Occupational Health Services

Baroness Finlay of Llandaff Excerpts

Thursday 1st March 2012 Lords Chamber

[Lord Freud]

I will not talk about the prodding too much, my Lords, although we get plenty of that here. One of the most valuable developments has been the self-referral process. There has been a lot of experimentation and piloting in relation to self-referral to physiotherapy and it has all been found to be very valuable. Patients have been empowered and highly satisfied with the results, with a lower level of work absence. The service provision has reduced costs and has substantially reduced the quantity of medicines prescribed as a direct result.

[Baroness Finlay of Llandaff]

Do the Government recognise that, given that on average 17 days’ sickness absence can be related to musculoskeletal disorders, the placement of physiotherapy in the workplace, as has happened in Rhyl in North Wales, can result in a decrease in sickness and the maintenance of people in work? Rhyl’s experience is of 82 per cent of people being able to remain in work, but that requires joined-up thinking between employers, health services and the benefits system.

[Lord Freud]

My Lords, that is absolutely smack on what the sickness absence review is looking at and whose recommendations we will be examining. The noble Baroness mentioned Rhyl. There have indeed been some quite remarkable improvements in this area. The project with which I was most impressed was in Lincolnshire, where triage was available on the same day. Advice, triage and signposting dramatically reduced the level of absence from work and, indeed, reduced the number of sessions of prodding that were required.

Welfare Reform Bill

Baroness Finlay of Llandaff Excerpts

Tuesday 31st January 2012 Lords Chamber

[Baroness Howe of Idlicote]

My Lords, a Division on a similar amendment was lost by two votes. We must all remember that we have here a compromise that would mean that at least some of the huge number of children would not be as severely deprived of the many things that they need in their lives as otherwise. It is also a question, as we have heard graphically spelt out, of many single parents, mainly young mothers, coping on their own with all these additional burdens and the need to stretch the money in ways that your Lordships have read about day after day in the pleadings that come through to us all. I ask the Minister to give serious consideration to whether a compromise of some sort would do. Personally, I would prefer the amendment as it is to be passed in full; it is about the maximum that any reasonable, fair-minded person would be happy to receive.

The amendment tabled earlier by the noble and learned Lord, Lord Mackay of Clashfern, was passed. If the Minister cannot give us sufficient reassurance and this amendment is voted on and passed, the other place will have an opportunity to see just how widespread is the support for it across all Benches, as we saw with the noble and learned Lord’s amendment. Therefore, I hope that the Minister will think very hard about accepting this amendment, which was so brilliantly moved by my noble friend Lady Meacher.

[Baroness Finlay of Llandaff]

My Lords, it has been said that the mark of a civilised society is the way that it cares for its most vulnerable. I remind the Minister that the speech of the noble Baroness, Lady Browning, encapsulated the societal burden of a failure to demonstrate that we are a civilised society.

I wish to put some figures on the table which have not been mentioned in the debate to date. The Family Fund is a charity that provides grants to low-income families caring for severely disabled children. In 2010, it had to pay out to a range of families, 64 per cent of whom had a child who was not receiving the higher rate of DLA. Recent figures from the Social Fund found that 69 per cent of families with disabled children are worried about their financial situation, with 61 per cent of those struggling to pay monthly bills and three-quarters believing that the high costs of caring for a disabled child are the cause of their financial situation. Other children in the family will suffer as a result of that, probably disproportionately greatly, because the psychology of a parent caring for a disabled child often dictates that that child becomes a focus of disproportionate attention.

Research by CLIC Sargent found that on average parents spend about £367 on extra expenses a month following a child’s cancer diagnosis and treatment, resulting in an annual spend of about £4,400 for parents of a child with cancer. When these families, whether suddenly or gradually devastated by illness, do not have the money they need with which to pay not for luxuries but very basic things to enable them to provide care for the disabled child, the other children in the family, the health service and society as a whole end up paying a higher price in many domains.

The amendment was eloquently introduced by my noble friend Lady Meacher. I urge the Minister to accept it, thereby removing the need to test the opinion of the House.

