PIP benefits system constituted ‘systemic maladministration’ finds Northern Ireland Public Services Ombudsman

A 20-month investigation by the Northern Ireland Public Services Ombudsman, Margaret Kelly, found that repeated opportunities were missed to make the right payment as early as possible in the process.

The report said there was a failure by both Stormont’s Department for Communities and Capita (the company that carries out the assessments on behalf of the Department for Communities) to seek and use further evidence, including that from medical professionals, which meant claimants had to continually challenge the decision, often all the way to appeal, before the correct decision was made

The repeated nature of the failures led the Ombudsman to conclude that it constituted “systemic maladministration”.

PIP replaced Disability Living Allowance (DLA) in Northern Ireland in 2016 as the benefit for some of the most vulnerable in society.

Ms Kelly said: “Too many people have had their claims for PIP unfairly rejected, and then found themselves having to challenge that decision, often ‘in the dark’, and on multiple occasions, while not knowing what evidence has been requested and relied upon to assess their entitlement.

“Both Capita and the department need to shift their focus to ensure that they get more of the PIP benefit decisions right the first time, so that the most vulnerable people in our society get access to the support that they need, when they need it.”

Ms Kelly added: “My investigation highlights that the system for dealing with further evidence, a critical part of how decisions on PIP are made, is characterised by confusion.

“Claimants face huge uncertainty throughout the process over who is responsible for providing further evidence, what evidence has been obtained and whether or not it has actually been considered as part of the decision to award benefit.”

The Ombudsman’s investigation found that of 96 cases considered that were designated for a face-to-face assessment, in only one was further evidence requested after the initial review.

The report said the most common reason for not requesting further evidence was that “it was unlikely evidence would be obtained within the time scale required” – despite the fact that there were six weeks available within which to gain such evidence.

The report said face-to-face assessments of claimants was often the primary and in some cases the only source of evidence relied upon by disability assessors.

Ms Kelly concluded: “I accept that the delivery of PIP is a huge task and that there has been significant work by the Department and Capita on implementing PIP in a timely manner, but it is my view there is more work to be done to improve both the experience and outcomes for claimants and public confidence in the system.

“I welcome that the department will be taking forward the many recommendations I have made, which I hope will fundamentally improve the PIP decision-making process and have a positive impact for those most vulnerable claimants for whom the support of PIP is critical in their day-to-day lives.”

PUP Councillor John Kyle said the failures uncovered in the report were “shocking”.

He added: “The Ombudsman’s report on PIP and the value of further evidence is a damning indictment of both Capita and the Dept for Communities.”

Some claimants “can rightly feel their application was given only cursory consideration” and grounds for refusal were often unclear, he added.

Some of NI’s most vulnerable citizens have been subjected to a wholly inadequate benefits assessment, the retired GP said.

“The Deptartment for Communities must take immediate corrective action.”