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

I beg to move amendment No. 171, in page 7, line 6, at end add—

‘(7) A person authorised to exercise the functions in subsections (2) and (3) may be required to undergo such training in relation to claimants with particular impairments and health conditions as the Secretary of State may by regulation require.’.

It is a pleasure to serve under your chairmanship once again, Mr. Amess, and I am looking forward to continuing these debates in the positive spirit in which they have been conducted so far, especially, if I may say so, from the Government Benches, from whom the only party political remarks we have heard have come.

Hon. Members:

Oh.

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

It’s a pilot scheme for being nice.

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

I notice that the hon. Gentleman on the Tory Front Bench, from a sedentary position, seems also to be engaged in a pilot scheme of being nice—he is managing reasonably well so far. No doubt, however, we shall be able to get some more rancour into the debate as the week goes on.

Amendment No. 171 would allow the Secretary of State to require those carrying out assessments of claimants with particular impairments or health conditions, in relation to limited capability for work, to be trained. The amendment probes the Government’s intentions in that area. Given the range and complexity of disabilities, impairments and health conditions that might be encountered in the assessment process, as described in previous debates, it is important to ensure that assessors have the required degree of training, knowledge and understanding of the full range of those conditions or impairments.

It is interesting to note that in some cases specialist nurses are used already for assessments in relation to disability living allowance, specifically to ensure that specialist knowledge is brought to the assessment. By contrast, however, personal capability assessments so far have relied exclusively on general practitioners, but it is widely believed, particularly by disability lobby groups, that GPs’ knowledge of some conditions or impairments might not be sufficient to make a reliable  assessment. The amendment would empower the Secretary of State to order such training as might be necessary to bring them up to speed.

Currently there are no statutory obligations for training for medical assessors in relation to certain disabilities, particularly in relation to mental health conditions, learning disabilities and so on. A higher level of understanding of those non-physical conditions would help to reduce the current high level of appeals and their high success rate. For example, in 2003 nearly 48 per cent. of appeals against the refusal of incapacity benefit were successful; indeed, 68 per cent. were successful when a citizens advice bureau or other adviser with expertise in the appellant’s condition attended the appeal. In many cases, the lack of knowledge of the nature of the condition or impairment at the initial PCA is cited by appellants as a reason why they think that the first decision was wrong. The amendment aims to bring more specialist knowledge to the PCA.

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

The hon. Gentleman will not be surprised to hear that I am very much sympathetic to the lines of his argument; they are entirely congruent with what we have heard from disability and other organisations over the years.

Would the hon. Gentleman accept that there are two practical problems with his amendment? First, in relation to multiple conditions, is it possible for any one examiner to have the sufficient range of knowledge to be able to embrace all the difficulties and their interaction? Secondly, in order to produce the full range of expertise it might be necessary to have a panel of people examining simultaneously, which could be extremely daunting for the claimant.

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

The hon. Gentleman makes two very good points. Of course, it might be asking a lot for the same doctor to have expertise in every single potential condition, impairment or disability. That is a valid point, and if the answer was to have a panel of people who a claimant might appeal to, that too might be intimidating. It could also reinforce some of the biggest problems with the assessment process at the moment.

With regard to disability living allowance, specialist nurses can be called upon where someone with a particular condition is presenting. Bearing in mind that in the application for employment and support allowance the applicant has to spell out their reasons, it should be possible to predict with a large degree of accuracy the cases in which some form of specialist input might be useful. That could mean either ensuring that the doctor who is carrying out the assessment has the requisite skills, knowledge or understanding or,if they do not and if no one in that particular locality has those skills and experience, making sure that another specialist doctor or a specialist nurse could be brought in.

I am not seeking to create an unnecessarily burdensome or intimidating assessment procedure. What I am seeking to probe is the extent to which the Government consider it important that specific knowledge of health conditions or disabilities is included in the assessment process to ensure that it is  accurate. This is also important in relation to fluctuating conditions, particularly those, such as MS, where specialist knowledge of the condition may be useful in carrying out an assessment.

Particular representations have been made to me in relation to people with autism or autistic spectrum disorders. According to the National Autistic Society, 40 per cent of GPs do not have enough information to make informed assessments in relation to disorders on the autistic spectrum. It is worth noting that only 6 per cent of people who are autistic in some way are in employment. That is an incredibly low figure compared with 49 per cent for disabled people as a whole. This may, therefore, be an area where having a degree of specialist knowledge throughout the assessment process would really help to add value at all stages. I shall be grateful if the Minister will address that point specifically in his response.

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

The training for assessors has been brought up in the past and I know that Mr. Hood said that we would not have any stand part debate on this clause, so I feel that this is a good point to raise it.

Training in general terms is a concern of many bodies that represent people with disabilities; the fear is that a general practitioner would be given a job as an assessor with absolutely no knowledge of some of the problems suffered by the people that they would be assessing.

Can my hon. Friend the Minister allay my fears on that, and maybe go into some detail on the training for assessors? Can he also clarify the point on collation of information? I mentioned that when we debated an earlier amendment. It is important that he reiterates the fact that we would pull in all information and, if all the information were not available, we could go back over it a second time to gather any missing information.

The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) makes good points about the fact that it may be necessary to bring in more than one expert for discussion. I would like to know what sort of liaison is carried out in relation to talking to the medical experts, whether they are, for example, experts on injuries or on mental health.

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

Welcome to the Chair, Mr. Amess, on this grey morning—not as cheerful as the other days when you have been in the Chair.

I would like to tease out from the Minister a couple of points which bear on what the hon. Member for Glasgow, North-West (John Robertson) has just said. On the question of the types of people who would be doing the assessing, the Secretary of State in evidence to the Select Committee in the Spring this year said,

“my understanding is that people agree that we should involve the skills and expertise of a wider relevant range of healthcare professionals to help us do this.”

