Recent legal judgments have interpreted the assessment criteria for PIP in ways that are different from what was originally intended by the coalition Government. We are therefore now making amendments to clarify the criteria used to decide how much benefit claimants receive in order to restore the original aim of the policy previously agreed by Parliament, which followed extensive consultation.
I want to be clear about what this is not. It is not a policy change, and nor is it intended to make new savings. I reiterate my commitment that there will be no further welfare savings beyond those already legislated for. This will not result in any claimant seeing a reduction in the amount of PIP previously awarded by the Department for Work and Pensions.
Mental health conditions and physical disabilities that lead to higher costs will continue to be supported, as has always been the case. The Government are committed to ensuring that our welfare system provides a strong safety net for those who need it. That is why we spend about £50 billion to support people with disabilities and health conditions, and we are investing more in mental health than ever before, spending a record £11.4 billion a year.
Personal independence payments are part of that support, and they provide support towards the additional costs that disabled people face. At the core of PIP’s design is the principle that support should be made available according to need, rather than a certain condition, whether physical or non-physical. PIP is also designed to focus more support on those who are likely to have higher costs associated with their disability. PIP works better than disability living allowance for those with mental health conditions. For example, there are more people with mental health conditions receiving the higher rates of PIP than there were under the old DLA system.
This is about restoring the original intention of the benefit, which has been expanded by the legal judgments. It is entirely appropriate for the Government to act to restore clarity to the law, as Governments have done before and will no doubt continue to do in the future.
In a written statement published without warning on Thursday, Ministers announced the cuts to which the Secretary of State has just referred, which will take effect in two weeks’ time. Over the weekend, another Member in government said that this was to stop the payment of benefits to people
“taking pills at home, who suffer from anxiety”.
Why is so little notice being given, with no opportunity at all for parliamentary scrutiny of these substantial cuts? Will the Secretary of State confirm, as stated in the impact assessment published with the regulations, that people suffering from schizophrenia, learning disability, autism and dementia will be among those worst affected by the cuts? The cut is being achieved by taking the benefit away from people whose mobility impairments are the result of “psychological distress”. According to the wording of the regulations, they will no longer be entitled to benefit. Does that not directly contradict the Prime Minister’s commitment to treat mental health on a par with physical health?
I thought every part of that question was based in error, if I may say so. Nobody is losing money compared with what they were originally awarded by the DWP, so that part of the right hon. Gentleman’s question is simply factually incorrect.
Far from being slipped out, the Department made a huge effort to let people know that this was happening. I left a message for the shadow Secretary of State, Debbie Abrahams, and I spoke to the Chairman of the Work and Pensions Committee, Frank Field. I know that my hon. Friend the Minister for Disabled People, Health and Work also spoke to a number of colleagues, so the idea that this was slipped out is simply ridiculous.
The right hon. Gentleman talks about individual conditions, and I can only repeat what I said earlier: PIP is awarded not for conditions, but for the living or mobility difficulties that result from such conditions. All that the regulations do is to restore the situation to what it was in late November, before the two court judgments. This is not a new policy or a spending cut; this is simply restoring the benefit to what was intended when it was first introduced under the coalition Government.
Does my right hon. Friend agree that any welfare payment, especially one providing a tiered range of cash payments to people living with enormously diverse physical and mental conditions, requires clear assessment criteria and clarity in law? The new regulations will restore precision to the law, which will benefit all users of the system.
I completely agree with my right hon. Friend, who obviously has huge expertise in this area, that we need clarity. In particular, the vulnerable people receiving PIP deserve clarity. I reassure them and the House that all the regulations will do is to restore us to the situation that everyone knew they were in late last year, and in which they have been ever since PIP was introduced.
As we have heard, on Thursday the Government issued the new regulations by which disabled people or people with a chronic condition will be assessed for eligibility for personal independence payments. PIP helps disabled people to fund their living costs and, in particular, the additional costs that they face because of their condition. The regulations will come into force in just over two weeks’ time, but they were issued without any consultation with the Social Security Advisory Committee. The Government have said that this is because of the urgency of the issue.
