Jimmy Hood (Lanark & Hamilton East, Labour)

I have looked at the wide-ranging amendments to clause 8, and at the moment, I do not intend to call a stand part debate.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

I beg to move amendment No. 255, in clause 8, page 6, line 7, after ‘work’ insert ‘or work-related activity’.

Jimmy Hood (Lanark & Hamilton East, Labour)

With this it will be convenient to discuss the following amendments: No. 256, in clause 8, page 6, line 9, after ‘determined’ insert ‘by a single assessment’.

No. 251, in clause 8, page 6, line 24, after ‘work’ insert ‘or work-related activity’.

No. 252, in clause 8, page 6, line 27, after ‘work’ insert ‘or work-related activity’.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

On the face of it, the amendments are relatively simple. They are based on the question of whether it would be possible to combine the assessment for limited capability for work, as described in the clause, with the assessment for limited capability for work-related activity in clause 9. The amendments would make possible not only one single assessment, but the removal of clause 9.

Mr. Hood, I wonder whether you will allow me some latitude in my explanation of why we tabled the amendments. They touch on one of the two most important themes that I wish to draw to the Committee’s attention in all our 16 sittings. It concerns the fundamental thinking behind the Bill, which is that if we are going to make it easy for disabled people to re-engage in the world of work, two things have to be considered.

The first is the welcome provision in the Bill that gives people additional help to deal with their health conditions and to deal with the challenges that they may face in entering or re-entering the labour market. There are lots of excellent things in the Bill, which have been presaged by the successfully piloted pathways programme. I commend the Government not only on presenting the Bill to the House but on the pathways programme, which has given Opposition Members a great deal of confidence that roll-out can occur practically and successfully.

There is a challenge, however, and it is the complexity of the system. The current benefits system for disabled people is extraordinarily complex, and these amendments attempt represent a small step towards simplifying the processes—not just the complexity of different available benefits, but the assessment processes as well. The report that was published last year—“Improving the life chances of disabled people”—gives an example of a hypothetical person called, I think, Kelly, who becomes disabled in her twenties. It lists all the benefit applications that she would have to make. They include applications to the wheelchair service, to the local council for a disabled facilities grant, and to Access to Work for help in modifying her computer and her desk. There would also be applications for help with housing allowance, to social services for help with a personal assistant, and to the independent living fund, if the PA were going to cost more than a certain amount. The report does not mention that, on top of that, she would have to apply for the disability living allowance, or—if she were not in work—incapacity benefit.

Tim Boswell (Shadow Minister, Work & Pensions; Daventry, Conservative)

Could my hon. Friend not add to his list the question of passported entitlements—for example, to free prescription charges—that might apply on receipt of certain benefits but that would not be automatic?

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

Yes, indeed—that is an excellent point. There are so many applicable benefits. I have read that the Minister is apparently the only member of the Government who can name all five members of the Spice Girls—I think that that appeared in The Guardian.

Jim Murphy (Minister of State (Work), Department for Work and Pensions; Renfrewshire East, Labour)

It was nine years ago.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

All I would say on that—

Jimmy Hood (Lanark & Hamilton East, Labour)

Order. The hon. Gentleman asked for some leeway, but I am looking for a reference to the Spice Girls in the amendment paper and I cannot find it.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

I am grateful, Mr. Hood. I was merely pointing out that it was considered to be a great feat of memory that the Minister could remember five Spice Girls, but there are many more than five disability benefits.

Why is that a challenge? The reason is something that the Government often talk about, and which—to their credit—they understand. It is the link between disability and poverty. We know that the proportion of disabled people in poverty—nearly a third of them are of working age—are in income poverty, and the level has risen during the last 10 years, which is of great concern on both sides of the House. It is poverty of that nature that makes the benefits system so vital to some of the most vulnerable and disadvantaged people in society.