“Wider” implies wider than is the case under the current regime. He went on to say:

“There will be a list of people, I am sure, occupational therapists and physiotherapists and others, but who actually is involved in individual assessments I think is going to have to be something we discuss with people over the next few months.”

That is fair enough; the Secretary of State says that a wider range of specialists and professionals will be involved. I think I know which group polices and executes the conditions under the current regime, but it would be extremely useful, given that the Secretary of State was generous in saying that he would consult on involving a wider range, if the Minister could give us some information on that.

That brings me to my second point. Does it trouble me? I do not know—it niggles a bit at the back ofmy mind. In evidence to the Select Committee,Dr. Boardman of the Royal College of Psychiatrists, who gave a lot of evidence for the excellent Select Committee report on the pathways programme, set a hare running—certainly in my mind, if a hare can be set running in a person’s mind, and I think other people were also worried—on the question whether there would be enough people to carry out the wider assessments. Obviously, there will be more varied assessments under provisions in these clauses than under the current regime; we all know that.

The idea was floated that lay people could be trained to carry out the mental health assessments, which is an interesting idea. The reason I want the Minister’s view on that point is that Dr. Boardman is very distinguished and a bit of a player in incapacity benefit reform. He said to the Select Committee that

“it is quite possible, for example, to train anybody to do a perfectly good interview with somebody with a mental health problem and come up with a reliable judgment. This is used in research all the time. When we look at the results, say, of the OPCS survey of Psychiatric Morbidity in Great Britain, a national survey, this was all done by lay interviewers using a particular form of structured interview.”

I do not know what is in the mind of Ministers but that distinguished psychiatrist raised the possibility of lay people carrying out mental health assessments. I do not have a preconceived view, but I would be interested to know whether the new regime will recruit lay assessors for the mental health component of the tests that we are considering.

My final point relates to observations fromSue Christoforou and Mind. I shall quote, becausethe quotation raises powerfully the main issue of this amendment and a theme that is a leitmotif of the whole Bill. We have personal advisers under the pathways programme and we will have personal advisers under the new regime, but do they and will they have enough training? Later I hope to show that the advisers themselves do not feel that they have enough of a skill set to be able to do the extra things required of them under the new regime.

Mind said:

“The majority of doctors who carry out PCAs”—

this is under the current regime—

“will be locums. Most will be GPs who have done a day’s work and will do PCAs in addition.”

This is Mind’s view; I am not necessary impugning all those who work with and for Atos Origin. I have seen a simulated version of Atos Origin’s PCA in Woking and it seems to be a professional company.

“They do get some condition-specific training but it is very limited. They certainly do not have much in-depth knowledge of mental health problems in the experience of our”—

Mind’s—

“advisers who work with people with mental health problems.

I spoke recently to one of our welfare rights advisers. She attended, I think, 50 PCAs with various clients and in only one case did she find the person to have any understanding of what the issues were, to treat the person with respect, and to conduct the assessment at a pace that could give the person the opportunity to discuss as much as needed to be discussed in order for the assessment to be thorough. So I think, given that40 per cent. of people in receipt of incapacity benefit at the moment have a primary diagnosis of mental health problems, not to mention whatever per cent there is of the rest of the caseload who have a secondary diagnosis, it has to be the case that the doctors conducting PCAs have to have a thorough, possibly NVQ level three mental health training at the very least, as indeed should decision makers, in order to make proper judgments.”

We are talking not about decision makers here, but about the cutting edge assessment that is the subject of the clause and the amendment. I certainly know from one of the Department for Work and Pensions reports on evaluation of pathways that the NVQ level 2 was the average for incapacity benefit personal assessments. An NVQ level 3 in mental health is being asked for here.

Those observations may be partial. Perhaps Atos or Ministers will dispute what Mind has said, but it is an interesting debating point which relates to the amendment. I should be grateful if the Minister responded to that point. I have no idea whetherDr. Boardman’s suggestion that lay people can be trained to do mental health assessment is sensible or not, but it would be useful to hear the Minister’s views on that and on the point that the Secretary of State raised in evidence to the Select Committee.

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

Good morning, Mr. Amess. Earlier in our deliberations the Minister outlined a process whereby, at the early stages of an assessment, a paper sift would be possible. I have been looking at cases in my constituency and at the level to which the NHS can now treat conditions that hitherto were untreatable. I cite the case of a woman in my constituency who was horrifically attacked. She was unfortunate to be attacked but lucky to be alive, given the extent of her injuries. She would like to work now but, unfortunately, the consultant vascular surgeon who is treating the injuries to her brain says that she would be ill advised to do so because he has been able to stabilise her only enough to be at home, not to be able to go out to work.

Under the current system, people looking at my constituent and answering the questions would assess her as suitable to work because they would not look closely enough at the consultant’s advice. I want the new process to take account of such clear advice from a consultant that someone would be harmed by going through the process, and that the injuries are such that it could be a threat to their life if such a process were to continue. We should all be assured that the almost daily advances of medical science can catch up with the process that we are trying to deliver for another part of someone’s life.

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

I should like to add one or two comments to this extremely interesting set of exchanges and questions for the Minister. If one looks at the rubric of the clause it seems to be about limited capability for work, which is a kind of lay assessment that, on the other hand, requires professional expertise to provide the gateway. I think that trying to blend those two concepts is inherent in some of the comments made already and, indeed, in the difficulties that the traditional PCA system has met—the high level of appeals and so forth. That is not because assessors are wicked or malicious people proceeding in a hurry, but because their job is inherently very difficult.