The Government are in effect overturning two tribunal rulings that allow chronic “psychological distress” to be included in the PIP assessment. However, if the Secretary of State was so unhappy with the tribunal rulings, why did he not use his powers under sections 25 and 26 of the Social Security Act 1998 and regulations 21 and 22 of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 to challenge those rulings in the courts?
The Secretary of State’s actions not only undermine the judicial process, but reduce eligibility to PIP support for over 164,000 people with debilitating mental health conditions, including those not able to go outside their own homes. What discussions has the Secretary of State had with disabled people’s organisations ahead of bringing forward these regulations? What is his assessment of the effects on the health and wellbeing of the people affected by the cuts? Given that disabled people are twice as likely to live in poverty as non-disabled people as a result of the extra costs they face, how many disabled people will be driven into debt or face poverty as a result of these cuts? What is the cumulative effect of these cuts along with the employment and support allowance work-related activity group cuts that are due to come into effect in April, which will affect 500,000 disabled people? Finally, why are the Government contradicting their earlier argument in the 2015 upper tribunal case of HL v. the Secretary of State for Work and Pensions in which they argued that “psychological distress” should be included in PIP assessments?
We have been arguing for parity of esteem for mental health with physical health for some time now. Indeed, the Prime Minister famously said that people with mental health conditions need more support. Why will the Government not honour that?
Let me deal with some of the detailed points raised by the hon. Lady. Incidentally, we are appealing the judgments, but because of the lack of clarity that would be caused by leaving the current regulations in limbo following the upper tribunal’s decisions, it is better to move quickly. I should also say that the tribunal has itself said that the assessment criteria are not clear. If the tribunal believes that, I am more than happy to accept it—indeed, I am grateful to it for telling us that the criteria are not clear—so I am now taking the opportunity to clarify the existing regulations.
The hon. Lady talked about the effect on disabled people. I absolutely agree with her that that is the central core of what we are trying to do. I point out to her that over two thirds of PIP recipients with a mental health condition get the enhanced rate daily living component, compared with just 22% who used to receive the highest rate of DLA care. That is why PIP is a better benefit than DLA. That happened previously under the existing regulations, and I am now restoring that situation.
The hon. Lady’s questions were predicated on this being a cut. It is simply not a cut; it is not entirely honest of her to say that it is a cut. If she looks at the facts of the case, she will recognise that people claiming PIP—specifically those with mental health conditions—have been and are better off with PIP. We are making the benefit clear. We are making the change so that the benefit is paid as it has been since it was first introduced, which is better for people, particularly those with mental health conditions.
Order. I respect the cut and thrust of debate, but there can be no accusation of dishonesty in this Chamber.
Order. That is quite sufficient. No further explanation is required. I am very grateful to the Secretary of State, and deeply obliged to him.
I welcome the fact that the Government are now, rightly, spending a record amount to support those with long-term health conditions and disabilities. If the Government were to decide to increase that amount yet further, surely that should be done in conjunction with charities and stakeholders, utilising their expertise, rather than on an ad hoc basis dictated by the courts?
My hon. Friend, who also has huge expertise in this area, is exactly right. There was very extensive consultation when PIP was first introduced about the design of what is, inevitably, a very complex benefit. As I have explained, we have seen a considerable improvement in awards, particularly for those with mental health conditions. The Government’s changes will restore that situation, which was better than people ever knew in the past.
The changes will, despite what has been said, exclude disabled people from vital financial assistance. They send a dangerous message to the public that people suffering from mental health conditions are less worthy of support than those with physical disabilities. We cannot and should not pit one disability against another. With condemnation across the spectrum, I urge the Secretary of State to rethink these callous changes. Can the Secretary of State offer any explanation as to why those with mental health conditions are not entitled to the same levels of support as others? Will he clarify whether this matter will be brought to the House? Finally, I ask that a debate takes place as a matter of urgency to give the House the opportunity to scrutinise the proposals fully and to put forward the concerns of disabled people across the UK.
