Select Committee on Social Security Minutes of Evidence


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 pensions—a significant aspect of it is tied up with medical matters and the interpretation of medical opinion—I 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 you—just to dispose of it, because I hope you will tell me it is not something that is a major concern in terms of problems—because 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 complaint—if 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 Agency—that it seems to take so long. So we commissioned an independent review announced through the Central Advisory Committee in December—and we got consultants to do it—of 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 in—on 54 occasions during the year—meant 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 because—and my other colleagues did not have the benefit of the presentation—these 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 occurred—that he did serve in a particular regiment at a particular time—and 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-off—this 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 communications—it 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 mentioned—and there are over 100 of these different forms—will 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 that—one 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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