My comments are informed by my now dated experience of being responsible for the disability brief, and by when the Department kindly arranged for me to visit Atos—or rather its precursor, Schlumberger—to observe how it trained its assessing doctors. One day, I sat in on a session. I went with some trepidation because I thought, as a lay person, “What on earth can I do?”, but, by the second hour of the process, I realised that essentially we were in the same job—I did not see theirs as being very different from mine or, indeed, any other Member’s when dealing with a constituent at an advice bureau or surgery, depending on what we call them. The job involved putting people at ease, enabling them to express themselves and forming a general view of their condition. That is a stream of the matter.

As I and others in Committee have said before, the ability to encourage claimants or customers—call them what we may—to act positively and to express themselves authentically is an important part of the process. However, the assessment is a gateway to a benefit, so it is perhaps understandable that it should require a professional framework, particularly for the physical side. Historically, the IB process has been driven primarily by physical conditions, such as muscular skeletal or circulatory problems, but now it is largely informed by people’s mental conditions. I am saying not that too much emphasis is placed on mental health, but that anything that might lead to a clinical illness is examined—the claimant might just lack confidence. Tuning that change is a difficult part of the process.

I suspect that somebody will ask me to comment, albeit briefly, on my visit last Friday to the pathways to work pathfinder in Derby. Members were aware that I was going, and I found it a positive experience and quite encouraging. However, I came across some information about the mental health aspect which made me think, “Well, I have not really focused on this before.” Conventionally, it is said that some 40 per cent. of benefit claims fall within the mental health framework, but if we include secondary mental health effects—for instance, for people who have a physical condition such as back pain that has consequences for how they feel—we are probably looking at two out of every three claimants. So that is a very big part of the matter.

This is a proposition not a conclusion: the Minister should address the fact that more people are presenting a series of mental conditions, which are inherently less easy to measure, and indeed, doctors are often less equipped to deal with them than with somebody who  has, say, a limb deficiency or circulatory problems.The situation is becoming more difficult. The tests encourage people to show their capability for work, not whether they have a series of finite medical conditions that would make work impossible.

That is a complex and difficult matter. My exchange with the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) was designed to eliminate some of the practical difficulties. Does one have a full suite of people taking account of allthe circumstances? Is the cure for that lack of omnicompetence worse than the disease of not being omnicompetent? Those are difficult issues for the Department.

I add one more thing. I suspect that there might be a medical test here. It would fall outside the Committee’s remit to ruminate on whether the law, and in particular the growth of administrative law, has helped the nation’s commonwealth, as it were, or impeded it. It is certainly very good for the lawyers—a member of my family is a practitioner in that area—but I am not sure whether it adds to the sum of human happiness.

One of the difficulties, if one uses lay people, is that the nature of their assessment and the appropriateness of their training become directly relevant. There is a certain expectation about an examining doctor who has been registered with the General Medical Council and who meets certain professional standards and indeed professional commitments and duties. No matter how they behave, and they normally try to behave in a highly professional manner, they have at least some cover for their position. If, on the other hand, one uses a barefoot doctor or a lay helper on the medical health side, however well intentioned and however well skilled, it may be that they do not have the kind of professional coverage that would prevent them or the Department from being challenged in court. These are serious issues that the Minister and his Department need to address.

Where we go from here should be informed by one simple test. We need to be able to assess people’s capacity for work in the round. We need to do it in a way that is positive and sympathetic and emphasises their capacity and not what they cannot do. That is going to require a rather broader and more holistic approach than we have had hitherto.

I rehearse one more point as the Minister might like to say something and I do not want to make it seem banal by leaving it till the end. As he will know, and indeed I have asked questions of the Department, there are now logic-driven protocols as to how to do assessments. He has referred to the number of points that is required to pass, or fail, the test, according to the way one looks at it. I do not think this is wrong as long as it is not seen as being a literal-minded exercise. It is a guide to good decision making. Perhaps he could say a little about the use of protocols. Also, how is this being mapped on to the experience of GPs who are referring persons for incapacity benefit or writing them sick notes? We need to have in these complicated areas a better understanding of the process. We need people to know what they are talking about, to be able to exchange information professionally in the right way and to have the right training to carry out assessments.

I am sympathetic to Ministers as they try to pick a way through that and I would be even more sympathetic if they could reassure us that logic and  protocols will be used as a servant and not as a master in the process. The underlying principle should be to support, identify and celebrate the capacity of the individual rather than to conduct some penal exercise.

I am sure the word on the street is that the exercise is designed to take people off benefit at all costs. I know that that is not the Minister’s intention, and it is certainly not our intention or that of anyone in the Committee, but the process has to be fair and in the end fairness is probably how this will stand or fall.

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

May I too welcome you back to the Chair, Mr. Amess? It is a pleasure to serve under your chairmanship, which, in the best spirit of the employment and support allowance, has been light-touch and supportive, with minimal use of sanctions.

I think that this is an important amendment because, on the face of it, it is not a matter of law at all. The reality is that the Secretary of State does not need regulations passed by this House to insist on proper training for people who carry out the assessments or indeed for Jobcentre Plus personal advisers.

I am grateful to the hon. Member for Inverness, Nairn, Badenoch and Strathspey for tabling the amendment because it allows us to draw attention to an important failing in the current system. I ask the Minister not simply to deal with the point of law and whether the amendment should be covered by the regulations, but to address the wider issues that have come up, put most eloquently by my hon. Friend the Member for Daventry (Mr. Boswell). In particular, I draw the Minister’s attention to some comments by the Citizens Advice Bureau. It says that it has

“particular concerns about the ability of Job Centre Plus personal advisers to appropriately and accurately identify the support needs of people with fluctuating and unpredictable conditions or those whose conditions are likely to get progressively better or worse over time.”

It continued:

“Customers with mental health problems were seen as particularly challenging and ever more experienced advisers did not feel confident working with them.”

That was according to recent DWP research. There is clearly an issue about the training of Jobcentre Plus advisers, and if it is important for those advisers,it is doubly important for those who perform the assessments.

My hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) and I held a seminar in which we invited representatives from disability organisations to talk about welfare reform. One very moving submission came from a lady who had a bipolar disorder. Hers was a fluctuating condition and she said that when she went through her PCA, she felt obliged to “ham it up”—her words—because although at the time she might have been feeling fine, she had little confidence in the assessor understanding how a fluctuating condition works. She was worried that unless she pretended to be suffering at that moment, she might not get the right assessment.

Yesterday, I was in Sheffield and I met a man with a learning disability who said that his biggest fear about the assessment was that the assessors did not really understand the concept of hidden disability. It is easy to grasp the disability of someone in a wheelchair, but harder if the disability is hidden. I draw particular attention to the comments of my hon. Friend the Member for Daventry and the hon. Member for Colne Valley (Kali Mountford). This is a hugely complicated area; it is particularly difficult to grasp the difference between a learning disability and a mental illness. A lot of people with learning disabilities also have a mental illness, but it is crucial, if there is to be confidence in the system, that assessors understand that difference and know what can be sorted out by the NHS and what is a long-term condition.

My hon. Friend the Member for Bury St. Edmunds made the point clearly that we do not want the debate to descend to the level of tabloid arguments about welfare scroungers. If the assessment does not have credibility, and if the ability of assessors to accurately determine whether someone has a hidden disability and to discriminate between that and mental illness is not absolutely rock solid, we will give ammunition to those trying to discredit the whole process.

Natascha Engel (North East Derbyshire, Labour)

I do not want to make a speech, so I shall keep this to an intervention. What the hon. Gentleman said is very important, especially on the distinction between a mental illness and a learning disability. However, there is no way in the world that national legislation or even local practice can ensure that those will always be correctly identified. There is absolutely no way of doing that. It is important, however, that this legislation involves organisations with expertise in the identification of those differences and includes them in the assessment phase in order to deal with claimants and show them where to go so that they can access the help that they need. That is what the hon. Member for Bury St. Edmunds was talking about—a more holistic approach. Rather than using lay people, we should bring in organisations—

David Amess (Southend West, Conservative)

Order. The Committee is delighted to hear the hon. Lady, but I think that that did turn out to be a speech.

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

I am grateful to the hon. Lady; she made an important point, enthused, I am sure, by her work on the Select Committee.

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

As we look forward to the use of contractors in pathways, which my hon. Friend and I would be happy to accept as a principle, is it notalso extremely important that there is also some commonality of understanding as to the availability of expertise and practice? Although the contractors are responsible for their areas, they need to operate within the same general framework so that the test is not merely seen to be fair nationally, but is also seen to operate evenly and fairly between different localities.

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

My hon. Friend makes an excellent point. I do not want to prejudge what the Minister says, but I  suspect that the fact that this test is conducted by contractors gives the Secretary of State the opportunity to include any training requirements into the contractual stipulations, and that would probably preclude the necessity for legislation or regulation. I completely agree with the comment of the hon. Member for North-East Derbyshire (Natascha Engel) that no national legislation can deal with the complexity of these issues.

All I ask the Minister to address is not the legal point on this amendment, but the substantive point of the very real concern about the understanding of hidden disabilities, in particular among people performing the PCA as it is now or the revised PCA and, indeed, among Jobcentre Plus personal advisers. If this programme is to be successful, there is no doubt that this issue needs to be addressed.

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

Good morning to you, Mr. Amess, on this rather dreich morning that we are enjoying in SW1. I am delighted to see you with us again.

To respond first of all to the comment by the hon. Member for South-West Surrey (Mr. Hunt), by necessity, I have to respond to the legal and technical sense of the amendment, but I am happy to respond also to the common-sense comments. I accept it is a probing amendment, but let me explain why it would not be legally necessary. All health care professionals undergo such training as designated by the Secretary of State that he or she considers to be appropriate before they are approved to carry out medical assessments to determine limited capability for work. With regard to the specific suggestion that we place this provision in regulations, we cannot as a Committee, a Government or Parliament micro-manage every intervention and interface between a health care professional or a health care practitioner and each of the customers. To put it in regulations would be generally accepted as impractical. It would leave us sluggish and with an inability to respond to ever-changing circumstances. It would also fly in the face of so much else we are trying to do in terms of empowering personal advisers and ensuring that at a local level a situation evolves and changes quickly enough to be able to support people regardless of their circumstance or condition.

The Secretary of State has the power to designate what would be appropriate training and also the appropriate support that either assessment staff or personal advisers should undertake and offer to customers. As this has proven through pathways to be an effective way to operate, I think that it is the best way to proceed. I hope the hon. Gentleman accepts the strictly legal point that we have the power at the moment and that this power is entirely flexible and enables us to respond to evolving circumstances.

I will try to respond in the time available to the 25 or 27 questions that were asked, but if hon. Members do not think that I have done so they can intervene or we can take it up further in our proceedings.

To respond to the point made by the hon. Member for Inverness, Nairn, Badenoch and Strathspey, it is absolutely clear—we said it on Second Reading and we say it again today on the record—that, as we change our ambition, in trying to support people who in the  past have been written off, and on the basis that we are not being party political at the moment, let us just say that they were written off for whatever reason by —[Interruption.]

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

Successive Governments.

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

I have been provoked.

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

If I could help the Minister out inthe spirit of consensus, may I ask whether a drafting suggestion would be acceptable? Successive Governments up until and including this one have, regrettably, tended to write off those who have been furthest away from work. All politicians of all parties should acknowledge that they have not performed as they should in helping those people. We should all celebrate that acknowledgment on both sides today in Committee. Does the Minister agree?

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

I do not wish to try your patience, Mr. Amess, by making this point: I would not accept the amendment, but I would accept that successive Conservative Governments deliberately allowed people to be written off.

