Part 6: Clients’ experiences and perspectives
6.1
In this Part, we bring together our observations of aspects of the Ministry’s client services, alongside:
- case-managed clients’ views from the 11 in-depth interviews29 we carried out;
- relevant findings from our companion audit on how the Ministry deals with complaints; and
- views from organisations that provide advocacy services for beneficiaries.
6.2
Case-managed clients have a range of goals from their interactions with the Ministry. For them, effective case management means someone listening to their needs, considering their goals and any limits, and then tailoring services and support to meet those needs.
Summary of our findings
6.3
Work and Income front-line staff get most aspects of service delivery right most of the time. When something goes wrong, staff and managers try to fix problems. However, they are not always good at letting clients know the outcome. A few people have lost trust and confidence in the Ministry. The Ministry could do more to learn from these experiences.
Getting most things right, most of the time
6.4
Work and Income surveys about 18,000 people each year, including working-age beneficiaries and Senior Services clients. The survey shows that the overall client satisfaction rate has remained stable at about 85% since 2009.
6.5
The Acting Deputy Chief Executive of Work and Income provided figures that show that Work and Income carries out 1.77 million face-to-face appointments a year and receives 125,000 telephone calls each week. In 2013, the Ministry received 8000 complaints. Our audit on how the Ministry deals with complaints suggested some potential under-recording of complaints. However, as a percentage of the transactions carried out by the Ministry, the level of complaints is not likely to be much more than the 0.5% reported by the Ministry.
6.6
During 2013/14, the Ministry calculated 90.5% of payments correctly the first time, slightly exceeding the performance standard it agreed with the Government.
6.7
We interviewed 11 case-managed clients. We based our interview questions on Work and Income’s service standards (see Appendix 4). In our interviews, people had more positive comments than negative ones. Advocates told us that the move to one-to-one case management is proving positive for clients.
6.8
Those who have had positive experiences with case managers said that they feel supported. They feel that the Ministry has given them the confidence and support they need to get back into the workforce. This usually involves more than just financial support, and some case-managed clients said they felt emotionally supported by the Ministry as well.
6.9
Clients acknowledge that case managers are people and therefore variable in their service delivery. When case managers are good, clients described them as:
- helpful;
- friendly;
- caring;
- happy to see their clients; and
- understanding and empathetic about the client’s circumstances.
“She understood that it wasn’t my fault. I was pleasantly surprised at the way I was treated.”
Client
6.10
Some clients said their experiences with the Ministry were far better than they could have imagined. Several people spoke of being reluctant to visit a service centre because of how they thought the staff might treat or judge them. Once there, they felt welcome and said case managers showed empathy for their situation.
6.11
Other clients said the help they had received from Work and Income got them out of a bad situation. They said a combination of pride, embarrassment, and stories from friends and family had kept them away.
6.12
Clients found the Ministry’s service at least acceptable in helping them get, and telling them about, entitlements. Clients said that the Ministry adequately explains the benefits they receive so that they understand their rights and obligations. A few thought the Ministry was less than forthcoming on additional allowances.
“The website is hopeless, I looked and looked, they don’t want you to find information.”
Client
6.13
Clients said that they relied on their case manager for information. Communicating face to face was important for clients, and case managers gave clients information in a way they understood. Few clients reported using the Ministry’s website, which presents something of a challenge to the Ministry as it moves to more online services.
6.14
Clients commented favourably on the appointments system and local initiatives to prevent clients having to wait. For example, in one centre, staff booked in clients without appointments at a separate desk. This meant that those with appointments could make their appointments on time, without becoming stuck in the queue. A few clients commented that the system could be a bit unreliable, but this was not a major theme of the feedback we received.
6.15
Some clients said the Ministry liaised well with other agencies, and felt this benefited them, by removing some of the administrative “hassle”.
Putting it right when things go wrong
6.16
In our survey of people who had complained about Work and Income, most people said that the Ministry had resolved their complaint. Many also said that the Ministry’s final decision about the complaint was fair. Most of those surveyed felt that it had been worthwhile complaining to the Ministry.
