Health and Disability Reform - Statement

Part of the debate – in the House of Lords at 6:43 pm on 1 May 2024.

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Photo of Baroness Sherlock Baroness Sherlock Shadow Spokesperson (Work and Pensions) 6:43, 1 May 2024

My Lords, I am grateful to have the opportunity at last to ask some questions about this Statement, because the route here has not been pretty or swift. The Prime Minister made a speech on 19 April about the need to reform sickness and disability benefits. Cue lots of headlines about sick note culture and the need for a crackdown. Then, there was silence: 10 days of expecting a Statement which did not come; 10 days of asking for detail; 10 days during which, if noble Lords are anything like me, they will have had a succession of messages from sick and disabled people who were very anxious about what was going to happen to their benefits.

When the Secretary of State finally talked, it was not to Parliament but to the media, of course, so we began to find details there. The Telegraph ran the headline, “Disability benefits could be vouchers, not cash”. The Sunday Times said, “Depressed and anxious face losing … benefits”, with the sub-headline, “Tories plan welfare reform as election divide”. I sorry to say it, but there we have it. The Secretary of State was quoted in the Sunday Times as saying that

“it was ‘extraordinary’ that Labour was refusing to say whether it supported his benefit changes”.

At this point, there was no document, there had been no Statement in Parliament, and no details were available. In fact, when the Statement was made in Parliament, the Secretary of State did not even observe the usual courtesies of giving an advance copy to the Speaker and the shadow Secretary of State. I do not know why the Government would sit on the Statement and document for 10 days and then publish them in the week of the crucial local elections—it is a mystery.

Now we have the details, although it is not very detailed. I read the Green Paper from cover to cover, and if you exclude questions and the padding in the annexes, there are 14 pages of content. The Green Paper could hardly be any lighter green.

How did we get here? In 2013, the Government abolished disability living allowance and created PIP. According to the Green Paper:

“PIP was intended to differ from DLA by being fairer (by paying greater regard to needs arising from mental health, sensory and cognitive conditions)”.

It was also to be

“more consistent … objective … transparent … sustainable … modern and dynamic”.

The Government committed to undertake an independent review of PIP after two years and again two years later. There have been two consultations covering PIP since then.

Then, in July 2021, the Government published Shaping future support: the health and disability green paper, which launched a consultation on PIP and ESA. Nearly two years later, in March 2023, the Government published a health and disability White Paper which set out the Government’s vision

“to help more disabled people and people with health conditions to start, stay and succeed in work”.

That paper announced the plan to remove the existing universal credit limited capability for work and work-related activity element and replace it with a new universal credit health element. It was also going to abolish the work capability assessment, which was people’s gateway to those benefits, so there would be only one health and disability functional test in future: the PIP assessment.

Now, a year after that White Paper, we are back to a Green Paper, which proposes abolishing the PIP assessment. What is going on? How will anyone be assessed for anything? Will the Minister tell us what happens to people who are clearly too sick to work at the moment but are not disabled? How will they have their support assessed when there is neither a work capability assessment nor a PIP assessment? Is the plan still to have a new universal credit health element, or is that under consideration again as well? The Government suggest that some health conditions can be taken out of PIP assessments. Can the Minister tell us which conditions they have in mind? PIP is also passport to the carer’s allowance. How will that work if there is no PIP assessment? Do people risk losing their benefits and their personal care from family or friends at the same time?

The Government said that DLA was the problem and PIP was the answer; now it seems that PIP is the problem. The fact is that we have a problem in this country: we have a record 2.8 million people locked out of work due to long-term sickness. But what or who is to blame? How much of that is down to the Government's record on the NHS? When the Statement was debated in the Commons, the chair of the Work and Pensions Select Committee pointed out that:

“PIP assessment providers confirm that worsening delays in NHS treatment are a big factor in the increase in the number of people applying for PIP”.—[Official Report, Commons, 29/4/24; col. 52.]

We have also been hearing strong hints that the real problem is people with mental health problems. I do not doubt the Minister on this, but politicians in general need to be very careful about how we speak about mental health, for risk of stigmatising people or making them afraid to speak out or seek help. Can the Minister say whether the Government’s plans involve treating people’s mental and physical health differently? If so, can he explain the legal basis for making such a distinction? Can he also say what the Government will do about the near impossibility, for many people, of getting any timely mental health support at the moment?

A Labour Government would take a different approach. Among those who need the help of the state, there are some people who are temporarily or, in some cases, permanently unable to work and who need support to have a decent life. There are many others who need extra help to get, keep and advance in a job, and it is the state’s job to give that to them. For those people, health and work are two sides of the same coin.

Rather than blaming people for being sick, a Labour Government will support our NHS. The last Labour Government delivered the highest patient satisfaction level on record, and that is the record on which we want to build. We will drive down NHS waiting lists by getting patients treated on time, with 2 million more weekend and evening appointments, and we will ensure more support for those with mental health problems through an extra 8,500 mental health staff.

We will focus constructively on work, the other side of that coin, because the costs of failure in this area are a disaster for individuals and the country. Where it is possible, work is good for us—for our mental and physical health. Labour will have a new deal for working people, improving rights for the first time in a generation. We will drive up employment in every region, devolve employment support and end the tick-box culture in jobcentres. We will tear down the barriers to work for disabled people and provide help for young people.

Labour will carefully review the issues raised by this latest Green Paper. Clearly, sick and disabled people need appropriate help and support, but we also want to be a country where disabled people have the same right to a good job and the help to get it as anyone else. We will judge any measure that the Government bring forward on its merits and against that principle. I look forward hearing more from the Minister.