[Baroness Howarth of Breckland]

My Lords, I support this amendment, but in so doing I understand the position in which the noble Lord finds himself with a set of sealed envelopes. Like many other noble Lords, I encourage him to go back to the Treasury, or at least to have a look at how the available funding can be properly distributed. After all, this is a compromise. Personally, I would like us not to be in this position at all but rather to ensure that we do not make any cuts, because these are cuts—unlike some of the other reforms—to the budgets of families with disabled children.

I do not want to repeat the eloquent speeches that have already been made but to make three brief and, I hope, slightly different points. First, the Government need to take the long view as regards financial management. If we take the short-term view, we will find that many of these families will fall into even more disarray than they are in already. We should remember that, as has been said—I reinforce this point—the majority of these families are single-parent families looked after by mothers. These are not women who have had a child for some feckless reason, as is often portrayed in the newspapers, but women whose husbands cannot tolerate the pressure of having a disabled child in the household and have simply gone out of the picture—so these women are alone. Often that means that they cannot support their child’s situation, which results in many children going into care. I shall not quote more statistics, but noble Lords know that there are large numbers of disabled children in care at the moment and placing them in foster homes is very difficult; in fact, to get them adopted is almost impossible. The state’s burden of caring for such children is huge; the costs per week of caring for a disabled child can run into thousands. In taking the long view, we have to remember the number of children in care.

My last point is that, as several people have said, if we are a civilised society, we want children to grow up to be active young people and to have a proper transition into adulthood. I declare an interest as the president of Livability, a charity which looks after young people in schools, in colleges and through into adult care. I understand the need for that transition. If we are to do that and if we are to ensure that such families have a proper life, appropriate funding is crucial. Noble Lords may have disabled children but, if you are trying to bring them up on the kind of money that these families have and in the housing conditions and relationship situations of these families, funding is absolutely crucial to underpin the care, love and continuity that these children desperately need. I ask the Minister to look in his envelopes again to see whether there is not some way in which the money can be redistributed to ensure that that does not happen.

Welfare Reform Bill

Baroness Finlay of Llandaff Excerpts

Tuesday 17th January 2012 Lords Chamber

The amendment would achieve three things: it would align universal credit with PIP and the Government’s plans in other parts of the system to treat 16 and 17 year-olds as still being part of their parents’ household; secondly, it would safeguard young people from being assessed using an inappropriate tool, albeit that more explicit reference is made to mental health in the criteria; and, thirdly, it would further simplify the system. I look forward to the Minister’s response to these points. I beg to move.

[Baroness Finlay of Llandaff]

My Lords, the noble Lord, Lord Patel, and I have amendments in this group. Our noble friend Lady Meacher has spoken most eloquently to the specific problems for these age groups. This is Report stage, and we are well aware that there has already been much debate about young people who have to transition between children’s services and those for adults. However, I remind the Minister that, coming from a medical background, we have tabled our amendment because of the specific problems for those who fall ill suddenly or who are severely ill. As they transition for all their care in the medical sense, they transition also for all their life events and social interactions. They struggle to move to a degree of independent adulthood and are faced with a whole range of problems that those who are more settled either in the security of childhood or, later on, in an adult framework might not encounter so acutely. For that reason, we ask the Government to allow them to be considered separately should it be appropriate.

[Lord McKenzie of Luton]

My Lords, we have strong sympathy with these amendments, spoken to so effectively by the noble Baronesses, Lady Meacher and Lady Finlay. We had a bit of a canter around this issue in Committee, focusing particularly on 16 to 24 year-olds. I took from that debate, and the Minister may take the opportunity to confirm or deny it, that there is potentially scope within the Bill for a regulation not to require 16 year-olds inevitably to move towards PIP. If that is not the case, it is important that we clarify it, because it impacts on how we approach the amendment.

A number of questions have been posed which I should like to emphasise. The first is whether the Minister contends that the PIP assessment as currently constructed is fit. Does he believe that it would be appropriate for most 16 year-olds? The assertion is that it is not. Another issue is the extent to which there is alignment of ages for a range of things—the UN convention certainly, but care generally and education and training. Would it not be better if that alignment were brought into effect also for the purposes of the PIP and the DLA cut-off?

