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Recent legal judgments have interpreted the assessment criteria for personal independence payments in ways that are different from what was originally intended. The Department presented regulations, which clarify the original policy intent, to the Social Security Advisory Committee. I welcome the SSAC’s careful consideration and we are looking closely at its suggestions.
Let me be clear. The SSAC decided that it did not require the regulations to be formally referred to it and would therefore not consult publicly on them. I believe it was right to move quickly to clarify the criteria, and it is clear that the SSAC is not challenging that decision.
I want to make it clear again that this is not a policy change and nor is it intended to make new savings. This is about restoring the original intention of the benefit, which has been expanded by the legal judgments, and providing clarity and certainty for claimants. I reiterate my commitment that there will be no further welfare savings beyond those already legislated for. This will not result in any claimants seeing a reduction in the amount of PIP previously awarded by the Department for Work and Pensions.
You will recall, Mr Speaker, that on
As the Secretary of State said, the Committee examined this issue on
Parliament has had no opportunity to debate the regulations fully, or to vote on them. When will it be able to do so? The Committee found that
“it is possible that some claimants may have been awarded the mobility component or a higher rate of mobility component…following earlier decisions by the Upper Tribunal on this issue.”
That directly contradicts statements by the Prime Minister and the Minister for Disabled People, Health and Work that no one would see a reduction in their PIP award. Will the Secretary of State take this opportunity to correct the record? Will he guarantee that that will not be the case when claimants are reassessed?
The Government’s decision to change the law on PIP is a clear demonstration of the fact that people with mental health conditions are not given equal treatment. Does the Secretary of State agree with his Department’s new guidance, issued yesterday, which states that mobility impairments caused by psychological issues are “not relevant”? An analysis published today by Scope shows that 89% of PIP cases resulted in successful decisions for claimants following either mandatory reconsideration or appeal. Will the Secretary of State now review the flawed PIP process as a matter of urgency?
We have argued for some time in favour of parity of esteem for mental and physical health. The Prime Minister famously said that there needed to be more support for people with mental health conditions. Will not the Government finally honour that pledge?
Let me deal with the hon. Lady’s questions in turn.
We will of course respond to the letter from the Social Security Advisory Committee. Obviously, we take everything that it has said very seriously. We will also maintain the practice—in which the Government have always engaged—of continuous improvement in the PIP guidance. The assessment guidance is freely available, and can be viewed on gov.uk. We are constantly changing it, and the way to do that is to make parliamentary regulations, which is precisely what we are doing in this case. I am conscious that the hon. Lady has personally prayed against these regulations, which gives Parliament a chance to scrutinise them. That process will go through the normal channels, as it always does.
The hon. Lady asked a number of other detailed questions. I can only repeat what I have said before, and what has been said by my hon. Friend the Minister for Disabled People, Health and Work: no claimants will see a reduction in the amount of benefit that they were previously awarded by the DWP. The Committee says that a tribunal may have lifted the awards of some people, and it is indeed possible that that has happened. We will not claim back money that those people have received during the period before the new regulations come into force, and no one will receive less than they were awarded by the DWP. That is what I have said all along. [Interruption.] As the hon. Lady knows, reassessment happens regularly in the case of PIP and other benefits.
Let me now respond to a very serious point made by the hon. Lady. I want to clear up the position and reassure people, because I think that millions would be put into a state of unnecessary distress if they thought that PIP was not fair to those with mental health conditions. The truth is that PIP is a much better benefit for people with such conditions than its predecessor, disability living allowance. Under the regulations, people with a cognitive impairment alone can receive the highest rate of the mobility component of PIP. It is simply not the case that people with mental health conditions will not be able to do so. If the hon. Lady reads the regulations, she will see why that has happened.
Even if the hon. Lady and other Opposition Members are not willing to accept what I have said, may I please ask them to go away and look at the facts? The facts are these: 65% of PIP recipients with a mental health condition received the enhanced-rate daily living component, whereas 22% used to receive it under DLA. As for the specific mobility aspect, to which the hon. Lady referred. 27% of PIP recipients with a mental health condition receive the enhanced-rate mobility component, whereas 9% received it under DLA. It is perfectly clear from the facts that the regulations restore PIP to its original policy intent, and that that policy intent is better for people with mental health conditions than earlier benefits were.
