Welcome to our new Pensions Ombudsman Update. These updates are designed to help you get to grips with the Ombudsman’s thinking, to keep track of decisions on matters concerning police and fire service injury awards and non police related injury benefit schemes and to identify underlying trends.
Published in our “news” section, we will try to summarise the interesting decisions of the past three months or so.
John Lewis Partnership Pension Scheme (PO-11695)
Mr N has complained that the Trustee did not take the decision to cease his ill health retirement pension in a proper manner. In particular, he considers it placed too great a reliance on the advice from its own occupational health physician and did not give reasons for preferring her advice.
In PO-11695 Mr N (17 May 2017) the JOHN LEWIS PARTNERSHIP scheme trustees decided (having used the Trustee’s occupational health physician, Dr Eraneva, to consider medical evidence) that the member’s ill-health pension should be suspended as his condition was not permanent, despite the trustee having decided in 2009 and 2012 that it was. The Ombudsman’s Adjudicator was unable to find evidence of any change in the member’s condition or proposed treatments since those assessments.
The decision made it clear that there is an underlying principle that a pension, once in payment, was payable for life. A natural reading of the John Lewis scheme rule provided discretion to vary, suspend or reinstate pension was one that looked for a rational basis for change. The trustee did not apply its mind to the specific question of whether it should remove the existing entitlement, but took an approach akin to requiring the member to make a fresh application for an incapacity pension. This was maladministration and the trustee was directed to re-consider the decision to suspend the pension.
The Deputy Ombudsman accepted that the John Lewis scheme did not have to continue to pay an incapacity pension if this was no longer justified, but the trustee had to be able to point to a change in the member’s circumstances. The discretion to suspend was not an opportunity for the trustee to change its mind or interfere in its predecessors’ decisions.
Mr N stated that the Trustees placed too great a reliance on the advice from its own occupational health physician (Dr Eraneva) and did not give reasons for preferring her advice.
Whilst saying that it is not the role of the Ombudsman to review the medical evidence, the Deputy Ombudsman said;
but I also have reservations about the standard of proof applied by Dr Eraneva
Our Comment
The John Lewis scheme is a discretionary scheme whereas the police injury benefit Regulations are a statutory scheme. This is not the first time that the Pension Ombudsman has been guided by a purposive view of scheme rules dealing with ill-health. In PO-9309 Mrs R (10 June 2016) the Ombudsman opined that the starting position, where an employer had a discretion to pay a discretionary ill-health enhancement, should be to pay it.
All too often, because of the influence of NWEF , the selected medical practitioners used by police forces consider themselves as quasi-judicial and supposed “judges of fact”.
In fully upholding Mr N’s complaint, the Pension Ombudsman is showing a pattern that the views of the scheme’s own occupational health doctor do not trump the person’s own clinicians. This is inline with previous decisions, such as the ill-health early retirement of Mr Y (PO-13059) when it was found that the employer’s flawed decision over-relied on its own medical advisers’ opinions.
I wonder how many bloody judgements these police forces want before they start implementing the pension regulations properly.
We have Judicial Review decisions and Pension Ombudsman decisions and still they try to wriggle out of performing IOD reviews lawfully.
The SMP’s involved in these corrupt practices need to sit up and take a serious note.
When they spout the ridiculous notion that they are in a quasi judicial role and are some sort of judge, as opposed to an independent medical professional as the regulations require, (it could of course be argued that some are not fit for the title of medical professional and certainly not independent) then they are leaving themselves wide open to their integrity and conduct being challenged.
You are not judges, quasi or otherwise. Nowhere in the relevant regulations does it give you the title or role of any sort of judge. You are supposed to be a medical professional, independent at that, making a determination of medical fact, end of.
You cannot get away from the fact that your only role is that of a medical practitioner assessing a patient, and of course that role is governed by the General Medical Council.
I would refuse to be MEDICALLY assessed by a JUDGE. Only a suitably qualified medical practitioner could have my permission to assess my medical issues.
Every SMP who claims to be anything other than a medical practitioner needs reporting immediately to the GMC. It is a false assertion and the assessment would not have my true consent.
REPTILES
The assumption and assertion of SMP’s having a Quasi Judicial Role are the teachings of our very own preacher of Hate, Nicholas Wirtz.
Unfortunately for them the Regulations as they currently stand refer to the position, as being occupied and performed by an Independent Doctor, not a Quasi Judicial Judge.
It just takes you straight to the simple question, that should be qualified right at the start of the process.
” Are you performing this Review as my Doctor, and for the purpose of this review am I your Patient ”
It is a Yes or No answer.
There is no room for, ” actually I have a Quasi Judicial Purpose, and I am a judge ”
If the answer is anything other than yes……
See you later alligator!
These people should never be allowed to forget that they, like us, are servants, that are supposed to serve, for the good of their oath and their patients.