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

This is not a profitable line to go down. Our response to the Minister will simply be to ask why, if the problem was so serious, the Government waited eight or nine years before doing something about it.

David Amess (Southend West, Conservative)

Order. I appeal to the Committee to get back to the amendment.

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

You are right, Mr. Amess.

The amendments are about how we support the2.7 million people who are on incapacity benefit. Pathways has been exceptionally successful. The funding for pathways was not entirely consensual. I know that the hon. Member for South-West Surrey was not here and did not have the opportunity to vote against the money for pathways, but if he had been, he would have had the same opportunity as his hon. Friends.

We are having a conversation about the future and how we support the 2.7 million who are on incapacity benefit. If no action had been taken in recent years, that figure would be 4 million. The trajectory through the 1980s, half the 1990s and up till now would have put that figure at 4 million. I say that simply because I was encouraged to do so by the hon. Gentleman on the basis that it is important to have consensus about the future. However, let us not forget that people on incapacity or equivalent benefits have not been supported as they should have been and that is across Governments. There was a genuinely dark period for about 10 years, when as a matter of public policy, incapacity benefit numbers were allowed to treble.

We can leave it there if hon. Members wish, or we can continue the conversation. It is nevertheless a statement of fact that incapacity benefit numbers trebled over that period. Nothing different was happening in the environment. We did not have a sudden outburst of a certain condition or ailment.  There was nothing different in our air, our water or our food chain. The numbers simply trebled. We can discuss why that happened.

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

May I encourage the Minister to return to what he is seeking to do in the Bill? If he wants to talk about what happened under the previous Government more than nine years ago, we will feel obliged to respond. We interpret those events differently, but I do not think that it is a good use of the Committee’s time to rake over those arguments. We certainly do not want to have that discussion—

David Amess (Southend West, Conservative)

Order. I appeal to the Committee for the final time. I ask Members to return to the amendments.

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

Thank you, Mr. Amess. I will do exactly as you suggest. Perhaps we will continue that conversation another time, perhaps even in another place. It is important not to forget the past so that we can avoid repeating the mistakes.

Returning to the consensual tone of five minutes ago, the hon. Member for Inverness, Nairn, Badenoch and Strathspey asked about specific support. I was in the middle of saying that if we are to achieve the ambition that we all now share to cater for those2.7 million customers, with their various conditions and complicated and multifaceted needs, and for ESA customers from 2008, we will need to change the training in Jobcentre Plus and Atos Origin. When pathways is rolled out nationally, we will need to change the training given to personal advisers through the private and voluntary sectors. We will need to change the way in which all our agencies—not just the DWP, those to whom we subcontract and Jobcentre Plus, but other aspects of the Government, including the health service—make support available.

Quite fairly, the hon. Member for South-West Surrey mentioned the Citizens Advice briefing on the clauses and amendments before us. It says:

“Citizens Advice therefore recommends that adequate resources and training be provided to personal advisers to ensure that those in the support group who chose to participate in work focused interviews are able to do so in a meaningful way.”

I agree absolutely with the thrust of that quote. Of course, it is about a specific group of customers, but the general thrust—that we need to provide personal advisers with adequate resources and training—is entirely fair. We are addressing that point, which the hon. Member for Inverness, Nairn, Badenoch and Strathspey raised in his amendment.

I was asked specifically about autism.

Mr. Boswellrose—

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

I would like to make some progress before I give way.

I was asked specifically about autism, which is another example of what we are talking about, although there are many others. We will all have come across such examples as constituency Members of Parliament and in preparing for these deliberations  and we will all have met people and listened to their experiences. Entirely fairly, the National Autism Society put it me that a personal adviser who does not have knowledge or experience of supporting people with autism could mistake a customer with autism for someone who was being unco-operative or even belligerent, and think that they were failing to participate. We will ensure that that important point and others that are made to us feed through the process. Indeed, that is why, in preparing for the revised public consultation, I and the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stirling (Mrs. McGuire), ensured that autism groups could join some of the technical working groups in which they had not taken part before. We did that to ensure that we were sensitive to the autism spectrum.

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

It just occurs to me that the Minister might like to comment on the fact that there are also quite strong management and organisational implications for the Department. Much as we want outreach—it will certainly be important that rural areas are also covered—it is equally important that the body of expertise in a pathways area or its successor, whether contractorised or in the Department’s capacity, should draw on the advice of specialists with background knowledge of the individual that is appropriate to the case.

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

I welcome the hon. Gentleman back from his sojourn in Derby and I am delighted to see him back in his place. He is right in the sense that it is important, certainly when subcontracting, that we bring in niche experience and niche service. I will not say which organisation might be involved, because Ministers are, quite rightly, not involved in the contracting process.

Let me step away from the matter of autism for a moment, however, and deal with the general point. I recently visited constituencies in west central Scotland to listen to the experiences of people in pathways and on long-term IB. I had the sense that trade unions, for example, which had previously represented and supported the work force in heavy industry—there is no longer any heavy industry in that community—and which had campaigned for their members while they were in work, could bid for some of the contracts to support people in pursuing their right to work now that they were out of work and had been on IB for a long period. Such people might have been on IB for10 years, but that does not preclude a trade union from becoming involved in providing the support for work-focused interviews that will get people closer to the labour market. In talking about private and voluntary sector pathways, we have not yet properly discussed the role of trade unions and other progressive organisations and charities in the voluntary sector in supporting people using the relationship of relative trust that exists already. That would be important.

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

In the spirit of the Minister’s remarks, does he not agree that it should at least be open for a consortium or partnership that may well involve some of the groups that he mentioned as well as the private sector or other representatives to make a joint bid?