6.17
The client advocates we spoke with told us that the Ministry had become better at listening to them during the last 10 years or so. There had been many cases during the years where policy conflicted with legislation, and many cases used to go to an appeal process. More recently, the Ministry has realised that, if advocates were raising an issue about legislation, the issue probably warranted looking at.
6.18
Advocates said that regional office staff are responsive and will resolve matters when they can. The Ministry also tries to work with advocates to resolve serious matters. It tries to do this so that clients do not have to ask for a “review of decision” through the Benefits Review Committee (the Committee) process. The Committee is made up of three people who had no involvement with the original decision. One will be a person from the community, appointed by the Minister for Social Development and Employment.
6.19
In 2013/14, around 1350 cases advanced to the Committee stage, with around 3400 resolved at an earlier stage. The Committee found in favour of the client on 258 occasions. Of those, in 149 cases the original decision was overturned. In a further 109 cases, the original decision was varied.
6.20
Staff in the offices told us that the culture about dealing with complaints was changing. For example, one staff member told us that in their office, they were trying to stand back, not be defensive, and ask themselves: “Did we do the right thing here?” Some staff were also sharing what they learned from clients’ complaints in their weekly briefing sessions.
Current matters raised by clients and their advocates
6.21
Advocates and clients raised a few matters with us that are beyond the scope of our audit, because they concern the decisions and policies of the Government. We have already discussed some other aspects of operational practice earlier in this report. We discuss the rest in the following paragraphs.
Clarity on entitlements and allowances
6.22
A few people felt that the Ministry does not always tell them about all the support for which they might be eligible. Some of those said they thought staff had incentives to minimise the amounts that clients claim, although we found no evidence to support this perception.
“You only know what they choose to tell you.”
Client
6.23
For some clients, improving the Ministry’s website so that they can check the Ministry’s figures would help with transparency. The website does allow some checking of some allowances, but the Ministry is currently unable to provide a full range of calculators. This is because some of the calculations have so many variables – it would be easy for clients to end up with the wrong result.
6.24
However, several people said they would not use the website or did not have access to a computer. The Ministry might need to look at other ways of communicating sometimes complicated calculations to those people.
6.25
One opportunity for improvement is the letters the Ministry sends out to beneficiaries when they have a change in circumstances. We found some of the letters to be inadequate. The letters are standard letters that lack any personalisation. The ageing SWIFTT system produces the letters.
6.26
Although SWIFTT is reliable, it produces poor letters. The letters we saw sometimes do not contain enough information for clients and can only add to the sense that the Ministry does not communicate well about entitlements. The typeface looks like an old-fashioned computer print-out, and the Ministry is also obligated to write to clients each and every time their circumstances change, to inform the client of the change and their right to ask for a review. This can lead to multiple letters being sent out, sometimes for very small changes to payments. Clients say that this makes them feel like a machine is making decisions about them, rather than a person.
6.27
The Ministry is well aware of the short-comings of the system-generated letters. It put in a significant amount of work before the welfare reforms to try to improve the letters, but is hampered by system constraints. The Ministry considers that allowing staff to personalise letters would increase the risk that case managers might unintentionally overstep the law – for example, by inadvertently creating ambiguity in letters.
6.28
We saw other letters to clients to inform them of obligation failures. In our view, these letters do not contain all the information that the legislation requires them to have.
6.29
In our view, if the Ministry is to keep using SWIFTT for at least another five years, then it needs to give urgent attention to the letters it generates and sends out to clients.
| Recommendation 4 We recommend that the Ministry of Social Development include full and clear financial information in suitably worded letters to clients, including letters sent after a change in a client’s circumstances. |
The balance between fraud prevention and building trust
6.30
Work and Income correctly focuses on detecting fraud. This is to the benefit of all taxpayers and society more broadly. Many people would expect nothing less. However, some clients said that they felt staff considered them untrustworthy and questioned them unnecessarily. These feelings affect client trust and confidence, and clients said they often felt that they are a problem, rather than an individual eligible to entitlements because of their personal circumstances.