Can my right hon. Friend name any other country that spends as much in direct cash payments to people living with as wide a range of physical, mental and psychological disabilities and illnesses as we do here in the UK? Is that not something we should be proud of?
We should indeed. My right hon. Friend previously did this job, and he and I share the passion to make sure that the benefit system is as fair as possible to those who deserve to receive these benefits. That is why we spend £50 billion a year on disability benefits and why PIP is an improvement on previous benefits, particularly for people with mental health conditions.
The Government continually trot out the line that serious mental ill health should be treated in the same way as any other illness, but their response to these rulings betrays the old attitudes and stigmas towards mental illness. They cannot keep shifting the goalposts every time they lose a battle at court. If a person needs help, he or she needs help regardless of the nature of their disability or health condition.
The Scottish Parliament is in the process of taking over responsibility for personal independence payments, and until that time the UK Government need to be consistent and stop mucking people about. So many of the people becoming destitute in our communities, being sanctioned, falling through the safety net, and becoming dependent on food banks, are people with mental health problems. Why will the Government not acknowledge that? Will the Minister back away from this ill-judged move, or are they intent on bulldozing this through regardless of the opinions of this House?
I can only say to the hon. Lady that the premise on which she based that question—which is that those with mental health conditions, as opposed to physical disabilities, are in some way being treated unfairly under this benefit—is simply and demonstrably wrong. I will not weary the House by quoting again the facts I have just quoted, but if we are to have an intelligent discussion about the details of benefit policy—this House deserves to have such a discussion—we have to base it on the facts, and the facts are that PIP is a better benefit for people with mental health conditions than the old disability living allowance.
The Government are rightly spending an extra £3 billion a year supporting those with long-term health conditions and disabilities. Does the Secretary of State agree that if we are to continue to improve the system, that should be done in conjunction with the expertise of charities, stakeholders and users, and not be based on ad hoc legal decisions?
My hon. Friend, who obviously has great personal expertise in this area, is precisely right. There is a continuous dialogue between the Department and the charities. Sometimes we agree and sometimes we do not agree, but that dialogue is very important and I am determined to maintain it precisely so that when we make changes they are practical changes that make sure that the original good intent of the benefit is maintained.
Despite what the Secretary of State says about the current benefit favouring those who do not have physical disabilities, the evidence coming to the Select Committee which is inquiring into PIP shows that those with other disadvantages find it difficult to qualify. Might he look carefully at the form and at the way his staff interpret it for people who do not have physical disabilities and who have difficulties in qualifying?
The right hon. Gentleman knows that there is a review going on precisely to address the points he very reasonably makes. Clearly, there is a degree of complexity with any benefit and we will need to keep working on it. We are waiting for the review carried out by Paul Gray, chairman of the SSAC. Knowing Paul, I am sure he will have some trenchant recommendations, and we will obviously look at them very carefully and use them as the basis for further improvement of this benefit.
While I agree that PIP is indeed a big improvement on DLA and that nobody stands to lose from this change, for me the court ruling has highlighted the fact that there are still flaws in the PIP process and that more can be done for mental health claimants; I know that as I have sat through two PIP assessments myself. Therefore, rather than just legislating to ignore this ruling, should we not use it as a catalyst to look at the whole PIP process from the beginning?
My hon. Friend is right that we need continually to look at improvements, and I think they are done better as part of a coherent process rather than as a result of individual court judgments. I am sure that she will agree that the improvements in the benefit system need to go hand in hand with the many improvements we are now beginning to see in the health service’s treatment of people with mental health conditions. All of this must be tackled as a coherent whole across government so that we improve all the services available to people with mental health conditions.
