My Lords, it is a pleasure to follow the noble Baroness, Lady Bennett. I support the regret Motion tabled by my noble friend Lady Stedman-Scott for the reasons that she set out so clearly in her excellent introductory speech. But before I go into that, I too want to say what a delight it is to see the Minister, the noble Baroness, Lady Sherlock, on the Front Bench.
As has been said already, these regulations look like they are just simple administrative regulations. They look like they might be just fixing the backlog and look like they might be benign. Of course, nobody wants vulnerable claimants to lose their entitlements to those really important benefits because the department has not conducted a review on time. But that is not what we are debating here today. What we are, in effect, saying, is that it is acceptable for the Government to respond to a system that is failing by suspending one of the few safeguards that exists within it.
If we all cast our mind back to when the personal independence payment—or PIP—system was introduced, it was never intended to be a benefit that just rolled on indefinitely after it had been awarded. When Parliament debated and agreed the PIP system, the whole point of it was supposed to be based on the fundamental understanding that conditions can change over time and can get worse but can also get better, so you should not just lock somebody into a system of benefits and never look again. That is a fundamentally pessimistic way of looking at human lives.
I listened to the speech by the noble Lord, Lord Davies, and he was obviously very critical of the former Government. I am sure that he is probably right on a lot of those points—I am not an expert so I cannot possibly go back over 14 or 16 years of that history—but, at the end of the day, the current Government have been in power for more than two years, so there must come a point when they now need to take the responsibility for fixing what is currently presenting in the system and looking at the things that have happened on their watch.
If the department does not have the capacity to conduct the reviews, the answer cannot be to abandon them. We need to look at the root cause. Why do we have this backlog? Why do we have so many more claims in the system and this lack of capacity? It is due to the unprecedented rise in the number of people claiming disability and benefits. The growth, as has been said, is particularly striking among younger people claiming on mental health grounds. We have a social security and welfare system that is increasingly being asked to compensate for not just severe disability, which we all agree it should do, but a large and growing number of mental health conditions, such as anxiety, mild depression and ADHD, which would not have been recognised as disabling just a generation ago or even more recently.
Before I came into the Chamber, I saw somebody putting a comparator on X. I do not have the citation, but it is very interesting and I urge the Front Bench and everyone to look at it. The rise in mental health conditions and mental health disability is proportionately much greater in this country compared to about 40 other developed nations. We in the UK are not biologically different or biologically more likely to be disabled because of mental health than people in countries such as France, Germany, Canada, Korea, China, Singapore and so on, so we need to start asking ourselves some of those hard questions. I have spoken in this House on a number of occasions—
Does the noble Baroness acknowledge that we should look at our society and ask why we might be suffering from higher levels of those conditions, and why people are not able to find a place in our society, as well as looking at biology?
I am sure the noble Baroness is right, and I thank her for that point. She has posed a very broad question, and I fear I would detain the House for much too long if I tried to answer it with the seriousness it definitely deserves.
I want to touch on a few themes. I have spoken in this House on a number of occasions about what I and a growing number of others regard as the growing medicalisation of ordinary human experiences—just life experiences. We do not do people any favours if we do not distinguish between severe and enduring mental illness, and the very broad spectrum of distress and difficulty that finds its way into our welfare system in one way or another. This is at the root of my worries about these regulations, because every change that reduces scrutiny or delays reassessment sends a signal that says to that person, “Now you are in this system, we expect you to remain there. Just carry on. You are getting the benefits. We have decided that this is the thing that is making your life difficult, and we are going to support you”. It is not saying. “We are looking at you through an optimistic lens about what we can do to help you move off this system”.
Reviews are not just a mechanism for saving money, but that is important. People have mentioned the Timms review, and I am sure it is an excellent piece of work. There are many good points in it. My real worry is that the Minister, when interviewed about this, said that he did not have any worries about the level of welfare spending. That is completely unrealistic; it is fantasy. We should be concerned about the level of welfare spending in this country. It is completely unacceptable, unsustainable, wrong for the taxpayer and wrong for people who are on welfare.
This debate and these regulations risk masking the true scale of the problem. We should be expecting Ministers to explain why they think this is acceptable. It is great that the Minister is here today, but we should be having a much more in-depth debate. We should be asking much bigger questions. Why do we have so many young people, in particular, in this system? Why are we diagnosing them with these mental health conditions that mean they are receiving welfare, PIP and other benefits? Why are we allowing this welfare system to reinforce itself and reinforce a life on benefits for some of these people?
