Welfare Reform Bill
Baroness Hollins Excerpts(12 years, 6 months ago)
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Baroness Hollins
“(d) if the claimant has a long term health condition or impairment, the claimant commitment must specifically address any reasonable adjustments which need to be made.”
Baroness Hollins
What I am going to talk about is very relevant to the discussion that has just taken place. I shall speak about Amendment 51CD first, whose purpose is to require Jobcentre Plus staff who are drawing up an individual claimant commitment to specifically address whether the claimant has a long-term health condition or impairment. There is growing evidence that the current system often fails to take adequate account of specific health needs of some individual claimants. This is relevant when considering compliance with the conditions that the claimant has agreed to as part of the assessment in the claimant commitment. It is a concern both when looking at a person’s performance during the work capability assessment and with respect to their ability to attend and fully explain their condition at the assessment.
The policy intention is for staff to make reasonable and appropriate adjustments as required by the Disability Discrimination Act. I was going to give noble Lords a different example, but last night I had a phone call from an acquaintance who is autistic—a middle-aged woman, who rang up to ask my advice about something. She does this quite regularly on a Sunday evening. I thought last night, “I really don’t want to have this conversation”—but in fact it was very useful, because halfway through the conversation she said, “I’ve just had this work capability assessment, and they have said that I have to join the work-related activity group”. She does not know what I do, apart from being a psychiatrist. So I said, “That’s really interesting. What conditions have been suggested and what is happening? Did they ask your doctor for advice?”. She is autistic, she has epilepsy and at the moment she has a neurological condition which is leading her to be quite unable to move very far or fast. She does not have very much insight and she has a recurrent depression, which is really not good at the moment. I find it quite difficult to imagine what conditions one would be able to put in place. I would love to see her back in work but, knowing her as I have done for 20 years, I really wonder. She said that as far as she knew, her doctor and her psychiatrist had not been asked for their opinion, so I thought, “I need to tell the Committee about her”.
The claimant commitment really should include specific reference to a health problem and to the agreed adjustments which should be made to enable a person to meet the conditions which are set. Another example was given: if somebody had agoraphobia and was perhaps unable to travel by bus or outside their own familiar neighbourhood, that would restrict where they could reasonably be expected to seek work. Yet there is some evidence that many quite ill people are being sanctioned because they have not been able to comply with conditionality, when such needs have not been taken into account.
Understanding that particular candidates have particular needs is the first step to ensuring that the claimant commitment is workable, which is of course what we are looking for. That awareness could be built on through training Jobcentre Plus staff. Good training is clearly vital but it is not enough to rely on, so that is the reason for this amendment. Many of these people will be covered by the Disability Discrimination Act and there is a requirement for the DWP to make reasonable adjustments, but I want to make sure that the question is specifically addressed in the claimant commitment so that it cannot be overlooked. I hope that the Minister will agree that staff training is not enough but that through this amendment, the requirement to make reasonable adjustments as part of the claimant commitment would make it more likely that appropriate action would be taken locally. I suggest that addressing the responsibility to make reasonable adjustments would in fact result in improvements in treatment for a lot of claimants and should be put into law.
The purpose of Amendment 51CE is to ensure that the work-focused health-related assessment process takes into account:
“Evidence from the claimant's own”,
doctors, who will of course have much fuller knowledge than the independent assessor. The purpose of these assessments is to highlight what they can do and what useful steps they can take to get back to work. It is important that they give as accurate a picture as possible of the impact of the claimant's condition on their daily life but the assessments carried out by an independent assessor, without access to the person's medical history, often fail to pick up vital information. If the healthcare professionals do not know somebody, a 40-minute assessment really is not long enough to fully appreciate the nature of a claimant's condition, particularly if it is complex. I propose that medical evidence from the claimant’s own doctors should become a key part of any work-focused health-related assessment.
Mind has written about a client who attended a work-capability assessment and failed to score any points, but what was not taken into consideration was that the client had a serious mental health problem and had been in hospital under Section 3 for six months prior to the assessment. She knew very little about her own condition and had a long history of hospitalisation.