I have to say that I am finding an increasing discrepancy between the way that the Secretary of State is describing the PIP benefit and the people who are coming to my advice surgeries in tears having been completely let down by the system. We all want to see a society where we give support to the most vulnerable, and that is who we are talking about here. Will the Secretary of State now undertake to ensure that some of his highest officials come and visit us in our advice surgeries and look at how this system is actually working out on the frontline, because it is not remotely like how he is portraying it today?
We all know from our own constituency surgeries that there are individual cases that might need to be taken up, sometimes simply because people disagree with a decision, or if there are delays. I am absolutely aware of that. [Interruption.] I point out to Debbie Abrahams, who is characteristically chuntering from a sedentary position, that the appeal rate against PIP is extremely low, so actually the facts again do not suggest those kind of problems. But we are absolutely keen to improve this. That is why in the coming weeks we will be setting up service user panels precisely so that we get the real world, on-the-ground experience available to the Department that the hon. Lady wishes us to have.
I appreciate my right hon. Friend’s concern. The committee makes a number of recommendations, and, as ever with the SSAC, I will take all of those recommendations very seriously and respond to them fully.
My hon. Friend Tim Farron has tabled an early-day motion signed by 143 Members, including the Leader of the Opposition. Why are the Government so keen on ignoring this place and Parliament and on bulldozing this unpopular change through? Will the Secretary of State agree to a proper debate in this House on this unpopular measure?
Since, I think, this is the second time that we have discussed this issue in a week, it is hard to argue that Parliament is not having a say. We have followed the usual procedure: we have tabled a statutory instrument, which the hon. Gentleman and his party leader, Tim Farron are free to pray against, and that then goes through the usual channels. This is a perfectly normal procedure.
There appear to be two most frequent misunderstandings about the legal judgments: first, that the Government amendment amounts to a cut, and, secondly, that people with mental health disabilities get less under PIP than under DLA. So will my right hon. Friend confirm again that actually there is no cut at all to people who have been previously awarded through PIP, and, secondly, that actually those with mental health disabilities get more under PIP than they did under DLA?
I am happy to reassure my hon. Friend that nobody who had an award from the Department for Work and Pensions will have that award reduced, and indeed that PIP is demonstrably a much better benefit than DLA for people with mental health conditions. Is there room for improvement? There is always room for improvement in life.
This is a cut and it directly targets people with mental health problems. The regulation, which is taking effect tomorrow, inserts into the qualifying conditions for PIP, in the section about planning and following a journey, the phrase
“For reasons other than psychological distress”.
Why is psychological distress being carved out in this way, and a cut made as a result?
I am afraid that the right hon. Gentleman is simply wrong in his premise. A person
“with cognitive or sensory impairments who cannot, due to their impairment, work out where to go, follow directions or deal with unexpected changes in their journey ” even when the journey is familiar, would score 12 points under descriptor F on mobility activity. I apologise for getting into the technical weeds here, Mr Speaker. Hence, that person would be entitled to the enhanced rate of the mobility component. That is the situation that pertains now, and that is why more people with mental health conditions are getting the higher rate of PIP—three times as many as did so under DLA—so it is simply not the case that this discriminates against people with mental health conditions.
Will the Minister ensure that the mobility factor in PIP is maintained? It is important to all of us in the community. It is vital for all of us that our friends and family who have mental health problems, dementia or cognitive problems from strokes are out and about and visible in our community. Can he assure me that the descriptors and assessments are formulated according to need, and that no condition is ever excluded?
My hon. Friend’s last remark is precisely right, and I can give her the assurance that she seeks. PIP is about the effects on daily life or on mobility. It is not based on the underlying condition. That was the key change when PIP was introduced, and of course we are maintaining that.
I want to understand exactly what the Secretary of State said a few moments ago when he said that nobody would face a cut in their benefit. Did I understand him correctly when he said that, while people would not see their initial DWP benefit award cut as a result of these regulations, they could see their benefit reduced to the original award level when the benefit has been increased by a tribunal and these regulations now supersede the judgement of that tribunal?
That is indeed what I said. We think that there may be a handful of people whose appeals have gone through the courts in this very small period, and that money will not be clawed back from them. That is what I said earlier on.