The problem with the current system is that it is like an onion with many different layers. If one is disabled, one is completely dependent on it, and one is likely to be dependent on it in one form or another for the rest of one’s life, so one does not wish to risk one’s entitlement to some or all of the benefits. That is why it is dangerous to countenance making the system even more complex.

Tim Boswell (Shadow Minister, Work & Pensions; Daventry, Conservative)

My intervention is supportive, and it will be the last that I shall make, because I agree with my hon. Friend’s line of argument. Does he agree that the Department’s report entitled “Opportunity for all”, which was published this week, indicates not merely the coincidence between disability and lack of employment and poverty, but the knock-on effects on families and children? Typically, children growing up in families where one of the parents is disabled suffer directly in the face of poverty and are most difficult to help.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

As ever, my hon. Friend makes an important point. One of the advances that the Government could make to be more successful in meeting their child poverty targets would be looking at the link between child poverty and disability issues. We should like there to be a specific strategy to make that happen.

Returning to the poverty issue, because it is important, the Minister and the Under-Secretary will know that the Joseph Rowntree Foundation has tried to quantify the additional costs of being disabled netted out from the additional benefits that people receive. Disabled people face an additional £200 per week in costs, ranging from the fact that if they are in a wheelchair, they will not be able to shop around as easily to get the best deals in the shops, as other people can, to the additional costs of laundry, adaptations and so on. Because of those extra costs and the link with poverty, the complexity of the benefit system makes many disabled people fearful of risking the package that is so vital for them.

We have to be careful with this Bill, because although the extra help that it is providing is to be welcomed, it also makes the benefits system even more complicated by replacing incapacity benefit with a new benefit with two elements—a support element and a work-related activity element. I should like the Minister to consider whether anything can be done to simplify the assessment processes.

I should have preferred to debate a much bolder Bill dealing with the transfer to a single working-age benefit, because that would be a huge step towards simplicity. However, the measures that we are talking about have much to commend them, which is why we support the Bill in principle. However, the Minister should consider not just the complexity of the benefits system, but the complexity of the assessment procedures and whether it would be possible to move towards a single assessment process that would be passportable across different benefits so that disabled people did not have continually to go for different assessments for various benefits.

Natascha Engel (North East Derbyshire, Labour)

We considered the simplification of benefits in Select Committee and came across the big problem of complexity in disability itself. It is not just a matter of disability being physical or mental; if the benefits system were simplified too much, it would not capture people’s disabilities and people with different disabilities would be disadvantaged.

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

The hon. Lady makes an important point. It is important that any simplification of the benefits system—the purpose of which, as in this Bill, is to make it easy for people to transfer in and out of work of work depending on their personal situation—reduces the barriers that make them concerned about transferring into work, particularly if they are out of work. She is right; nothing that we do must make it more difficult for us to react appropriately in the benefits system to the extraordinary range of complexity of disabled people’s conditions. If there were a thorough single assessment process considering every aspect of someone’s disability, it would lead to a definitive report that would, in my ideal world, be used by all organs of the state without that person being required to go through the process time and again.

A Mencap report says that 37 per cent. of severely disabled children have to deal with eight or more different professionals from different services, often asking the same questions. Although simplification would not be a quick win for the Government—it is rather complicated to get Departments to talk to each other—it would be an easy win in the sense that it should be a measure that saves money, rather than costs more. The assessment processes are expensive and there would be, on the face of it, an enormous saving to the Government if it were possible to have one single assessment that could be transferred across.

Mr. Hood, you have given me some latitude, for which I am most grateful, but let me return to the specific amendment. I hope that the Minister might consider it. He might have some good reasons as to why it is not possible to combine those two assessments and we will listen carefully to those reasons.

Would it not be possible to have one assessment that—as I understand it—is an assessment of the level of someone’s disability and if that disability is above a certain level so that they have limited capability for work, they are entitled to ESA and if it is above a higher level, they are entitled to the support element under the Bill? Would it not be possible to do that in  one assessment, therefore simplifying the process for disabled people, saving the Government money and speeding up the process for everyone concerned?