Baroness Hollins
Yes—she did not score any points. I would like to mention a small, recent study done by Citizens Advice and presented to the Select Committee looking into the personal independence payment proposals last week. It reviewed 37 reports. The claimants went through the report with the CAB adviser, looking mainly at the section where the healthcare professional is meant to record the claimant’s account of the impact of their impairment or health condition on their life. Sixteen of the 37 were reported to have a very substantial level of inaccuracy. The suggestion is that if information from the claimant's own healthcare professionals had been involved, the accuracy of those assessment reports would surely have been better. In another recent report commissioned by DWP, healthcare professionals working for Atos were interviewed and agreed that the provision of medical information from a claimant's own doctor is rather helpful in completing their own assessment.
Lord Freud
The noble Baroness, Lady Wilkins, makes a point, which we have actually discussed in the Chamber in the past. She knows my concern about this. I think that the Atos and WCA process is genuinely improving now, with the changes that have been made. A lot of the stories that we have are of the system as it was, unreformed. It is gradually improving. That is not to say that it is now perfect—that is not my claim. We are committed to getting the process right, and we inherited that process. I know the concerns that there are, seeing them at first hand in many cases. It is a terrible balance between abandoning people and saying, “You’re out of the economic life of this country” and then trying to pull them in in a coherent way. Getting that balance right, as all noble Lords here today understand, is complicated and a path that we are moving down. But I am determined that we will get to a position where we are doing it with the right balance.
Baroness Hollins
My Lords, I am grateful to the Minister for his response, particularly for saying that he is going to consider these amendments deeply as we move towards implementation. There were three things that the amendments were trying to do. One was to try to ensure that evidence from claimants’ own health professionals would be properly taken into account at an early enough stage to prevent some of the distress that is currently affecting some claimants. The second one was about reasonable adjustments, which are a requirement under the law but are perhaps not fully understood. It is about an individualised approach, is it not? The third one was ensuring that the impact of a health condition on a candidate’s ability to comply was properly assessed and understood. It is not about asking for a rigid list of things in the claimant commitment. What it is really about is asking for joined-up work between different departments with different responsibilities and joined-up care for people with health conditions with the NHS and the DWP. There is no reason why Jobcentre Plus staff and existing specialist NHS staff could not share some information for the benefit of the claimant, both at the assessment stage and during their progression into work, which is what we would all like to see.
Although decision makers are required to take information into account, there is evidence that they are not always doing that. Yes, of course people can appeal, but appeals are very distressing, not just for the individual but also for their families. These amendments were intended to make the system work better both for claimants, so that they are more likely to succeed, but also because it is much more satisfying for staff to work in a system that they know is working fairly. So I am hoping that the Minister will find a way to ensure that the spirit of the amendment is taken on board. I beg leave to withdraw the amendment.
Welfare Reform Bill
Baroness Hollins Excerpts(12 years, 7 months ago)
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Lord Wigley
My Lords, I speak very briefly in support of Amendment 35, to which I have my name, to endorse entirely the comments of the noble Lord, Lord Rix, in introducing this bank of amendments, and to support the other amendments that deal with disability particularly. In doing so I should declare my interest as vice-president of Mencap Wales. In fact, at the Mencap annual conference in Warwick on Saturday, there were people who asked specifically about these matters. They said, “They have taken away from us home ownership for people with long-term disabilities, and now they are going to start clobbering us on housing benefit, where people with disabilities may be in a particularly vulnerable position”. I should therefore like to ask the Minister, so that I can respond to people who raise these questions with me: do the Government still believe in home ownership for everybody, and if so, does that include people with long-term disabilities? If the Government, having taken away the previous scheme, are not going to put something in its place, surely that is a straight contradiction of what the party opposite has always put itself forward as believing in?
Secondly, with regard to people with disabilities and housing benefit—the amendments before us would make exceptions for them—I hope that the Minister will be able to spell out how he will ensure that they do not suffer. If the amendments are not acceptable, I hope that amendments will come forward from the Government on Report. If not, I hope that there will be an opportunity to vote on these matters to show exactly where each of us in each of our parties, including the coalition partners, stand on such a basic issue.