When somebody aged 15 is about to become 16, that is the point at which things change on the DLA journey and we move into a somewhat different regime. If somebody reaches that once PIP is up and running, do they inevitably have to apply and go through the PIP process at that point, or is there an opportunity for them to remain within DLA or perhaps migrate at a subsequent point? Otherwise, there is a real risk that these young people will the first to test the new PIP arrangements. What is the technical position there? Does somebody who wishes to make their first claim after the age of 16 have the route only to PIP and not to DLA? Would somebody currently claiming DLA necessarily be denied the opportunity to continue with that until, perhaps, the migration plan has run its course? I thought part of the noble Lord’s response to our Committee debates was that you could deal with this in part by the way people in the DLA system migrated towards PIP. One way of dealing with some of the issues that have been very validly raised in this amendment would be to use that flexibility, if it exists. If not, it seems doubly important to lock into the 18 year-old cut-off point, which is being pressed.

--- Later in debate ---

[Lord Freud]

I accept that there are concerns but one has to stand back. We are spending £12 billion on PIP in real terms, which is the same as the spending in 2009-10. The talk about a big cut refers to a big cut of a projection—the 20 per cent. I want to reinforce that point. In this House we should not get carried away with the simplicity of the big cut. It is not a big cut. With PIP we are trying to direct scarce resources, at a very difficult time, to the people who need them most. That is the purpose of it.

One of the other things that is happening—and is probably the biggest difference in emphasis between DLA and PIP—is that PIP is trying to take account of people with mental health problems in a way that DLA finds much harder. That is why the assessments and activities that are looked at are very different. Therefore, PIP is different and there are changes. Some people will lose out but they are the people who need the money less. That is the point of making the adjustment. However, the overall sum remains that £12 billion.

To pick up the point of the noble Lord, Lord McKenzie, we have the power and flexibility to treat 16 year-olds differently. This includes different assessment processes during the migration period. We are working actively now with children’s groups to make sure that we have the right migration strategy for youngsters and to finalise it. We will publish that approach. It is not a settled matter, which was, I think, the noble Lord’s real question. We are working very hard to get it right.

Let me deal with some of the amendments. Amendments 57, 58, 50ZGA and 56ZC would prevent our abolishing DLA for those aged 18, and potentially limit our flexibility by imposing statutory duties that would be less able to respond to change, especially as we refine and improve processes as a result of feedback and our experiences. It is very important that we have that flexibility. One of the things that we will discuss later this evening is feedback and the amount of research that we will carry out on a continuous basis. Clearly we want to incorporate that into how we apply PIP, particularly for youngsters.

This is very technical but I need to make it clear that the Government consider Amendment 56ZC to be consequential on Amendment 50ZGA; and, separately, Amendment 58 to be directly consequential on Amendment 57. I do not want any misunderstandings later, although the noble Baroness, Lady Hollis, is not in her seat at the moment to give me a piece of her mind. Given the reassurances that I have given the noble Baroness, and the technical limitations that the amendments of the noble Baroness, Lady Finlay, would impose, I hope she will withdraw her amendment.

[Baroness Finlay of Llandaff]

If the amendments which the noble Lord, Lord Patel, and I have tabled would be more restrictive, does the Minister now have more powers to make regulations to exercise discretion in relation to people of different ages? Does this discretion remain wider by not including our amendments where an age group is highlighted?

[Lord Freud]

This is a framework Bill. There is a lot of potential flexibility as we set up the regulations, particularly in this migration period, as we move into them. This flexibility would be denied by these amendments.

Welfare Reform Bill

Baroness Finlay of Llandaff Excerpts

Wednesday 11th January 2012 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, I shall make a brief intervention in support of the noble Baroness, Lady Meacher. It is important for the House to remember that whatever is said in the prognosis of someone who has an advancing life-threatening disease, it is completely unreliable; it is no better than a guess. These patients are living with uncertainty. They may die much sooner than their prognosis predicts or they may live longer, but they know that death is staring them in the face.