Danny Alexander (Shadow Minister and Disability Spokesperson, Work & Pensions; Inverness, Nairn, Badenoch & Strathspey, Liberal Democrat)

I have considerable sympathy with the hon. Gentleman’s remarks in support of his amendments and want to press the Minister to explore a number of issues on those points. I agree that the benefit system facing disabled people is complex. The hon. Member for North-East Derbyshire (Natascha Engel) is right to point out that disability is complicated and many faceted. Nevertheless the complexity of both the benefit system and the assessment process can create considerable hurdles for many disabled people.

For example, one of my constituents, having had an injury at work, was faced with going to the same medical testing centre in Inverness on three separate occasions over eight weeks to be asked slightly different questions by the same doctor—one visit for incapacity benefit, one for disability living allowance and one for industrial injuries disablement benefit. Such repeated exposure to what—no matter how hard those people who are doing the assessment attempt to make it an easy process and one that people feel comfortable with—can feel like an intimidating and intrusive experience. That is something that, if we can in the course of this Bill, we should try and make simpler if possible. That is not to decry the point about the complexity of disabilities that people face and that one is trying to understand and assess, but to look at whether the assessment process can be made more simple.

That captures the point made by the hon. Member for South-West Surrey (Mr. Hunt) about poverty faced by disabled people, particularly disabled children and their families. In his earlier remarks in Committee, the Minister referred to how he wishes to see the provisions of this Bill used to help address the question of child poverty. That is something that should be in our minds throughout our proceedings—both the complexity of the system and the assessment process and whether that may or may not act as a disincentive to people to take part. Therefore, we need to look at the justification for having separate assessments for limited capability for work and limited capability for work-related activity.

The draft regulations for clause 9 set out the descriptors for the assessment of limited capability for work-related activity—which we will no doubt come to when we debate clause 9 in more detail. They have many common factors with the list of descriptors set out in the “Transformation of the Personal Capability Assessment - Report of the Physical Function and Mental Health Technical Groups” document published by the Department for Work and Pensions about a week ago. The list of descriptors are different in some respects, but similar in many respects.

Therefore, even if it is not possible to consolidate all the assessments, it must be possible to create some type of core assessment that would not just inform limited capability for work-related activity but disability living allowance and industrial injuries disablement benefit assessments. It could also inform assessments for assess-to-work funding. The Bill could be improved if the assessment that people get when they are applying  for benefit carried with it an understanding of what level of access-to-work funding someone might be entitled to or what type of adjustments they might be entitled to funding to support.

John Robertson (PPS (Dr Kim Howells, Minister of State), Foreign & Commonwealth Office; Glasgow North West, Labour)

I have listened intently to the hon. Gentleman and I have great sympathy with what he says. Does he agree, however, that part of the problem is not just the amount of assessment but the people who are doing the assessing and that we can have three different assessments with three different outcomes? It is not the people who are being assessed who are the problem, but the people doing the assessment.

Danny Alexander (Shadow Minister and Disability Spokesperson, Work & Pensions; Inverness, Nairn, Badenoch & Strathspey, Liberal Democrat)

I agree with the point that has been made and I would like to table further amendments that I hope we will be debating later today in relation to training for the people who carry out the assessments. With regard to some mental health conditions in particular, lack of training and lack of awareness are a real barrier to getting accurate assessments of the conditions and barriers to work that people face when they have certain conditions or impairments.

I would like to hear from the Minister whether he thinks it is possible to combine these core assessments. I raised this issue with representatives of Atos Origin, which carries out the assessments on behalf of the Government, when I had a very useful visit to its testing centre in Inverness in August. I got the impression that having to make different assessments for different benefits, often for the same people, is sometimes a source of frustration for them as well. This may simply be due to the fact that they have to make different appointments with the same person over a period of weeks. It would be easier for the individual concerned if someone only had to come into the office once, even if they had to undergo a slightly longer assessment.

