(4 months, 3 weeks ago)
Lords ChamberMy Lords, I congratulate the noble Baroness, Lady Hughes of Stretford, on bringing this important debate to the Floor of the House today. I declare my interests, both in the register and as having close relatives who are in receipt of disability benefits and for whom I have some responsibility.
Today, I will focus on disability benefits. I am of course aware of the current consultation on PIP, which I will respond to in writing, in respect of those on the autism spectrum with learning disabilities and with mental health issues. However, I want to put on the record my ongoing concerns about the process of claiming disability benefits, the ethos surrounding the system, and the impact this can have on people, many of them already vulnerable.
These are some of the problems they face. There are lengthy forms, exceeding 20 or 30 pages, which put many people off applying in the first place. Many need help to fill them in, and there are often time limits, so finding that help becomes a pressure. Then there is the ability of the DWP to have applications assessed by qualified people with a working knowledge of the medical conditions they are assessing. It is dire. Do not take my word for it: as we have heard, the appeal rate for PIP is 70%—that is 70% granted on appeal. Only last year, a form that I assisted with was rejected. We asked for reconsideration, and when it came back, having been reconsidered, it had been awarded at an enhanced rate. What the person who looked at it in the first place was thinking about, I really do not know.
The questions are geared mainly to narrowly defined physical conditions, with each question scoring points, leaving out the complexities of autism, mental health and learning disabilities and giving few opportunities for people to explain in any detail how their lives are affected. They lose on points. This arbitrary points system is not flexible to take account of fluctuating conditions, good days and bad days, or degeneration. Complex conditions involving more than one disability do not stand a chance.
Despite paper forms, there is a presumption that applicants will then communicate via the internet or phone. Some will, but not everybody. I know several people on the autism spectrum for whom making a phone call to a stranger, or receiving one, is quite traumatic. There are long waiting periods, often without any money at all, and there is a problem with answering letters, even signed-for ones. We have heard that even children and young people starting cancer treatment can wait in excess of 20 weeks without any money at all.
All this builds anxiety and stress. It should be remembered that this is disability, not capability for work. PIP, for example, is a benefit that applies to people who are in work as well as those who are not. We are talking about disability, but somehow the debate seems to have moved to whether people are capable for work. I do not know quite where that has come from.
It is a given that many unemployed disabled people would like to work, and I support any initiative that supports that, but disability brings with it myriad extra costs, even for people who are working, and this whole process brings such a level of anxiety and distress. It is time the whole process was reformed. In doing so, the DWP should be as concerned about safeguarding the health—particularly the mental health—of claimants as it is about assessing them. I say that because even the very process of engaging in the benefits system can result in extreme outcomes.
I pay tribute to a former colleague of ours in this House, Lord Newton, Tony Newton, who was also a colleague in mine in another place. He got up out of his hospital bed to come here and speak on this subject. I also pay tribute to the much-missed late Lord Field, Frank Field, whom again I served with in both Houses. He was a champion in this area. On 25 September 2019, he tabled this Written Question in the House of Commons:
“To ask the Secretary of State for Work and Pensions, how many inquests relating to benefits claimants who have ended their life by suicide her Department has submitted evidence to since 2013; and in how many inquests it was ruled that the policies of her Department were partly responsible for the deceased person’s state of mind”.
Noble Lords will be familiar with the reply from the Department for Work and Pensions:
“Unfortunately, the information requested is not held centrally and is therefore unavailable without incurring a disproportionate cost”.
Frank—being Frank—then approached the National Audit Office and asked it to investigate what was going on with the suicide rate among benefit claimants.
As a result of a report by the Comptroller and Auditor-General, some progress was made at the DWP. I reassure my noble friend that I am aware that it has made progress, but the point is this: in what other area of disability would anybody or any department—least of all a government department—have to collate information about suicide rates that resulted from their own activities? That surely is unacceptable and I say to my noble friend: I know that the Government want to modernise the benefits system for disability, but it requires absolute root and branch reform.