Baroness Hollins
I, too, support Amendment 35, as introduced by my noble friend Lord Rix. As we have already heard today, tidy laws are not always fair laws. I am concerned about some exceptional people whose needs cannot neatly be described and I hope that common sense will prevail.
I shall give the example of a young man with autism and learning disability, Theo. Since early childhood, Theo has loved and become very knowledgeable about cathedrals, churches and architecture. He is also a man with complex impairments and a history of behaviour which has challenged every shared setting he has lived in. With specialist advice from Housing Options, and support and endorsement from social services, his parents set up a safe and individualised housing and care package for him.
The Government’s view may now be that it has never been the intention that SMI would cover all a person’s housing liabilities, but Theo’s shared-ownership mortgage was offered precisely on the basis that it would cover the mortgaged part of his housing cost, as was DWP policy at the time. The past nine years of Theo’s life have been built on that. His home has provided the all-important stability that someone with autism needs; and his disabilities combine to make change much more disturbing than we would find it.
Theo has an interest-only mortgage, so the possibility of the acquisition of a valuable capital asset does not apply in his case. With careful management by his parents, he has been able to lead a happy life at a much lower cost to the public purse than the alternative arrangement of a secure hospital. However, the new FSA rules require mortgage-lenders to set aside more capital and to treat mortgages on shared-ownership properties as 100 per cent mortgages. The result is a sudden gap between the rate at which lenders have to lend—for example, 6 or 8 per cent —and what the new SMI rate, which I think is 3.63 per cent, will cover. In Theo’s case, this leads to a shortfall of £200 per month. You can imagine that the arrears are already quite high. A new mortgage would be at an even higher rate, but he would then have to find a 25 per cent deposit for his property. He does not have the money to negotiate another mortgage.
There has been quite a bit of publicity about the adverse effect of this reform on HOLD. Experienced housing experts say that fewer lenders are likely to want to deal with disabled applicants seeking this solution to support a non-institutional life.
Ageing parents of disabled adults have followed similar paths with the help of enlightened housing associations. Those parents have been making responsible arrangements in their own lifetime, hoping for some assurance of long-term stability and security for their child. Instead, Theo's parents now face the prospect of seeing Theo’s distress at being uprooted from his home and moved, probably, to an inappropriate and less sensitive institution, which will be much more costly.
As the noble Lord, Lord Rix, pointed out, there are probably about 1,000 customers with learning disabilities—0.4 per cent, I understand, of the total caseload looked at by the impact assessment. Some of those administering HOLD have suggested ways in which the cost of continuing higher-rate payments for this group of disabled people could be contained, but it would require acceptance that there are indeed exceptions to the rule.
Since the Poor Law 1601, society has tried to tidy away people whose needs do not fit present-day norms, but in today’s more enlightened society we have made huge strides towards creating an inclusive society in which every person's humanity and dignity are respected and in which they have a place regardless of the extent of the difference that the person presents. However, these gains are quite fragile and we need look no further than Winterbourne View to be reminded of the previous scandals in mental handicap hospitals such as Ely and Normansfield in the late 1970s. Surely, we must now realise that without adequate advocacy and diligence we could again allow such inhumane provision to be re-created—people shunned by society and placed out of sight and out of mind at considerable expense but in the interests of tidiness. The test of a humane society is how it treats its most vulnerable members.
I had little awareness of the lives lived by some people with learning disabilities until I had a disabled child. My eyes were opened. I should like the Minister to consider using the Bill to reinstate SMI at the higher level for people such as Theo, which would allow them the opportunity to live with dignity in their own homes.
Lord Boswell of Aynho
My Lords, I rise briefly and somewhat diffidently because I did not have the privilege of hearing some of the earlier exchanges, as I had other obligations at that time. However, I have been listening to the later stages of the debate and before I add one comment to it I want to make it clear that in no sense am I derogatory of the very real problems that disabled people face—and those faced by other people of particular categories, including foster carers and others. Indeed, a good deal of my trade, time, interest and passion in my previous vocation as a Member of the other place was directed towards these issues. Of course they matter, and the people who are experiencing them matter. They have complex and difficult needs.