Privacy
6.31
Clients in smaller service centres said that “everyone knows your business”. Work and Income centres have good accessibility, but also high visibility, in the community. Many Work and Income service centres are centrally located, and people feel uncomfortable entering the service centre. These clients said that this makes them feel ashamed, embarrassed, and awkward when interacting with staff. They said that people who know them might be more likely to judge them negatively for needing financial support.
“There’s no privacy, everyone can see you going in, it broadcasts that you are on a benefit, destitute.”
Client
6.32
Privacy issues also arise in this context, because clients said that staff have access to their records, including health and employment history. This can feel compromising to some clients.
6.33
Privacy of information is a matter for some clients who said that the open-plan design of service centres can make them feel uncomfortable about disclosing personal information. During our audit, we saw staff trying to minimise this effect. For example, they played radios at a low volume to make it harder to overhear conversations or spoke quietly so clients would talk quietly too.
Trust and confidence
6.34
When a client’s relationship with a case manager is poor, or they feel unfairly treated, they report “digging their heels in” or avoiding their case manager altogether. They also said they felt bullied and intimidated.
6.35
When case managers and clients do not have a good relationship, clients describe them as:
- rude and impatient;
- intimidating; and
- demanding and dictatorial.
6.36
Most complaints about Work and Income are about staff attitudes (49% of the complaints received, or about 3920 complaints).
6.37
Clients in distress are more likely to perceive a power imbalance between them and staff. Clients told us that this affects how effective they consider their case management to be. People spoke to us about feeling frustrated, angry, ashamed, embarrassed, and sometimes desperate. They worried about other people thinking they were a “bludger”, and some saw Work and Income as their last resort.
6.38
Helping staff to understand clients’ emotional responses, as well as assessing their need for financial support, is an important part of a developing case management practice. We have already commented favourably on the Ministry’s practice guides and see these as being a sound basis for further training.
6.39
Figure 9 summarises the type of improvements the clients we interviewed would like to see. We have covered most of these in the report, and they are mainly practical in nature. We consider that giving direct dial numbers for case managers would be too disruptive, because they would be mostly with other clients. However, direct email contact is something that the Ministry might wish to consider.
Figure 9
List of improvements suggested by clients we interviewed
| Category | Suggested improvement |
| Appointment booking | Clients would like certainty that an appointment is confirmed, especially those who have transport difficulties or high transport costs. Provide a list of documents and items needed for an appointment (for example, birth certificate, IRD number, and bank account details). |
| Communication | Email and direct phone contact with case managers. List entitlements and criteria for qualifying on website. Greater clarity about the case management process, goals, and outcomes. Text reminders about appointments. |
| Entitlements | Greater clarity about additional or ancillary entitlements. |
| Case manager qualities | Case managers need technical skills, but also people skills. Ability to listen and tailor solutions to people (not “one size fits all”). Matching case managers to people. Personal connection is key for some clients to feel that their case management is effective. Ability to make decisions, rather than having to get manager approval for some entitlements (which can cause delays). Some clients want their case manager to provide emotional support that gives them self-confidence and belief in themselves. Some case managers do this currently, and it is positive for clients who receive this type of support. |
| Skills and aptitude | Case managers have better understanding and training about disabilities, mental illness, or other illnesses, and the effect on capacity. |
| Privacy | Awareness of the effect of open-plan offices on disclosure. In smaller centres, case managers talk to clients about confidentiality and cross-over relationships. |
| Other | Children’s books and toys at the service centre to keep young children occupied while parents wait or during appointments. |
6.40
Staff from the Knowledge and Insights team told us there are plans for the Ministry to do qualitative interviews with case-managed clients for the first time this year. We consider this an important addition to the satisfaction survey and the complaints process, because it will provide first-hand information from users of the Ministry’s services.
29: One of our 12 interviewees was unable to proceed with the interview on the day.
30: See our earlier 2014 report Ministry of Social Development: How it deals with complaints, available on our website at www.oag.govt.nz.
31: In our survey of complainants.
32: We reached this figure by taking the 49% from our survey and applying it to the Ministry’s reported figure for total complainants.