Examination of witnesses (Questions 1
- 19)
WEDNESDAY 14 APRIL 1999
MR GORDON
HEXTALL, MR
ALAN BURNHAM,
and DR E ANNE
BRAIDWOOD
Chairman
1. Good morning, ladies and gentlemen, can
I declare the public session of evidence open? We welcome the
Chief Executive from the War Pensions Agency, Mr Gordon Hextall,
Mr Alan Burnham and Dr Anne Braidwood. Can I say, before I do
anything else, that we are particularly grateful that a small
contingent of the Committee was looked after in a rather foreshortened
visit (we would have liked to have spent longer with you), but
it was an extremely valuable visit and we are very grateful for
the time and effort spent in setting the visit up. We were impressed
by what we saw while we were there. I may say, the last time the
Committee did this was in 1995, and if you look at the work of
the Agency a lot has changed since then. The then Chief Executive
of the Agency is now the Chief of the Benefits Agency, so if Mr
Hextall plays his cards right you never know what might happen
in future! The other thing to say, of course, is that one of the
things that was driven home to me yesterday was that the timing
of this session is particularly apt because of the prior options
review, which, of course, is very important, not just for yourselves
as an Agency and staff but for the voluntary organisations and
customers and clients that you seek to serve. So we are very pleased
to see you this morning. Perhaps, Gordon, you could start by explaining
what your colleagues do, then say anything else you might want
to start off with, and tell us whether there are any bits of additional
brief you might want to supply. Then we can go into the series
of questions we would like to raise with you.
(Mr Hextall) Thank you for visiting us yesterday,
we were pleased you were able to come. Could I introduce Dr Anne
Braidwood, on my left? Anne does not actually work for the War
Pensions Agency. She is the Medical Policy Manager for war pensions
and works, therefore, for the DSS headquarters, but because of
the nature of war pensionsa significant aspect of it is
tied up with medical matters and the interpretation of medical
opinionI believed it was going to aid our understanding
this morning if Anne was going to accompany us. On my right is
Alan Burnham, who for the last month has been the Acting Operations
Director but for the three years prior to that was head of the
Welfare Service and Ilford Park Polish Home and so has got much
of the history and detail from those areas. In terms of information
I might pass to you, I am aware that there is a belief that war
pensions claims are in decline and that it is quite a dramatic
decline. In actual fact, I have graphs representing the new claims
received over the last 30 years and the caseload over the last
30 years.[2]
That actually shows a remarkable picture in terms of the explosion
of claims that occurred in the early 1990s. To put it in context,
the number of new claims we are receiving now are as high or higher
than they were at any time during the 1960s, 1970s and early 1980s.
So it is only in comparison with the early 1990s that the claims
have actually reduced. Then the other graph is related to the
caseload, which is the number of war pensions in payment and that,
in itself, generates an amount of work. Whilst that was in steady
decline over the 1960s and 1970s following the large influx of
claims, it shot up from 20,000 a year to 150,000 in one year,
started to rise again in the early 1990s and is currently starting
to come down. Statisticians forecast that that trend will continue,
so that by the year 2005 the new claims received will be half
what they are today, and the caseload will be slightly lower.
However, the caseload is still substantial and there is still
a lot of work to do for the war pension community and for war
widows. I think that gives a little bit of background and context.
2. Thank you very much. I received this
paper yesterday and thought it would be valuable for colleagues
to see. It might take a wee bit of explanation later on, but I
wonder if I could ask youjust to dispose of it, because
I hope you will tell me it is not something that is a major concern
in terms of problemsbecause the Committee is worried, as
is the department, about the levels of fraud that there are within
the various set-ups in the social security system. Would I be
right in thinking that fraud is not really as big an issue for
you in terms of the difficulties that there would be for people
to, say, impersonate people in making claims, or, indeed, to manufacture
false symptoms, because there are checks on these things? There
are not many opportunities, if I could put it that way, in your
particular work in the social security system, in which fraud
could be easily perpetrated on a big scale. Would we be right
to think that?
(Mr Hextall) Yes, it is a different situation
to the other benefits that the DSS operates, because the evidence
required is so difficult to manufacture, because we are looking
for service record evidence, for medical record evidence, and
it is a quite protracted and in-depth investigation of that evidence.
So it would be difficult to manufacture a claim and so opportunities
for fraud in an area like war pensions would arise from people
failing to report a change of circumstance or people manipulating
instruments of payment, and that kind of thing. The feeling from
the risk assessments that we have done is that it is low in comparison
with other benefits.