At the same time, it is worth putting down a marker. My remarks are prompted by those of the noble Baroness, Lady Meacher, about the cumulative effect. Of course, in a sense, I entirely agree with her point about the cumulative effect of changes, but I am afraid that the argument runs both ways. If the effect is cumulative and poses difficulties for the individual, a cumulative set of concessions or changes to the package that the Minister is presenting to us also has implications for public expenditure. In our debates last week on disabled children, I made the point that I regarded their overall position as being one of particular pressure that required the Minister’s attention and the maximum degree of flexibility. While I do not for a moment resile from the arguments that have been put with great passion by noble Lords on the range of difficulties, we will not be able to meet all those requirements within the equal requirement that the Minister and the Government have for economies in public expenditure—and with the commitments that have been undertaken to secure the prize of universal credit.
What we must do—and I will certainly want to listen to the Minister’s answer on this—is ensure that we understand the implications, and that is why debate is so important. We should be prepared to make changes where the shoe pinch is particularly hard or where the interaction that the noble Baroness referred to may have taken place. However, we will not be able to solve all the problems of all the client groups, however good our intentions are, without making it impossible for the Bill to survive and be sustainable. The Minister has to answer in that vein, and I hope that he does so.
Lord Freud
I will repeat the two points. The first point is exactly the issue that we want to deal with and the one that the foster community is worried about—the voids area. That is something that we are aiming to address. My response to the second point was, and remains, that this is where we would expect discretionary housing payments to come into play. It is exactly the complex set of judgments that need to be made, and local authorities are best placed to make them.
Baroness Hollins
I apologise for this, but I think that the Minister said that the same mortgage rates would be applicable as for everybody else. From my understanding, in the example that I gave of Theo, the mortgage rates had changed from the previous preferential rates, leading to a gap in the costs of his housing that he cannot meet.
Welfare Reform Bill
Baroness Hollins Excerpts(12 years, 8 months ago)
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Baroness Hollins
My Lords, there are winners and losers in life. Usually it is those who already have most who are the winners, perhaps because they are better able to advocate for themselves, and also because their needs are better understood in government. I am particularly concerned about two groups of disabled people who often lose out: people with learning disabilities and people with fluctuating mental health problems. I want to ensure that the welcome introduction of universal credit is adequately sensitive to their needs, and that they will gain from the changes.
Many mental health charities, including the Royal College of Psychiatrists, of which I am a past president, are concerned about a number of aspects of the Bill. It needs to be considered alongside other new legislation, the effects of which may be cumulative. I am thinking, for example, of the Localism Bill and the debate about housing tenancies. The Welfare Reform Bill has a heavy focus on increasing the use and severity of conditionality and sanctions. Mental health charities believe that this will be ineffective and potentially damaging for many people with mental health problems and learning disabilities. They fear that it could exacerbate the problems and have huge knock-on costs for health and social care services.
It is vital that mental health is a key consideration in the welfare reform process. Up to 40 per cent of all claimants are claiming primarily because of mental health problems. Many more experience mental health problems alongside physical illness or a disability such as a learning disability. The health and recovery of an individual must remain a focus when considering appropriate employment opportunities, because some work may be conducive to mental health and other work detrimental to it. The Bill proposes a one-year time limit on contributory employment and support allowance. However, this takes no account of the often complex issues that disabled people need to address in preparing for and finding work. The Disability Benefits Consortium makes a good case for the removal of the time limit. I understand that the Department for Work and Pensions has estimated that the vast majority of those on ESA and in the work-related activity group will take longer than a year to find work. Despite the Minister's introductory comments about people being able to move back on to universal credit quite easily, I remain unconvinced about the wisdom of the time limit.
I will explain my concerns further by giving two examples. The first concerns those with mild learning disabilities who achieve some independence from their parents and who, despite a lack of educational qualifications and limited literacy and numeracy, may be found fit for work and put in the work-related activity group. However, it is notoriously difficult for people with a learning disability to find work. Only 7 per cent of those known to social services are in employment. The paradoxical worry is that if they are found fit for work, they could lose their independence. This is a concern that I have had much correspondence about.