I support my noble friend’s regret Motion, and I will certainly vote for it if she divides the House.
My Lords, I am grateful to the noble Baroness, Lady Stedman-Scott, for introducing her Motion. I am also grateful to all noble Lords for their contributions, and I appreciate their many kind words. If I had even a moment’s thought that they meant I would get away with anything at all, this debate has made clear that I definitely will not—but I would not expect to. I enjoy our discussions too much, and they are too important, for me to expect to get away with anything.
I am going to do my best, but we have had a pretty broad debate that has taken us from the nature of our society and demographic changes through to Chips Channon’s experience of wartime. I am not convinced that I will manage to cover the whole territory—it is a lot of weight for a relatively small measure to bear—but let me see what I can do.
The measure we are discussing today relates to how we assess eligibility for benefits, but the context of this change does matter. The fact is that the system of sickness and disability benefits that we inherited was simply not fit for purpose. This Government have begun taking steps to address the structural problems. We have legislated to rebalance the support provided in universal credit. The Timms review, which was mentioned, is looking in detail at the way in which the personal independence payment, or PIP, works; its final report is due in the autumn.
In the short term, we need to take steps to help repair the system we have. This measure grants the Secretary of State the ability to extend awards to make the most efficient use of resource. In doing so, it provides a much-needed safeguard against potential future challenges in order to protect payments to vulnerable people. The noble Lord, Lord Palmer, is right that we have to make the right choices about how to use resources; that is key to what we are doing today.
Under the contracts with assessment providers, which were negotiated by the previous Government, the reality is that we can call on only a finite volume of assessment capacity. We could carry on using a large part of that capacity on frequent reassessment of PIP claimants whose circumstances will most likely not have changed, as the previous Government did. However, we want to use that finite resource in a more productive way.
These regulations enable us to administer the system more efficiently and do more work capability reassessments, clearing that backlog and thus delivering savings down the line.
Secondly, we want to increase substantially the proportion of assessments carried out face to face. They used to be pretty much all done face to face; then came the pandemic and, for reasons we all understand, they were switched to being phone-based, with some video assessments. But once the pandemic went, face-to-face assessments were never properly switched back on again. As my noble friend Lord Davies pointed out, telephone was retained as the main channel, with just a few face-to-face assessments starting back in 2021. We just do not think that is good enough.
At the time of the general election, only about 7% of WCAs and PIP assessments were carried out face to face. We want to do better. I take the point made by the noble Baroness, Lady Maclean of Redditch, that we absolutely have to address the problem, so we are going to do that. We have already started to rebuild the capacity. We have begun to increase the proportion of WCAs and PIP assessments carried out face to face, on our way to a target that at least 30% of both will be so. To achieve that, we will need additional assessment resource; this measure will help us to obtain it.
The assessment system simply was not equipped to do the job. There were contractual limits that, at most, 20% of assessments would be done face to face, but the fact is that there was not nearly enough capacity even to do that, so we are having to fix the system to be able to do it. Before this amendment, a decision to extend an award of PIP meant there had to be one of: a new claim; evidence of an error or mistake with the decision; evidence that a claimant’s circumstances had changed; or a report being completed by a healthcare professional appointed by the Secretary of State, which in many cases would involve an assessment.
As my noble friend Lord Davies pointed out, where such a decision could not be taken before an award expired, claimants would simply cease to be entitled to PIP until a further decision was completed. This amendment to the legislation grants a specific discretion, enabling only the length of an award to be extended, and only where doing so is necessary for the administration of the benefit. That protects vulnerable claimants who risk losing entitlement to PIP when circumstances threaten to limit the capacity to administer it. We saw that during the pandemic and we see it now, when assessment supply simply cannot meet demand.
Initially, this Government will use this new power to increase the length of a large number of existing awards in line with the policy on award lengths for new awards, for which the Secretary of State already has the power, and in doing so to improve efficiency and ease the burden on the health assessment system. Existing claimants’ awards will be extended, so that most first-time awards for those over 25 are for three years’ duration and most subsequent awards are for five years. Only awards deemed appropriate for these durations will be extended.