3. I am grateful to that. Can I turn to
getting clear the whole question of getting claims right first
time? Generally speaking, I think it would be fair to say that
when we consulted the organisations with whom you work on a regular
basis they were all prepared to give you quite glowing crits,
although that is not to say they did not have individual complaints
and concerns about how things might improve in future. I think
it is fair to say, however, that, by and large, they were satisfied
with what you were doing. One of the things that SSAFA particularly
drew to the Committee's attention, which engaged my interest,
was their concern about the number of claims that actually go
to appeal. Could you say a word about that? Is there some work
in-hand to try and deal with the quality of decision making, getting
things right first time and the qualitative criteria that you
use? This is all core territory for the Government and the Secretary
of State. What are you doing in that direction to try and address
that complaintif you recognise it as a valid complaint?
(Mr Hextall) I do recognise it as a complaint
and it is wrapped up with the length of time it takes to deal
with decision making and appeals. That was a particular concern
for me when I joined the Agencythat it seems to take so
long. So we commissioned an independent review announced through
the Central Advisory Committee in Decemberand we got consultants
to do itof the whole decision making and appeals process,
and not just the bits of the process that are within the Agency
but the whole end-to-end process, which also includes the Pension
Appeal Tribunal and the representatives of appellants as well,
in the form of either ex-service organisations or individuals.
We had the report of that review just last week and we will now
be in a situation where we are doing analysis and preparation
for the future. However, the specific comment is that if we spent
more time getting the claim right in the first place there would
be fewer opportunities for appeal. Two things come out of that:
one is that we do spend an inordinate amount of time trying to
get things right at the outset, which is why it takes so long
to decide a claim and appeal. However, we do that by receiving
a claim form and then corresponding with the claimant. One area
where we believe we can improve the quality of the decision is
by actually having a conversation with a claimant rather than
just taking a claim form. Quite often in the current process,
the first opportunity there is for someone to ask questions in
this situation is when the man is in front of an Appeal Tribunal
and typically, one of the reasons why Appeal Tribunals will overturn
a decision is because some new information or some new evidence
comes out in a conversation. So one of the recommendations is
that we have a conversation at the outset, and we would expect
to do that either by using the telephone or making increased use
of the War Pensioners' Welfare Service to visit people at home
so we can get the maximum amount of information possible at the
start. Then that will enable, hopefully, a better decision to
be made.
4. I would like, later in the proceedings,
to come back to decision making and appeals in more detail, but
can I ask you one further question about that, which is related
to your targets? At the end of February the target of having no
more than 23 per cent of outstanding appeals more than 260 days
old (and 260 working days is, effectively, a calendar year) had
not been met, and the figure was 38.9 per cent. That is not clever,
is it?
(Mr Hextall) It needs an understanding of how
the target was agreed in the first place, and it was agreed on
the understanding that, according to statistical forecast, there
would be 4,500 new appeals in 1998/99. In fact, that statistical
forecast was not met.
5. Who got that wrong?
(Mr Hextall) I suppose the statisticians did.
That is one of the dangers of basing targets on inputs and outputs.
So it became clear to me, in about September, that it was going
to be impossible to make that target unless the number of new
appeals picked up, which it did not, and so instead of 4,500 which
were forecast, we ended up with 3,200 during the year, in actual
fact. In the memorandum to the Committee we were trying to demonstrate
that even though we recognised it was going to be difficult, if
not impossible, to reach the original target, we were trying to
meet the spirit of the target by processing as many of the older
appeals as we could. I think the graph in the memorandum demonstrates
that.
6. I do not think it does. Maybe I am missing
something here, but what you have said to me, if I understand
it, is that you cannot meet the appeals targets because you are
getting fewer appeals. That seems to me to defy logic. Your memorandum
is very helpful but I was perplexed by Annex E. I am genuinely
not trying to catch you out here, I am simply seeking the truth,
but in Annex E the targets are set out and you say that at 31
March 1999 "to have no more than 23 per cent of outstanding
appeals more than a year old", as I have just said. There
is a little star there, next to the box "Progress as at 28
February 1999" and if you look at the star it says "Number
of new appeals received has been significantly less", and
then goes on "The total number of cases available to clear
is statistically non-viable in relation to the target measure,
and the target of having no more than 23 per cent of appeals over
260 days old is, thus, no longer achievable." That does not
compute. I do not understand that. Can you help me, genuinely,
to understand what that means? There is a little graph here that
says "Appeals in Progress" which shows that they are
getting less, and if they are getting less I do not understand
why you cannot clear them quicker.
(Mr Hextall) Because the 23 per cent is about
the mix of new appeals compared with older appeals.
7. How is that hard for you?
(Mr Hextall) It was intended to focus the Agency
on clearing older appeals, and the older appeals do take longer.
