[Mr David Amess in the Chair] — Working-Age Disabled People
David Amess (Southend West, Conservative)
A number of colleagues want to speak. I understand the time pressures and the arrangements, and I will accommodate everyone. I hope that we can work together so that everyone is satisfied in terms of their commitments. I call Anne Begg.
Anne Begg (Aberdeen South, Labour)
I am glad to hear you say that you hope to accommodate everybody, Mr Amess. Rather a lot of people have turned up, I am glad to see.
As Chair of the Select Committee on Work and Pensions, I shall speak to our report published in February. Although the title is “Government support towards the additional living cost of working-age disabled people”, most people know the issue as the switch from DLA to PIP, but we thought that that might be confusing, which is why we used the long title.
I begin with a declaration: since 1977, I have been a recipient of, first, the mobility allowance and then the mobility element of disability living allowance. Therefore, any changes to DLA will directly affect me in terms of the benefit for which I qualify. Some people might think it a handicap that I have to make such a declaration, but I hope that having been the recipient of the benefit in question gives me not a unique perspective, because everybody else who receives the benefit will feel the same, but an unusual perception and understanding, in parliamentary terms, of how important the benefit has been.
When I first qualified for the original mobility allowance, I was an impoverished student finding it difficult to get around. I certainly could not afford to own a car and did not come from the kind of family who could afford one, although I had been able to drive since the age of 17. The mobility allowance and then access to a Motability car revolutionised my life as a young teacher on a not particularly high wage. It made my life so much easier, and I have always paid great tribute to the late, lamented Lord Alf Morris, whose idea Motability was. He will be sadly missed for all the work he did in that area.
Returning to the report, the Select Committee’s first finding was that there is considerable scope for reform of DLA. Much of the evidence that we got, even from people who might be critical of the new scheme, admitted that many things about DLA perhaps needed to change. The claim form was long and complex, the criteria were not straightforward and there was no proper or rigorous system for reviewing awards where necessary. Having accepted the need for reform, many of the people from
whom we took evidence went on to say that that could have been done by reforming DLA, and not necessarily by introducing a completely new benefit, although the Government said that the new benefit could represent an opportunity to address the problems of DLA while improving support for disabled people. In their response to our report, they said:
“These reforms present an ideal opportunity to start afresh, keeping the best elements of DLA… but bringing the benefit up-to-date in order to better reflect 21st century society.”
However—this is a big “however”—the Committee felt strongly that part of the problem was that the backdrop to the introduction of the reforms got them off to a poor start. The first knowledge that anyone had of an intention to reform, and indeed replace, DLA came not from the Department for Work and Pensions, but from a Budget document in 2010. Page 36 of the Budget policy costings said:
“This measure will introduce an objective medical assessment and revised eligibility criteria… The assessment will follow a similar process to the Work Capability Assessment (WCA) used for claims to Employment and Support Allowance, with a points based system to assess eligibility… the central assumption for this policy is that it will result in a 20% reduction in caseload and expenditure once fully rolled out.”
That was the introduction to the change. Because it mentioned a 20% reduction, people in receipt of DLA and many of the disabled organisations that represent them immediately felt that the reason for the change was not to improve the benefit, but to save money. The mention of the WCA and the fact that the Government would follow the kind of framework used for employment and support allowance also rang a large number of alarm bells among disabled people. By the time the Government’s proposals were published, the WCA had already obtained a bad name for being mechanistic, uncaring and unfeeling, and for getting assessments wrong. Putting all those together, we find that the principle of reforming DLA was somewhat overshadowed, because those to whom it would apply were immediately suspicious about the Government’s motives. We said in our report that we thought that that was unfortunate, because it certainly did not get the reform off to a good start.
It is true that during the process the Government listened to some of the criticisms. They dropped the proposals in the original draft of the Welfare Reform Bill to end the payment of the mobility component to care home residents. They also agreed, as the Bill went through the House, to extend the personal independence payment qualifying period, and it is certainly true that the first consultation on the first draft of the eligibility criteria produced some welcome changes, particularly on, for example, people’s ability to get around and preparing a meal. Important changes were made.
However, there are still a lot of questions. I hope that the Minister will not mind, but most of what I am about to say takes the form of questions. I know that she is a new Minister and keen, but I suspect that she will not be able to answer them all today. It will be good if she answers what she can. I know that she has already agreed to appear before the Select Committee some time in November; perhaps this debate will give her a taste of what we might ask her when the time comes. In some cases, she might be in a position to write to us with explanations, and about what has changed.
Part of the problem is that we do not yet know a lot of the detail of what will happen. The framework in the Welfare Reform Act 2012 was very vague. Everything is being done through regulation, but we still have not seen the final regulations. The most recent criteria were published in November 2011. Considering that PIP will be paid to new claimants from April next year, time is getting tight, and a lot of people are concerned about exactly how it will be tested and what the impact of the reform will be.
The first issue I want to raise is the lack of an impact assessment. Although the Government introduced the original PIP proposals in December 2010, it was not until January 2012 that they estimated the claimant count reduction—at about 500,000 people by 2015-16, which would be 23% of the claimant cohort. The published criteria included a number of hypothetical case studies that showed which types of claimant would and would not qualify for the new PIP, and at which rate. Crucially though, the case studies did not state whether, and at which rate, claimants would have qualified for DLA, so, without that information, it has been impossible to do a comparison and get an idea of who would and would not get the new benefit, and which types of claimant would lose out.
According to a survey published this week by the Hardest Hit coalition, entitled “The Tipping Point”, some 94% of disabled people fear that losing their DLA would be detrimental to their health, with 65% feeling that they would be unable to work and 75% saying that losing DLA would increase their local authority care needs. Without a full impact assessment, we are unable to answer a number of questions. How many people will lose their adapted Motability cars, and how will that affect their ability to work? Many people use a DLA care component to pay for local authority services, so what will the impact be on local authorities if those people do not qualify for PIP? What assessment have the Government made of DLA’s role in preventing people’s health conditions from worsening? What could the impact be on NHS budgets?