We are talking about adults of working age. They often have dependants. They often have children for whom they must make provision. If they do not use what energy they have to work on making provision for those children, the problems in the next generation among bereaved children will be much greater. There are questions about who will care for the children, what provision will be made, what the children are being told, how they are being prepared for bereavement and so on, quite apart from legal arrangements. Many people who are single parents say that making provision for those children is particularly difficult at times. Therefore, it does not make sense to take what little energy people who are ill have and put them through a system that stresses them further. It is much better for our society to use the energy that they have to do the thing that they know needs to be done, which is to make provision for those who will be left behind after their death.

I just emphasise that the uncertainty with which they live makes their lives even harder. It is impossible for an employer to know accurately about taking someone on. They may take them half way through an induction period before they become ill. Given the competition for jobs at the moment, any employer seeing this will, if they are in their right mind, say about the job that needs to be done, “Hang on, is this sensible for my place of work?”, however much they want to help someone. I caution the Government against preventing people using the energy that they have to make provision for the future of those who will be left behind after their death.

[Baroness Morgan of Drefelin]

I just want to thank the Minister for bringing forward Amendment 43 and the other government amendments in this group, and for listening to the debates in Committee. I do not want to detain the House in any way—I know we are engaged in several critical debates this afternoon—but the noble Baroness, Lady Meacher, has explained very eloquently the challenges that the Government have in addressing the thorny, knotty and difficult problems of people facing terminal and life-shortening illness. I do not want to say more than that because her points have been made so clearly.

--- Later in debate ---

Given that the costs will be lost in the margin of error, I hope that the Minister will show the same openness of spirit with this amendment as he showed with the earlier government amendment, and accept either this amendment or one along similar lines—or, as the noble Baroness, Lady Meacher, has suggested, that he will bring forward an alternative amendment at Third Reading. If he cannot make such a commitment, I hope that your Lordships’ House will stand up for this very small group of vulnerable young people.

[Baroness Finlay of Llandaff]

My Lords, I have also added my name to Amendment 45, which was so ably spoken to by the noble Lord, Lord Patel, and the noble Baroness, Lady Lister of Burtersett. There are many complex issues in this group, all of which been addressed pretty comprehensively, but I would like to add a piece of new research which emerged in December. It shows that half of young cancer patients have to borrow money as a result of their illness. More than one in five have borrowed over £1,000, while almost one in 10 have borrowed over £2,000. The eligibility of young people is heavily dependent on their circumstances, such as their educational status and so on, and they are in a unique situation.

I should like briefly to address the situation of students. They are unable to access contributory ESA, and can access income-related ESA only if they are already in receipt of disability living allowance. Many young cancer patients, particularly those with initial treatment periods of less than nine months, may not be able to access DLA. Furthermore, there are students who are fit and well one day but, for whatever reason, discover that they are not on the following day. Some are diagnosed with devastating diseases such as osteosarcoma or cancers like Hodgkin’s lymphoma. There are also those involved in traffic accidents or who suffer catastrophic sports injuries, head injuries and so forth. The numbers are small, but suddenly these young people become very dependent and require long periods of rehabilitation. If you are a full-time student whose life suddenly collapses around your ears and treatment starts immediately, the costs mount up quickly. The problem with the way that the Bill is worded at the moment is that it closes the door on young people being able to access options for financial support. The complications of this have already been discussed, and I hope that between now and Third Reading the Minister will be able to consolidate the sentiments and ensure that we do not inadvertently remove a very important safety net for young people.

[Baroness Howe of Idlicote]

My Lords, those of us who sat through the entire Committee stage and have listened to and contributed to these arguments are now hearing it all again. We are hearing the horrific details about the suffering of children and their families and carers, and indeed of grandparents who are often involved in the care needs of these children and young students. All this must help to persuade the Minister, who we know has tried his very best in a number of respects, and has succeeded in a number of areas in which we had considerable concerns. In this case, however, with the numbers so small and the need to look elsewhere to make savings if that is necessary, why should we continue to penalise this group? Surely we can get around the European inhibition confronting us, and we have even had suggestions about that. Some brilliant speeches have been made today and I hope that they have had the desired effect.