What about someone with a mental health problem? A person with a mental illness may be more likely to obtain employment after a period in the work-related activity group than a person with learning disabilities, but the recurring nature of their condition may make it harder for them to stay in employment. People with less severe mental impairments can often derive huge benefit from relatively minor financial assistance. Focusing resources only on those with the most substantial and tangible impairments may seem intuitively acceptable, but the risk is that many with less obvious or less severe impairments will lose benefits which have helped to prevent relapse or social deterioration.
Understanding the variable impact of fluctuating conditions in mental health is important when considering each individual’s eligibility for benefits. For example, one person with a mental health problem may find that for part of the time at work, their mood is low, that at other times they cannot concentrate or may be irritable, or that they may have to withdraw from their work setting to deal with auditory hallucinations. None of these experiences on their own may be severely incapacitating, but together they could be sufficient to affect their overall functioning in the workplace. There are real concerns about Jobcentre Plus and Atos assessing staff’s knowledge and understanding of mental health conditions. Can the Minister reassure the House that staff will have sufficient training in mental health?
More than 40 per cent of current decisions from the work capability assessment are being overturned on appeal. We could ask whether this is the fault of the appeals process or, perhaps more likely, of the original assessment? I appreciate the intent to remove benefits from people who are not genuine claimants, but reports are emerging of a lack of sensitivity for claimants with mental health problems, learning disabilities or autism when undergoing assessment for eligibility for benefits. Raising people’s employment aspirations now needs to be met with genuine opportunities for such individuals. This will require substantial efforts to address discrimination and stigma in recruitment and in the workplace.
You can imagine how difficult is it accurately to predict the sustainability of a work placement. Will the companies winning tenders to support individuals into employment, such as those that I have described, have a sustainability clause built into the contract? Without a commitment to sustainability, I think that the Government will find that this policy will prove to cost more in the longer term.
The Bill also looks to introduce regulations laying out how housing benefit costs can be integrated into the universal credit and how mortgage costs would be covered. Until recently, support for mortgage interest, the housing cost payment that people could receive under certain circumstances, enabled individuals with a learning disability, for example, to buy a property via the HOLD scheme—home ownership for people with long-term disabilities. Mencap is aware of around 1,000 people with a learning disability who have so far bought their homes through this route, but since last October this has in effect been closed down. I have brought to the attention of the Minister one case of a man with autism—there is no time to describe his circumstances—but the support for mortgage interest payment needs to continue to be available in the long term for those on income support or the equivalent under universal credit. I would welcome the Minister’s assurance that the regulations will address this.
I urge the Government to think very carefully about the impact of these proposed reforms on the wealth of some the most vulnerable in our society. My concern is upheld by the recent Institute of Fiscal Studies report which shows that the effects of the reforms will hit the poorest in society the most.
Pensions Bill [HL]
Baroness Hollins Excerpts(13 years, 1 month ago)
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Baroness Bakewell
My Lords, I support the idea that these changes to the pension age are going too fast. There was a successful film recently called “Made in Dagenham”, which helped to bring home to a new generation of women how much the gender equality gap had changed. It pointed up the distance that women have come today from what they called the bad old days of discrimination. Look at us today, the film said; we enjoy much greater equality, and now we have the law on our side to back us up. Barbara Castle featured in the film, brilliantly played, and she was feisty in her defence of equality for women. The film assumed that the audience who saw it would feel that the story was complete and that equality was an accepted part of our society.
Therefore, it is sad to see a necessary piece of legislation going through that harps on the idea that women will just have to put up with this new piece of discrimination. Half the population of this country are highly tuned to notice what happens to women and the disadvantages that are placed on their lives. Women have more complicated lives than men, as we know; they take time out to have children, to nurse older people and to create stable households—an ideal that I know the Government hold precious. Women therefore need consideration in the pattern of their lives that the amendment seeks to improve.
Bringing in this change to the pension age is extremely important; it is evident that we are an ageing population and we will all of us have to work longer. It is the method by which we bring that about that calls for nuance. Nobody is challenging the fact that we are getting older. Nobody is challenging the fact that, as the noble Lord said, men have been disadvantaged. We do not want them to be disadvantaged; we want people to be treated fairly and equally, and we want gender-free legislation.