David Ruffley (Shadow Minister, Work & Pensions; Bury St Edmunds, Conservative)

Does the hon. Gentleman agree that the hon. Gentleman the Member for Glasgow, North-West (John Robertson) raised a key point when he said that different assessments could give rise to a large number of appeals? The complexity of this new regime is not just bad for the claimant, but could result in many more appeals.

Danny Alexander (Shadow Minister and Disability Spokesperson, Work & Pensions; Inverness, Nairn, Badenoch & Strathspey, Liberal Democrat)

I certainly agree with that point and we may wish to debate this later as we go through this clause and clause 9, as I am particularly concerned about the way in which the Government propose to test the new personal capability assessment, which relates particularly to clause 8 on limited capability for work. My understanding is that the testing proposal is simply that the new assessment should be run in parallel with the old assessment. There should be some medical assessors looking at how it works and there should be a study of the outcomes of the two different assessments.

Unless the Minister can clarify this point, I think there that there will be serious questions about whether the criteria that will be used are better. If we consider whether the outcomes are the same—the point that the hon. Members for Bury St. Edmunds (Mr. Ruffley) and  for Glasgow, North-West (John Robertson) made in relation to the outcome of assessments and appeals—we see that, in many cases, the current assessments do not work very well as they result in numerous mistaken assessments that result in many appeals, many of which are successful. If all we are doing is seeking a new assessment that is as good as that, our ambitions are very low indeed.

I would like to see a much longer period of study for the proposed new personal capability assessment to make sure that it works properly, and I would like that to be carried out by an independent body. Having the company that is responsible for the assessments making the judgment as to whether the new one works better or not is not desirable.

Natascha Engel (North East Derbyshire, Labour)

To return to our investigations at the Select Committee, one of the dramatic differences between the personal capability assessment that is now proposed and the medical assessments that are carried out today is the massive cultural shift away from assessing someone’s incapability to do something to considering someone’s capacity to do something. That cultural shift from incapacity to capability will make an enormous difference in the way that people are assessed and will give a far more holistic approach to the way the medical profession view someone who is to be assessed.

Danny Alexander (Shadow Minister and Disability Spokesperson, Work & Pensions; Inverness, Nairn, Badenoch & Strathspey, Liberal Democrat)

I should have made it clear that, having studied the documentation in relation to the transformation of the personal capability assessment, it seems to me that a great deal of progress has been made in rethinking the way the assessment works. My point is not that the thinking that has gone into it is not good or that progress has not been made, but rather that the evaluation of this new assessment should be more robust and more independently led than the fairly brief assessment that the Government are proposing.

Given that the Bill is proposing two separate assessments, one for limited capability for work and one for limited capability for work-related activity, which on the face of it seem to be quite similar even though they are intended to reach different decisions, what are the Government’s intentions as to how these two assessments should be carried out? What will be the claimant’s experience? Do the Government intend a claimant to be invited for an assessment for limited capability for work to determine whether they are entitled to ESA and then, once that decision has been made, for another, separate assessment to determine their limited capability for work-related activity? That second assessment would determine whether the person was entitled to the support component or the work-related activity component. How will the claimant experience those two different assessments in practice?

David Ruffley (Shadow Minister, Work & Pensions; Bury St Edmunds, Conservative)

On that point, is it the hon. Gentleman’s understanding—it is my understanding, although this is not dealt with in the Bill—that the two assessments will be done at the same time, by the same person, in the same room and on the same day?

Danny Alexander (Shadow Minister and Disability Spokesperson, Work & Pensions; Inverness, Nairn, Badenoch & Strathspey, Liberal Democrat)

Although it is not in the Bill, that is my understanding. A claimant would go to the medical assessment office, sit down and have their assessments for limited capability for work and work-related activity. At the end of those assessments, the person would leave the room and a decision would be taken about whether they were entitled to the support component or the work-related activity component. Depending on that decision, the person might or might not be invited back into the room for a further, work-related, health-focused assessment to determine the work-related activity to which they were entitled.

