Welfare Reform and Work Bill
Baroness Howe of Idlicote Excerpts(10 years ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Lord Bishop of St Albans
My Lords, I, too, support the Government’s aim of getting people out of unemployment and back into employment and I am grateful to the Minister for his clarification in Committee that reporting on the disability employment gap will be included as part of the Government’s overall employment reporting. However, like other noble Lords, I fear this commitment may not go quite far enough.
If the Government are to stay true to their commendable aim of halving the disability employment gap, detailed data and thorough reporting are absolutely crucial to achieving it. Particularly important is the breakdown of how unemployment rates differ across disability groups. If the government reporting looks only at the disability employment gap as a whole, it will be extremely difficult to see which disabled groups are making progress and which are not. I am concerned that this would make it possible for the employment gap to drop significantly through government interventions targeting only those with the most limited impairments.
We know anecdotally that those with physical impairments tend to find it easier to return to work than those with mental health problems and learning difficulties. While it might therefore make economic sense to target programmes and interventions at this easier group, I am sure the Minister will agree that this will go against the spirit of the Government’s manifesto commitment. Any government reporting needs to look at the range of barriers faced by those in all disability groups and work to combat these barriers across the board.
We need work programmes that are properly targeted to address the needs of all those who are seeking employment across different disability groups. Statutory reporting of the disability employment gap, using the metrics outlined in this helpful amendment, would put such programmes on a clear footing and will provide a clear rationale for the way forward. Anything less than this would be a missed opportunity for the Government. I hope the Minister will consider carefully the points that have been raised.
Baroness Howe of Idlicote (CB)
My Lords, in supporting the amendment so ably spoken to by my noble friend Lady Campbell, I will speak to my Amendment 42, which seeks to make changes to the Welfare Reform Act 2007.
The amendment would much improve the support provided to help people with mental health problems into work. It would add people with mental health problems in the ESA work-related activity group to the list of those currently exempt from the higher levels of conditionality introduced in the Welfare Reform Act 2012.
We all want the same thing: to help more people into work. We are also far more frequently discussing in your Lordships’ House the importance of better supporting those with mental health problems. My amendment speaks to both of these motivations.
The types of conditions that people in the ESA work-related activity group experience are more complex than those experienced by people on jobseekers’ allowance. We can easily imagine how people’s symptoms could be exacerbated when they are required to attend activities in order to qualify for their benefit. However, we also know that many of the activities are not tailored to their individual needs. People with social anxiety disorders can be mandated to attend confidence-building classes with 20 other people who do not have a mental health problem, and many people talk of being sent to health and safety courses. Often nothing is offered to address their real barriers to work.
The individual placement and support model is currently being piloted by the department to support people with mental health problems into work. This approach has been shown to work. At WorkPlace Leeds, part of Leeds Mind, 32% of its clients secured employment through voluntary support last year. That is a far higher rate than the 9% achieved through the Government’s Work Programme nationally.
Welfare Reform and Work Bill
Baroness Howe of Idlicote Excerpts(10 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Howe of Idlicote (CB)
My Lords, my Amendment 51 would amend the Welfare Reform Act 2007 to include people with mental health problems in the ESA work-related activity group on the list of those exempt from the higher levels of conditionality introduced in the Welfare Reform Act 2012.
Research shows that people with mental health problems have a high “want-to-work” rate yet a high unemployment rate. Almost two-thirds of people with severe mental health problems are unemployed. Conditionality—that is, mandating people to take part in generic work-related activity such as CV-writing classes—has become an undisputed part of back-to-work support. Yet the use of the conditionality for this cohort of 250,000 people who are unwell because of a mental health problem is based on no evidence at all. The current schemes are clearly not working for people with mental health problems and the use of conditionality is not balanced with effective support. Less than 9% of people with mental health problems have been supported into work through the Government’s flagship back-to-work scheme. The evaluation and report by the Department for Work and Pensions, as well as much independent research, shows that support is not tailored or personalised, and people with mental health problems are not supported as they should be. As well as being ineffective in helping people back to work, these mandated schemes make people’s mental health worse. Mind’s survey of more than 400 people with mental health problems showed that 83% on the Work Programme or with Jobcentre Plus said that it made their mental health worse or much worse.