8. Why?
(Mr Hextall) I have been into this myself and
I have sat in with an individual member of staff right throughout
the appeals process to try and understand why. It is all wrapped
up in the decision making and appeals review.
9. That is not your fault because the DMA
is nothing to do with the War Pensions Agency.
(Mr Hextall) Our decision making and the appeals
review. That is the process. The appeal starts with the decision
in the first place.
10. So this is under your control?
(Mr Hextall) Yes. It is all to do with being able
to control that mix. It was the older appeal I was trying to explain.
At the moment, there is nothing to stop people (and this typically
happens), during the course of an appeal, raising new information
or raising a new condition, or asking for their existing conditions
to be reviewed and that slows down, currently, the life cycle
of the appeal. One of the recommendations from the review is that
we get a clearer definition of the difference between a claim,
a review and an appeal, so that an appeal can naturally progress
to its conclusion without being halted by new claims or requests
to review an existing claim.
11. Genuinely, I am not trying to make life
difficult for you, but what I do not understand is why that is
different for older appeals versus new appeals. Mr Burnham made
a very good presentation to us yesterday with the slides which
made it easier to understand, in terms of people coming along
with new conditions during the appeal, which sets the whole thing
back, but why is that different for old cases as opposed to new
cases? You seem to be saying that because you are getting fewer
new cases it is harder to clear the old ones, but you can still
get the new conditions coming in for the new cases, just as much
as in the old. Why is there a qualitative difference between the
residual old caseload and the new caseload that makes it difficult
to get these appeal targets met?
(Mr Hextall) Because, typically, the reason they
are old is because of the combination of new conditions and new
requests for review. That is why they have become old. It is very
difficult to get those through to a conclusion when someone can,
literally, claim a request for a review almost on a daily basis.
I had to write to someone recently who, on 54 separate occasions
during the year, had written in and asked for something different
to be taken into consideration. We were trying to explain to him
that the very fact that he was writing inon 54 occasions
during the yearmeant that his appeal was not being progressed
to a conclusion. However, there is nothing to stop him actually
continuing to do that. So the recommendation for the future will
be that we get greater clarity between an appeal, a new claim,
a review and adding new conditions in, so that the actual appeal,
which started off in the first place, can progress to a conclusion.
That is the reason why they do become older.
12. You are looking me straight in the eye
and you are telling me you are doing all you can; you are not
just using these conditions. I do not say it is easy at all becauseand
my other colleagues did not have the benefit of the presentationthese
things are very complicated.
(Mr Hextall) That is right.
13. Nobody is denying that, and you are
not using this caseload as an excuse not to meet these targets;
you are doing everything you possibly can to get these targets
improved, and concentrating on doing something.
(Mr Hextall) Absolutely. I am quite passionate
about it, in fact, because, as I say, when I arrived in the Agency,
the fact that it had taken 145 days to deal with a first claim
and 260 days to deal with an appeal is unsatisfactory, as far
as I am concerned.
Chairman: Thank you
for that.
Ms Shipley
14. Just to clarify then, you are suggesting
that in a percentage of cases it is the individual's fault that
things are being held up because they are putting in letter after
letter after letter, thinking that they are informing you more
and, actually, they are delaying. We have heard about the one
individual you wrote to, but what steps do you take to inform
people that this will happen?
(Mr Hextall) If we are able to have a conversation
with them over the telephone we will try and explain that in a
very pleasant and polite way.
15. Let me clarify. Do you, as a matter
of course, instruct the people who are dealing with cases to inform
in writing that the more times somebody writes in with another
little bit of information the more the case is likely to be delayed?
I can see you might do it here and there occasionally, but as
a matter of course do you do that?
(Mr Hextall) It is actually very helpful, most
of the time, when people do give us additional information, because
that helps.
16. So are you saying you do not or you
do?
(Mr Hextall) I am saying that we do not, as a
matter of course, do that, because each appeal is different and
some can be processed quite quickly. I think, really, I need to
explain the life cycle of a claim.