(5 months, 1 week ago)
Lords ChamberMy Lords, I declare an interest as I have for decades been the person who has supported two near relatives in receipt of PIP. In fact, I spent two hours on Sunday night helping to fill in a PIP review form—26 pages—for a PIP application that was refused in the first place and given at an enhanced rate on appeal. My noble friend will recognise from this that there is a lot already wrong with PIP and the way questions are asked and formulated.
I am particularly concerned about autism-related anxiety. It is not the same as people who just have the slings and arrows of outrageous fortune to cope with, which we all do. The brains of people with autism are wired differently. The things that make them anxious can very easily lead to a downward spiral that can result in suicide. I say to my noble friend—I know we are limited on time—that when it comes to the worried well, I put my hand up, because every day of my life now I wonder who on earth is going to help with those forms and applications when I am no longer here. It is a nightmare.
(11 months, 3 weeks ago)
Lords ChamberI should remind the noble Baroness that we uprated by 10.1% in 2023, and I take her point. I can reassure her that the process leading up to April 2024 is beginning; I have no doubt that the Secretary of State will be looking very carefully at all the evidence, and announcements will be made at the appropriate time.
My Lords, I declare a long-standing family interest in ESA, particularly in the support group. I venture to offer my noble friend some advice, as I could write not just a book, but a series of books on applications to ESA. The Government need to make sure that they employ people who fully understand the medical conditions they are dealing with. To give a quick example, it is no good having so-called doctors asking people who suffer from epilepsy and epileptic seizures whether they can get in and out of a bath. When the reply comes, “As someone with epilepsy, I am advised not to get into a bath of water”—for obvious reasons—the reply comes back, “Just pretend you don’t have epilepsy. Could you get in and out of a bath or not?” It is not just a joke—it is tragic, because it causes the most appalling problems for many disabled people.
(1 year, 5 months ago)
Lords ChamberThe very fact that we have been rolling out a universal credit system over the last few years since 2013 comes to the essence of what we have been trying to do, which is to simplify the system. The noble Baroness makes a very good point about putting children first, as I said previously. One example of that is what we have done with free school meals.
My Lords, I declare a family interest in this Question. Over the next two years, people with long-term disabilities who currently receive employment and support allowance will be moved to universal credit, and there is already an acknowledgement that there will be some differences in the amount of money they will receive. What analysis has my noble friend the Minister and his department done to check whether that particular group—people with long-term, life-long disabilities—will not become part of the group we are discussing today, who cannot afford essentials?
My noble friend makes an excellent point, because, apart from the fact that we spent around £67.9 billion last year on benefits to support disabled people and people with health conditions, we are doing more, as the Spring Budget said, to help those who are disabled, and particularly those who wish to go into work.
(3 years, 8 months ago)
Lords ChamberMy Lords, it is a great pleasure to follow the noble Baroness and to hear from her first-hand experience.
The severe disability benefit, as we have heard, awarded to people with existing disability benefits such as ESA and PIP, is by definition for the most complex disabilities, including physical and learning disabilities, autism, mental health challenges and, as we have heard, for people who are terminally ill. The excellent Motion of the noble Baroness, Lady Sherlock, states that when moving to universal credit claimants should be,
“advised before moving from legacy benefits … that they could suffer financially”.
This is perhaps, in many cases, one of the groups who find it most difficult to obtain advice. For many, access to, or even ability to use, IT will be a challenge in itself when the benefit system is becoming almost exclusively an IT facility.
The Secondary Legislation Scrutiny Committee of this House examined the Explanatory Memorandum and discovered that it did not make clear that transitional payments would erode over time. The Government responded to that point and revised it to include further information at the request of the committee. However, if it takes a scrutiny committee of the House of Lords to identify that people are going to be worse off under a system, what hope is there for many people outside this House who do not have that expertise, knowledge or understanding? There is a responsibility on the Government to be absolutely transparent and make sure that before people make the move to universal credit, which, as has been said, is a one-way system—there is no going back, once people are in it—they do not erroneously put themselves at a financial disadvantage.
I know that my noble friend the Minister understands these things. She, of all people, with her experience of work before she came into the Lords, understands only too well how disadvantaged people live. I have a high regard and respect for that knowledge and I am glad that she is there to bring it to her department.