“The PIP assessment will look at disabled people as individuals and not just label them by their health condition or impairment.”—[Official Report,
Vol. 554, c. 148W.]
I am happy to confirm that to my hon. Friend. I think that he and I would agree that that was a significant step forward when it was introduced, and I am determined that we maintain progress in that direction so that people who have a disability—whether a physical or mental impairment—can lead as full a life as possible.
I agree with the Minister that we need to have a discussion on this whole issue. However, these changes have been introduced without such a discussion, and the assessment has been made that 160,000 current claimants will be ruled out as a result of the changes. Does the Minister dispute that? Is he contesting his own Department’s assessment?
No. I think that the hon. Gentleman has slightly misunderstood the effect of the court case. I am not changing anything; I am just putting forward regulations that restore us to where we were in November. The court case said that the regulations were unclear and suggested changes that would indeed, conceivably, apply to very large numbers of people. So what we are doing with these regulations is simply returning to the position that was there before.
It is appropriate to be discussing this on the day on which the Devon Partnership NHS Trust’s mental health services have been rated “good” by the Care Quality Commission. This marks some improvement. Given the erroneous comments that we keep on hearing about cuts, will Secretary of State confirm that the constituents who are getting in touch with me who have had an award from the DWP will not see any reduction in what they are receiving?
Further to the Secretary of State’s response to my hon. Friend Kate Green, will he confirm that he is saying that some people who have been awarded additional resources by a tribunal will see their income cut as a result of these regulations? Will he also confirm that an extraordinary number—89%—of the relatively low number of appeals relating to PIP are overturned? Does that not show that there is something deeply wrong with the system?
I think the problem that the hon. Gentleman identifies with the system as it is running at the moment is that a huge number of the very small number of people who go to appeal introduce new evidence during the appeal process. That is the main reason why the figures are as he says. It is clearly better all round—not least for the avoidance of delay for claimants—if we can get all the medical evidence in at the start of the process. That might well preclude the necessity of any kind of reassessment or appeal in the first place.
I am grateful to my right hon. Friend for the clarification that he has provided today. What steps is he taking to meet and engage with charities and other stakeholders to clarify the impact of these regulations?
The Minister for Disabled People, Health and Work and I are in constant contact with charities and other groups concerned with this area, precisely because we want to improve the system in a systematic and coherent way so that we are not simply responding to individual cases in front of the courts. I am sure everyone would agree that that is a more sensible way to proceed in continuing the improvements we have seen under PIP.
I asked the Secretary of State this question two weeks ago. If he is arguing that the purpose of PIP is to cover the extra costs that people incur because of a disability, why are those with mental health conditions being paid a lower rate than someone with a physical disability if they struggle to plan or follow a journey?
They are not. I can only repeat what I have said before, and if necessary, I will quote the facts again, or the detailed case that I gave to Stephen Timms. I could go into the details, but I suspect that your patience would be tested by that, Mr Speaker. Do you want me to read the descriptors out again? [Interruption.] But seriously, the point is that it is perfectly possible to qualify for the standard rate or the enhanced rate purely with a mental health condition, so it is not the case that people with mental health conditions are discriminated against.
Let me read it out again. A person
“with a cognitive impairment who cannot, due to their impairment, work out where to go, follow directions or deal with unexpected changes in their journey”,
even when the journey is familiar, would score 12 points under descriptor F on mobility activity 1, which covers planning and following journeys, and hence be entitled to the enhanced rate of the mobility component. Examples of such conditions could include dementia or a learning disability such as Down’s syndrome. I hope that that reassures you, Mr Speaker, and the whole House.
I want to press the Secretary of State on the question of assessments. Will he look again at the quality and professionalism involved? I just cannot understand why some of the people who come to see me have not been awarded their benefit. I have had experience of cases such as these over a number of years now, and I have never come across such difficult cases as those I have seen recently.