--- Later in debate ---

[Lord Freud]

The figure that I quoted is the existing one. I shall come straight on to the cancer issue because it is clearly of great importance. On the basis of the Harrington recommendations, the figure is expected to go up by about 10 per cent on the existing figure on our modelling basis.

There is a great deal of misinformation about the position and I shall try to pull out some of the main issues on cancer. First, the Guardian printed a letter from Professor Harrington in which he said:

“I believe the government’s proposals would significantly improve on the current system and would be of considerable benefit to those who face the real personal challenge of a cancer diagnosis and subsequent treatment”.

He went on to say:

“The government’s proposals have been developed as a result of evidence submitted to me by Macmillan and discussions with cancer specialists. The proposals would considerably increase the number of people who receive unconditional support in the benefits system. They would also reduce, not increase, the number of face-to-face assessments that individuals suffering from cancer would undergo. The proposals are underpinned by a presumption that people undergoing cancer treatment will be entitled to the benefit if they have the necessary supporting evidence. They widen the scope of the people this applies to, while also allowing people who want to work to do so. This will mean better provision all round. Delays in these proposals may ultimately affect individuals and their quality of life”.

We have now published the Macmillan evidence, which I hope is available and of great interest to noble Lords. What is interesting about the evidence is how many professional oncologists support this approach. I have a few quotes here which I would like to share with the House. The first states:

“Not all patients will experience toxicity related to treatment … Not all patients should be exempt”.

The next states that,

“some people on long-term maintenance treatments may have little or no upset and be quite able to work”,

and so on. That evidence is available to noble Lords.

As to where we are on the important issue of cancer, we are now carrying out a consultation with the industry. That will be ready in March, when we will pick up the responses and apply them. The noble Lord, Lord Patel, may take some comfort from the fact that there is now a major process going on as we consider this issue, and he would be right to take such comfort.

On the point raised by my noble friend Lady Thomas on the WCA, we are absolutely committed to making it as effective as possible. It is beginning to move quite quickly now in the right direction. We have taken forward all of Harrington’s recommendations from year one, which means that decision-makers are better supported and have received new training, and all the ATOS reports now have a justification. Professor Harrington has praised the improvements that he has seen so far.

The other point raised by the noble Lord, Lord Patel, was—

[Baroness Finlay of Llandaff]

Before the Minister moves on, I wonder if I could ask for some clarification. When he talked about the evidence from oncology, he implied that patients would have to be not working for two years. I do not see anything in any of the proposed amendments that stops people going back to work as soon as they want to go back to work. Indeed, one hopes that many people will get back to work, perhaps on a part-time basis or whatever, within months of having their treatment, but the purpose of the amendments is not to force those who are so debilitated post-treatment or during treatment, particularly with fatigue that can go on for weeks or months before it improves, and not to make them subject to a guillotine coming down at the end of the year. Can the Minister clarify that there is nothing in the amendments that stops people going back to work as quickly as they want to?

[Lord Freud]

Clearly, there is nothing in any amendment or proposal to stop people going back to work should they wish to go back to work, but we are talking about the expectations that there are between the citizen and the state. That is a really important psychological relationship between the two, and that is what we are talking about rather than anything else.

I pick up the point made by the noble Lord, Lord Patel, when he quoted Citizens Advice. We were disappointed by what it said, not because it said stuff that we did not like to read but because it was based on the evidence of 37 work capability assessments when there were more than 600,000 completed in the year to May 2011. That report also relied solely on Citizens Advice’s own interpretation of the healthcare professional’s report and did not allow the HCP the opportunity to explain the reasoning.

Our view and policy is that the right way to address cancer diagnosis and treatment is by ensuring that the WCA provides an accurate and effective dividing line between the support group and the work-related activity group. We want the WCA to consider and assess fully the effects on an individual from both their cancer and the treatment they are receiving for that cancer. As I said, sufferers will be entitled to any income-related ESA.

