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Page 16 House of Representatives Wednesday, 30 November 2016 formed a view—which I accept may not have been ideal, from your perspective—that the policy lead for the DSP is the Department of Social Services. We would simply follow the policy directions, which are set by government through the Department of Social Services for implementation in our department. ACTING CHAIR: Who made that decision? Dr Charker: Within the department, we made that decision. ACTING CHAIR: Was the minister's office or the minister consulted? Dr Charker: I believe we advised the minister that that was our intention. ACTING CHAIR: From the committee's point of view at least, from my point of view and, I think, judging from the chair's comments, that was regrettable or an error of judgement in that the policy-led submission waffled around and outlined a bit of the process and they set policy, but a significant part of this committee's role and the audit report goes to the administration, the delivery, the efficiency, the effectiveness—which is clearly in your basket—so I do not know how you could have expected the policy lead to actually address half of these issues. Dr Charker: Just to be clear, we did not expect DSS to address service delivery issues. We simply wanted to clearly remain focused on the fact that DSS is the policy lead. For submissions around aspects of a particular program we would normally defer to the policy department. Mr GEE: I had a question but I think you have largely answered it. I would echo those comments that have been made. It is regrettable that the submission to this committee was not made. I think you should have. Ms FLINT: I wonder if DHS or DSS could comment on a few of the ANAO findings or statements that the DSS reports little or no information 'about the efficiency, effectiveness and economy' of the DSP or processes, such as job capacity assessments—this is in relation to recommendation 3—and that DHS and DSS have been publishing different figures, with a lack of consistency, on a number of DSP recipients. I wonder if you agree with those statements or whether you want to comment, generally, on them? Dr Charker: In terms of a couple of comments, I suppose, we do not necessarily meet our own claims timeliness key-performance measure, and we noted that the timeliness result in quarter 1 of 2016-17 was 66 per cent against a provisional benchmark that we aim for of 70 per cent for new DSP claims processed within 49 days of the claim being lodged. We noted that the ANAO did acknowledge the complexity of assessing DSP eligibility and that we assess over 100,000 claims each year. From our perspective, we are continually trying to do what we can to improve the timeliness. It is a very complex assessment process. Of all the claims that we administer in the department, DSP is one of the more complex, partly because of the enormous variability and the amount of information required for the department to establish whether a person is actually eligible for a claim and, as we have talked about before, there can be a number of steps in that. There can be an initial assessment. It can often lead to a job capacity assessment, which is done by the department. If that is still not yielding a clear ability for the assessor to determine eligibility, it will proceed to a government contracted doctor independent medical assessment. So the timeliness aspect, there, can be quite challenging. We noted the ANAO's comment about opportunities for the department to analyse the accuracy of eligibility decisions and understand the reasons for changes to decisions and improved decision-making. We certainly agree with that. We pay great attention to outcomes of review processes, whether they are internal reviews in the department or they are done by the AAT. We pay attention to the outcome of those processes, particularly where they have resulted in a change to the initial administrative decision which was made. We clearly pay attention to what has changed and whether that means we could have improved processes in some way. To your final point, the ANAO articulated that DHS and DSS publish different numbers of claims assessed each year in the annual report. That is because the two departments capture different sets of information relevant to their particular area of focus. DSS is more focused on program and customer outcomes, as is entirely appropriate. For DHS the focus is on service delivery. In other words, we pay particular attention to the transactions process, through the process, not the outcomes for a particular customer, though the difference between the two is about one per cent. ACTING CHAIR: Did you have any further questions on that point? Ms FLINT: No. ACTING CHAIR: I will go back to the opposition questions. There are a series of questions around the time and the cost burden being imposed on recipients being reviewed to gather medical evidence. We have had a number of submissions on that point. To start with, is 21 days the standard time frame that is given to all people being reviewed to respond with requested information? PUBLIC ACCOUNTS AND AUDIT COMMITTEE
Wednesday, 30 November 2016 JOINT Page 17 Dr Charker: Yes, it is. When we write to someone who is selected for review, we do ask them to provide that information in 21 days. ACTING CHAIR: Who decided on that time frame? Dr Charker: I presume the department. It would be a standard process, a standard that we use. ACTING CHAIR: Take that on notice about where it was decided. Dr Charker: Certainly. ACTING CHAIR: Does the time frame take into account the delays in Australia Post letters being received? It is from the date of the letter, and we had a number of submissions pointing out that letters are received often 10 days later now with delays, particularly in regional and rural areas. Dr Charker: My understanding is it would need to include any delay that is experienced in the mail system. ACTING CHAIR: So in setting that time frame—whether it was you, the minister, consultation or however it was set; you can come back to us and outline precisely where that was approved—how did DHS factor in the number of reports, costs and time for people with disabilities to arrange reports in the program design phase? Dr Charker: In terms of the intent of your question, I do not think we could say that we had an algorithm to come up with a magical figure of 21 days and allow for a particular number of reports. There is clearly not that level of sophistication in a statement of 21 days. What is really important to note though, which can get lost, is that we really recognise that for a number of people that time frame does not work, so we have options to support people for whom it does not work. We can actually extend the time frame, which is the most helpful one. We can directly contact treating health professionals for a person. Often that is actually quite helpful. So instead of their having to act as the intermediary, if you like, we can directly contact, with their agreement of course, the treating health professional ourselves. We can use our own medical practitioners and our own allied health professional workforce as well to expedite some aspects of the assessment process if we can. So we would simply ask that if someone is really concerned about the 21-day limit that they contact us within that period on the main number— 13 32 17 or whatever it is—and there is a particular option 3 on that line that will put them straight through to a special DSP support team to deal with this issue. ACTING CHAIR: It is good to hear and to have on the record those other two options, because I have not heard them promoted before. I have never been advised of them in the multiple cases I have raised with Centrelink so that is good to know. With that being a standard time frame, do you actually believe, or is there any evidence, that people can obtain and attend appointments with medical specialists and obtain a specialist report within that period of time? Dr Charker: I do not have evidence to that effect one way or another, other than to note that there certainly are people who provide us with the medical evidence that they may already have on hand in many of those cases. To illustrate, we have commenced nearly 13,000 medical reviews this financial year under the medical review measure. We finalised almost 2,000—let me get the exact number for you. We finalised about 2,000, who have been reviewed and assessed as remaining eligible; another 1,100 were finalised without a job capacity assessment or disability medical assessment et cetera. Clearly, of the ones that have been initiated to date, a number of people have been able to provide what we need. ACTING CHAIR: Do you have a percentage of the people sent a review letter who seek and are granted further time to respond? Dr Charker: We would have to take that on notice. ACTING CHAIR: Certainly some of the submitter experience and our experience suggest that a significant percentage—I do not know if you would say the vast majority—seek further time to respond. I am mindful of the previous audit report that shows the Centrelink phone waiting times have blown out. That is an issue, that people have to sit there on hold, chewing up your phone queue time to get an automatic extension to an unreasonable time frame. It does seem to be something that is worthy of a recommendation that would just take some wasted effort out of the system by giving people a more reasonable time. The other issue I wanted to raise is the criticism we have received from a number of medical specialists. There are a number of letters I can table or, if they are deemed confidential, share with you, which you probably have on file. What response does DHS have to the criticism of medical specialists regarding two points: the lack of targeting of reviews, which is seen as a complete waste of time for all concerned and a traumatic exercise for families, and, again, the advice from medical specialists of the clear impossibility of obtaining specialist information within 10 to 15 days? PUBLIC ACCOUNTS AND AUDIT COMMITTEE
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