The hon. Lady will know that what is considered for debate are matters for the usual channels. It ill behoves any Secretary of State to try to interfere in the actions of the usual channels.
The hon. Lady’s first question is based on the misapprehension that people with mental health conditions are doing worse under PIP as it is currently run. That is simply factually not the case. I am proud of the fact that overall the Government are spending £11.4 billion on people with mental health conditions—more than any previous Government have paid out. Overall, we are spending £50 billion a year on disability benefits. In every year of this Parliament we will be spending more than was spent in 2010. That is how we are meeting our commitments to disabled people, which I take very seriously and the whole Government take very seriously.
There are always lessons for anyone who writes regulations. By necessity, benefit regulations are complex, particularly because they need to be very sensitive. We are dealing with vulnerable people. In this case, we are dealing with disabled people who have extra living costs or difficulties with mobility. Inevitably, the framers of regulations try to make them as exact as possible. It is one of the roles of the courts to point out where that has gone wrong. In this case, the courts have said that they were not clear. What the Government are doing is clarifying them. That is to everyone’s benefit.
The Prime Minister has said that there should be parity of esteem between mental and physical health conditions. By overriding the courts on this matter, 160,000 people who would otherwise have been receiving support through PIP will not now receive it. Did the Prime Minister agree with the decision to overrule the courts and deprive these people of the support they desperately need?
The hon. Lady is wrong to say that 160,000 people will not get PIP because of the decision. She knows the details well enough to know that this is not about whether or not people receive PIP. There are two different cases and two descriptors—[Interruption.] She keeps treating me as though I am the Prime Minister. I am grateful, but I am not. I am the Secretary of State for Work and Pensions. The hon. Lady is simply wrong when she says that this will deny people PIP. As she knows, PIP is given on the basis of the difficulty of living costs or mobility costs. It is not a binary case. Twelve different attributes are considered and each attribute has a large number of descriptors. The court case affects two descriptors. It is not as she paints it.
We are engaged in a PIP improvement project. My hon. Friend is right to ask the question about consistency of assessments. That is one matter we are certainly addressing. The other matter, which I know is of concern across the House, is delays. I am glad to report that because of the PIP improvement plan, claims are now being cleared at over five times the rate they were in January 2014. The delays in the system are being reduced and we are addressing the issue of consistency.
Has the Secretary of State forgotten that one of his predecessors resigned a year ago because of cuts to the disabled? Does he understand—it does not seem that he really does—the strong feeling among so many of the vulnerable that they will again be in the firing line for cuts? There is so much anxiety. We receive emails constantly from those affected, and from organisations, about the way the disabled are hit time and time again.
I am happy to assure them and the hon. Gentleman that what I am talking about today is not a cut. We are not going to have any new welfare cuts in this Parliament, apart from those that have already been legislated for. The decision we have taken is not—not—a cut.
It is clear that different medical conditions will have different impacts on people’s living and mobility. Does my right hon. Friend agree that we must recognise this simple fact if we are to continue to target resources on those who are most vulnerable and most in need?
I do. Indeed, that was the purpose of the original design of PIP. It is better than disability living allowance, which it replaced, precisely because it reflects the reality in individuals’ lives that some will have more difficulty in going about their daily business because of a disability. The PIP benefit is specifically designed in a very careful, and therefore complex, way to achieve that and it does. Ministers have to ensure that the rules are completely clear and that is what we are doing today.
If everything is working so well, why are my advice surgeries full of people who have been waiting for their PIP assessments for a very long time? Long-term disabled people are being denied them and being caused massive amounts of distress by the process. They feel utter despair at having to have anything to do with it.