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

The hon. Gentleman is absolutely right and we are looking at ways in which we can further devolve that contract, so that a group of organisations from the public, private and voluntary sectors can work together and say, “In and of ourselves, we could not provide this, but collectively in this area we think that we could”. That would be an important and welcome departure from the current situation.

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

If I may, I should like to return to the substance of the clause, which is about the training provided to assessors. With the indulgence of the Chair, we widened the debate to include Jobcentre Plus personal advisers in general. I think that the Minister said that he recognised that something needed to be done and that plans are afoot. Will he give us details about those plans?

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

I think that Jobcentre Plus staff undergo 13 weeks of initial training and are encouraged to undertake further training. However, it is clear that, by 2008, Jobcentre Plus will not be undertaking PCAs—indeed, in most cases it will not be undertaking five of the six work-focused interviews. It will be conducting only the first of them, in most instances.

Despite the fact that the role of Jobcentre Plus is changing, it will remain an important organisation; it will still come face to face with most customers—although probably only once because the other five work-focused interviews will be conducted by the private and voluntary sectors. It will meet people with different experiences. Many people at Jobcentre Plus have already undertaken excellent training and done fantastic work on pathways. Indeed, the success of pathways is due in part to the skills that many people at Jobcentre Plus have that enable them to support claimants. The hon. Member for Daventry saw that for himself only last week.

Between now and 2008, on the basis that Jobcentre Plus will see all sorts of people who until now it might not have, and be expected to provide them with support and advice that until now it has not been expectedto provide, the training will have to be adjusted accordingly. I do not have a set of prescriptive solutions that state exactly what will happen in 2008. Jobcentre Plus’s training will adapt to the demands of ESA in 2008 and we will work with its senior managers to ensure that that does happen.

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

I do not want us to career off into the realm of personal advisers just yet because we will get to that later.

I think that the amendment relates to the skill levels of assessors involved in the reformed PCA, and the work-related activity and work-focused health-related assessments. I would be grateful if the Minister responded to my point about the wider range of professionals at the new reformed PCA stage that the Secretary of State was talking about in March. What level of training will they have?

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

With your indulgence, Mr. Amess, I shall come on to the content of the amendment. We can pick up on the wider points about the training of personal advisers later in proceedings.

The hon. Gentleman mentioned comments by Mind—both his and Mind’s intentions were fair, I  know—but Atos Origin has 273 full-time doctors. As he knows, it is not a hotch-potch of part-time GPs doing extra shifts. It has 273 full-time doctors. GPs who work half-day a week as part of their involvement in the assessments have to undergo similar refresher training to doctors at Atos Origin. As he accepts, those doctors do not do it for some overtime, as is also the case with Mind.

The specifics of training Atos Origin and other health care professionals relate to the point made by my hon. Friend the Member for Glasgow, North-West. They will receive training in disability analysis, which of course requires different skills, by 2008. The training includes aspects of clinical medicine, the gathering and evaluation of evidence and report writing. We know from our constituency experience that report writing has improved in recent years, but how the reports are structured and what is in them is still a source of friction. The language must be understandable to people with no medical background or experience, particularly those with fluctuating mental health conditions. There is also training in general customer care issues such as equal opportunities, how to handle or avoid complaints and how to carry out assessments sensitively. I believe that those undergoing the training also have to undertake four additional modules a year, and as we move towards 2008 we will assess whether that is the appropriate number.

On a point that my hon. Friends have raised, health care professionals will be expected to access additional information through the new PCA when appropriate, perhaps from a local GP or increasingly from other health care professionals in the community—psychiatric nurses and others—who have a relationship of trust and knowledge with customers and experience of them that an Atos Origin doctor might not have. That is the sort of additional information that the Secretary of State alluded to.

We will ensure that the technical groups keep the revised PCA under review so that it is fit for purpose, particularly on mental health, and is achieving what we want. That is on top of the commitment that we have already made that the PCA will run alongside the current PCA, so that there are no unintended consequences.

I have responded to the points that my hon. Friend the Member for Glasgow, North-West made on additional medical experts. In an earlier sitting, he asked how we will gather relevant information, on time, that is clear enough for decisions to be made. My response was that we will ensure that there is an additional phase of reconsideration. We will not simply gather information and come to a judgment that might be wrong because not all the relevant information has been provided, asked for, or provided in the right way to enable an informed decision. The move towards reconsideration in advance of any appeals process will ensure that decisions are right the first time round and based on accurate information. In response to the hon. Member for Bury St. Edmunds, it is important to say that the chief medical officer, on behalf of the Secretary of State, agrees the content of the training syllabus and the materials used. That will provide an additional opportunity for technical and professional input as we move towards 2008 and the employment and support allowance.

The hon. Gentleman also mentioned the comments of Dr. Boardman. Neither the hon. Gentleman nor I are medically qualified, as Dr. Boardman is. I believe that his suggestion would be difficult to carry out, but a number of people have argued the case for training others to provide the mental health support that folk require. For example, yesterday I met representatives of the Scottish Association for Mental Health, who said that they wanted to find different ways to support people with mental health issues. They mentioned their own pilots, whereby the association, or those working on its behalf with mental health experience, can support people without needing three or four years of medical training. I did not commit that that is where we wish to be; I said that we should continue the conversation to see whether it is a valuable route for us to continue along.

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

This possibly answers or anticipates the Minister’s answer to my specific question about what might be termed the legal cover for this exercise. Should a possible model be that the assessment process—it will be a process rather than a spot event in many cases—is monitored or signed off by a medical practitioner, drawing on information that others, who might not be formally qualified but who are appropriately trained, bring to that assessment?

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

On the point made by the hon. Member for Bury St. Edmunds, the issue is to continue that conversation to find out the most appropriate way to support people with mental health experience. I am happy to have that conversation with him and others.