Chairman
17. Please. That might help us all.
(Mr Hextall) In the analogy yesterday that we
were explaining, with any other normal benefit you were dealing
with you would receive a claim, you would collect the evidence,
you would arrive at a decision and issue a notification. With
Income Support, Job Seekers Allowance and other benefits, that
is a relatively quick process, because you see the evidence and
you are able to issue a decision fairly quickly. In the case of
war pensions, the claim could be for one single condition or it
could be for multiple conditions at one time. The most conditions
we have for a single claim is 93 separate conditions they are
saying they are suffering from as a result of war injury, but
typically it is 4 to 6 different conditions. Each of those conditions
has to be investigated, and we are required to be able to link
a disability to service. So, in collecting evidence, we first
of all, have to obtain evidence that service occurredthat
he did serve in a particular regiment at a particular timeand
we have to collect medical evidence, which might be from a GP,
it might be from hospital medical records or it might be from
Army records, or it might require a medical board for him to be
examined, or a referral to a regional consultant. That evidence-gathering
process often does take quite a while, and there is nothing to
stop the claim today being for an injury in 1945 that has never
been mentioned before. So there is no time limit as far as that
is concerned. So quite often it is difficult to arrive at that
evidence. During the course of that claim it is not unusual for
a new condition to be introduced. It is not unusual for him to
have met someone who has got a similar experience of claiming,
and they have said "Did you claim for this?" So a new
condition can easily arise. At some stage we will be able to make
a decision, and the decision may be that we are able to accept
all the conditions, it may be that we have to reject all the conditions,
or it may be that we are accepting some and rejecting others as
not being connected to service. The claimant then has the opportunity
to appeal, and our notification tells him how to appeal. He may
appeal against not being entitled, or he may appeal, even though
the claim is allowed, against the level of assessment and the
degree of disability that has been decided. So there could be
an entitlement appeal or an assessment appeal, or both, arising
out of one claim. During the course of us then preparing that
case to go to the independent appeal tribunal, he may introduce
another condition, he may introduce more information that he will
think is going to be helpful to him, or, at some stage, he may
say that one of the conditions that he claimed for originally
has deteriorated. This is a typical case I am describing, I am
not talking about something that occurs as a one-offthis
is normal. During the life-cycle, if you can imagine, of that
claim, lots of information from correspondence is coming in, and
having to be adjudicated on. At some stage it will go to the Pensions
Appeal Tribunal. Just as an aside, one of our targets that I have
been concerned about, is about us getting our bits of the appeal
through the door to the Pensions Appeal Tribunal. For the future,
we will be looking at working co-operatively with them so that
their clock does not start ticking then but makes sure they are
aware of that appeal from the outset, because typically it will
take another year for them to arrange a hearing. So if we take
260 days, plus their year, that is unacceptable. So, to return
to your question, during the course of that claim, decision making,
and evidence gathering, we will have written and telephoned and
spoken to the claimant, in some cases, almost on a daily basis.
Certainly in the case I was talking about, 54 times in a year
we had written all over the place to try and get confirmation
of what he was telling us. So it is a much more complicated situation
than the Job Seeker's claim, the Income Support claim or the Retirement
Pension claim.
Chairman: That is
a very concise statement of what we were told yesterday. You were
mentioning some of the communication difficulties with clients.
Can I ask Howard Flight to continue questioning along those lines?
Mr Flight
18. I think what you have just said makes
the point that you have got complicated rules and complicated
procedures, and, self-evidently, maximum efficiency of communication
is a key priority in order to keep the number of appeals down.
We have seen some criticism from the War Widows' Association,
the Royal Air Forces Association and the British Legion of the
effectiveness, clarity and user friendliness of communications.
Can I, first of all, ask you what steps, if any, you are taking
to improve the provision of information to make it user friendly
and understandable, and, secondly, what you are doing to improve
the quality and speed of communication on war pensions?
(Mr Hextall) I suppose there are three types of
notification that we issue. There are some computer produced notifications
that are also issued by our mainframe computer system that makes
payments. There are then a number of "tick box" forms
(that I really do not like) where we send out a notification and
we tick one of the three or four boxes because it is appropriate.
They are very impersonal. Or we may have handwritten communications
from individual clerks to try and get some extra information.
Various things have been done over the years to try and improve
communicationsit has not been unrecognised. I think a review
in 1997 made some quite significant improvements but we are currently
in the middle of a review that is going to provide some IT support
so that in future those "tick box" forms that I have
mentionedand there are over 100 of these different formswill
be automated so that the clerk can actually make those an individualised
letter. So for the future we will eliminate those forms.
19. I have noticed, from recently handling
my mother's probate, that in that area, interestingly, there has
been, I think, a huge advance in communication. There is a simple
form for estates under the ceiling that are not too complicated,
and one more complicated, old, nightmare probate form. Is there
scope within your territory for something as, really, straightforward
as thatone form to deal with more straightforward cases
and one for more complicated cases?
(Mr Hextall) There are significant differences
between different types of claims and individuals, and it would
be difficult to have a universally simple form for simple claims
etc. I am sure you are right, there are some areas where we have
got a simple form to do with payments and the receipt, or sending
of order books and such like. We have got some where we can do
that but in the main, the types of form that these tick boxes
are used for, because there are 100 of them it means there are
100 odd different situations with multiple options on each one.
It is those that, by automating them, we are able to eliminate
the bits that do not apply.
2 See Ev p 39. Back
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