As I say, an improvement plan is in place, which lets the hon. Lady know that things need to improve. They are being improved, as I explained in answer to the question from my hon. Friend Kelly Tolhurst. I hope Ms Eagle can be reassured by the fact that we are recruiting a team of health professionals to help us to scrutinise the suppliers’ training and assessments. Both suppliers have their own improvement plans in place as well. We will be trialling audio recording of selected assessments from the beginning of next month to understand better how assessments can be improved.
Yes. That point has been made by a number of non-governmental organisations, as well as colleagues on both sides of the House. We are looking at it very seriously.
Some of my constituents are unable to leave their homes without assistance due to a physical disability and some are unable to leave their homes because of a mental disability. Why should one be entitled to receive support via PIP, but not the other?
They will both be entitled to PIP at the level that will be assessed. Each individual is different and has different levels of difficulty. It is often the case that for people who are blind, with visual or cognitive impairments, they will not have a fluctuating condition. It will clearly be less amenable to treatment than some other conditions. It is the level of difficulty in a person’s daily life, whether they have a physical or a mental health problem, that matters in terms of the PIP assessment.
The Secretary of State will be aware that since joining this place I have been a strong campaigner for parity of esteem between mental and physical health. Is not one of the key points he is making that this is not a binary decision between mental and physical health? The point of PIP is that it promotes targeted help for people with mental health conditions. Is it not also the case that more people are receiving payments under PIP for mental health conditions than ever was the case under DLA?
I pay tribute to my hon. Friend for the very good work he has done in his time in the House on mental health. He is absolutely right. A core tenet of PIP’s design is the principle of equivalence between physical and non-physical conditions. The whole House ought to welcome this move. It is why, as he has explained, it is a better benefit than DLA. Rolling PIP out in this way and attempting to improve the assessment process in the way we are is the best way for us to help people with all kinds of disabilities, specifically those with mental health conditions.
I received an email following the remarks of the No. 10 adviser over the weekend. My constituent wrote:
“As someone who has been diagnosed with PTSD and phobic anxiety, I am deeply distressed and angry about his remarks. Considering the current lack of funding and social stigma that mentally disabled people already have to suffer, this is beyond the pale.”
Do the Government recognise the offence these remarks caused, and will they dissociate themselves from and apologise for them?
The hon. Gentleman talks about a Government adviser. I assume he is talking about my hon. Friend George Freeman, who has apologised for his remarks and who has, as it happens, also done a lot of work on mental health issues. As he has explained, he has a personal and family history that makes him particularly sensitive to mental health issues. I hope that the House can accept his apology.
For those of us who deal with vulnerable constituents, it is frustrating to hear these matters described as cuts when they are clearly not. Where in the £50 billion disability budget would savings have to be made to pay for this increase?
Since the purpose of the announcement and the regulations that the Government are introducing is not to have to look for cuts elsewhere, I am happy to say to my hon. Friend that we can avoid those, but he is quite right. We have a welfare budget and are spending more on disability benefits than any previous Government, and we are proud of that fact.
The Liberal Democrats have tabled a prayer on this to try to force a debate, and I thank the Leader of the Opposition for supporting it. A constituent, Katherine, has contacted me concerned about how the amendments will impact on her when she is transferred from DLA to PIP. She currently receives the lower rate mobility component and suffers from attention deficit hyperactivity disorder, depression, generalised anxiety and social phobia. Her life is severely affected by her mental health. She cannot plan the route of a journey or follow the route of a familiar journey. Why do the Government want to deny her the mobility component of PIP?
Katherine will see no change to the rules that have applied to her in the past. I gently point out to the right hon. Gentleman that these rules were passed by a Government of which he was a member.
Yes. Not only will they come under the appropriate descriptor for PIP, but—this has not been mentioned yet—they will receive support from the NHS as well. We have a healthcare system precisely to advise people on issues such as medication, so the state is already doing something to help them. Clearly that is necessary and will continue to be an important part of the system.
Mind says that the proposed changes will affect about 160,000 people and could prevent people from accessing the financial support they need to get to health or job appointments and from getting out to pay for fuel and heating, take their children to school or see friends and families—things essential for their daily lives and recovery. If the Secretary of State is so confident that he is right and Mind is wrong, will he meet representatives from Mind to discuss who is right and who is wrong, and then come back to the Chamber and give the same assurance?
