Blue Badge reform Survey

8. Payment Processes

8.1 The payment processes underlying the issuing or rejection of a Blue Badge are not coherent or logical. The survey only asked about the payments associated with mobility assessments so we do not have data on any other charges or payments.

8.2 The costs of mobility assessments carried out by GPs can be reimbursed to the GPs. In some cases the payments for this come from Health Boards, in others from Local Authorities though the routes are not consistent. Specific funds are held by some but not all Health Boards and Local Authorities to pay for assessments. Although some Local Authorities mention the involvement of the Scottish Government, the origin of the funding for the mobility assessments is opaque from the survey returns.

8.3 There are considerable variances, confusion and numerous differences between areas. Furthermore when the description of the payment processes outlined in Health Board responses and those issued by the Local Authorities that they share population with are compared side-by-side there are significant discrepancies. The overall payment process, as reported by the Health Boards and Local Authorities via the survey is outlined overleaf:

Chart 2: Payment Processes

8.4 There are considerable differences that emerge from the survey in the payment processes undertaken around a Blue Badge application. Outlined in the process chart above are processes reported as a part of the survey, however clearly some of them must be in error. The processes suggested by the survey respondents are described below.

• Scottish Government pays GPs via the central nationally provided NHS Practitioner Services Scotland. From here the fees are paid directly to the GP to cover the costs of an assessment.
• Local Authority pays directly. This seems to be the case certainly in one rural Local Authority area as the Health Board pays nothing for these assessments, and may also be the case in one urban area where some of the Local Authorities pay. In one area the Local Authority pays, but with money provided by the Health Baord.
• Local NHS boards are the principal vehicle through which this funding is provided to GPs. This is true in four Health Board areas.
• Applicant pays the GP directly – this is stated as being the case in two Local Authority areas.
• UK Department of Work and Pensions pays. This is stated as being the case by one Local Authority.

8.5 There are significant discrepancies and possible omissions between the payment processes described by the Health Boards and those described by the Local Authorities, and these cover almost all of the areas in the survey. There is confusion over who is paying, budgetary inaccuracies and the questions surrounding whether in some areas mobility assessments are unfunded.

8.6 The largest area of discrepancies and anomalies is in the question of who pays the GPs for their mobility assessment services. These are as follows:

• One Health Board reports that its’ Local Authorities pay for the assessment. By contrast a Local Authority, which is one covered by that Health Board, reports that the Health Board is paying for the assessment.
• Three councils report that they pay GPs for the assessments undertaken. By contrast the Health Board reports that it pays for the assessments. A further Council in the same Health Board area, reports that it does not pay for the assessments. It is possible that all of these statements are correct, but if so it would seem inequitable.
• One rural Health Board reports that it pays nothing towards these assessments and that the costs are covered by the Local Authorities. This is supported by one council in the Health Board area who spend a significant sum (£19,000) on these assessments. However this is contradicted by another Council in the same Health Board area, but who pay nothing, and who state that the costs are covered either by the applicants or by the Department for Work and Pensions.
• Two councils pay nothing for the assessments and their Health Board pays £134,000 for their assessments and also for a third council’s assessments. The third council however states that it pays £26,000 for its assessments; this is because the Health board provides the third council with the funding, which it then distributes to the GPs in its area.