My amendment would take away the conditionality part of support for people with mental health problems which requires them, under threat of sanction, to attend support whether or not it is effective or appropriate. Removing this pressure would mean that providers and Jobcentre Plus must give better support, relationships between claimants and advisers—so vital for successful back-to-work programmes—would improve and those with mental health problems would feel less pressure, which ultimately helps in their recovery.
Some may question how by removing the conditionality regime from people with mental health problems their employment outcomes will improve. The rationale here is that schemes which are voluntary for people with mental health problems have far better success rates at supporting them into work than the generic back-to-work schemes. If we want to halve the disability employment gap, we should create systems that work. To take one example, there is WorkPlace Leeds, which is part of Leeds Mind. It works solely with people with mental health problems. No conditionality is used and the support is linked with people’s health as well as employment outcomes. Crucially, the advisers have a real understanding of mental health, the type of symptoms people experience and their specific barriers to work. In 2014-15, the programme secured paid employment for 32% of its clients, some of whom had not been in work for many years before starting the scheme. That is a far higher rate than the 9% achieved through the Work Programme nationally.
Why would my amendment work? Being placed under pressure and burdened by the fear of sanctions has a negative impact on people with mental health problems. When we think about the types of symptoms such people experience—intrusive thoughts, fear, distress, hearing voices, low mood—it is clear that the additional pressure and stress of being mandated to attend certain activities is particularly difficult, especially when these activities do not address the individual’s mental health condition, as is often the case. By removing conditionality, people with mental health problems will gain more choice and control over the back-to-work support they receive. This is one of the most basic principles of supporting people with mental health problems, as outlined in NICE’s guidelines, which say that shared decision-making should be a key part of any service. It does not seem to make sense to have guidelines based on evidence about how best to support people with mental health problems but then ignore them and look to something else.
As I said earlier, people with mental health problems have a high want-to-work rate and there is no evidence to show that conditionality achieves success at supporting them into work. We all want the same thing: to help more people into work. This amendment would provide a real opportunity to transform realistically the support into work offered to people with mental health problems. I hope that the Minister and the Government can accept my amendment.
Lord Layard (Lab)
My Lords, I speak to Amendment 52, the purpose of which is to remedy an extraordinary anomaly. We have nearly a million people on ESA due to depression or anxiety disorders, which are extremely treatable conditions. However, only about half these people are in any form of treatment. Most of them have never even had a diagnosis. None of this makes sense and the solution is obvious: we must help these claimants into treatment if we possibly can.
The key services here are those belonging to the national system of Improving Access to Psychological Therapies, otherwise known as IAPT. Last year, these services saw and assessed 900,000 people and roughly half of those treated recovered during treatment. The average cost of treatment was about £1,000, which compares strikingly with the cost to the Exchequer of a person being on ESA for a year rather than working, which is £8,000. Obviously, we want as many as possible of these claimants to enter into treatment with IAPT, for both their sake and that of the taxpayer.
Amendment 52 proposes that as soon as claimants are awarded ESA by virtue of mental illness, they should immediately be referred by the jobcentre to the local IAPT service for assessment and treatment—unless they are so ill that they need to be referred to step 4 care, in which case they should be referred to secondary services. The proposal does not involve compulsion. It says that the claimant should be offered assessment and treatment. However, if this is organised in a friendly way which assumes that this is simply what happens next, most claimants would accept it—though they should be offered the opportunity to say no.
Let me review a number of possible problems that have arisen in the discussion of this proposal—the proposal is not new. First, why is the referral to a psychological service rather than to something else? The answer comes of course straight from the NICE guidelines. Those say that all people with depression and anxiety disorders, which are the most common forms of mental disorder, should be offered modern, evidence-based psychological therapy. Clearly, that is what we need to bring about. The secondary mental health services are too busy with people who are more severely ill to be able to provide that to the vast body of people suffering from depression and anxiety disorders. That is the reason why IAPT was created and why it should have a key role in helping mentally ill people to get better and back into work. People can self-refer into IAPT, so there is no problem in having the jobcentre facilitate that without delay.
State Pension: Equalisation
Baroness Howe of Idlicote Excerpts(10 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Altmann
My Lords, as I have said, this matter was properly and thoroughly debated by Parliament. All those arguments were put to both Houses of Parliament and a majority voted for the legislation more than four years ago. This afternoon, I checked quite carefully and it is clear that this issue was missing entirely from the Labour Party’s manifesto before the general election. No party committed to doing anything about the billions of pounds that it would cost to change any of these plans.