I am happy to reassure the hon. Gentleman that I am already doing that. As I said in answer to a previous question, the chairman of the SSAC is doing one of his regular reports on PIP as a whole, and that will focus very much on the quality of assessments. I take the hon. Gentleman’s point, and we are all concerned to ensure that the assessments are not only of high quality but consistent across the country. That is an important improvement that I want to see in the system.
I can confirm that, and I have already quoted the specific figure for disability benefits. We now spend £11.4 billion on mental health services every year, and we will be spending more on disability benefits in every year of this Parliament than was spent in 2010.
In the view of the mental health charity Mind, the new regulations and guidance contradict the stated aims of the primary legislation. What information has been transferred to the Department for Communities in Northern Ireland, where parity applies, regarding the new guidance? Will the Secretary of State ensure that the regulations are taken off the table to allow a full debate in Parliament and to ensure that nobody with a mental health impairment is financially penalised in any way?
I can only repeat that the regulations, which are being returned to their original state, do not discriminate against people with mental conditions. If anyone observing these proceedings is unnecessarily worried by that assertion, I regret that. I am happy to assure the hon. Lady that the Minister for Disabled People, Health and Work has made direct contact to ensure that information is flowing properly.
The only clarity and certainty that PIP is bringing to my constituents is real distress every day. At 12.14 pm today, I received an email that said:
“I would be grateful if you would contact PIP and address my complaint about taking PIP off me. I do fear that this has caused me to consider taking my own life”.
Complaints of that type come in to our constituency surgeries on a daily basis. The system is broken. It needs to be completely revisited and reconstructed. It cannot be mended.
I do not agree with the hon. Gentleman. Any benefits system will obviously have difficult individual cases, and decisions have to be made, but to say that the whole system is broken is going much too far. I can only point out that just 3% of all PIP claims are overturned on appeal, which suggests that the benefit is largely working for the vast majority of people who receive it, but there will always be individual cases where people disagree with the assessment.
It is clear from the Social Security Advisory Committee’s letter to the Minister for Disabled People, Health and Work that there is some confusion outside the Department about the policy intent and the psychological distress of planning and following a journey. We need much greater communication from the Department, so when we can expect an updated version of the PIP assessment guide?
As I am sure the hon. Lady knows, we redo the assessment guide on a regular basis, and the next changes will be available in the next couple of months. It is freely available on the internet for hon. Members to view. It is not some secret guide that goes out to assessors from the Department; all the guidance is public.
Only last week, I was contacted by a constituent who has been refused PIP despite having previously been in receipt of DLA. She managed to get to her assessment only because her daughter took her and supported her through it. However, the physiotherapist who did the assessment said that her mental health issues were insignificant because she had managed to attend and to communicate with him. Does the Secretary of State agree that for the process to be fair, the person doing the assessment should, as a bare minimum, be qualified in the appropriate medical specialty?
It is obviously impossible to generalise from one case, but if the hon. Lady wants me to look at that case, I will be happy to do so. We are determined to maintain the highest levels of professionalism among the healthcare professionals who do the assessments.
The transition from DLA to PIP has been incredibly distressing, and the new assessment criteria and the number of Motability cars that have been returned only to be reissued on appeal are just two examples of why. Now there is this rushed, unscrutinised decision. Given the repeated questions from Members on the Opposition Benches about constituency cases, is the Secretary of State concerned about the erosion of our constituents’ trust in the system?
No, because I do not believe that to be the case. Of the many people who receive PIP, vast numbers find it satisfactory and a better benefit than DLA. Specifically on mental health conditions, far more people receive PIP than received DLA, so I just do not accept the hon. Gentleman’s basic analysis of the situation.
Will the Secretary of State guarantee that no PIP assessors are required to turn down a quota of their assessments? I find it impossible to understand some of the decisions they make. There can be an arm’s length of medical evidence in front of them, but they turn some people down, particularly those with mental health issues. If he does not know the answer, will he go away and investigate the situation? Something is wrong. So many examples have been given to him that he cannot dismiss them as the odd case.