On the specific point made by the hon. Member for Daventry, through the PCA and the revised PCA a medical health practitioner would carry out the assessments, so technically they would sign off the assessment. It is important to put that on the record. However, they would not make the decision. They would make the assessment, but the decision maker would make the decision. Hopefully that reassures the hon. Gentleman that a medical professional would be involved in the assessment.

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

I am grateful to the Minister for that assurance. Does he not also agree with something that I have gleaned from my experience from Jobcentre Plus: when the decision maker considers the report of the medical practitioner in a PCA case even now, it is not so much that they hold up their hands and say, “The whole thing is wrong medically” but that they refer it back? There is then a dialogue, or expression of views, which enables the process to be refined and cross-checked.

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

The hon. Gentleman raises, for the first time in our proceedings, this important point: a decision maker is not in place to second-guess the medical assessment of Atos Origin. The decision maker is a legal necessity, as the legal responsibility lies with them. The decision maker, when looking at the paperwork, might say, “Two contrary boxes have been ticked. This does not make sense. A procedure has not been followed,” after which they would go back to the  assessor and ask more questions to probe further. The decision maker is in place to ensure that processes have been followed and that there is a robustness to the journey for the customer. They will then make their decision based on that.

It is important to say clearly that the decision maker has a legal responsibility, and that they have a responsibility to ensure that processes have been followed. They are not in place to overrule, in a medical sense, the recommendations from those who carry out the assessments.

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

My hon. Friend has just made an important point, but it brings into question what happens when two medical opinions directly contradict each other, particularly where conditions are more rare or less well understood. This might be a difficult area, although possibly a small one. Where a contradiction of opinion exists, how can it be properly ironed out to the satisfaction of the person who is being assessed?

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

That is another important point. On the revised PCA, the individual carrying out the assessment would ultimately make the judgment. You would not thank us for going through the whole customer journey again, Mr. Amess. Jobcentre Plus would initially ascertain whether it thought it was appropriate for the person to go for an assessment or whether they could immediately be admitted to the support group based on paper evidence. We would prefer that to be the route for most entering the support group. Ultimately, the decision as to the impact of that illness, ailment or condition on a person’s ability to undertake work-related activity or to work at all will be a decision of the person carrying out the assessment. All the evidence provided in writing and in the face-to-face interview would be taken into account. Ultimately, the person doing the assessment is the arbiter of all the different evidence. They will reach a conclusion and make a recommendation that will go to the decision maker. The customer, who will also increasingly have the right of reconsideration, will then have the right of appeal. Additional medical evidence—perhaps from their GP—will be heard on appeal.

As my hon. Friend acknowledges, it is important to make a distinction between the different medical views: a GP is there primarily to diagnose, rather than to assess the impact of the relevant condition on the customer’s ability to work. There will be two different medical practitioners for two different purposes. On appeal, the issue about which my hon. Friend is concerned could be raised.

We had a one-minute conversation about why the amendment is not technically necessary: because in our process there is a flexible power to amend training as is necessary. I encourage the hon. Member for Inverness, Nairn, Badenoch and Strathspey, who has been offered additional reassurance, to withdraw his amendment.

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

I am grateful for that detailed response. I take on board the Minister’s points about the legality of the amendments. However, I press him  for clarity on three further points. Not wishing to try the Committee’s patience, I shall do so briefly. Some of what he said at the end of his remarks was important and needs to be teased out.

The Minister finished by discussing the role of the decision maker, an issue that could be brought up under a number of clauses. It may as well be dealt with now. During our last sitting, we discussed the process by which someone went from their assessment for limited capability to work to their assessment for limited capability for work-related activity and then, potentially, on to their work-focused health-related assessment. In a previous sitting, the Minister stated that a claimant is potentially sanctionable if they do not turn up for the work-focused health-related assessment and that the Government intended the claimant to take part in that assessment immediately after their assessments for limited capability for work and for work-related activity. That hangs crucially on the question of when the decision is taken and the decision about entitlement to the benefit support component, or whatever, is taken. If someone attending a first work-focused health-related assessment immediately after the other two assessments can be sanctioned at that point, that implies that the decision is taken when the Atos Origin doctor decides, not when the information goes to the decision maker to confirm, as the Minister said, that the process has been gone through properly and so on.

My point is important legally. Someone could be sanctioned following their decision not to participate in a work-focused health-related assessment because they believed that the decision as to whether they were entitled to the support component was wrong and they wished to appeal. I should be grateful for the Minister’s clarification on that point.

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

I understand the sensitivity of the hon. Gentleman’s point. Having reflected on the process at the weekend, I thought that it must be open to any claimant or customer, at any stage, to abort the process—or rather not allow the process to advance beyond the stage under consideration—unless and until a decision had formally been taken. In other words, if this is a test on limited capability for work, it would be open to the Department to say, “Without prejudice to this test and the formal decision on it, would you like to be considered for limited capacity for work-related activity?” However, it would be open to the individual to say, if they wished, “No, I want the issue out of the way. Then we can come back and consider any subsequent issues under later provisions”.

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

I am grateful for that intervention, with which I partly agree. I was convinced by the Minister’s previous remarks that it made sense for the assessments for the limited capability for work and for work-focused activity to take place at the same time, and that the break that the hon. Member for Daventry wants the claimant to have could legitimately take place after the assessment for limited capability for work benefit, and before the work-focused health-related assessment. The question whether one is entitled to the benefit is one of the criteria that is considered before a sanction can be applied. If someone has a work-focused health-related assessment  immediately following that, but before a decision maker has taken the decision, that decision not to attend should not be sanctionable. I apologise for going into this matter now, but as we are following on from the Minister’s remarks about decision makers, I thought it was worth pursuing.