This legislation is not gender-free. It cannot be said too often. My colleagues on these Benches have said so already. Listen to the numbers: one-third of a million women will see their state pension age rise by 18 months. Thirty-three thousand will see it increase by two years. It is not just those women who are affected by this but their children, families, neighbours and other women. Women are very aware of legislation that goes against them. It is unfair—we can see that it is. Women are being penalised out of the blue because the Government are rushing forward with pension proposals that need slower and fairer introduction.
One of the Government’s flagship aspirations is to get people to show a greater personal responsibility. That is an excellent thing but how can people do that—how can they plan for their old age, which will take a lot of complicated financial arranging as people live far longer—in so short a time? Indeed, as people age and begin to look forward to their retirement, they formulate attitudes towards it that are hard to change. They see it coming towards them; they make allowances for the time it will give them to look after their own, by now very aged, parents. They may feel they deserve to see a reward coming towards them for a life of hardship and trouble. I know people feel this because they write to me, as they do to my fellow Peers. They complain in their letters that it is an outrage.
This is not a matter of discrimination that will go on in the way that the film showed discrimination operating in the 1960s and 1970s and earlier. We know that this is a transition and one that is important. Of course we have to move to a fairer system. We will all work to 70 and things will eventually come right. However, is it legitimate to see them coming right at the expense of a group of poor and disadvantaged women, who somehow have to be sacrificed on the altar of this speedy operation? In this case there is an alternative.
Baroness Hollins
My Lords, I, too, am concerned about what the noble Lord, Lord McKenzie, described as disproportionate disadvantage. I am concerned about women, the great carers in our society—the people who care about the members of their family who are perhaps more vulnerable or dependent and need extra support. They are the people who, because they care so much, are willing to give up their time and perhaps work part-time. I belonged for a period to the Standing Commission on Carers. A survey was reported to the standing commission in its first year which found that the vast majority of family carers are indeed women. It found that when women care, they are more likely to work part-time or give up their occupation, and that men who cared did so extremely well but for fewer hours. Caring was much less likely to impact on their employment hours.
This change is being made too quickly and comes too soon. I acknowledge that, on the face of it, women live longer and that it is perhaps anomalous that their current pension age is lower. Yesterday I met the carers’ forum at the Royal College of Psychiatrists. It was made up of 12 people who represent carers of sons, daughters, partners and elderly parents with different mental health conditions. Some cared for somebody in their family with a learning disability or autism. The majority of them were women. I asked them how this change, and the speed of this change, would affect people in their position. They represent carers of people with mental health conditions, and they made some very important points quite forcibly.
They said that pension equality is fine, but that perhaps it should come into effect when society is more equal—when women start getting equal pay and occupational pensions, and particularly when men begin to share the caring burden more equally. They support the right of carers to work; they recognise the role of work as respite. They wanted me to stress the importance of not underestimating the effect on carers of a rapid change in their pensionable age when they might have made decisions about caring and occupation in anticipation of an earlier pension age. They talked about the need for health and strength to be an effective carer and the insidious nature of caring—the way in which it can lead to so much tiredness and often depression. They said: “Adrenalin keeps us going when we are caring. But sometimes when our caring responsibilities end, that is the moment when we ourselves begin to experience health problems which we have been storing up during those caring years”.
These are people who have saved the country huge amounts of money through giving up their own occupation and their own time to care and support more vulnerable members of their families. I appreciate that, in a good carers strategy, it might well be that welfare reform will attend to carers’ needs. What they would have liked as carers is a flexible pension that took account of individual need rather than assuming the same age was right for everybody. However, I support these amendments. The speed of change is too rapid particularly for this very vulnerable group, who represent a significant number of people if it is true that as many as a sixth of this particular age group are at the moment affected or carers, as the noble Baroness, Lady Hollis, suggested.
Employment and Support Allowance (Limited Capability for Work and Limited Capability for Work-Related Activity) (Amendment) Regulations 2011
Baroness Hollins Excerpts(13 years, 2 months ago)
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Baroness Browning
My Lords, I begin by declaring an interest as the named carer of an adult in receipt of severe disablement allowance. I also associate myself with the words of my noble friend Lord Kirkwood of Kirkhope. I concur both with his concerns and with his support for the need to enable as many people with a disability as possible who have not worked or have not worked for a long time to be assisted into appropriate work through an appropriate process that takes account not just of what they cannot do but of what they can do.
