Source · Select Committees · Public Accounts Committee
Recommendation 25
25
Rejected
Department attributes overturned decisions to assessment judgement and fluctuating medical conditions
Conclusion
We therefore asked the Department whether it was concerned that so many decisions were being overturned. The Department stressed that there was a degree of judgement involved in the health assessment process it used to determine eligibility for disability benefits, compared to, say, a mathematical formula, which could be used for benefits such as income replacement benefit or state pension. It explained that “a huge amount of time” went into understanding the way in which a particular health condition is disability was affecting someone’s daily living or mobility, “but you can sometimes look at the same situation and take a different judgement”. It explained that this was rarely because new evidence was provided, but sometimes because the medical condition had fluctuated over time. It told us that in some instances, when it came to a tribunal, “the case is put more clearly or the questions are answered in a different way, and you suddenly see the picture more clearly than earlier in the process when it was missed”.50
Government Response Summary
The government explicitly disagrees with the committee's implied recommendation regarding overturned decisions. It states it has started publishing new HTP MI quarterly and already publishes overturn rates in PIP Official Statistics, and will look to include equivalent measures in future HTP publications.
Government Response
Rejected
HM Government
Rejected
The government disagrees with the Committee’s recommendation. On 19 December 2023, the department published the first in a new series of HTP MI. Publication of this MI will continue quarterly in line with the PIP Official Statistics release schedule. This release includes monthly information on the number of referrals to the Health Transformation Area (HTA). As the programme and underlying data systems mature, the department will be able to evolve this publication to report against KPIs and underlying performance metrics. Health assessments are conducted on the same legislative basis and same clinical standards across providers. The department will keep under review what data can be published on performance of the existing providers and is currently designing the publication strategy for when new FAS contracts are in place from Autumn 2024. The department already publishes overturn rates at Mandatory Reconsideration (MR) and appeal in the PIP Official Statistics and will look to include equivalent measures within future HTP statistical publications once the service is suitably developed and robust, and where publishing will provide a representative picture of the HTP’s progress.