I pick up the point raised by the noble Lord, Lord Wigley, on the burden on those who can least afford it, because some quite simplistic numbers are flying around here. We have said that income-related ESA will be available to those with the lowest incomes. I accept that if an ESA claimant’s partner has earnings of £152.70 a week, no income-related ESA will be available, but that does not mean that the couple will be £94.25 a week worse off when the contributory ESA is withdrawn. I give an example of why that is not the case. A couple with a rent of £100 a week and council tax of £25 a week, one with the earnings of £152-odd and the other with a contributory ESA of £94, will have a total income of £291 before ESA is withdrawn and £277 afterwards. The main reason is that housing benefit and council tax rise substantially. So there is less income but there are not these very dramatic changes when you go through the actual sums—

Welfare Reform Bill

Baroness Finlay of Llandaff Excerpts

Tuesday 13th September 2011 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, there have been many admirable speeches tonight. They must have given the Minister much food for thought. As a patron of Foodbank Cymru, I fear that we will see a rise in the number of people who beat a path to our door because they are in financial crisis and cannot even put food on the table.

In the short time allocated, I will address the situation of people who become suddenly and catastrophically ill, and what happens to them and their families. Before I do that, I will say that the clear aim of the Bill is to get more people into work. This principle was underpinned by the very elegant speech of the noble Lord, Lord Feldman, whom we all welcome. The Bill refers to assessment in considering a person's physical or mental condition. Of course, these are so often integrally linked, which is why the findings of Sir Donald Acheson’s independent inquiry into inequalities in health are so relevant. He states:

“Some of the excess morbidity and mortality associated with unemployment may be a result of people in poorer health being more likely to become unemployed, rather than vice versa … It does … illustrate the double disadvantage that people with chronic sickness or disability may face: their ill-health puts them at greater risk of unemployment, and the experience of unemployment in turn may damage their health still further”.

My noble friends Lord Patel and Lady Morgan of Drefelin highlighted the problem for young people who suddenly find themselves ill with life-threatening disease. They referred to the mismatch for 16 to 18 year- olds that must be addressed. I am sure that amendments will be tabled to that effect.

I understand that those with cancer, HIV and MS will be eligible for PIPs from the time of diagnosis; that is when the clock will start ticking. However, what about those with other neurological diseases, those with massive injuries such as head injuries, the loss of a limb or any sudden, catastrophic disease, or those who are seriously ill with conditions that are difficult to pin down at the time of diagnosis but which fluctuate and make progress rapidly? Huge expense is often incurred at the moment that people lose their health, particularly with a diagnosis such as cancer, which demands punishing chemotherapy, often very rapidly, or where there has been a road accident and massive injury has occurred. The costs of heating, transport, food and childcare suddenly rise in an uncontrollable way. Waiting three months for the DLA is already hard enough. Why make it much harder by creating a six-month qualifying period? Many have argued tonight for the year to be redefined as a three-month qualifying period followed by a nine-month prospective test period. It would cost the same. I hope that the Minister will take away the consistent message that has emerged in the debate.

The mobility component of the DLA is critical to keeping people well. Those in residential care are not being double funded. The joint report of 27 charities, Don’t Limit Mobility, makes that clear. For some who live in residential homes and the young, severely disabled people in supported residence, taking away the mobility allowance is like locking the door and throwing away the key. One person said:

“Without it, I would be severely depressed like I used to be … My independence is my most prized possession”.

One case that we must consider is that of the young single parent who suddenly becomes ill and whose ex-spouse does not provide child maintenance. In Wales, 68,500 parents—half of all single-parent families—need the Child Support Agency to obtain child maintenance. According to the Bill, such parents will now have to pay a registration fee and a levy on each payment, suddenly making their situation even worse, while they will have to wait six months to be eligible for PIP if they become suddenly ill. If that young parent needs an electric wheelchair to carry on coping with his or her family, they will not be able to get one without the mobility component. The noble Lord, Lord Kirkwood, spoke of hopelessness. Indeed, that is a real danger, as so many people are terrified of how they will be able to live, fearing becoming imprisoned by their condition. They fear the assessment process, rather than believing that a personal independence payment will help them to keep living.