Among the many disability charities which consider this statutory instrument to be premature due to the as yet incomplete recommendations of the Harrington report is, as the noble Lord, Lord McKenzie of Luton, has mentioned, the National Autistic Society, of which I am a vice-president. I would like to focus on the concerns for people on the autistic spectrum. In order to qualify for the ESA in a work-related activity group, people have to be assessed to have gained more than 15 points. The way in which it is currently proposed to change the descriptors, as we have already heard, has a detrimental impact on people on the autistic spectrum. I remind the Minister that it was only last Thursday at Oral Questions that I asked him to confirm that the Government accept that autism is a communication disorder.
The descriptors take no account of communication difficulties, verbal or non-verbal, due to mental impairment. This is a major omission. Communication and comprehension are essential in the workplace, and it is a critical area of impairment for people with autism. Making oneself understood is covered only by a physical descriptor, descriptor 6. Unless guidance clearly states that this covers people who find it difficult to communicate due to a non-physical disability such as autism or a learning disability, these needs will not be recognised in the assessment. Noble Lords will understand my concern that already I am looking at areas where autistic people should be given a point on that descriptor scale, but getting them to reach the 15 points, if appropriate, is already excluding those areas where they will be in some considerable difficulty. Understanding and comprehension impairments are covered only due to a sensory impairment under descriptor 7, where the emphasis is on aids used by those with hearing or visual impairment.
The wording of the descriptor itself is vague; it is based on an ability to complete “two sequential personal actions” in the context of planning, organisation, and problem-solving. People on the autistic spectrum—even those with honours degrees and high IQs—always struggle with planning, organisation and problem-solving. It is too broad to be meaningful and leaves too much scope for interpretation to accompanying guidance. For people with autism, this may vary from turning on the tap and wetting their hands within the process of washing their hands, or getting ready for work and then making their own way to the workplace. For many, doing that unassisted will be a major challenge.
The National Autistic Society is also very concerned about changes to descriptor 17. It has been simplified to make the wording clearer, but it has become overly simplistic. Someone who frequently has uncontrollable episodes of aggressive or disinhibited behaviour, particularly when under pressure or in an environment with which they are really not familiar—that sort of behaviour would be unreasonable in any workplace due to cognitive impairment or mental disorder—cannot realistically be assessed as not having limited capability for work. As the proposals stand, we do not believe that employers would accept as employees people who the descriptors would deem as capable for work, but showed those sorts of behavioural problems in the workplace.
People with autism may exhibit behaviour which does not meet the minimum criteria set out in this new descriptor 17, but which would cause disruption in the workplace. For example, people will flap, hum or spin. I know of one person who, in a stressful situation in the workplace, would make cat noises as a sort of comforter in order to exclude the distress going around him. There is a limit to how long those working with people like that will put up with somebody making cat noises on a continuous basis in a busy office. These are all regarded as individual or rather quirky, but they are very real parts of their disability.
I say to my noble friend that there is genuine concern about the speed with which these changes are being brought in, ahead of what Professor Harrington is saying.
I mentioned that I am the named carer for a person on severe disablement allowance. This allowance, which comes within this legislation, is a very old disability benefit; it was something often given to young adults and adolescents who, having come out of full-time education, were at that time assessed and deemed not able to apply for paid employment. I would not even want to exclude them from the new opportunities for employment as disabled people, but—and I particularly refer to learning disability, mental health and autism—many of them are now getting on a bit because they were awarded this some years ago. Some of them will be in their 30s and 40s or even older and for many of them, getting the support they have been given to date to enable them to live as independently as possible or to be as socially integrated as possible has not been an easy journey. It has been a long journey and there has been a lot of input to get these people where they are today. But their situation is always going to be fragile, and there is nothing that I can see in the way these assessments are made to take account of what is at the moment a sustainable situation, as far as independent living is concerned. We must not put too many demands on them, however, and ensure that the process associated with it does not give them some form of detriment as a result. As my noble friend Lord Kirkwood mentioned, they might lose money, which is a very important part of their life and allows them to be able to plan and be secure with their finances.