On this issue, yes. As I have already pointed out, nobody is losing any benefit originally awarded to them by the DWP. That is the fact that most needs to be conveyed to those receiving the benefit.
Yes, my hon. Friend makes a correct point, and one that I have made several times in the past few minutes. PIP is a better benefit than DLA for several reasons, perhaps the most important being that it is more available to those with mental health conditions. It always has been. The rules we are putting in place will make sure that it continues to be.
I am happy to assure the hon. Lady that psychological distress is included in PIP assessments. It always has been. Nothing changes as a result of these regulations.
I thank the Secretary of State for the reassurances, given the correspondence I received after the media coverage. Will he go further and confirm that the regulations will not result in anybody receiving less money than they were awarded by the DWP and that there is no intention to make new savings?
People with learning disabilities, schizophrenia and autism—the conditions highlighted by my right hon. Friend Stephen Timms—are more likely to feel anxious about their assessment and experience greater difficulty in conveying information about their condition and, according to my constituents, are increasingly subjected to a more hostile and aggressive assessment process. Does the Secretary of State share my concern that these people will be particularly vulnerable if the proposals are not introduced very carefully?
We are introducing them very carefully. I completely agree that people likely to suffer from anxiety should not be made unnecessarily anxious, which is why I am at pains to reassure them, the House and everyone else that this is not a policy change or a cut. Nobody will receive less benefit than they were originally awarded by the DWP.
Is not the reality of the situation that the disability benefits system, whether PIP or its predecessor benefits, has never been sufficiently sensitive or flexible when it comes to the needs of people with mental health illnesses, and that the court ruling was one small step in interpreting existing regulations—not new ones—to make the system just a little better? Does the Secretary of State not recognise that by rushing out these new regulations, he is changing the interpretation of an existing one, and in doing so will make people with mental health problems and illnesses a lot more anxious and unfairly treated?
The hon. Gentleman makes an important point, but I do not agree with his assessment. The upper tribunal said that the regulations were not clear enough, so we are clarifying them in a way that restores the original intention of the benefit. That should provide certainty to people, not uncertainty.
As ever, my hon. Friend makes a good point. He is right about greater integration, which is precisely why we created a work and health unit. For the first time, my Department and the Department of Health are working together daily for the many people whose needs fall partly under health and partly under the benefits system, so that we can provide a more integrated, personal and sensitive service.
So many of my constituents have had to go through the mandatory reconsideration process all the way to a tribunal to be awarded the number of PIP points they should have been awarded in the first place. Alongside these regulations, does the Secretary of State have any plans to introduce support for disabled people who are awaiting the outcome of tribunal decisions?
The hon. Gentleman makes a point about people who appeal, but only 6% of PIP judgments are appealed—a very low number. We are seeking to improve the system by making sure that more health information is available earlier in the assessment process, which I am sure will help the hon. Gentleman’s constituents.
I have been following exchanges closely, and my constituents will want to know that their MP has understood things correctly. Can the Secretary of State confirm my understanding from what has been said that 25% of PIP claimants now get the highest rate compared with 15% under DLA, and that more people with mental health conditions qualify for PIP than ever did before under the old DLA system?
Yes, my hon. Friend is right in both those assumptions, and I am happy for him to share them with his constituents. Let me add a more specific assurance—that more PIP claimants with mental health conditions claim the mobility component, which stands at 27% as compared with 9% of those on DLA, which is another improvement.
In common with my hon. Friend Ms Eagle, who has just left her place, I have had surgeries at which constituents are increasingly anxious about these changes. Can the Secretary of State please confirm what assessment the Government have undertaken on the impact of these cuts on the already vulnerable mental health status and well-being of claimants, and will he make that assessment available to the House?