I mention one thing in passing and I hope that noble Lords will not think that it is too sexist. This debate has predominantly been contributed to by women. I sometimes wonder whether that is because it is women who take the responsibility in the family for the benefits of relatives and dependants. Maybe that is why women have a more instinctive understanding—I have no doubt that people will complain about this—of the real impact of these issues on day-to-day lives.
A lot of the disability groups have made their case about the financial impact this will have, including Disability Rights UK, among others. Disability Rights UK has made very strong statements, which I am sure the Government are aware of. But on the question of managed migration, my experience is that this group, who are the most severely disadvantaged because of the level of their disability, have been subject to all sorts of changes and disadvantages. But we have not had this spelt out in debate in either House.
My noble friend will know that last year, after 30 years of experience in Parliament of personally dealing with casework—I cannot imagine how many I have dealt with—I actually struggled to engage with the Government’s website to apply for ESA for a young woman in a very difficult situation with an advancing degenerative disease. In order to apply for ESA, the computer made me keep going to universal credit. This woman was married to a man in receipt of the support level of ESA, and the only way the computer would allow me to apply for even universal credit for her was if that man agreed to forfeit the right to his ESA. I know my noble friend has taken this up, and I hope she has made some progress with it. But this is what people are facing. They deserve a lot better than this.
(6 years, 4 months ago)
Lords ChamberMy Lords, it is important to re-emphasise the fact that this Urgent Question is about two specific cases that occurred before the regulations were amended in March 2017. It is about a five-month period. We are focusing on support for those two particular claimants and will ensure that any loss will be recovered and paid to them, literally within the coming days.
I sense that the House is perhaps referring to a judicial review decision that was made in the sense that the Secretary of State decided not to appeal a judgment towards the end of 2017 in relation to mobility activity 1, which is different from today’s Question. However, in relation to that, we will be carrying out an administrative exercise to identify claimants who may be eligible for more support under PIP and we need to screen the whole PIP caseload of 1.6 million to identify those people as a result of that JR judgment. The actual number of people whose award will be affected is much smaller. The judgment relates to people who suffer from overwhelming psychological distress that affects their ability to plan and follow a journey. Anyone who is identified as affected will be contacted by DWP and their payments will be backdated to the effective date in each claim.
My Lords, I declare a personal family interest. While I appreciate the constraints of this particular Question and judgment, my noble friend referred to the judicial review that was debated in this House. There have been many changes since the initial legislation came in. Can she tell the House how many existing people remain on DLA and are still waiting for their PIP assessment from DLA to PIP?
My Lords, I apologise. I hope that my noble friend will appreciate that this was given to me as an Urgent Question. I know that since PIP was introduced, 3.1 million decisions have been made, which will include some who were on DLA as well as new applicants for PIP, 9% of which have been appealed and 4% overturned. I am struggling to give the exact figure of the number of people who have moved from DLA to PIP. In that case, I am happy to write to my noble friend.
(7 years, 11 months ago)
Lords ChamberI know that the noble Baroness has very strong feelings about this. At her urging, I did make significant changes to the mobility measure. We did not have a clean measure before. We now have a precise measure with the 20 metres but we have it on the basis defined—safely, securely and regularly—which is something that she wanted, and have made it a much more measurable part of the PIP process. More people are receiving the top rate of PIP than receiving it were under DLA.
I have great respect for what my noble friend is trying to do, particularly in getting people with autism into work. Will he bear in mind a couple of things? First, we have seen many schemes over a long time that are badged as work prep, with all sorts of names attached to them to get people ready for work. They are important but where they have failed in the past is in going that step further and finding the appropriate job and getting a person into that job. That applies particularly to those people on the autistic spectrum with learning disabilities or chronic mental health problems. When my noble friend is engaging with employers, I ask him to make sure that it is not just the prep they think about but the advice people with those conditions need for interviews and on how to adjust in the workplace.