The Government need to consider the cumulative impacts on disabled people of welfare reforms, including the reform of DLA. We also have the 12-month time limit on contributory ESA, the incapacity benefit reassessment to move people on to ESA, cuts to local authority care budgets and the lowering of disability premiums under universal credit. Some claimants might be hit by only one or two of the changes, but some might have to deal with them all as they come in over the next three years. That would be an enormous change for them.
Our report said that we were glad to hear in evidence that there had been a form of co-production of the PIP criteria and the implementation of PIP, involving organisations that represent disabled people. However, we have spoken to some of those organisations, and they said that calling the PIP policy development “co-production” is somewhat absurd. There has been some consultation, but until we get the final assessment criteria, we, and they, will not know whether the Government have listened to them and acted. The Government consulted the organisations and might have heard what they had to say, but action is a different matter.
Disability groups have not been consulted about the framing of the PIP assessment contracts or the guidance to assessors, so, although there has been limited consultation, the wider implications of how the measure will work in practice have not been subject to any kind of co-production. In one meeting, the Disability Benefits Consortium told us that the documents had been counted in and counted up, and that it had been given 15 minutes to look at them. That, again, is hardly co-production.
On the PIP assessment, the Government have said that there will be a requirement for face-to-face assessments for most claimants. That also raises a number of questions. On what basis did the Government come to that conclusion? Will the Government not be able to take account of existing evidence in most cases? That leads me to a question on a slightly different point: will there be any transfer of information already held by the Department for Work and Pensions, so that people do not have continually to remind it of such things as, “This is a glass eye, and of course I am not going to see out of it.” That is not as daft as it sounds. Sometimes, when people have gone for a WCA they have been asked what vision they have in their left eye when they have not had a left eye for decades.
The Department clearly has that kind of information—for example, details of a claimant’s need for different formats—or information that highlights the fact that a claimant is particularly vulnerable or lives in a care home or supported accommodation, which might not be clear from their address, so will it be passed to whoever is administering PIP assessments so that people are not insulted by constantly being asked questions the answers to which would be obvious to anyone who knew them.
There is another question about the face-to-face assessment. Does an arbitrary decision to require a majority of claimants to undergo such an assessment not risk subjecting large numbers of disabled people to unnecessary stress and anxiety, and wasting a considerable amount of public money? I understand that the companies that might deliver the assessments have come up with wildly different figures for the number of home visits there will be.
The other concern regarding the PIP assessment relates to the assessment of fluctuating conditions, which has also been an ongoing problem with the work capability assessment. The activity descriptors attempt to capture the effect of fluctuating conditions by considering impacts that are present on over 50% of days, and that is a welcome change to the provision.
Where two or more activity descriptors apply on fewer than 50% of days individually but reach the 50% threshold when combined, the descriptor that applies for the greatest proportion of time will apply. However, people with such conditions can experience enormous fluctuations; one person might have a condition that fluctuates in such a way that they walk well one day but need an electric wheelchair the next. The difference between their good days and bad days is so extreme that they need the adapted house and all the equipment, although the bad days account for less than 50% of the time. Can the Minister shed some light on that?
The other big concern is the contracts. Atos has won the contract for two of the three areas that cover most of Great Britain, and Capita has won the other. Some of the criticism of the work capability assessment falls unfairly on Atos, and some of it perhaps not. Atos is
delivering a contract that was written by the Government, so any problem with that contract is the Government’s responsibility. There has been little public discussion about what the Atos and Capita contracts will hold, so we do not know whether the Government are likely to get those contracts right.
One of the flaws of the WCA contract is that providers get paid for every assessment, regardless of whether they get them right, and right first time. On what basis will the providers be paid? The Committee argued that they should be paid for assessments that are right first time. There might be some leeway, but given the number of wrong WCAs there should surely be a penalty in the contract so that the companies would not be paid regardless of the accuracy of the assessments.
On top of that, will there be robust sanctions for provider failure? Will the Department look at the different approaches of the two providers and compare their accuracy and assessment reports? I think that will be crucial, a number of months in, in judging how the providers compare with each other and how they are doing. I know part of the reason why the Government adopted the framework approach to the contract, rather than a single contract covering the whole country, was, hopefully, to get that information and to see which provider was the most successful.
On the PIP assessments and the new assessments for the transition from IB to ESA, we recommended that the Government be sensitive to the timing of WCAs when scheduling PIP assessments. The Government should not underestimate the cumulative impact on vulnerable people of frequent reassessments. There is ample evidence that the WCA has been damaging individuals’ health and may be a factor in some suicides. The Government’s response to the Committee’s report was vague on that matter. They said they would try to ensure, where possible, that claimants will not be called for multiple face-to-face assessments in close proximity. How will they ensure that? Will there be data sharing from the part of the DWP that deals with employment support allowance and the part of the DWP that will deal with the new PIP?
The claim process is meant to be streamlined and very fast, which is to be welcomed, but that may cause some problems because it might be too fast for some people. We know the Government are saying that PIP claims should take about a month, yet, at the moment, the average waiting time for a citizens advice bureau appointment is six to eight weeks, which may be a problem for people who need expert help.
Will four weeks be sufficient to gather medical evidence and for vulnerable claimants to get the help and advice they need? How many people are likely to drop out of the process? If the claimant has a lifetime award, might they think that the reassessment does not apply to them? If the DWP does not hear back from people, will it send reminder letters to say that there may be an issue that has not been picked up? Again, some people will get the letter and think it is a circular, not realising that it is very specific to them and their position.
If the providers’ deadline is to be 30 days to make a judgment, and the end-to-end process is likely to take about two months, will there be flexibility in the time allowed to complete the end-to-end process to ensure that all relevant medical evidence can be collected?
What responsibility will the assessment provider have to seek relevant medical evidence? That is what happens at the moment with DLA, but it looks as if it might be different with PIP. Will all the evidence have to be supplied to the claimant? More crucially—again, this has been a problem with the WCA—who will pay for that medical evidence? Doctors, consultants and other health care professionals are being inundated at the moment with requests to provide such reports. Traditionally, they do not always charge the patient, although they do charge the DWP. Who is going to pay for, in some cases, multiple medical letters, especially as there is a good chance that a large proportion of claimants have a limited income?