Baroness Howe of Idlicote
My Lords, I hope that the Minister will forgive me for going back, as I do, a long way in the history of equal opportunities for women. I would like to press her once again on this point. Does she really believe that MPs would have voted for the accelerated rise in 2011 had they known that many women had not been notified or given sufficient notice of the rise in the state pension age under the Pensions Act 1995? This really has not been a fair process all the way through, and women have been disadvantaged at an amazing number of levels.
Baroness Altmann
My Lords, I have also been checking up on this point. I am assured by the department that any woman who had asked for a state pension statement since 1995 would have known what her pension age had been changed to under the Act. Given the uncertainties around the amounts of state pension that any woman could receive under the very complex system that we have at the moment, if a woman had planned her retirement on the basis of that, she would surely have got a pension statement and known about her state pension age change.
Welfare Reform and Work Bill
Baroness Howe of Idlicote Excerpts(10 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Howe of Idlicote (CB)
My Lords, it would be wrong to discuss the measures in this Bill without highlighting the disproportionate impact the changes would have on people with mental health problems, and I am very glad to say that a number of your Lordships have already raised this issue as important. Just like physical health, we all have mental health. More of us are speaking out about mental health than ever before but, as has been mentioned, there is still a long way to go.
One area where people with mental health problems are still far too often unsupported and misunderstood is in back-to-work support. Over a third of people with mild to moderate mental health problems, and almost two-thirds of people with more severe mental health problems, are unemployed. Only 9% have been supported into work through the Government’s flagship back-to-work scheme, yet we know that the majority of people with mental health problems want to work. It is essential that this legislation looks at improving support to help people with these difficulties into work.
One problem is that mental health needs are not properly understood or acknowledged, which leads to the wrong support being provided. This does not help people get into work. The story of Lee, a 38 year-old man with mental health problems including depression, anxiety and a personality disorder, illustrates the difficulties. When out of work, in the employment and support allowance work-related activity group—the ESA WRAG—Lee attended a weekly self-help management course at his local jobcentre, which he had to attend or face his benefit being sanctioned. But the support he was provided with did not take into account his mental health. Lee said that,
“it was focussing more on people in pain, people who had bad backs and first aid ... and I did say a number of times at these meetings that this doesn’t apply to me. I’m not in pain as such, I have a mental health problem”.
Of course, Lee’s experiences are not unique. Another sufferer said that her adviser,
“simply did what I could already do on my own, put together a CV and look for jobs. There was not enough support geared to my specific difficulties. Every task was the same for everyone. Not everyone’s needs are the same”.
In addition, the conditionality and sanctions regime has become an unchallenged aspect of back-to-work support. Research by Mind, which does so much in this field, shows that people with mental health problems are three times more likely to have their benefit sanctioned than they are to be supported into employment. That is a clear signal that the system is not working for people with mental health problems, despite this group making up over half of all people on employment and support allowance.
The changes which this Bill legislates for—namely, reducing the amount people on the employment and support allowance work-related activity group receive by £30 a week—would have a serious impact on people with mental health problems, as others have said. We should all be concerned by the Government’s lack of assessment of the impact that these changes will be having on people and their families. I am pleased to hear about the review being undertaken by my noble friends Lord Low, Lady Meacher and Lady Grey-Thompson, which I gather will look at how the cut will affect the day-to-day lives of disabled people and whether it will help them move closer to work. We know already that 75% of people with common mental health problems, such as anxiety and depression, receive no appropriate treatment, and that many people use their benefit to pay for talking therapy treatments and well- being activities. There is space in this legislation to support people with mental health problems better and ultimately to move closer to the Government’s welcome commitment to halve the disability employment gap.
I end by asking the Minister two questions. One is a repeat of the question that my noble friend Lord Rix asked. The government impact assessment stated that the justification for the £30-a-week cut was to,
“remove the financial disincentive to work”.
Can the Minister present us with the evidence to show that cutting disabled people’s benefits results in more disabled people getting jobs? Secondly, the Equality and Human Rights Commission has said that the impact assessment accompanying the Bill does not,
“fully assess the impact on equality and human rights. This may make it difficult for parliamentarians to properly consider the implications of the measures in the Bill”.
Does the Minister accept this criticism? It would be good to hear his reply at some stage as the Bill progresses through your Lordships’ House, even though I do not expect much of an answer this evening.