Examination of witnesses (Questions 20
- 39)
WEDNESDAY 14 APRIL 1999
MR GORDON
HEXTALL, MR
ALAN BURNHAM,
and DR E ANNE
BRAIDWOOD
20. It is slightly outside the territory,
but are you saying that there is or there is not scope to simplify
your rules or procedures in order to make communication easier,
all other things being equal?
(Mr Hextall) I think they are two separate things.
Rules and procedures are oldthe legislation is old legislationand
developed for a situation that does not currently exist. However,
that is separate from the fact that we can improve the forms and
notification, because I believe we can.
21. So both need addressing, as it were?
(Mr Hextall) Yes.
22. In terms of the Helpline and telephone
contact, and so forth, you made the point that this can be crucially
important in one-on-one interviews at least down the telephone.
Do you think you have got enough Helpline staff? Has the cost
of calling Helplines been looked at? Have you thought about Freephone
arrangements? What are calls charged at at present?
(Mr Hextall) At the moment the cost of calls is
borne by the caller.
23. At what rates?
(Mr Hextall) Wherever they are living. It could
be national rate, yes, and if that is the case then we would offer
to call them back.
24. Why not have a Freephone?
(Mr Hextall) Yes, I am examining that, because
I believe there is a business case to be made for that. I think
Freephone rates today are not what they used to be. So, yes, from
those people who we deal with over the Helpline we get very good
press and very good satisfaction ratings, but I am aware that
some people have difficulty getting through at particular times
of day. So we have increased the number of operators and the number
of lines; we upgraded the type of equipment we use last November.
When the Helpline first started we had four operators, which we
have increased gradually. We increased it from 12 to 15, I think,
in November and to 20 this last month. So it seems that the more
people we put on there the more calls come in, so we are looking
at more radical ways of dealing with that, perhaps by lengthening
the time of the day, including weekend working, or by syphoning
off some of the calls which do not come in from war pensioners
but which come in from other agencies and Government departments
through the Helpline. We ought to be able to make other arrangements
for them.
25. Are these 20 people effectively frontline
case officers? Can people get plugged straight into the case officer
with their file through the Helpline?
(Mr Hextall) It could be both, but the aim is
for the Helpline person who takes the call to be able to answer
it and deal with it. They have got access to the computer system.
Just going back to notification, one of the new IT developments
we have on line for June this year is to give them access to the
notifications, because at the moment if someone rings up and asks
about a particular notification, they have to describe the notification
because the Helpline operator will not be able to see it. So from
June we will have the ability for them to view on-screen the notifications
that have gone out. At the moment we just deal with enquiries
through the Helpline. As part of the review for the future we
will be looking at taking claims over the telephone, taking change
of circumstances over the telephone and for us to use the telephone
to get in touch with people. Relating back to the question earlier,
rather than there being a long gap where they hear nothing, on
a regular basis we will be looking to telephone them to tell them
what is happening on the claim.
26. Are you going back to the point you
made earlier that it may not be practical to have one-on-one,
physical interviews to pull out all the information, but certainly
if you are going to upgrade your telephone contact that, surely,
must be a high priority?
(Mr Hextall) Yes, it is.
Mr Dismore
27. I have a couple of questions on communication.
First of all, I saw the bulging number of new cases in 1992/93,
and I will start in the context of what I am going to put to you.
That is the issue of what efforts are made to encourage people
to make claims. For example, one of my constituents, who I want
to come back to later, mentioned to me that she made a claim in
1993her condition occurred soon after the war, in fact,
but she only made a claim in 1993after she read an article
in the Daily Telegraph which said that claims can still
be made, yet for all that time she had no knowledge of the fact
that she was entitled to make a claim. I do not know if that coincides
with the numbers in 1993 and the readership of the Daily Telegraph!
Has the Agency got any theories or ideas to try and encourage
take-up? What efforts are you putting into that? In particular,
people who are members of the British Legion may get information
but a lot of people are not, so what efforts are you making to
publicise the availability of the right to submit a claim, particularly
amongst the older age group?
(Mr Hextall) People are told about war pensions
in their discharge papers, when they actually leave the service,
so that is the first time they would receive information about
how to claim war pensions. For the existing population, the War
Pensioners' Welfare Service which we operate, is proactive in
managing exhibitions and supporting other organisations who have
exhibitions. Typically, they will be out and about somewhere in
the country every week with publicity. At the Royal British Legion
conference we would have a stand; we had one last year and, hopefully,
will have one this year as well. We also have a mobile exhibition
that travels round the country. So that is a bit ad hoc but it
is trying to focus on where you might find ex-servicemen and women.
28. My concern is going beyond that. As
I say, I think the British Legion, both locally and nationally,
and other organisations, have got a pretty good network, and you
mentioned some of those things. How do you get beyond that network
to all those other peoplelike my constituents who have
not been involved in the British Legion, as far as I knowwho
suddenly read something in the paper which sparks off their claim?