Let me look at some of the questions that have been asked. First, on the size of the benefits bill and the increase, it is worth pointing out that while PIP is going up—there is no question about that—in fact, the rate at which it is going up has fallen under this Government. It fell from around 13% a year for the period 2019-20 to 2024-25 to the current forecast of around 7% a year from 2024-25 to 2029-30. It is still going up, and that is a huge pressure, but the rate of increase has declined and we are working on that. I have explained why we believe this measure will help us to do a better job.
Briefly, in response to the noble Lord, Lord Shinkwin, I cannot get into the whole issue of defence spending and where that takes us for taxation, but we simply do not think it is a zero-sum game between social security and defence—between welfare and warfare. The defence investment plan will provide a significant increase in defence funding and we have set out our targets for increasing defence spending. But our aim for welfare reform is actually designed to help long-term sick and unemployed people to get back to work; that is the game of this.
If I have time later, I will talk a bit more about the Milburn review, but my Secretary of State has looked at what is happening with young people and the very large numbers of them who are economically inactive. He has said, “Look, the system at the moment says to a young person in this situation, ‘What benefits do you need?’, when what we should be asking is, ‘How do we help make your life better? What do you need to turn your life around?’” That may be services or support; it may well be a job, work experience, training or skills. With the Milburn review, we are looking right across that to see how we bring together all that support to give people the opportunities that they really need.
In response to the noble Baroness, Lady Stedman-Scott, this power is limited, as my noble friend Lord Davies said, by considerations such as that it must be necessary for the efficient administration of the benefit. These are strong legal terms and show that it can be used only in limited circumstances where necessary. As I explained, the policy on minimum awards will apply to most claimants aged 25 or over, but exceptions to the policy will be applied to those expected to recover or make significant improvements within a shorter timeframe, who will therefore get a shorter award. Longer review periods can still be made for individuals with the most severe or long-term conditions. We do not want to be having unnecessary reviews; we want to be reviewing the right people. There is no maximum period and the regulations will continue to give longer awards where appropriate, as I said, and shorter ones where necessary.
I was asked: why younger people? Given that spells of unemployment and inactivity at a young age have clear long-term scarring effects, we do not want young people whose functional capacity has improved to be on PIP any longer than necessary. We are therefore not applying the wider policy change or these regulations to young people, who will continue to be assessed as now.
There was a question about whether claimants are going to lose out by this. Obviously, we are absolutely committed and, in response to the noble Lord, Lord Palmer, we want disabled people to have the support they need to live independently. If a claimant’s condition is to deteriorate or improve, they should still report a change of circumstances for their award to be reviewed. Claimants have a duty to report a change of circumstances; that is something they must do. Whether the condition deteriorates or improves, they have a duty to report it. That could result in an award review at that stage, and they can report a change at any time.
The noble Baroness, Lady Bennett, talked about the experience of people in PIP. I can tell from what she said that she has read the Timms review interim report. In the responses to the call for evidence put out by Timms, people told the steering group that while PIP is widely valued, they found the assessment process dehumanising and stressful, and that it causes anxiety. We have heard that very clearly. The review’s interim report sets out what the steering group has found and heard to date. In the next stage, it is going to carry on gathering evidence and engagement while developing and testing recommendations over the coming months. The Government will then have to look at that and make some decisions. It became quite clear that the assessment process is not fit for purpose.
However, we have to make sure that we do all we can to support people who can work to get into work or back to work—and where they cannot work, we must give them the appropriate support. Our job is not simply to focus on getting benefits out. It is also to make sure that, as we are doing now, we invest in the health service, bringing health and employment together so that we can support people. We are taking action, for example, through connect to work to stop people falling out of work when they first get sick, so that we do not end up with them on PIP for long periods in the first place. We are doing all those things.
This change is, none the less, a small but specific and pivotal question that will make a difference to our ability to manage things in the short term. As I have said, it would simply allow us to make more efficient use of limited assessment capacity, reduce assessments where they are not needed, so that we can focus them where they are, and allow PIP awards to be extended in a crisis such as the pandemic. It is a measured amendment to ensure the effective administration of the system.
Finally, I will say a word on young people. We will continue to press into this area. I know that this House as a whole believes we should not be leaving our young people without opportunities; we all agree on that. We have made sure in the past to share information with the House about the important work that the Milburn review has done for its interim review. We are looking forward to having the final report soon. We will make sure the House is informed about that and knows what this Government are doing.
Our job is to get the right support to the right people. Everybody who can work should be given the help and support they need to do it. Those who can work should work; those who cannot work should be supported. The system has to get that right, and this instrument is part of trying to do that.