Employment and Support Allowance and Work Capability Assessments

Kate Green Excerpts

Thursday 5th February 2015 Westminster Hall

[Kate Green (Stretford and Urmston) (Lab)]

Thank you, Mr Walker. It is a pleasure to serve under your chairmanship for this debate, which is based on a full and impressive report by the Work and Pensions Committee. It has been informed by other developments in this area, including the fifth report of the independent reviewer, which my hon. Friend the Member for Aberdeen South (Dame Anne Begg) referred to, the evidence-based review carried out by a number of independent organisations into an alternative assessment model and the Minister’s recent appearance before the Select Committee.

These issues are of huge interest to disabled people and the taxpayer. We face an £8 billion overspend on employment and support allowance and incapacity benefit in this Parliament because the DWP has not been able to assess people, reassess people or get them into work and off benefits. In 2010, the Government said that incapacity benefit would end, but 173,000 were still on the benefit in May 2014, the latest date for which we have figures; 527,000 cases were stuck in the ESA queue as of December. The new assessment provider, Maximus, has been contracted to carry out 1 million assessments in the first year of that contract. The Office for Budget Responsibility says it will take two years to clear the backlog and, as has been pointed out this afternoon, reassessments have been suspended for a little over a year now.

Will the Minister tell us when he anticipates the reassessments might restart? That would be helpful for the peace of mind of people who are still anxious about when the process might come back to hit them and helpful also because, from the point of view of Maximus and of the Department, it is an important question for planning work flow.

The costs and backlogs sit alongside a range of policy and operational issues that have been raised by the Select Committee, starting right at the very beginning of the process, when someone submits a claim for ESA and the evidence is gathered to inform an assessment and determine whether a face-to-face assessment is required. We know that there are difficulties with getting the relevant evidence together. We have heard this afternoon, in particular, about some of the difficulties associated with reliance on evidence by GPs. It seems from reports from claimants that evidence that should have been considered by the assessor and informed the assessment is often not available.

The Select Committee has made a number of helpful comments and suggestions on that concern—in particular, the suggestion that the DWP should take ownership of the process of submitting the ESA50 form and bringing the evidence together. It should not be the claimant or the health care professional who carries out the assessment for the independent company; the DWP itself should own the process of getting together the information for an assessment.

The Committee recommended that the taking on of that responsibility by the DWP should have been considered before the appointment of the new contractor. The new contractor, Maximus, is now in place, but as far as I am aware there has been no change to the process or to the responsibility of the DWP in relation to it. Will the Minister say what consideration the Government gave to that recommendation by the Select Committee? If there has not been a change of procedure, will he say why not?

The Select Committee made a number of recommendations about what I would call good housekeeping in relation to the assessment and decision-making process. There have also been recommendations from the independent reviewer and the evidence-based review of experts that looked at an alternative assessment model. It is clear that there are a whole range of really very helpful—and, I guess, obvious—suggestions that the Government should consider, and I hope the Minister will comment on those. For example, it has been recommended that the assessment process should be constituted on a semi-structured interview model; that we should ensure that the claimant can see what is being written and recorded during the course of the assessment; that assessors should avoid making inferences from what claimants say; and, as the hon. Member for Newton Abbot (Anne Marie Morris) said, that the assessment process should properly consider whether a task or function can be performed reliably, repeatedly and safely. There is also a need for much better awareness and understanding of, and training on, fluctuating conditions.

I welcome the fact that the new contract with Maximus is going to introduce more rigorous performance standards on access to assessment centres. It is obviously quite ridiculous that we are still hearing reports of claimants being asked to go to centres that they cannot get into or in which they cannot move around. However, access goes beyond the physical ability to enter and move around buildings. In particular, a key element of the Select Committee’s report focuses on improving communications, including written communication and communication with the claimant during the assessment.

In a debate in this Chamber on Tuesday, secured by my hon. Friend the Member for Edinburgh East (Sheila Gilmore), the Minister talked about the priority he is giving to improving communications. Can he say more about that? For example, is he looking at ensuring that communications are presented in Easy Read and other accessible formats? What steps is he taking to ensure that communication during the assessment is appropriate to the circumstances of a claimant, in particular for those claimants with autism or learning difficulties?

I turn now to ESA itself. The Select Committee has made a number of comments. As has been noted by the hon. Member for Newton Abbot, since 2010 we have seen a significant difference in the proportion of people going into the support group or being found fit for work. In 2009, 10% of claimants were in the support group and 63% were found fit for work; now the position is 47% in the support group and 34% found fit for work. That has thrown up a number of issues.

First, as Dr Litchfield pointed out in his review, when assessors’ recommendations are overturned by decision makers, that almost always results in someone being moved into the support group. The previous independent reviewer, Professor Harrington, had suggested regular audits of decision-maker performance, and I wonder why that suggestion has not been followed. Dr Litchfield also pointed to the troubling rise in the number of young people at severe mental or physical risk being placed in the support group, with 34% being placed in that group without a face-to-face assessment. I would welcome the Minister’s observations on that. Does he intend to increase the number of face-to-face assessments? What steps is he taking to ensure that appropriate support is being given to that vulnerable group of people?