Another thing is the scale of the task and the implementation timetable. As I have already said, new PIP claimants will start to be assessed next April. The figures involved are mind blowing. We as a Committee concluded:
“It is…essential that DWP allows itself sufficient time to get the assessment right and to be able to convince disabled people and their representatives that this is the case.”
It is very difficult to see how that can happen under the existing timetable. How can the DWP hope to learn from the early implementation of 10,000 new claims a week from April 2013 in time to implement new claims nationally from June 2013? The Department has from April to June to see whether the thing is working for new claimants. Why is there no pause before national implementation to make that assessment and see whether there is anything that has to change? We know that with all welfare benefit changes there are always unintended consequences and difficulties that people did not expect—they start hammering our doors, as MPs, saying, “This is what has happened.”
What happens if the assessments are found to take much longer than anticipated in the planning? What if there is found to be a greater need for home visits than was envisaged? All that takes longer. What if the descriptors are simply found not to work in real-life situations? I know there has been some testing, but there seems to be no time to test the final descriptors, which we have not seen yet.
I have done a very quick calculation—I suppose it is called a back-of-a-fag-packet calculation—that we have almost 2 million DLA claimants, and the Government will have 31 months end-to-end to assess all of them. We should remember that, to begin with, they will assess only 10,000 claimants a week, but the DWP will have to reassess some 70,000 claimants a month. That, in itself, is a huge amount. The calculation is fairly rough and ready, and I am not saying that that is the figure, but it will be in that ballpark.
The DWP is already assessing people for the move from IB to ESA. At the moment, the number is meant to be some 11,000 a week, but we know the providers are finding that incredibly difficult to manage. They are finding 11,000 a week—44,000 a month—difficult to achieve, and they will have 70,000 DLA/PIP assessments and 40,000 or 50,000 IB/ESA assessments to do, so to deliver their timetable they are looking at having to assess 100,000-plus disabled people face-to-face each month.
I do not think that is going to be possible, because I do not think there are enough health care professionals in the country for Atos or Capita to get through such a
work load. I would not be particularly perturbed if the timetable slipped, which might be what is needed, but the Government have set a rod for their own back by trying to get so many people through the assessments when we know, anecdotally—we do not have the final figures—that they are really struggling to deliver the much lower numbers who are being put through the work capability assessment.
We know that being online might speed up the process—as a Committee, we have some concerns about that—but the online claims system will not be available for April 2013. Is that not indicative of a rushed implementation process? The most important thing is that we need the claimants’ outcomes to be tracked. Will the outcomes be tracked as part of an evaluation strategy? What monitoring will the Government put in place to ensure that all that is working and not falling apart?
Mr Amess, you will be glad that I am about to draw my remarks to a close because I know other people want to speak. I realise I have asked a lot of questions, and other colleagues will have questions, too, so I appreciate that the Minister will not be able to answer them all, but we look forward to taking evidence from her.
I have one last question on the legislative process. When will the final regulations and the final assessment criteria be laid before Parliament? Will the criteria be published in draft before the regulations are laid? If so, when?
We think that time is running out and that the Government have, unfortunately, started off on the wrong foot on what could be a useful reform by giving a lot of wrong messages to disabled people. It is understandable why disabled people feel that the reform is not to help them but merely a cost-saving measure.
The people who will be involved in the process are the most vulnerable people in society. It will be difficult for all of them, including those who will qualify for the benefit and for whom there is no doubt that they will qualify. If the WCA and the change to ESA are anything to go by, even those genuine claimants feel very stressed at having to go through this process. It is incumbent on the Government to get the process right and make it as easy for people as possible and to listen to the criticisms and do something about them, because the people who will lose out are those who need the money they receive through the DLA, and consequently PIP, to survive and have any kind of quality of life at all. They depend on that money to participate fully in society. I am sure the Government agree that that is the absolutely correct and laudable aim of any benefit, and they have to ensure that they deliver.
David Amess (Southend West, Conservative)
I apologise to the hon. Lady for not addressing her by her correct title, which is Dame Anne Begg. Secondly, on behalf of the House, I should have welcomed her back after her awful accident, which I learned about in T he House magazine. I am sure I speak for everyone in welcoming her back.
Stephen Lloyd (Eastbourne, Liberal Democrat)
It is a privilege to serve under your chairmanship, Mr Amess. It is also a privilege to follow Dame Anne Begg, Chair of the Work and Pensions Committee, of which I am a member.
Some of my colleagues already know that, unfortunately, and in true DLA style, my hearing aid conked out a few days ago, so I do not have it with me. I am rather deaf, so if the folk on my right want to intervene, they should wave furiously. If I miss that, Mr Amess, please let me know. I apologise, but that is the reality of disability.
Introducing a new disability benefit in place of one that has been around for a number of years is fraught with complexity, anxiety, and often inaccurate media reporting. Consequently, I intend to drill down to a number of the specific features and concerns that the Select Committee has with the new personal independence payment benefit, and the current response from the Department for Work and Pensions. This is a complex issue. The hon. Lady mentioned a number of areas where we have concern. I have flagged some of them up before, and I am going to be precise.
I hope that all of us in the Chamber agree, to a varying extent, that disability living allowance is a benefit based on unclear criteria, is not well understood and has no proper system of reviewing awards. The Committee recognised that. For example, the 2004-05 national benefit review found that approximately £630 million of DLA per year was overpaid as a result of unreported changes in circumstances, while £190 million was underpaid—vital support not reaching the people for whom it was intended.
The concept behind the introduction of PIPs is to ensure that the state, rightly, can continue to support those individuals experiencing the greatest barriers to living an independent life while ensuring that the benefit continues to remain affordable and sustainable. It is also worth noting that the new PIP assessment has been developed in conjunction with a group of independent health, social care and disability experts, and the DWP believes that it will be fairer, more objective and consistent. The theory is that there will be a more responsive and individualised process for ensuring that claimants continue to receive the right support. In taking evidence, the Committee found that the complex DLA claim forms can make it difficult for people to make a claim. Therefore, I and the Committee broadly support the Government’s intention to address those issues.
In addition, we found that there is no proper system for reviewing DLA awards; for instance, 24% of working-age DLA claimants have either had no change in, or no review of, their award for more than a decade, which underlines the Government’s point.