Secondly, I filled in a work capability assessment form on behalf of a relative. It is not always doctors who can interpret how a particular medical condition affects somebody’s everyday life or how it will affect them in the workplace. Very often physiotherapists, social workers or support workers are better placed than the local GP to know just how an individual is impacted and how they need to be supported in a much wider range of ways than just giving a diagnosis and saying, “This is how it affects them”.
The noble Baroness is right. One of the areas of greatest concern is people who have learning difficulties and people with autism. The figures are not good. There are more than 1 million people with learning disabilities and only 6% have work. I think we are going to see a report on autism this evening showing that only 16% of people with autism are in work. Clearly, in this period of consultation we need a particular focus on people in this group to help them into the workplace.
(8 years, 10 months ago)
Lords ChamberMy Lords, it is always a great pleasure to follow my noble friend Lady Hollins. I hope that I will not repeat too much of what has been said. I refer the House to the register and my declaration of an interest as vice-president of the National Autistic Society.
I want to focus on the change to the work-related activity group ESA. One group of people has not been mentioned at all so far: the support group, who have been independently assessed and deemed not to have to apply for paid work, and the WRAG group, as we shall call them. For a year, they are required to attend interviews—they are not just left alone, they must attend interviews—but the activity side of it is meant to involve getting back into work. We have heard from across the House today: from the noble Lord, Lord Patel, speaking very knowledgably about cancer patients; from the noble Lord, Lord Layard, speaking about mental health; and from my noble friend, who spoke about learning disability. In that very large WRAG group are a considerable number of people on the autistic spectrum. I pay tribute to the Minister for the interest he has shown in and the time he has devoted to the problem of getting people on the autistic spectrum into paid work. I know that he cares about this issue and has put a lot of time into it since becoming a Minister. I hope he will not think me presumptuous when I say that, to judge by our conversations about this, he knows just how difficult that is.
The point about people on the autistic spectrum is that I know of no other group with disabilities who are so passionate about wanting to take their place in society and become independent, even if it is only working on a part-time basis. They are passionate about wanting to earn some money and be just like everybody else. This is not a group of shirkers or people who are “working” the system. It is not just children who are being newly diagnosed with autism; a lot of quite mature adults are still being diagnosed with it, very often because crisis points develop. I wonder what it is about people on the autistic spectrum which means that in 2017, they will be deemed to live on £30 a week less than the group who have been independently assessed as currently unable to work because of their disability or illness.
The impact assessment, which has been referred to today, is available in the Printed Paper Office. It says that the reduction in the WRAG level of payment will,
“remove the financial incentives that could otherwise discourage claimants from taking steps back to work”.
That is printed in a government document. I have to say to my noble friend Lord Freud that I am disgusted with those words. I am disgusted that they were repeated down the other end and I hope that when my noble friend speaks, he will not in any way pray in aid that concept. We have heard about people such as cancer patients and many people with behavioural problems, autism or mental health problems—and people with complex problems whose disability is often a mixture of more than one of those. Those are very difficult people to help back into work. It is not always impossible but it is difficult. Where is the evidence for that statement in the impact assessment? What evidence have the Government identified from the people in the current WRAG group, who have already been independently assessed and put into the group? What is it about them that has given the Government sufficient evidence to change a policy in such a dramatic way? In 2017, this will almost certainly affect that whole raft of people we have heard about today, whether they are cancer patients undergoing chemotherapy or people newly diagnosed on the autistic spectrum.
I have a feeling that the reason why the Government have gone in this direction is not as obvious as the Treasury putting the DWP’s arm up behind its back and saying, “This is what you are going to do”. Everybody who has served as a Minister will sympathise with my noble friend Lord Freud, because we all know the Treasury’s ability in the art of arm-wrestling. However, the Government need to take a clear look at how they see disability, and to look first of all at the individual. It is quite striking that disability issues, and the Office for Disability Issues, are placed within the DWP—the Minister’s own department. That is considered the right place for them to be. Can the Minister perhaps share with the House in due course what exactly the Office for Disability Issues does? Is it looking across the piece and beyond that important point about getting people into employment, which I do not disagree with? My noble friend will know that I have banged on his door many times to talk about getting disabled people back into work, or into work for the first time. But what is the Office for Disability Issues meant to do?