As has been mentioned this afternoon, the Select Committee also highlighted a number of issues about re-referrals. Thirty-six per cent. take place within three to six months and 63% of young people at severe mental or physical risk are reassessed within 12 months of being placed in the support group. Those relatively short re-referral periods make little sense. In some cases, they might suggest that people are being wrongly allocated to the support group; in others, the issue seems to lie with the so-called prognosis period—that language seems quite unhelpful, if not misleading.

In evidence given by charities, the Select Committee heard about a number of disturbing cases of people with degenerative conditions being assessed as improving, recovering or becoming fit for work. In the debate earlier this week that I referred to, the Minister said that he did not rule out the idea that some people in that group could become fit for work in the future or might want to work. He argued—I think I am right in saying this—that that explained why some people with degenerative conditions might be put in the work-related activity group.

The Minister told the Select Committee that even someone who had been deemed unlikely to return to work could still be doing some work-related activity. I have to ask him: what, and why? As the Chair of the Committee pointed out, given that there is a mechanism for reassessment of those in the support group and the opportunity for them voluntarily to work or prepare for work, there is no justification for placing in the work-related activity group people who are not fit for work now and for whom the prognosis is that they are unlikely to be fit for work in the future.

We have also heard that the suspension of the WFHRA has left a gap in the assessment process. The work capability assessment can take us only so far in identifying the level of benefit someone ought to be on or what group they ought to be in. Both the evidence-based review and the Select Committee have highlighted that those in the WRAG or found fit for work might need considerable adaptations or support to be able to work. There is nowhere in the process where that need can be appropriately reflected.

The Select Committee also raised concerns about former incapacity benefit claimants being placed in the WRAG via a paper assessment. I know that the Minister is keen to minimise the number of assessments where possible, but the Select Committee has pointed to some real problems arising from that situation. Many claimants do not understand the decision that has been taken or its implications; they do not understand the structure of conditionality that will apply, that they will receive lower benefits when in the support group or that, if they are on contributory employment and support allowance, they could lose the benefit altogether after 12 months—for example, if there is a partner working in the household that will mean that they might no longer be eligible for means-tested support. If the Minister is determined that people should be able to progress into the WRAG without a face-to-face assessment in some cases, will he say what steps he is taking to make sure that they fully understand the decision that has been taken about them and what it means for them?

My hon. Friend the Member for Edinburgh East made a number of useful comments reflecting the Committee’s recommendations about mandatory reconsideration. I will say, for the record, that I welcome the potential for mandatory reconsideration to speed up the process of getting a decision for claimants. However, although there has been progress in recent months on reducing the time taken for mandatory reconsiderations, the most recent figures, as my hon. Friend pointed out, still show some 44,000 people—25% of cases—waiting over 30 days for the outcome. I do not think we have a breakdown of how much longer than 30 days they may be waiting.

The time scale for mandatory reconsiderations is especially important, because ESA is not paid during the reconsideration process. Although claimants can claim JSA during that period, many are reluctant to do so either because of the stricter conditionality that pertains or because they fear that it will compromise their ESA claim and their mandatory reconsideration. As was said earlier, the conditionality can and should be varied according to the individual circumstances, but that does not seem to be happening routinely in Jobcentre Plus. What plans does the Minister have to provide reminder training to Jobcentre Plus staff on that issue?

There is also an issue of transparency in relation to the mandatory reconsideration process and to the figures that are available. The statistics that we have seen do not separate out decisions overturned from initial decisions, and, as my hon. Friend the Member for Edinburgh East pointed out, we do not have any figures for the outcome of mandatory reconsiderations. Therefore, we do not know how many are successful, how many are unsuccessful, how many go to appeal and what the total cost is to the taxpayer. The Minister said that he would get back to the Select Committee on the outcome of mandatory reconsideration, and I hope he will be able to say something about it today. The Department has not made available its guidance on mandatory reconsideration, so will the Minister commit to making it public?

The Select Committee and the independent review made a number of points about the ESA and WCA processes, and their relationship to improving employment outcomes for disabled people. The Minister told the Select Committee about a host of measures, pilots and initiatives, some of which are referred to in the Government’s official response. We now know about personalisation pathfinders, employer and young people portals, Disability Confident, the gateway employment tool, psychological well-being and work pilots, the employment and well-being toolkit to support Jobcentre Plus staff, the Fit for Work programme for getting people back to work, extra support in ESA hotspots, the well-regarded Access to Work programme, the less well-regarded Work programme and the six months’ intensive work coach support for those who have spent two years on the Work programme.

Some of those measures might be worth while, but, given that so much is going on, it is difficult to disentangle and monitor the effectiveness of each of them. It also makes it very difficult for Jobcentre Plus staff and work coaches to make the best choice about the support an individual should receive. What training do Jobcentre Plus staff receive identifying what is appropriate for individual claimants? That question is motivated by the fact that the number of specialist disability employment advisers has fallen by 20% under the Government.

There is widespread support for better information sharing from the assessment process with Jobcentre Plus, Work programme providers and others, which could be used for assessments for other benefits, such as personal independence payments. Will the Minister say a little more about how he envisages information sharing proceeding?

In conclusion, it is clear that the work capability assessment and ESA are complex, and that they continue to be a source of anxiety for claimants. I very much welcome the Select Committee’s report and the independent review. They produced many useful recommendations, and I look forward to hearing how the Minister will take them forward.