Sheila Gilmore (Edinburgh East, Labour)
The problem I have with the 24% figure is that it mixes up two things. We have to acknowledge that. It seems to refer to people who have never been reviewed and to people who have had no change, which is not the same as not being reviewed. It could well be that they have been reviewed, but have had no change in their circumstances. The 24% figure is often put across as if people are not assessed. My experience with constituents is that a lot of working-age recipients of DLA are being assessed, because they come to me with their problems.
Stephen Lloyd (Eastbourne, Liberal Democrat)
That is a moot point, because I know some people, even in my constituency, who have not been reviewed for many, many years, and who, in normal and sensible circumstances, would be going through a review process. The DWP has come up with the statistic and I think it is reasonably robust, but I take the hon. Lady’s criticism. Perhaps the Minister will clarify the matter.
Media coverage is one of the most challenging issues. The Department says that it recognises the need to work together and to do more to challenge and change negative attitudes towards disabled people. That is why, according to the Department, it is in the process of developing a new cross-Government disability strategy to give renewed impetus to the Government’s commitment to disability equality. Frankly, I do not think it is doing a very good job. I am disappointed with some of the media coverage in the past year or so, and, on occasion, with some of the responses, or even some of the stories that have been set running by either Ministers or the DWP.
The Committee recommended that the Government take on as a priority the fact that public opinion towards disabled people and disability benefits can be and is influenced by the media. We felt that the Government should take more stringent steps to ensure that their own contribution to media stories is accurate and contextualised by actively encouraging robust reporting of their own statistics on benefits.
Anne-Marie Morris (Newton Abbot, Conservative)
Does the hon. Gentleman agree—I think this emerged from the Select Committee report—that no Government and no political party can control the byline in a newspaper? I suspect that one of the challenges we have is that while we clearly need accuracy, we need to be mindful that we cannot control what the media write.
Stephen Lloyd (Eastbourne, Liberal Democrat)
I agree to a great extent. The way that some of the media, particularly some of the tabloids, have been reporting the issue has been disgraceful. I have said that more times than anyone can possibly imagine. However, the DWP and the Government have an enormous responsibility when they are introducing such a seismic change to a benefit. Some of the time, the Government and Ministers have been good and positive, pushing strongly and actively the social model and what they are trying to achieve; at other times, they have been guilty of pandering to people who are more focused on what I might term the tabloid agenda.
The Government have an enormous responsibility, and I would like them to be aggressive. If one of the papers—I do not even need to mention them; we all know the ones I am talking about—comes out with a particularly inaccurate story, I would like to see the Minister and the Secretary of State dealing with it aggressively on the airwaves.
Glenda Jackson (Hampstead and Kilburn, Labour)
Bylines in newspapers may not be the responsibility of the Government, but it is certainly the responsibility of the Government and the DWP to point out the fact that DLA is an in-work as well as an out-of-work benefit, which they markedly fail to do. They should also highlight the fact that more than 35% of families who claim
housing benefit are in work, and that the reason they qualify for housing benefit is because their pay is so very low.
Stephen Lloyd (Eastbourne, Liberal Democrat)
I agree entirely. A lot of people do not understand that the DLA was introduced to help to support disabled people in leading independent lives. I do not know the exact figures, but I know that an enormous percentage of people on DLA are in work. That is a very important point.
I retain doubts about whether that Select Committee recommendation has been followed, either by Ministers in their speeches or by the DWP, and urge that it be made a priority for the Government. However, I strongly support the steps taken by the coalition Government to involve disabled people in the process for devising and implementing PIP, which have proved effective. The DWP has continued to engage extensively with organisations that represent disabled people since May 2011, through its implementation development group, which has more than 50 members and represents a broad range of national and local disability organisations. Engagement at such a level should ensure that the operational design, implementation and ongoing operation of PIPs considers the informed perspectives of disabled people and their representative organisations.
As a consequence of advice and lobbying from me and other Select Committee members, the Department dropped its original proposals to end payment of the DLA mobility component for care home residents, after the Low review, and to extend the three-month qualifying period under DLA to six months under PIP.
I urge the DWP to continue to listen, consult and take on board advice from disabled people and their representative organisations, particularly about the descriptors in PIPs, which I shall come to later. For the record, the disability pressure groups and charities also have a responsibility to be factual in their advice, lobbying and media coverage, as much as the Government do. The victims of misreporting on both sides are disabled people themselves. That simply is not right.
I welcome the Government’s decision to support a three-month qualifying period for PIP, rather than extend it to six months as they originally intended. However, I support the Select Committee’s view that there is evidence of significant financial hardship caused during the current three-month DLA qualifying period, particularly for those with sudden-onset conditions. I ask the coalition Government seriously to consider the Select Committee’s recommendation to implement a facility for early eligibility, which could operate in the same way as that for terminal illnesses.
I welcome the changes made to the first draft of the PIP assessment criteria, which demonstrate that the Government have listened to concerns expressed by disabled people and their representatives. I have had a number of discussions with Lord Freud and his office, drilling down on how some descriptors written into the initial draft were inadequate. I look forward to the final draft, as does the Select Committee.
The DWP deserves credit for the way it has involved disability groups and disabled people in the co-production approach it has adopted to the development of the PIP criteria. However, thus far, mobility descriptors still concentrate too heavily on the ability to move a fixed
distance and do not include barriers to accessing public transport, or the difficulties of some locations for individuals where routes to shops, public transport and so on are particularly challenging.
The PIP assessment criteria also tend towards the medical model of disability. This is an incredibly important point. I value the fact that the DWP understands, or appears to understand, the social model of disability and that it is about providing support for disabled people so that they may lead independent lives. However, within the PIP criteria, we seem to be slipping back to the medical model. I urge the Minister to watch that closely. For instance, those criteria do not properly take on board the barriers to being independently mobile that a blind person may have face. Yes, they may be able get to the shops or their workplace via a route they know, but the descriptors do not take into account the challenges that a blind person might face if they were travelling to a destination they did not know, which is not uncommon for all of us on a weekly basis. If I had a visual impairment and was using a route that I do not know, I would face a series of different challenges. The descriptors need to show understanding of that and to take it into account.