I refer the House to my entry in the Register of Members’ Financial Interests. As chair of the all-party parliamentary group for disability, people from across the UK continually contact me to say that the process contains little assessment of psychological problems and does not seek information from mental health practitioners. The Secretary of State must be aware that a cognitive impairment is just not the same as a mental health problem. In fact, neither dementia nor a learning disability, the examples he gave, is a mental health problem, so he should go back, do his homework and find out what a mental health problem actually is.
I can give other examples that do include mental health issues, but I understand the hon. Lady’s point that there are obviously different forms of condition. Cognitive impairment is not necessarily the same as a mental health impairment, which covers a much wider and, in many cases, different range of conditions. However, all of them are covered fairly by PIP, so the contention from Opposition Members that the benefit is somehow bad at source is wrong. I can see that when I look at the number of people receiving it, particularly those with mental health conditions, who have not received any benefit in the past. I hope that the House will acknowledge that fact.
I have been listening to these exchanges, and I am trying to judge to what extent there is controversy over PIP. There clearly is controversy in this Chamber, and I do from time to time get letters from constituents regarding PIP. However, will my right hon. Friend indicate what percentage of total claims are disputed?
As I have just said, 3% of all claims are overturned on appeal. Now 3% represents many cases, and as I have said various times today, I am always looking to improve the situation and ensure that assessments are better and more consistent. However, having only 3% overturned does not give rise to the picture painted by many Opposition Members that the system is in some way broken.
I am not entirely clear about the hon. Lady’s last point. I am unsure whether she wants a target percentage of GDP for particular benefits, which seems a slightly odd way to run the welfare state. On her first point, I do not want to weary the House by repeating what I have said before, but ensuring that people with mental health conditions have proper access to benefits is and always has been extremely difficult. We are spending so much money across Government—£11.4 billion this year—on mental health conditions precisely to remove some of the barriers preventing people from claiming benefits to which they are entitled.
Earlier, the Secretary of State blithely said that there would be further updates and guidance in a couple of months. A couple of months is not good enough. What is he doing now to make sure that assessors have the correct information to properly assess claimants and provide them with the support they need?
Assessors work from the PIP assessment guide, which is available for scrutiny by Members and the public. Assessors are given that guidance in the most transparent and public way possible.
The Royal College of Psychiatrists, charities including Rethink Mental Illness and Scope, the Select Committee on Work and Pensions and many of our constituents all tell us that the Government are failing properly to support all disabled people who need help. Now the Social Security Advisory Committee has said that the Government should not proceed with the changes without further testing and consultation. What does it take to get the Secretary of State to listen?
I do not agree with the hon. Lady’s characterisation of what the SSAC said. The SSAC has the power to consult if it wants to recommend that we should not proceed, and it has specifically decided not to do that kind of consultation. Her characterisation of what the SSAC has said is off beam.
Thousands of disabled people who rely on the Motability scheme have had their car removed by this Government. In November 2016 the Minister for Disabled People, Health and Work said that the Government were looking at allowing PIP claimants to keep their car pending appeal, and possibly at widening access to the scheme. Three weeks ago the Prime Minister was unable to answer my question and update the House on the progress of that review, and she promised to write an as-yet undelivered letter to me. Can the Secretary of State update the House today?
I call Mrs Mary Glindon.
Further to a previous question, Muscular Dystrophy UK has said today that figures show that 900 mobility vehicles a week are being removed from people due to the PIP reforms but that many of the vehicles are subsequently returned on appeal. Will the Government ensure that a mobility vehicle cannot be taken away from any individual until there is a final decision on their eligibility for the enhanced rate?
We constantly work closely with Motability and, as I said in answer to Gavin Newlands, we are currently reviewing the whole scheme, so I pray the House’s patience while we conduct that review.
Thank you very much for spotting me, Mr Speaker. The Secretary of State seems to think—he has said it several times now—that just because we prayed against the statutory instrument, we are bound to have a one-and-a-half hour debate and a vote. That is completely untrue. The only person who can guarantee a debate and a vote is the Secretary of State. I promise not to tell anyone else, but if he could stand up now and be completely unambiguous in telling us that we will have a debate and a vote in this Chamber, we would be very grateful.