Carers of the seriously ill are not mentioned in the initial impact assessment. Can the Minister tell us how many of the current 500,000 recipients are likely to lose carers’ allowance and how many of those will be women, given that 73 per cent of those claiming carers’ allowance are women? Can he also explain how the three levels of DLA transferred over to the two levels of standard and enhanced in PIP will act as a gateway to carers’ allowance in the future?

The tripwire of all this change will be how the assessments are done. Many feel that ATOS is not fit for purpose—harsh words, I know, but 40 per cent of its rejection decisions go to appeal and 70 per cent are overturned. Many find the assessments humiliating and degrading, and medical statements are often ignored. Some die before lengthy appeals are heard. I hope that the new assessment processes will be better. Sometimes, one thinks that they could not get much worse. Even the pilots are revealingly complex, showing that a subtle nuancing is required to meet individuals’ needs.

Concluding on a positive note, I am glad that the Government have continued with the DS1500 principle. The terminally ill cannot wait for assessments and their changing conditions mean that a single snapshot assessment is not appropriate. But as the Royal College of Physicians told the Select Committee of the noble and learned Lord, Lord Mackay, prognosis is a probabilistic art. Sometimes those with fluctuating conditions appear to be dying, imminently, but do not die at the time anticipated—al-Megrahi is a clear public example of this. Can the Minister reassure us that under the new system those in receipt of the benefit will not find it stopped if they happen to be alive at six months and will not be expected to repay it if they live longer? Also, should they go into an unexpected remission and cease claiming, will they be eligible again when they face dying? The intention behind this Bill is to make our welfare system affordable but it will be the traps that we have to address.

Employment and Support Allowance (Limited Capability for Work and Limited Capability for Work-Related Activity) (Amendment) Regulations 2011

Baroness Finlay of Llandaff Excerpts

Wednesday 16th March 2011 Lords Chamber

[Baroness Finlay of Llandaff]

As president of MS Cymru, I want to flag up the problem for people with fluctuating conditions. All the difficulties around the assessments have been clearly laid out and I will not repeat them, but there is a real problem for people who have an assessment and then, possibly a week later, dramatically deteriorate. It is the fluctuating nature of conditions such as MS that is causing a lot of anxiety to people out there. The provision for those on chemotherapy is greatly welcomed, but I ask the Minister to explain how the second part of Professor Harrington’s review, which he is doing in conjunction with the MS Society, will be incorporated. How will the Government handle the possibility of quite a lot of appeals or even challenges when the next phase is rolled out?

[Baroness Wilkins]

My Lords, most of the points that I wanted to make have been made, so I will be brief. I emphasise the serious concerns that have been expressed by disability organisations, most particularly that these changes are premature. As we have heard, the second phase of the independent review led by Professor Harrington is still under way, and the advice on refining the mental, intellectual and cognitive descriptors has not yet been seen by Ministers, so in all likelihood we will be faced with two major, costly and confusing changes to the WCA to be made in a single year.

I emphasise that the cost of these changes has not been covered. The cost of people having to go to tribunals when their assessment needs to be overturned is enormous in terms of stress, worry and consequent ill health, but it is also a waste of time and money for the country. As the CAB has pointed out, the current WCA assessment routinely fails to identify disabled people’s genuine needs and inappropriately allocates them to jobseeker’s allowance, only to have that decision overturned on appeal. Currently 40 per cent of cases are overturned on appeal, which must cost the state a considerable amount.

According to the Welfare Reform Bill documents, almost £20 million was spent in 2009-10 on appeals to the tribunal service and, according to figures from the Disability Alliance, that means that roughly £8 million was spent on appeals to rectify the failings in the current WCA. There is now a nine-month backlog for appeals in some areas. If the new descriptors go ahead as planned, these changes could lead to even greater pressure on the system, especially since, as the noble Lord, Lord Kirkwood, pointed out, new ESA claimants will be joined by an estimated 10,000 people per week being migrated off incapacity benefits from April 2011.

The Government’s expert independent body, the Social Security Advisory Committee, has recommended that these plans are not implemented now. I urge the Government to follow their advice.