I was encouraged by the language used by the Minister’s predecessor, who described the PIP assessment as a conversation between claimant and assessor. It is vital that the PIP assessment does not take the same mechanistic approach, based on an inflexible computer system, as originally adopted for the work capability assessment by the previous Government. In time, though, I would like there to be a checking system or review system—call it what we will—that allowed PIP recipients to be reviewed without having to go through the stresses of face-to-face assessment. I suggest that a letter of support from a consultant or other expert in the field—someone with knowledge of their disability—should suffice once the face-to-face assessments have been completed.
I understand why the coalition Government are going through the process of face-to-face assessment—some people have not been reviewed for many years—but it is important that the DWP take on board the profound worry and stress that many disabled people and their families are going through because of the proposed changes. If the Government do not take this on board, they will be perceived as uncaring and their stated desire—our stated desire—to support the social model of disability and to provide additional support for those who need it while being properly careful with the public purse will turn to nothing. I for one will become not a supporter of the Government’s objectives, but a highly vocal opponent. I really do not want this to happen.
My many years in the field of disability lead me to recognise that the system is not good enough. An annual overpayment of more than £600 million and an underpayment of almost £200 million show that it is heavily flawed, but I request that the Government do all they can to ensure that we replace DLA with something better and fairer, and that works. PIP could be that, but it is not yet. I believe it can be and profoundly hope that it will be, by the time it is rolled out in the pilot scheme in April 2013. The coalition Government must get this right, because people’s financial security, their level of comfort and their daily lives heavily depend on it.
David Amess (Southend West, Conservative)
Order. The winding-up speeches will start at 4 pm. I do not want to impose a time limit and I want to call everyone, if we can share the time out.
Glenda Jackson (Hampstead and Kilburn, Labour)
It is a pleasure to follow Stephen Lloyd. I thank my hon. Friend Dame Anne Begg, as Chair of the Select Committee, for her prescient, direct analysis of what we have found in our deliberations to be the areas that the Government must address with no small haste, because if they mess this one up, hundreds and thousands of people will suffer grievously for the inadequacies.
Concerns have already been expressed, which all hon. Members must have heard from our constituents, about the whole assessment process. We all have horror stories to tell about the previous Atos regime. It does not seem to have got any better, because the number of appeals against existing assessments, although not necessarily with regard to DLA, are rising exponentially and being upheld almost exponentially.
One of the most glaring holes in the Government’s approach to the assessment process is in the area of illnesses and disabilities that fluctuate, the most obvious to me, having had representation from my constituents, being Parkinson’s disease. I have also had representations on multiple sclerosis and myalgic encephalomyelitis, and that is long before we get into the variabilities of people who are lifelong sufferers of mental health problems, not least those who are bipolar. My hon. Friend gave an example of someone who may be perfectly capable of getting out of bed one day, but the next day is completely incapable of moving, but under the present structure they would possibly be deemed to be perfectly capable of moving every day. That is simply not the case.
Aside from the Government’s black propaganda agenda for people who claim the whole range of benefits, which we touched on earlier, the great irony of what is being proposed is that no one in Parliament or in the country would argue with the concept of assisting disabled people into work. That seems to be fundamental—why else do we have Equality Acts or laws against discrimination? We want people to work, and people with disabilities are themselves desperate to work, but the great paradox of the Government proposals is that they are actively working against the possibility of people with disabilities being able to get into work because the process is so cloudy and unclear, as is the other issue of what passported benefits—to use that good old cliché—they will still be able to claim.
Anne-Marie Morris (Newton Abbot, Conservative)
Throughout the House there is acceptance that we want to do everything we can to enable people with disabilities to take a full part in life, whether working or not. If I may correct or add to what the hon. Lady said, I think it is true that more appeals have been unsuccessful than successful. My second point is the result of an interesting conversation that I had with our new Minister, who is dedicated to helping disabled people get into work. My constituents have said, “Well, that’s a lovely idea, but how can we do that when many of the jobs are nine-to-five?” I am pleased
that the Minister is now looking carefully at what is happening in other jurisdictions to ensure that flexibility is available in the work on offer, so that those who have good days and bad days may still participate in the world of work.
Glenda Jackson (Hampstead and Kilburn, Labour)
On the hon. Lady’s point about appeals not being upheld, the length of time taken to hear an appeal is growing exponentially—my favourite word—so we do not know. People are having to wait months before their appeal is heard, because of the increase in the number presented.
On the changes with regard to nine-to-five, with all due respect that applies to every woman who works—that situation already exists for women. The only job that they might be able to obtain is nine-to-five, although they have children who go to school and the times are completely outside their range. That is not something new that the Government have to address in particular for people with disabilities. If we are looking at the accessibility of existing jobs for people with disabilities, I give the example of one of my constituents who is profoundly deaf. One of the Government’s arguments on accessing the work capability assessment for DLA is that if people do not get the letter they can phone, but that is of absolutely no use to anyone who is profoundly deaf. It certainly does not help my constituent: if he goes along to the jobcentre because he has read about a job he could do, there is no one there to translate for him, so there are holes in the existing system, and I am concerned that they will become crevasses if the Government do not get their timing right and their assessment of people with DLA done within a reasonable period.
The assessments also need to take on board what we were told when the Government initially introduced their changes to the whole of the benefits system: the assessment process, which they accepted in the past had not been up to snuff, would be infinitely more flexible and sensitive. I see absolutely no signs, given the time scale for assessment of people with DLA, of greater flexibility and more sensitivity, which are absolute givens when talking about people whose lives will be fundamentally overturned if they fail to meet the precepts set down by the Government. With all due respect to my hon. Friend the Member for Aberdeen South, who as I said gave a remarkable oversight of the evidence and the concerns expressed, the organisations that work in concert with and on behalf of people with disabilities remain seriously concerned because such questions are not being answered now. We had evidence before us in Committee last week of a coroner in Leicestershire, I think, who attributed a suicide to the individual’s concerns about having to go through the DLA assessment. From our constituents we all know of the anxiety already out there, which is actively having an effect on people now.