There is another form of detriment. People may find that their self-confidence is shattered after it has taken years to build up; they may find that they can no longer cope with independent living of one sort of another as a result of being put through a process which undermines that stability. You cannot put a price on that detriment. I say cautiously to my noble friend who I know is sympathetic to these issues, please do not let this Government cause detriment to those vulnerable people.
Baroness Hollins
My Lords, I am very pleased to follow the noble Baroness, Lady Browning. I, too, will begin by declaring a personal interest. My 38 year-old son, who has a learning disability, was well described by the noble Baroness towards the end of her speech. He is always being assessed for what he cannot do and not for what he can do, which is incredibly demoralising for him. We his family spend our time trying to help him succeed and he would really like a job.
Some years ago, when I was consulted as president of the Royal College of Psychiatrists on the development of a work capability test, I suggested that the focus should be on capability, not lack of capability, from the point of view of the person being assessed. Although this is called a work capability assessment, it is an assessment of incapability.
I understand that, as my son is in receipt of severe disablement allowance, he may be required to undergo a work capability assessment. I tried out the online work capability self-assessment to see how he would fare. I will not go into the details but, of the three possible outcomes that we have heard about, he fell into the third category and would not be required, according to my assessment, to undertake any work-related activity. Perhaps that is a relief to me, in that his finances might not change, but I am sure that it would be a huge disappointment to him if that was the case.
So far that might be fine, except that the assessor may come to a different decision, in part perhaps because of my son’s lack of insight or understanding of his difficulties. He might then have to undergo an appeal and not everyone has the stomach for, or the capability for, an appeal. My reaction to trying out the test was that there is some sensitivity in the mental, intellectual and cognitive descriptors but probably insufficient sensitivity in the questions which relate to the type of complex difficulties that my son faces in his wish to be part of the workforce. They are difficulties which would require focused and sustained support to enable him to obtain work-related activity. The last thing that I or any parent in my position wants is for my son to fail yet another assessment, especially one which emphasises what he cannot do.
Another concern is that, if the assessment finds that he is capable, he is then given insufficient support, which would do terrible things to his self-worth and self-esteem. I question whether this assessment has been adequately road-tested and would want to avoid even one disabled person and his or her family having to face unnecessary appeals or loss of income through being unwilling to face yet another appeal. Even participating in the process of this assessment could be detrimental to the person’s mental heath.
My noble friend Lord Rix shares my concerns and has asked me to express his support to the noble Lord, Lord Kirkwood, today and to give his apologies as he is unable to contribute to this debate owing to family illness. He believes that many people with a learning disability will be denied vital support to help get them into work if they are not found eligible for employment and support allowance. That mirrors my concern. My noble friend believes that the crude indicators used in the regulations must be changed to more accurately reflect an individual’s capabilities.
For example, my noble friend is deeply concerned about the merging of the three descriptors—“memory and concentration”, “execution of tasks” and “initiating and sustaining personal action”—into one. They have been replaced with just one descriptor, “Initiating and completing personal action”. According to the regulations, this,
“means planning, organisation, problem solving, prioritising or switching tasks”.
The removal of the descriptor titled “execution of tasks” means that the time taken to complete a task will not be included as part of the assessment. This is particularly relevant to people with a learning disability and is likely to be a significant barrier to employment.
The current system already fails to meet the needs of people with a learning disability. My noble friend Lord Rix suggests that these regulations do not effectively assess limited capability for work, which means that the additional barriers and support needs of people with a learning disability are not being fully recognised in the assessment.
With less than 7 per cent of people with a learning disability who are known to social services being in any form of paid employment, the barriers to finding a job, combined with deep-rooted prejudice and discrimination, are already significant. Is it too much to ask that a coalition Government who claim to put fairness at the heart of their decisions should seek to tackle some of these barriers instead of perhaps making them even more difficult to overcome? For this reason alone, I and my noble friend Lord Rix, call for these regulations to be annulled.