor in detail by the SMO or a full-time medical officer. Deficiencies are pointed out and the doctor is advised how his work can be improved. The doctor's subsequent reports are monitored and if they fail to reach a satisfactory standard, and if it is clear that no further significant improvement can be expected, he or she is not asked to provide any further reports.
If the doctor's conduct is cause for complaint individual cases are discussed in detail. Advice is given by the SMO or MO on how a change of conduct might prevent further complaints. A doctor whose conduct continues to provoke complaints is not asked to provide further reports.
§ Mr. AshleyTo ask the Secretary of State for Social Security if there is any matching of doctors with particular specialisations and attendance and mobility allowances claimants with particular disabilities.
389W
§ Mr. ScottThe medical criteria to be met for attendance allowance and mobility allowance are not dependent on the claimant's exhibiting any particular disabilities. The Attendance Allowance Board, or its delegate, decides whether the conditions for attendance allowance are met on the basis of a report of an examination of the disabled person undertaken by a registered medical practitioner. That report provides an assessment of the nature and extent of attention to bodily functions and/or of supervision to avoid substantial danger which the disabled person reasonably requires from another by day and/or by night by reason of the medical condition(s) from which the claimant suffers. The decision by an adjudication officer to award mobility allowance rests on an examination and assessment by an examining medical practitioner of the claimant's walking difficulties due to a physical disorder.
By their very nature the medical examinations required for the purposes of determining eligibility for these allowances need the expertise and experience possessed by general practitioners who make up the great majority of the doctors selected and recruited by the regional office senior medical officer to perform this function. Consistency of advice across a wide range of disabilities and age-groups is also desirable. This is obtained by employing general medical practitioners. In the small number of cases where a specialist opinion is required to determine diagnosis, or assist in resolving complex cases, an independent report is solicited from a consultant clinician who would possess the necessary specialist knowledge applicable to the individual case.
§ Mr. McLeishTo ask the Secretary of State for Social Security if he will give(a) the total number of claims for mobility allowance in 1985–86, 1986–87 and 1987–88 for Scotland, England and Wales, (b) average lengths of time involved in processing these claims, (c) the length of time considered reasonable for an individual claim to be processed and (d) the total number of applications which remain to be processed to payments or refusal stage claims first submitted in the period 1 April 1987 to 31 March 1988.
§ Mr. ScottThe available information about the numbers of mobility allowance claims received is in the table; separate figures for Scotland, England and Wales are not available as claims are administered centrally. We endeavour to deal with all claims as quickly as possible but it is unlikely that the current average processing time of 7.8 weeks can be significantly reduced. I regret that figures for claims received up to 31 March 1988 and awaiting decision are not available.
Mobility allowance: Claims received 1985–86 to 1987–88 Numbers received 1985–86 151,000 1986–87 169,000 1987–88 223,000
§ Mr. McLeishTo ask the Secretary of State for Social Security if he will give(a) the total number of claims for attendance allowance in each of the years 1985–86, 1986–87 and 1987–88 for Scotland, England and Wales, (b) the average length of time involved in processing an individual claim, (c) the length of time considered reasonable by the Department for an individual claim to be processed and 390W (d) the total number of applications which remain to be processed to payment or refusal stage for claims first submitted in the period 1 April 1987 to 31 March 1988.
§ Mr. ScottThe information requested about numbers of attendance allowance claims received is in the table. We endeavour to deal with all claims as quickly as possible but it is unlikely that the current average processing time of 7.3 weeks can be significantly reduced. I regret that figures for claims received up to 31 March 1988 and awaiting decision are not available.
Attendance allowance: Claims received 1985–86 to 1987–88 Numbers received Scotland England Wales 1985–86 24,063 230,434 21,969 1986–87 26,897 246,650 23,620 1987–88 31,266 280,969 25,628