That was my introductory rant, but what I am most concerned about is the linkage between services for people with disabilities and local authorities providing such services. Owing to the massive cuts imposed on local authorities, we are already seeing a major downturn in, or removal of, services that many people with disabilities have been or still are dependent on, my favourite example being day centres. They can be a major part of enabling someone who, for example, cares for a person with disabilities to work and to maintain their families. Those
day centres are being closed, without there being any idea how support will be provided in the area and made accessible to all those who need it. That is another major issue, as is the accessibility of affordable transport, which is seemingly being taken away every five minutes. The argument that has always been made is that the kinds of services required by people with disabilities should be in their local communities, where they can be reached. An example given to me was of a six-year-old boy who needs a hydrotherapy pool. There is such a pool at the end of his street, but although it is in a state school, he does not attend it, so he is precluded from using it and his family have to drive 23 miles there and back to take their child to a hydrotherapy pool.
The overarching argument that I am attempting to put forward is that local authorities have a vital part to play in ensuring that people with disabilities can work, and that they can make a contribution not only in the workplace but in their local communities so that their quality of life and that of their whole family is improved. As we all know, in many instances if one or possibly two people in a family are disabled, the entire family is focused on supporting those people. The needs of the family can often be as great, if not greater, than those of the one family member.
I have probably exhausted the points that I wished to make. I am grateful for everyone’s patience. I stress to the Minister, however, that this is a once-in-a-lifetime opportunity not only for her Government but for the people in this country who have disabilities and for the much wider community—namely, the whole country. In future, do we really wish to be presented as a people who rejected the most vulnerable in society and who believed the black propaganda and accepted that the vulnerable were all workshy, when we all know that that is the antithesis of the truth? We have a duty to ensure that our best might possibly be demonstrated by the care we take of our weakest.
Jane Ellison (Battersea, Conservative)
Unfortunately, I have to go to a meeting between 3 and 4 pm, so I apologise to all colleagues in the Chamber and in particular to the Front Benchers if I miss any part of the wind-ups. It is nice to get an opportunity to comment, but as someone who hopes to join the Select Committee officially in the next few weeks, once the bureaucracy can be sorted out, I leave the detailed commentary to those who have helped to prepare such a detailed report and can comment with more expertise. I will confine myself to a few general observations and to a couple of things that I have taken from a brief glance at the report and the Government response.
One of the striking things is the consensus on the need to reform DLA. Clearly there are diverging views on how that might be done, but the consensus is interesting to see. I think it is generally agreed that DLA is a confusing benefit. I understand that fraud levels are low, so I agree with those comments, and I shall come back to the points about media coverage and so on. The DWP’s own figures estimate, however, that there is more than £600 million of overpayment and, more significantly, nearly £200 million of underpayment. Any benefit involving that level of misallocation of resource clearly needs to be looked at carefully to see how it can be reformed.
Once I knew I was likely to be joining the Select Committee and, in particular, to be contributing to this debate—although I have tried to speak in other debates on disability-related benefits—I made a particular point of talking to disabled people. I also have a disabled staff member, and over the last few days I have talked to carers of disabled people and looked at the case load that comes to my constituency surgery to try to get an insight into people’s lives and how they can be supported.
I took from the Committee’s report the concern about a big bang approach, and I note that the Government have said that the reforms will be phased in, although the Chairman of the Select Committee raised some concern about the phasing-in looking fairly big bang-ish, and I am sure the Minister will comment on that. However, it is sensible that some of the reforms have been characterised by not being big bang changes. The previous Government introduced some big bang reforms, and I understand from what former Ministers have said that they spent several years afterwards dealing with the consequences. I am sure that the Select Committee’s work is invaluable in trying to advise on how some of the reforms can be introduced without causing people unnecessary problems.
I also took from the Committee’s report—this goes partly to the point about coverage—concern about interaction with disabled people and the groups that represent them. The Government have responded positively to that. The snappily named personal independence payment implementation stakeholder forum is now holding a dialogue, and I am sure that the Minister will comment on its work and how it is informing the Government as they proceed.
I was interested to see that the Government have responded to some of the Committee’s recommendations, but other issues have been raised today to which they must also respond. I am firmly in the camp of my hon. Friend Stephen Lloyd as someone who very much wants the reforms to work, but I will use the knowledge that I have gained on the ground in my constituency and feed it back into areas where we may need to do something differently, because there is a slight danger. To put that into context:
“Our goal is to make responsibility the cornerstone of our welfare state.”
That could have been said by the Secretary of State, but it was in the Labour party’s manifesto at the last general election.
There is enormous consensus on the cornerstone of responsibility. I am not being partisan, but there is sometimes a danger that throwing up a series of practical concerns about implementation may add up to a cumulative whole that, if followed to its logical conclusion, might present an overwhelming case for not pressing ahead. I believe that there is an overwhelming case for pressing ahead and working through some of the implementation challenges, because there is a huge danger in not doing so. It may sometimes appear that throwing up such problems amounts to saying, “Let’s just put this in the ‘too difficult’ tray and come back to it in a few years.” That has been happening for decades, and it does a great disservice to the welfare state.
I want to pick up something that my hon. Friend the Member for Eastbourne said about the dialogue on
welfare reform, and particularly that involving disability. I completely agree with the comments about some of the tabloid coverage, and I am sure that Ministers have taken on board the need for all of us to be responsible, but there is a flipside, and those charged with representing disabled people—the activist groups, charities and pressure groups—also have a responsibility not to alarm people unduly. I will give a practical example.
I recently went to the annual general meeting of an organisation that provides support and advice to people with disabled children. A lady from a welfare advisory group gave a 25-minute presentation, during which she presented, almost without exception, the possible downsides of the reforms without knowing anything about the personal circumstances of the people in the room, many of whom I knew pretty well because they were constituents and people I had dealt with. Some of them had much to gain from some of the reforms she was talking about, but her starting point was how things could get worse.
Two things struck me about the lady’s talk. In 25 minutes, she did not at any point mention work. She made an assumption that none of the people she was addressing were in work or would progress towards work. That was dispiriting. It is important that those on both sides of the argument do not exaggerate for effect, and the Chairman of the Select Committee made the point about some people’s vulnerability.