If the Government are proposing that the two separate assessments described in clauses 8 and 9 take place seamlessly—at the same time, in the same room and with the same person—I fail to see why they should be subject to two separate sets of regulations. In practice, that could allow a future, perhaps less well-intentioned Government to separate the two assessments and invite someone back to the room on a subsequent day or in a subsequent week or subsequent month for a different assessment to do the same thing. I would be grateful if the Minister could clarify that point and I look forward to his response.

David Ruffley (Shadow Minister, Work & Pensions; Bury St Edmunds, Conservative)

We all look forward to the Minister’s considered reply, and I should like to hear his response on one final point. Although the issue is not dealt with in the Bill, we understand that the two assessments will be done at the same time or sequentially, within an hour or so of each other, by the same assessor and probably in the same room. Does the Minister agree, however, that there could be a potential conflict in what the assessor teases out from the claimant? A claimant will try to demonstrate that they are unwell enough not to be able to work and that they are eligible for the employment and support allowance, and they know that the first assessment will test their level of unwellness. However, in a very real sense, the next assessment will test something at the other end of the spectrum: what the person can do—their capability.

There seems to be an in-built tension in that arrangement. The first assessment shows unwellness, and the claimant will want to show that they are unwell, because they will want and need the allowance. However, a few minutes later, they will, given that they will be acting in good faith, have to demonstrate some level of functionality, if they have it. That will determine whether they are eligible for the support component or whether they have to go on to the work-related activity component. In the mind of the claimant, that will compromise their responses. I thought about this when I first saw the Bill and it has been confirmed by what some disability and support groups have told me. Claimants will think that if they show too much “capability” in the second assessment, it might compromise their eligibility under the first test about whether or not they get the allowance.

I do not, in any way, say that this is slack drafting or that having two assessments is a ridiculous proposition, because I know that officials and Ministers have put a lot of thought into this during a fairly serious period of consultation since January and the Green Paper.  We must make that clear and I must put it on record. There are questions to be asked. We will get to the issue of how much work has gone in, and will go in, to get the new testing regime right, and we will have a debate about piloting. Let us put all that to one side, because it is for another day.

Much thought has gone into the clauses, but I should sum this up again because I feel strongly about it: someone who is asked to show capability in the second test might think, and get worried, that it will compromise what has been decided on the first assessment about whether they get the allowance.

Kali Mountford (PPS (Rt Hon Des Browne, Secretary of State), Ministry of Defence; Colne Valley, Labour)

It is dangerous to try to put ourselves in the mind of another. My experience is contrary to that mentioned. The people I see making claims for current benefits do the opposite of what the hon. Gentleman is saying. They usually underestimate the difficulties and challenges that they face. They generally put forward the best case of the best day. They do not say, “This is the worst day” and give a proper assessment of their own capacity and incapacity. Perhaps it is time to examine in a more holistic way how an individual operates, not just on a specific day but over a period of time.

David Ruffley (Shadow Minister, Work & Pensions; Bury St Edmunds, Conservative)

The hon. Lady makes a good point. I know that she had much experience of these matters in her former life. I just want to clarify something. I am not suggesting for a second—I know that she was not putting these words in my mouth—that those who apply for the new allowance will be looking to make a bad fist of it and to exaggerate their illness. She makes the point that claimants will, in good faith, say, “I am not well enough to work and I need the support of this allowance—or incapacity benefit, as it is now”. We all agree on that. She has given examples where claimants will underestimate how unwell they are. That would be assessed in the first test, which is the subject of the clause.