I have a couple of other quick points. The Minister gave a comprehensive list of training that Atos Origin doctors are required to undergo, which I found very encouraging. One thing that he did not mention was training on when it would be appropriate to bring in outside advice, in other words training on making decisions about whether to bring someone else in when the person making the assessment does not realise that he has reached the limit of his expertise. It is important that doctors can make that decision and that the decision maker, when looking at the file, can say that perhaps someone else should have been brought in and perhaps the procedure was not followed properly in that case.

An earlier point about the opportunity to bring these matters forward with Atos Origin concerned revisions of its contract. Will the Minister tell us whether that contract is being revised anyway in the context of the Disability Discrimination Act 1995? If so, does that provide an opportunity to make some of the points that we have been discussing in this important debate clearer?

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

In order to pave the way for the Minister’s response, does the hon. Gentleman agree that the Minister owes the Committee a moment of time on the use of logic-driven protocols as part of the process as against the by and large assessments which have perhaps applied in the past?

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

I am grateful for that intervention. The hon. Gentleman, with his usual degree of foresight, predicts the third point that I wish the Minister to address. The personal capability assessment works through logic-driven protocols and the logic-integrated medical assessment system. Some of the disability organisations and others who are involved in the consultative groups for the redesign of the personal capability assessment have been given only limited information about the LiMA computer system that is used to administer the assessment. It is therefore important to consider how it works.

Answers are prompted by questions about a person’s typical day, for example. That is a good way to have the conversation. I can fully accept that. Answers are inputted into the system using, wherever possible, pre-coded responses. When one asks about a typical day and certain responses come up the doctor is asked to fit the response into a pre-coded response. The pre-coded responses themselves are then linked tothe descriptors which are described in some detail in the documentation about the revised PCA. That link between the pre-coded responses and the descriptors is where the question about protocols is particularly important.

Will the Minister consider the following point? The stakeholder groups—I assume that they will continue to help manage the process of changing the assessment—should continue to be involved not just  with the descriptors that are being used, but also with the operation of LiMA and its effectiveness. If possible the external stakeholders should be engaged in an ongoing basis in monitoring the effectiveness of LiMA so that we make sure that the link between the pre-coded responses and the descriptors continues to be valid and does not lead to decisions being made which perhaps the Government or the Committee would not intend to be made.

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

In seeking three specific points of clarification, the hon. Gentleman tempts us to reopen our entire debate. I will try to respond to those three specific areas. The first area was when and how the decision is formally taken and the relationship between that and the Atos Origin assessment. As we discussed in a previous debate, if someone attains the 15 points and is therefore entitled to ESA—we can have another competition as to whether that amounts to success or failure and that comes down to perceptions—and in the same interview someone meets one of the 46 descriptors that we have listed on page 18 of the draft regulations, then of course they would be in the support group. There would be no conditionality and there would be no requirement to undertake the work-focused health assessment.

If someone at that point says, “I do not want to be written off. I know that I have 15 points and I know that I meet one or two of the 46 descriptors but I still want to be in this system,” they would get the support group level of benefit, so they would have the higher rate of benefit. If they still wished to undertake the work-focused health assessment at that point they could do so. Regardless of what happens to them in that work-focused health assessment, if they do get closer to the labour market, based on the assessment that was undertaken by Atos Origin that they did have 15 points and did meet one of the descriptors, they would continue to receive that higher rate of benefit, as being part of the support group.

Where Atos Origin says that a person has 15 points and meets one or more of the 46 descriptors, the Atos Origin medical expert could then defer the work-focused health assessment. The decision maker would then examine all the paperwork. He is not there to second-guess the medical assessment of the medical expert from Atos Origin but simply to ensure that all of the procedures have been followed and that everything has been done within the laws that we agree on and the regulations that will be decided at a later point.

If the customer is told that they have the 15 points and are entitled to ESA but they do not meet any of the 46 descriptors and therefore they are not in a support group, they would be asked to undertakethe second interview for the work-focused health assessment. If the customer decided not to attend that interview there would be no sanction at that point. Any sanction, if appropriate, would be enacted at the point where a decision maker received the paperwork and the assessment took place. The customer would, of course, have the right of appeal as they have throughout this process on any decision that impacts on their level of benefits. I hope that reassures the hon. Gentleman.

Atos Origin does an important and technically difficult piece of work for us all and all of our  constituents. They know as well as we do that in the past there have been problems with their systems and they have sought to resolve those. The figure for the number of complaints about Atos Origin is down to 0.3 per cent. We can continue to find ways to reduce that 0.3 per cent even further.

With regard to disability organisations getting access to LiMA, they are happy to share that methodology and information with the disability organisations and, if they wish, will be happy to organise demonstrations of how the system works and dry run some cases to ensure that there is greater understanding of the system.

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

The Minister has been very helpful in giving those assurances. May I take him back to something that he said a moment ago about the decision-making process when he tied the main function of the decision maker to ensuring that processes are correctly carried out? Let me rehearse with him some wider concerns, which might or might not apply to the decision maker. If, for example, there is an examining doctor and there appears to be a pattern building up of racial prejudice or a particular blind spot on some medical issue, would it be in the powers of the decision maker to have a conversation with the examining doctor about it? The conversation would not strictly be about the paperwork or the process. A skewing of the conclusions might give rise to concern, however, and it ought to be addressed or examined.

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

The hon. Gentleman raises an important point, but it is better if the management information systems rather than the decision maker pick up on the issue. Work is under way to ensure that the systems are designed to pick up on wide variations in outcomes that are based on common character traits or the circumstances of the individual customer. There are different ways of implementing and assessing the 15 points or the 46 descriptors. If there are differences at the extremes, whereby one medical assessor has a 95 per cent. outcome for access to the support group and another has none, something is happening, and it is for the management information systems to pick up on. I do not agree with the hon. Gentleman about the way in which we pick up on that important point, but it is important that we do so.

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

I am grateful to the Minister for those assurances, and I beg to ask leave to withdraw the amendment.