If we are concerned about disability, surely we are interested in the individual in a holistic way—not just their employment opportunities but the help they receive, their well-being, their housing, their ability to take their place in society and their social environment. Surely that covers almost every piece of legislation dealt with by almost every government department. I wonder whether placing that responsibility in the DWP has made it become narrow and channelled. Perhaps it fails to look outwards at what the real, day-to-day living needs of disabled people are across the piece, particularly those with complex disabilities whom it is not so easy to get into work.
I have been so impressed by companies such as BT, which has made it its mission actively to employ people with mental health conditions. It has done a fantastic job. Right the way through that company’s culture, it now actively looks to employ people with mental health conditions. I have been impressed by what I have seen in some areas regarding the employment of people on the autistic spectrum, but it is patchy. It is hit and miss, unco-ordinated and not really as serious as it should be. I do not in any way hold my noble friend Lord Freud personally responsible, but I do believe that the Government have lost their way in making assumptions about people with disabilities and generalising about what living with a disability really means.
(10 years, 10 months ago)
Lords ChamberI am pleased to confirm that, as I have said in the past, the interim review is due to be published in the spring of 2014. I will be most pleased to discuss the findings of that review with Members of the House, who I suspect will be keen to have that dialogue.
My Lords, the National Debtline has announced today that the most rapid growth in personal debt is in the area of rent arrears. In the context of the Question asked by the noble Baroness, Lady Hollis, will my noble friend agree to examine on a regular basis the way in which personal debt is accounted for by rent arrears and to identify exactly why that is and what remedies might be brought in to suppress the increase of personal debt in this way?
My Lords, my noble friend is absolutely right that personal debt in this country is a major problem. There has been a series of important reviews of that in recent weeks. I am looking at it very closely in the context in particular of the introduction of universal credit. That is one of the factors in the review that I mentioned in response to the last question and I will keep it very much in mind.
(11 years, 7 months ago)
Lords ChamberI refer noble Lords to my entry in the register of interests. As the Minister will recall, in Committee and at Third Reading of the Welfare Reform Bill, a number of colleagues, notably the noble Baroness, Lady Browning, and the noble Countess, Lady Mar—who is no longer in her place—and I all raised issues about face-to-face assessments.
I urged the Government to take a “tiered approach” to the PIP assessment. This would mean that instead of people with conditions such as autism having to undergo a stressful and often inaccurate face-to-face consultation, assessors would first consider existing medical and other evidence about their needs. On the basis of this, a decision would be made as to whether a face-to-face consultation would be necessary. We are all keen to learn the lessons of the work capability assessment for employment and support allowance, which, as the Public Accounts Committee in the other place confirmed recently, continues to be problematic at best. A tiered approach to PIP would help make it fairer and more accurate for people with autism and other complex conditions.
The guidance that has been published by the Department for Work and Pensions for the assessment providers Atos and Capita reflects this tiered approach, which is certainly most welcome. However, the guidance also makes it clear that the end-to-end assessment process should be completed within 30 days. I understand that contracts between the DWP and the providers make it clear that there is a financial incentive to work towards this timescale; indeed, if fewer than 85% are completed within 30 days the providers are at risk of losing their contract.
I share the view of the National Autistic Society, which has serious concerns about whether evidence can and will be collected within this very tight timeframe and whether as a result people with complex conditions such as autism will undergo a stressful face-to-face consultation, and a decision will be made about their needs by an assessor who may not be in possession of all the relevant evidence. A one-hour face-to-face assessment will not enable the assessor to gain a full picture of the impact of autism on the claimant. It is an inherent part of the condition that people with autism will present differently according to the environment in which they find themselves.
Does the Minister think that 30 days is a realistic timeframe in which to get a response to a request for further evidence from busy health and social care professionals? Is he prepared to consider extending that, in particular with regard to people with autism and other very complex conditions?
My Lords, I refer to my interests in the register and also declare an interest in that I have close relatives who are in receipt of DLA. I want to use this opportunity to put on the record again my ongoing concerns, which are very much reflected in the amendment that the noble Lord has spoken to. I continue to have these concerns about the Government’s change from DLA to PIP for three principal reasons.