As I say, you have this bulging 1992/93 caseload and that must
have been caused by something. Are there any lessons about what
generated that increase in claims then that could be brought forward?
My concern is that we have got a lot of very old people now, or
people certainly beyond retiring age, who may have disabilities
which they now relate back to their time in the forces and in
the Second World War or around that time, but do not actually
realise that they can make a claim because they are not involved
in these ex-servicemen organisations. How do you reach those people?
(Mr Hextall) I do not think we do, actually.
29. Have you any thoughts about how you
might reach those people?
(Mr Hextall) Yes, and we have discussed it. Other
than by putting national advertising out and that kind of thing,
it would be very difficult to do that, and I think other benefits
would have the same difficulty. So we do what we can do by targeting
information at particular areas and groups, but I do not think
we are ever going to be able to pick up everybody who might possibly
have an entitlement to claim.
30. Clearly you are not going to pick up
everybody, but I am concerned, as you have just freely admitted,
that there is this whole raft of people you are, perhaps, not
reaching at all. Is there any way, for example through the BMA,
that that information could be passed on to doctors?
(Mr Hextall) I was going to say we can work through
putting articles in regimental magazines and things like that.
31. That is not answering my main criticism,
which is that a lot of these people are no longer involved in
ex-servicemen's organisations or regimental organisations. A lot
of people who are conscripted would come out of the Army and say
"I am going to forget about all that and get on with my life"
and do not want to be involved. Equally, other people do want
to hang on to the conventions that they have built during the
war years and are involved in ex-servicemen organisations, but
a lot of people are not. Everything you are saying to me points
to the fact that you are working through that network and not
reaching beyond that.
(Mr Hextall) I am very willing to take help on
that.
Chairman
32. Supporting Andrew's point, what is different
about you is that you know the people who are the eligible pool.
You cannot tell who is going to be eligible for Income Support
because any of us might be next week, but you are only dealing
with people who have been involved in active service, so there
is a finite numberI think you told me what it was yesterday
but I have forgotten, 4 million-ish. So you know the people out
there who are potential claimants and that puts you in a different
position from other parts of social security policy altogether.
(Mr Hextall) Actually, we do not know who they
are, but presumably the Ministry of Defence will know who they
are.
33. Presumably you talk to them from time
to time?
(Mr Hextall) Yes, we do, in getting service records.
Chairman: There is
this point about the peaks.
Mr Dismore
34. The question about the peaks is one
of the short points on this general issue. That is the war widows
issue. We have had quite a long submission from the War Widows'
Association about the lack of information or lack of clarity of
information. I was speaking to my local British Legion branch
yesterday to discuss what we were going to be talking about today
and they made the point that widows of war pensioners often think
their entitlements are very different to what they are, and it
comes as a nasty shock to them. Secondly, they made the point
about remarriage and widows who come back after remarriage and
then do not realise they may be entitled. Is there any particular
targeting you can do on war widows, or former war widows, who
may then become entitled, or even not entitled? Certainly the
information I have from my local branch of the War Widows' Association
is that that information is not as clear as it could be, or getting
out.
(Mr Hextall) When someone who has been a war widow
hands the pension back if they are remarried, the notification
we send to them then includes the fact that if, for some reason,
their marriage comes to an end then they will be entitled to have
their war widows pension restored. I have spoken to the War Widows'
Association about how we might be able to do anything more as
far as that is concerned, but one would hope that the marriages
would last and do not actually come to an end. It would be inappropriate
to be writing to them during the course of their marriage to remind
them of the fact that if their marriage should end they may be
entitled to a war widows pension.
35. For example if they are re-widowed.
(Mr Hextall) Yes, that is right.
Chairman
36. This will have to be dealt with at some
stage. Somebody might just spend two minutes explaining why we
get peaks like that.
(Mr Hextall) The peak is, largely, attributable
to an increase in the number of hearing loss claims during that
period. At the moment the hearing loss claims are round about
25 per cent of all claims that we receive. During that period
they were round about 75 per cent of all claims received, and
some were not for just hearing loss alone but were for other conditions
as well. The hearing loss issue, you might ask why it came to
an end, and perhaps I could ask Dr Braidwood to expand on that.
Mr Dismore: I would
like to come back to that in detail later on.
Chairman
37. Dr Braidwood, why not help us through
some of the medical science?
(Dr Braidwood) Thank you, Chairman. As Mr Hextall
said a war pension can be claimed by anybody who has served at
any time from service release. That means a lot of very old people
and some people with newly left service are equally eligible to
claim. Claims can be made for any disablement (so that is also
a bit different from many compensation schemes), and awards are
made where there is a causal link to service. The legislation
actually sets out how we have to assess war pensions. Doctors
are involved, quite unusually in a Social Security related scheme,
as being appointed or recognised by the Secretary of State for
the purpose of certification of claims. With respect to noise
induced hearing loss, and the peak in 1992/93, the report of the
Public Accounts Committee which looked at this, as Mr Hextall
has said, confirmed that the majority of these claims did appear
to relate to noise induced deafness. Further exploration of that
by Agency or Directorate officials, (as it was at the time), confirmed
that they were in the main coming from the geographical areas
of the country which were sites of heavy industry at the time.