I have also heard a contrary view, which might involve a minority of cases and the hon. Lady might be referring to the majority of cases. I wonder whether a minority of claimants might be stressed. We know that 40 per cent. of claimants currently on incapacity benefit have mental or behavioural conditions. It is at least likely that in a minority of cases there might be an inbuilt tension between showing unwellness and then having to show functionality and capability in the second assessment. People might get a bit confused by that, for perfectly understandable reasons.

I am not suggesting that this is driving a coach and horses through the proposition that Ministers have put forward in this clause and the next one. However, on the basis of both the evidence that I have been given by outside groups and my intuitive reading of the way the clauses are constructed, for what it is worth, it is at least worthy of a response.

Tim Boswell (Shadow Minister, Work & Pensions; Daventry, Conservative)

I shall not detain the Committee to prevent the Minister from responding. I just want to say that the hon. Member for North-East Derbyshire was on to a substantial and good point: we are changing the whole conceptual basis to encourage people to emphasise the positive rather than highlight  the negative. That must be welcome, and is across the Committee. We need to be able to deliver it. My concerns are twofold and congruent with what has been said, which I need not repeat.

My first concern is about friction in the process. We must hammer home the point that those people are non-expert, sometimes inarticulate, vulnerable, confused and worried about their situation. Many people come to us as constituency MPs with problems about medical assessments, and with stories that are sometimes well founded, sometimes not. Undoubtedly, the process is stressful, and the more it is simplified and made acceptable to them, the better. One assessment is in principle better than two, and if it is necessary to move from one phase of that assessment to the other, that may be a reasonable compromise.

My second concern is with legal friction, embedded in a clause that I drafted, new clause 6, which we shall debate later. It is about the hat that the assessor wears at any one time, about whether it is clear and fair to the claimant, and about whether the assessors are properly trained. We have all heard stories about doctors who have had an off day. That is not to subvert the system of medical assessment, but to say that there are difficulties. It applies legally, too. With that structure, carefully constructed though it is, there may be huge evidential arguments about whether the assessment was carried out under the terms of clause 8 or clause 9, while the poor claimant says, “I don’t care. All I know is that I went to my doctor, and I didn’t get my benefit.” That is the human side and the legal side.

Finally, there is the conceptual issue. Clauses 8 and 9 bear on the capability for work or for work-related activity. They are not tests about whether work has been carried out or whether work-related activity will be carried out, but prospective tests about a person’s capacity for them. I find it increasingly difficult as I reflect on the issue to see the logical distinction between work and work-related activity. There may be some functional differences, and the Minister will talk to them, but I cannot see the essential difference. If that links into the operational factors, the claimant’s concern, and the difficulty with producing a harmonised and coherent structure whereby it is clear at all times who is doing what to whom and whether the procedure is appropriate, the Committee should at least reflect on whether we have created an unnecessary complication in our effort to help people.

Natascha Engel (North East Derbyshire, Labour)

I understand that the hon. Gentleman is to visit the Derbyshire pathways to work programme in my constituency. It has been fantastic. He will hear some stories that the Select Committee, and myself as a constituency MP, have heard. The staggering part about the individual human stories that he has discussed is the shift from a tick-box medical assessment of what cannot be done to a more employer-based, support and training-oriented capability assessment. That is exactly what the Bill is about: to ensure that we focus on the job that a person can do, get them job-ready through condition-management programmes, and give them the skills that employers need. The assessment is outside work, but it faces work. That is the crucial difference.

Tim Boswell (Shadow Minister, Work & Pensions; Daventry, Conservative)

The hon. Lady is eloquent. I am very much looking forward to my visit to Derby, I have heard good reports, and I expect to be able briefly to share them with the Committee when I return next week. She is right, and our intentions are all the same. My only worry in simple terms is with a familiar phrase that chills many of our constituents. If one walks into a room and says, “I’m from the Government. I’m here to  help you,” that is the danger. The intentions are good; no one questions that. However, we must translate those intentions into a system that achieves our shared objectives.

Debate adjourned.—[Mr. Heppell.]