First, although I recognise, as others have, that my noble friend has worked very hard and made concessions that have very much improved these regulations, in successive debates about PIP he has repeatedly reassured us that “the most vulnerable” will still be in receipt of the benefit. To me, saying “the most vulnerable” is like saying “the most pregnant”—people are vulnerable or pregnant but the degree starts to give me cause for concern.
The second area that gives me concern, which has already been mentioned, is this figure that has been attached to how many people will lose their DLA. It seems to be an arbitrary figure and nobody seems able to identify quite how that figure came about or how it will be implemented.
Thirdly, in recent years the Government have had to take account of the demographic changes relating to the cost of the care of the elderly—something on which we have had an announcement in the past week. But equally, in looking at these changes, they have ignored another demographic change: the number of people with a disability who now live independently, who 20 or 30 years ago would not have done so.
When I had the privilege of representing Tiverton in Devon, in the 1980s we had three mental institutions in that constituency. The policy to take people out of mental institutions and integrate them into the community was not without its problems, but when you saw those people eventually living in the community it was only too evident that they had become institutionalised because they had basically been locked up for decades, and that the vast majority of them should never have been there in the first place. We do not do that any more. We do not lock people away. Equally, a changing trend that I am very pleased to see is that particular groups of disabled adults no longer live into their middle or old age with even more elderly parents. There are many who still do that, but the trend has been to move them into independent living.
If one sees the cost of what is required to move vulnerable people, even if they are only a little vulnerable, one realises that it is not a cheap option if those people are to be safe and to have the quality of life which we would all aspire to. The Government should have done their homework and looked at this change in society whereby we now integrate people into independent living in a way that a previous generation would never have countenanced. That is not just about putting a roof over their head; it is also about providing support and sometimes even having to contrive some sort of social life, which is again supported, so that they really feel that they are integrated into society.
My noble friend said at the Dispatch Box just now that the costs of DLA have gone up greatly in the past decade. I suspect that a lot of those costs are associated with the very welcome news that people are now integrated into independent living, sometimes supported but sometimes fully independent, where previously they would either have been locked up or sitting on the sofa at home with elderly parents. There would have come a point with those adults when their parents were no longer able to look after them and when, usually in an emergency, they suddenly became dependent on the state at much higher cost than those small amounts of money needed to support them in independent living. Unfortunately, despite what any Government say, Governments work in silos, so I appreciate that what my noble friend has to look at is the budget of the DWP, when a lot of people who are now moved into independent living are dependent not just on disability benefits but on health and local authority services. It is that package that helps them attain independent living.
I am seriously concerned that many of the 600,000 people, or however many it turns out to be—as my noble friend will know, I have a particular interest in this group—who are on the autistic spectrum, as my noble friend Lord Touhig described, or who have learning disabilities and mental health problems, do not always present initially as people with deep-seated problems and needs. Rather like icebergs, they very often present with a third on the surface and two-thirds under it. When they run into difficulties with independent living or taking their place in society it is not only devastating for them personally but very expensive on the public purse. It is therefore a false economy if that particular group, many of whom may be intelligent and do not present as the most needy or the most vulnerable, lose their DLA after achieving independent living. I say that on behalf of many autistic people whom I have known and on behalf of autistic young people whom I can think of who have committed suicide because they simply could not cope with day-to-day living. It may have taken a long time to get them to independent living and if you pull the rug from under them, the whole structure collapses around them like a pack of cards. It is not the case with learning-disabled or autistic people that, once they have achieved a level of independence you can walk away and say, “Okay, they’ll be all right now for the rest of their life”. They simply do not function in that way.
The Government should look at this changing trend in independent living. It is rarely mentioned by the Government but it is just as significant as some of the challenges that we face with the ever increasing dependency of old age. Much as all of us who take an interest in these matters appreciate what my noble friend has done—he has a very good understanding of autism and is doing a lot to try to help more autistic people into work—none the less, the words set out in this provision give cause for concern and it is a concern that I share.