I take issue with the suggestion that all disabled people are among the most vulnerable people in our society. I do not believe that. An obvious and clichéd example is that many of the Paralympians we admired during the summer—they were clearly not vulnerable. They had a disability, and we wanted to help them to get over that disability and make the most of what are already fulfilling lives. My friend who works for me has a disability and needs help to fulfil his working life, but he is not intrinsically vulnerable. I take slight issue with that suggestion.
There are two recent reports—“The Tipping Point”, and “Holes in the Safety Net” which Baroness Grey-Thompson introduced last week.
Stephen Lloyd (Eastbourne, Liberal Democrat)
My hon. Friend reminds me that I was at a meeting only last week when the partner of a blind person said that because his wife was blind and could not work they needed support. That was frustrating because, although I am sure he loves his wife, he was making the assumption that a blind person could not work. I know blind people who are earning more than £100,000 a year. We need to change public perception.
Jane Ellison (Battersea, Conservative)
I could not agree more. It is central to these important reforms that we ask people what they can do, instead of what they cannot do.
Glenda Jackson (Hampstead and Kilburn, Labour)
I take on board the hon. Lady’s point about overstatement of the most vulnerable, but some people who are asked that question are totally incapable of answering. A constituent who is 27 years old with a mental age of a six-year-old went to be reassessed. She is already in the system, and the assessor’s report was a million miles from the facts and the actuality. Without the new change that allowed her to take her mother with her, she would have been not only vulnerable but completely unsupported.
Jane Ellison (Battersea, Conservative)
Absolutely. That intervention illustrates two points. First, there is an enormous range of disability; we are talking about huge diversity. We must be mindful of the fact that it is difficult to say anything that is true of all disabled people because of the extraordinary span of people covered, from the example just given to some of the people we saw winning gold medals for Britain during the summer. Secondly, the system has already been changed to respond to that concern, and that is exactly as it should be. I am sure that the Select Committee plays an important part in looking at evidence from life to see how a small tweak to the system can enable someone who is exceptionally vulnerable to be properly represented in the system.
Glenda Jackson (Hampstead and Kilburn, Labour)
The hon. Lady is missing the essential point that I clearly failed to make. The decider in that instance is someone who has been appointed and financed by central Government. They make the decisions, and we have already spoken about the number of appeals arising. That individual should have said immediately, “This is absurd and no one should have sent you to see me”, but they went through the process. My only point is that the deciders of an individual’s life are sometimes a million miles from understanding. They are appointed by the Government, so it is the Government’s responsibility to ensure that assessors are up to the job.
Jane Ellison (Battersea, Conservative)
I completely agree, but that is not a reason not to press ahead with important reforms.
To return to my previous point, it is sometime possible to give the impression that when a series of practical concerns amass to so great a number—many have been brought up today—that is a reason not to proceed. That is exactly why we have made the mistake of leaving things in the “too difficult” tray in the past.
Teresa Pearce (Erith and Thamesmead, Labour)
I thank the hon. Lady for giving way; she is being very generous. On the problems that are being experienced, is it not the job of Government, the Opposition and all of us here to use our experience to ensure that when contracts are drawn up, they are the best contracts possible? It is not fair to say that it is oppositionism; it is experience. The hon. Lady said that there have been amendments to the Atos contract, and she is right, but this time we would like there to be no need for further amendments. The contract should be right in the first place. What we are saying is, “Let’s look at what could go wrong and what has gone wrong, and let’s get it right this time.”
Jane Ellison (Battersea, Conservative)
I do not disagree with the hon. Lady, and I have not used the word “oppositionist”. What I am trying to convey is that by constantly focusing on the things that might go wrong or sometimes do, we are not always talking about the things that have gone wrong; sometimes, we project forward and consider things that could go wrong, and that in itself can become a reason to doubt the point of the reform. That is the point I am making. We need to try to show some balance.
Finally, I believe in the welfare state. It is an enormously important, civilising aspect of our modern society. A problem we have at the moment is that there is not a general buy-in from the general public. We have talked about the media and some of the red-top coverage, and
so on. This is a critical juncture for the welfare state. If we care about it and believe that it is vital to everything that we are as a country, that should make us more determined to press on with reforming the parts of it that clearly are not working.
Stephen Lloyd (Eastbourne, Liberal Democrat)
I thank the hon. Lady for giving way. Does she agree that the welfare state, which I, too, passionately support, should be about a hand-up and not a handout? There are many tens of thousands of people with disabilities and disabled people already in work, and many more who would do outstandingly in jobs if they were given the right support to do those jobs and not seen by society as victims, which they are not.
Jane Ellison (Battersea, Conservative)
I absolutely agree, and that is why it is so important to rebuild the general confidence across our nation in our welfare state. Reform cannot be put off any longer, and although there might be difficulties and practical hurdles, we have to work through them. So long as people do not see the welfare state and disability support through the prism that my hon. Friend described, but instead have an unhelpful, negative, tabloid view of it, we will continue to lose the trust and the buy-in. That point is absolutely fundamental, and I hope that as part of the Work and Pensions Committee I can play a thoughtful and responsible role in holding the Government to account. I support the broad thrust of the Government’s reforms, because the future of the welfare state and the respect in which it is held are at stake if we do not press on and get this right.
Debbie Abrahams (Oldham East and Saddleworth, Labour)
Thank you, Mr Amess. It is a pleasure to serve under your chairmanship, and I look forward to welcoming Jane Ellison when she becomes a full member of the Work and Pensions Committee.
This is not a partisan point, but for clarification I should say that the Opposition support genuine reform when there are clear issues. We have never said that we do not. The issue raised by my hon. Friend Dame Anne Begg, the Chair of the Committee, is that the reforms are cuts. That is an important point to have made. There are practical issues that we need to address, but fundamentally, the evidence supplied to us independently indicates that the reforms are cuts.
Anne-Marie Morris (Newton Abbot, Conservative)
The hon. Lady is very generous. As I understand it, when we look at the figures in terms of the reduced amount available in future—the 20% cut, as she would describe it—and the assessment for the old DLA, which took account of expected changes, there is no difference. I am not sure, therefore, that the
talk about cuts is correct. It is more about recognising that the current system does not work, because people who need the support do not get it, and the people who do not need it, do. The cuts are really about trying to rebalance that.
