THIRD REPORT
The Social Security Committee has agreed to the
following Report:—
MEDICAL SERVICES
I INTRODUCTION
1. Disability and sickness benefits worth £25
billion are paid to some of the most vulnerable members of our
society each year.[1]
It is essential for the people who rely on these benefits that
the system acknowledges their eligibility for them fairly and
efficiently, and causes them minimum anxiety and inconvenience
in doing so; it is essential for government that such significant
expenditure is only incurred in payment to people who genuinely
need the benefits.
2. Although the decision as to whether claimants
receive benefit is made by Benefits Agency decision makers, the
nature of the benefits requires these decisions to be based on
medical evidence. These decisions can sometimes be based on written
evidence provided by the claimants. Frequently, however, this
evidence will need to be provided by an independent doctor, acting
on behalf of the Benefits Agency. Such doctors—known as
Examining Medical Practitioners (EMPs)—are therefore crucial
in determining benefit payment. It is to them, in practice, that
much of the responsibility of ensuring that payments are made
only to those who merit them falls.
3. In exercising this responsibility doctors have
to examine claimants in an independent and thorough way. However,
concerns have been raised that EMPs have not been consistently
conducting examinations in a professional and impartial manner.
These concerns are well known to many Members of Parliament through
their constituency workload, and they have been expressed to this
Committee by a number of agencies who work with claimants.[2]
These concerns provided the impetus for our inquiry into Medical
Services and the extent of the criticisms of the system suggests
that such concerns are well founded. However, in the course of
the inquiry we also became aware that aspects of the system might
result in benefits being paid to claimants who do not genuinely
merit them. Our prime objectives in the recommendations made in
this report are therefore twofold: to improve the service provided
by doctors in terms of treatment of claimants and quality of medical
advice given; and to remove those features of the system which
might lead to the payment of benefits in cases where they are
not justified.
4. We announced our inquiry and issued terms of reference
in November 1999. As well as receiving written evidence, we held
four oral evidence sessions, at which the following witnesses
gave evidence: the National Association of Citizens Advice Bureaux
(NACAB), the Royal Association for Disability and Rehabilitation
(RADAR), MIND, the British Medical Association (BMA), the Benefits
Agency Sessional Doctors Association (BASDA), Department of Social
Security and Benefits Agency officials, Advice Centres for Avon,
Sema Group UK Ltd (Sema Group Medical Services), Dr Kit Harling
(a consultant physician in occupational medicine), Judge Michael
Harris (President of the Appeals Tribunal), and Mr Hugh Bayley
MP, Parliamentary Under-Secretary of State, Department of Social
Security.
5. One oral evidence session was held at Bristol,
during a visit in which we also held informal meetings with Medical
Services, and with claimants who told us of their concerns with
the system. We are very grateful to all those who took the time
to meet us there, and to all the other individuals and bodies
who have provided evidence, both written and oral, during the
Committee's inquiry.
1 Q 512. Back
2
See, for example, ev. p. 3-15. Back
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