The equality analysis is available. I can only emphasise to the hon. Lady’s constituents—[Interruption.]—and indeed to those of the shadow Secretary of State, who is chuntering from a sedentary position, that this is not a change in policy or a cut. Nobody will receive less benefit than they were originally awarded by the DWP. [Interruption.]
There are people on both sides who are chuntering from a sedentary position, which is certainly not something I ever remember doing myself when I was on the Back Benches.
I remember that you sat next to me on those Benches, Mr Speaker.
We have an excellent Secretary of State, probably one of the most caring in the Government, and I am sure that what the Government are doing is correct. As Nick Thomas-Symonds said, however, Members have the opportunity today to highlight the fact that the process of assessment is not working for a number of our constituents. I am fed up with seeing every week a constituent who clearly should have been awarded PIP but is not getting it. Will my right hon. Friend say a little more on how we are going to improve that situation?
I am grateful to my hon. Friend for his kind remarks and indeed for your remarks, Mr Speaker, about the fact that you never chuntered from the Back Benches. This means that I will be able to correct my own memory of those circumstances, having sat next to you on the Back Benches for many years as well.
We are obviously trying to improve all aspects of the PIP process—the accuracy and the speed of the assessments—and, as I have said, the early provision of more objective health information will improve the situation hugely, not least for my hon. Friend’s constituents and others who find the process stressful.
I challenge the assertion that PIP is better for people with mental health conditions. One of my constituents has a diagnosis of bipolar disorder and used to receive DLA on the grounds of a need for continual supervision. This procedure is not recognised under PIP, and my constituent has lost not only her entitlement to PIP but consequently her working tax credit, which was passported via DLA. She is now considering leaving her job. What reassurance does this announcement give to my constituent and others in similar situations?
I can only repeat the facts to the hon. Lady. Over two thirds of PIP recipients with a mental health condition get the enhanced rate daily living component, which compares with just 22% who received the highest rate DLA care. As I have just explained to my hon. Friend Mr Hollobone, for the mobility component, which is the other part of PIP, the relevant figures are 27% and 9%. The facts are incontrovertible. More people with mental health conditions are receiving PIP than used to receive DLA. It is a better benefit for people with mental health conditions than DLA was.
My South Dorset constituents will be relieved to hear what my right hon. Friend said about looking at the assessment process, which goes horribly wrong far too often. Would he give more consideration to home visits and take into account information not only from health officials and GPs but from relatives, families or friends?
Of the many constituents who have come to my surgery with problems over PIP, one particularly sticks in my mind: a man whose long-term mental health issues meant he simply could not get out to work, yet PIP was refused for him. This was not somebody who wanted to sit at home and take pills; he was simply unable to get out there. How can the Government possibly claim to want parity of esteem for mental health when they are trying to enshrine disparity as a result of this change?
It is impossible for me to comment on an individual case when I have not seen the details, but the parity between mental and physical disabilities is embedded in PIP. It is the whole point of PIP. I shall not weary Members by repeating the figures, but far more people with mental health conditions are receiving PIP than used to receive DLA. It may be an uncomfortable truth for Opposition Members, but it is still true.
Why was the Social Security Advisory Committee, in effect, bypassed when this regulation was put through? What consultations has the Secretary of State had with organisations that represent disabled people? What does he say to those organisations that are concerned about his Department’s repeated attempts to award people with mental health conditions who cannot follow the route of an unfamiliar journey alone the lower and not the higher mobility rate?
I spoke to the chairman of the SSAC and explained why I was invoking the urgency procedure, which is allowed. He and his committee still have the power to look at these regulations and make recommendations. The hon. Gentleman will have observed that many Members of all parties have talked about the problems of uncertainty and how they particularly affect many of those people with mental health conditions whom we have been discussing. What we are doing as quickly as possible is removing the uncertainty, meeting the upper tribunal’s desire for greater clarity in the system and restoring it to where it was before, so that everyone understands it. These are the rules under which people have claimed for a long time, providing quick certainty for people, which is what many people want.