They seemed particularly to be involving people at or about retirement
age who, in a large part but not, of course, exclusively, had
done two years' National Service and then spent quite a long time
in industry. In 1975 the Industrial Injuries Scheme, which is,
as you know, in some ways, quite related to the War Pension Scheme
in terms of assessment and so on, recognised occupational deafness
as a prescribed disease. The conditions governing award of industrial
injuries disablement benefit are a little different from that
of a war pension. In particular, there are rules about the length
of time you have got to be in a particular occupation or industry.
We therefore formed the judgmentor our predecessors didthat
a likely explanation was that a number of people working in heavy
industry, having had a short period, in many cases, in service,
failed to have awards of benefit under the Industrial Injuries
Scheme and then made claims for war pension. At the same time,
the ex-service organisations, quite rightly and properlyas
is their functionalerted people to the War Pensions Scheme
and they made claims under that second scheme, which has generosities.
That is our understanding of the explanation. In 1992, the then
Government of the time, as I think you will know, because of the
last interview with the Chief Executive of the War Pensions Agency,
introduced a legislative amendment to the Service Pension Order
which effectively, brought the compensation threshold for war
pension for noise induced deafness into line with that which had
always been present in industrial injuries. That was done in 1992,
coming into effect early in 1993. That, we think, had an influence
on claims made.
Chairman: That is
very valuable, but I think we want to return to that later. Can
I turn to Julie Kirkbride and move on to another area?
Miss Kirkbride
38. This is, probably, a mopping up of what
we have discussed, which is that clearly there is a long lead
time to appeals coming to their conclusion and, really, we would
like to know what you are going to do about it, bar putting a
few more operators on your HelpLine.
(Mr Hextall) Yes, because it is going to require
something fundamental to make some dramatic reductions in those
processing times and that is what I am committed to. The review
that I mentioned earlier has made some recommendations that grouped
into some related policy. I mentioned earlier getting greater
clarity between what is a claim, what is an appeal and what is
a review. That would certainly help. Also, about time limits,
because at the moment there are, virtually, no time limitsor
if there are we do not operate any. So there are recommendations
about that. At the moment I do not know how acceptable some of
these recommendations are going to be; we will have to discuss
them with the Pensions Appeal Tribunal, the Lord Chancellor's
Department and the ex-service organisations as well as our own
policy people, but these are the recommendations. So some are
related to policy and some are related to IT. A key recommendation
is that we introduce workflow technology to give greater case
management capabilities and to make greater use of telephony,
as I mentioned earlier. So there are a couple of IT related opportunities
for us. A number relate to process and a lot of that is about
getting more information at the outset, as I have already referred
to, but also about the Appeals Tribunal process as well. At the
moment, one of the reasons that they are unable to arrange hearings,
perhaps, as quickly as they would like, is because the constitution
of an Appeal Tribunal is different depending on the type of person
you are, whether you are an officer or another rank. There are
several different constitutions in an Appeal Tribunal, depending
on the type of case you have, and the recommendation is that there
is a single composition of an Appeals Tribunalsomething,
I think, that the President of the Appeals Tribunal was keen to
support when he was interviewed in connection with this. So there
are a number of issues around process and a number of recommendations
around medical evidence gathering as well. At the moment, a comment
they made was that we are perceived by the claimants as protracting
this process, whereas, in actual fact, our claimants do not realise
that we are trying to help to gather evidence. This is because,
typically, when we receive a claim in the first instance we get
vague symptoms described, rather than a medical diagnosis, and
a lot of the time is spent trying to relate the symptoms to some
evidence that will lead to a diagnosis so that an award can be
made based on a diagnosis rather than evidence that might be "dizziness"
or "shortness of breath". So there are a number of points
about the medical evidence gathering process. In addition, we
must make greater use of the fact that we do have specialists
amongst our Medical Advisors we employ directly. Some are specialists
and yet at the moment, we still go out to third party independent
specialists. Some recommendations are that we could shorten the
process by using one of our own specialists to make the medical
judgement. So, taken together, those recommendations ought to
significantly reduce the time and I am committed to doing that.
It is unacceptable to me at the moment.
39. Can you elaborate a bit more on what
you said about there being time limits? What things are being
considered there? What is on the agenda? Whose time limits?
(Mr Hextall) They were suggesting a time limit
of six months once someone has had notification that this is the
decision and there is an entitlement to appeal. They suggest we
should allow six months. I do not know how acceptable that is
going to be. I think that is very fair compared to other benefits,
but whether it is fair compared to war pensions remains to be
seen.
|