War Disablement Pension (Hansard, 26 November 1997)

§ Mr. Denham

One of our key aims is that delivery of service should be simpler and more efficient. Queries on operational matters concerning the War Pensions Agency are for its Acting Chief Executive Mr. Steve Johnson. I have asked him to write to the hon. Member.

Letter from K. C. Caldwell to Mr. Paul Keetch, dated 25 November 1997: The Secretary of State for Social Security has asked me to reply to your recent Parliamentary Question about the current arrangements for the medical examinations of persons claiming War Disablement Pension. Most examinations, where considered necessary for the individual case, are conducted locally by War Pensions Examining Medical Practitioners, the majority of whom are General Practitioners. The Benefits Agency Medical Services (BAMS) who organise examinations for Social Security benefits are responsible for recruiting and training doctors to undertake medical examinations and for arranging these examinations for the War Pensions Agency (WPA). Doctors undertaking medical examinations for War Pensions must be registered with the General Medical Council and be experienced in medical examinations for Benefit purposes. BAMS are responsible for ensuring the satisfactory completion of the training of the doctors who conduct examinations for the WPA. The training of these doctors is based on the Handbook for Examining Medical Practitioners (War Pensions) which has been written and recently revised by Medical Advisors employed by the WPA. The WPA Medical Advisors make, on the medical evidence, decisions as to whether a condition is attributable to or aggravated by service and the degree of any disablement. The monitoring of completed examination reports is the responsibility of the WPA. All medical examination reports are reviewed by the WPA's Medical Advisors. Any reports which do not fulfil the WPA's requirements are returned to BAMS. In addition to these arrangements the WPA is currently developing a structured monitoring scheme to provide formal feedback to BAMS on the general quality of the examining doctors' medical reports. In the specialist area of hearing loss claims, audiometric examinations are conducted for the WPA by British Medical International, part of General Healthcare Group PLC. The reports from these examinations are considered by the WPA Medical Advisors as part of the evidence in these cases. These arrangements are formally monitored, both internally by the WPA Medical Advisors and through a regular external professional scrutiny. In addition to War Pension medical examinations, the WPA also requests specialist and Regional Consultant medical examinations. Specialist appointments are arranged through BAMS who in many cases nominate a local specialist with suitable expertise. In some cases the WPA's Medical Advisors nominate a specialist, normally the specialist who has been responsible for the clinical care of the claimant/pensioner. Regional Consultants are recognised authorities in their speciality and are appointed by the DSS Chief Medical Adviser. Regional Consultant examinations are requested by the WPA to resolve conflict of medical opinion and also in exceptionally complex cases. A list of Regional Consultants is held in the WPA and the WPA Medical Advisor is responsible for nominating the Regional Consultant. BAMS are responsible for arranging appointments on behalf of the WPA. 567W All the specialist and Regional Consultant reports are reviewed by the WPA's Medical Advisors. Any unsatisfactory reports are returned directly to the specialist or Regional Consultant. BAMS would be advised of any specialist who consistently provided unsatisfactory reports and use of that specialist's services would cease. Any Regional Consultant who consistently provided unsatisfactory reports would be notified to the Chief Medical Advisor with a view to removal from the list. I am satisfied that these arrangements work satisfactorily. I hope you will find my reply helpful.