Debbie Abrahams (Oldham East and Saddleworth, Labour)
I should also have said that I have to leave soon. I apologise because I will not be taking any more interventions, but I am happy to answer that question. What the Chancellor said in the emergency Budget in June 2010 was clear:
“It is right that people who are disabled are helped to lead a life of dignity. We will continue to support them, and we will not reduce the rate at which this benefit is paid. However, three times as many people claim it today than when it was introduced 18 years ago, and the costs have quadrupled in real terms to more than £11 billion a year, making it one of the largest items of Government spending.”—[Hansard, 22 June 2010; Vol. 512, c. 173.]
As my hon. Friend the Member for Aberdeen South said, there will be a 20% reduction in the number of people who are able to have a disability-related benefit awarded to them, and significant savings, again, can be identified within the Government’s impact assessment.
I want to unpick what the Chancellor said in that statement. He was, and is, saying that even if the prevalence of people with disabilities has grown by three times—there was a very unpleasant undertone implying that it had not—sorry, folks, it is just not sustainable. That is the key message that has been coming through, as my hon. Friend made clear. The impact assessment on the personal independence payment was, again, telling. It said:
“The new benefit will help to ensure that expenditure on DLA is sustainable and resources focused on those most in need of additional support.”
It goes on to assert that although there is an association between low income and poor health, there is limited evidence that providing money will improve health, which is correct. However, it continued:
“It is possible that the policy could have positive impacts on health if it leads to more disabled people moving into work.”
That, too, is very telling. First, the evidence was deflated or inflated, depending on what it said, to support the policy to get rid of DLA and replace it with PIP. The evidence was clearly manipulated and the lack of a comprehensive evidence base is shameful; my hon. Friend referred to that. There is real concern that the policy is being railroaded through. As we have discussed, there are a number of independent disabled people who are able to work. That is absolutely fantastic, but there are also some very vulnerable disabled people. The benefit should take them into account as much as it does those who are independent.
Secondly, the impact assessment makes an association with the positive impacts of work on health—which again, there are—when DLA has always been about helping contribute to the extra costs of being disabled. It is not an out-of-work benefit, so that relates to shifting the mindset of what the change is about. That is so important. The allowance has always been about supporting people with disabilities to lead as normal a life as possible.
For the record, the evidence on the trends in disability reflects our industrial heritage. The regions with heavy industries and occupations that did people’s health no
favours have the highest rates of disability and ill health. There are diseases such as coal miners’ pneumoconiosis, asbestosis and silicosis. Of course, many of those diseases have long latencies, and there are industrial accidents that Members will be familiar with. Most work is good for people’s health, but not all, and there is strong evidence about that.
As I have said, we can agree—there is consensus across the House—that the DLA system, as it stands, is flawed. For example, a clear system for reviewing some awards is needed, but we should not restrict the access to support to overcome the barriers to day-to-day living that a person with a disability faces. That is what we need to address.
As I said before, the Government’s own estimates predict that more than 500,000 people will not receive this support. As many expert witnesses in the Select Committee’s inquiry concluded, cutting DLA is nothing more than a cost-cutting exercise. It is part of the wider erosion of the welfare state. As has been said, public buy-in is achieved by changing our view of what welfare is about. Unfortunately, the Government have a willing accomplice in the media to help them to do that.
I am really disappointed. We have talked about the role of the media. We have done a number of reports highlighting the importance of the media’s role and of responsible press releases and statements. However, this morning on the “Today” programme, the Secretary of State was talking as though people who are claiming benefits are a drain on society. It was a very inaccurate portrayal of benefit recipients. It was an attempt once again to suggest that the majority are workshy scroungers when the facts are that most people on benefits are in work and most are net contributors to the Treasury. That was not being reported; it was as though people were really abusing the system. There have been a number of such reports, and that has to change.
In addition to the reporting and the way in which attitudes to welfare are being changed, a system is being created in which people on higher incomes see themselves as separate to or outside the welfare state. We are not in post-war Britain. At that time, there was buy-in to the welfare state by everyone. Everyone saw themselves as contributing to and gaining from it. We were literally all in it together.
The final issue—this happened in the US under Reagan—is the putting in place of policies whose implications are unclear. Little has been done to assess the impact on the people they will affect. We have talked about the shameful impact assessment. My hon. Friend the Member for Aberdeen South talked about the lack of information available on the implications of this benefit change.
Despite a detailed, evidence-based inquiry by the Select Committee, the Government have rejected our recommendations out of hand. They seem determined to press on with what they are doing. I really have concerns about that. My hon. Friend mentioned the case in which a coroner reported that a suicide could be directly attributed to the pressure that was felt by someone with mental illness as a result of having to go through the work capability assessment. Is this really the type of society that we want to live in? I ask that question because I have—
Debbie Abrahams (Oldham East and Saddleworth, Labour)
I will not. I am sorry, but I have only a few minutes and then I have to make a school visit.
I appreciate that I am talking about work capability assessments, but we have seen from the evidence that there is a link with the process that is to be adopted.
I want to touch briefly on the issues that have been mentioned in depth by colleagues. I have already talked about access to benefits being restricted. The application process is made as complicated and bureaucratic as possible, so that people already on DLA have to opt in rather than migrate across—the so-called “brown envelope syndrome”.
The assessment process is another issue because of the criteria used. They have little clinical relevance. It is a case of trying to set a very high minimum bar. I know, because I have met their representatives, that the royal colleges and the British Medical Association are really concerned that the criteria have not been developed in conjunction with them; they are often punitive and meaningless.
Similarly, there is an issue about assessors not being qualified in the conditions that they are assessing. That is an absolute nonsense. In addition, little attention is paid to the medical reports submitted in the assessment process. As an aside, I think that it is rather bizarre that Atos was contracted to undertake PIP assessments after such a poor performance on the WCA, but in Scotland it is sub-contracting the undertaking of the assessments to the NHS. What is going on? If this is about saving money, surely that is not the way to do it. In addition, there is little reassurance that someone will not be subjected to myriad assessments, potentially exacerbating their existing condition.