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

Lord Kirkwood of Kirkhope Excerpts

Wednesday 16th March 2011 Lords Chamber

Moved By

[Lord Kirkwood of Kirkhope]

That a Humble Address be presented to Her Majesty praying that the regulations, laid before the House on 10 February, be annulled. (SI 2011/228)

Relevant document: 23rd Report from the Merits Committee.

[Lord Kirkwood of Kirkhope]

My Lords, this is an important debate. I start by declaring my own interest as a director of the Wise Group in Glasgow. I have no pecuniary interest but the purpose that I am afforded by being a director of the Wise Group is that, four times a year, I get to go on a wet Friday to Glasgow after a six-hour train journey. Nevertheless, it is very fulfilling and important work. The group does an excellent job for the communities that it serves in Glasgow and I am pleased to be associated with it. That explains my interest in this important subject.

The background to this debate is, quite simply, that after considerable consultation the disability organisations—most of which colleagues will know well, as we have been working with them for many years—have concluded through the Disability Benefits Consortium that these regulations imperfectly achieve their policy objective. That is a clear steer that the disability community would like the House to consider annulling these regulations and we owe them nothing less than to do that.

I start by acknowledging the work of the Minister, who has brought drive and commitment to this policy area since he wrote his original report those few years ago. I am absolutely at one with him in trying to discourage inactivity and encourage sustaining work. I think we both understand that Carol Black’s work changed the game of active labour markets and I stand four-square with him in trying to make sure that we can develop and deliver schemes that enable people to get out of inactivity and into work. That work has to be productive and sustainable, but if they can do that then the well-being of the client group that we are seeking to serve will improve.

I am founding the evidence for this evening’s debate on the excellent work that has been done, as I say every time we talk about the subject, both by the Social Security Advisory Committee and by the Merits Committee, which looked at this in very great detail in its 23rd report. These are complicated regulations but if any colleagues are looking for a quick summary of exactly where this subject’s importance lies and of its importance to the individuals concerned, they should look at appendix 1 of that report and the evidence that was laid out there compellingly. The Social Security Advisory Committee report that was produced, which was done with formal reference to these regulations, also repays careful study and is worth reading.

I start with a concern that is new to me and disturbing if true. I would like to hear the Minister’s view on it. The SSAC says, in its conclusions at paragraph 19:

“The Committee is concerned that there is a disagreement of substance between the Department and the external stakeholders who participated in the review as to whether the”,

work capability assessment,

“in its present form could be said to be working satisfactorily”.

If that is true and the stakeholder community is talking past the department and neither party tries to get back into some sort of meaningful communication, it is in no one’s interests. I do not know what happened in the past but that is the first time I have ever seen an SSAC report saying anything so stark. I do not know whether it is true but I would like an assurance that the Minister will redouble any of the efforts which I know he has been making to ensure that that gap is expeditiously closed. It would be inimical to the interests of the client group that we are trying to help if the pressure group community does not have confidence in its channels of communication with the department. I hope that he can give us that reassurance.

The other evidence which is the core of the debate is the Social Security Advisory Committee’s view at paragraph 4.3. I will quote another sentence which encapsulates a whole load of evidence that I do not have time to go into. Perhaps other colleagues might pursue that, particularly on mental health, learning disability and fluctuating conditions. After a very big consultation—I think it had 400 responses—the committee noted that the department is undertaking an ongoing programme of review but concluded, among other things:

“There appears to be a widespread perception that, overall, rather than simplifying, streamlining and refining the test, these amendments”,

in these regulations,

“will make it harder in practice for claimants to demonstrate that they are incapable of work or that they have limited capacity for work or work-related activity”.

That is the core of my concern, which the department now has to address. As I say, I am absolutely indebted to the Social Security Advisory Committee and the Merits Committee, as we all are. Indeed, Richard Tilt, the chairman of the former committee, is an extremely wise man and his experience will, I hope, be available to us for some time to come.

Briefly stated, this is one of the biggest changes that I have ever seen in social security since I started studying this policy area when I was elected to another place in 1983. Why? Because in April we will open the door to a national reassessment of 2.6 million people. We have a model which arguably does not work for employment and support allowance claimants yet. It is a work in progress, but I am absolutely persuaded that Parliament is trying its best to get on top of it. However if in April we are really considering taking on an extra 10,000 or 11,000 new cases each week—it might be each month, but whichever—it is a very big increase and raises questions about capacity. We have to consider the capacity of the Atos Healthcare medical professionals who do these functional capability assessments for work capability assessments, and it raises questions about capacity for jobseeker’s allowance as well.

There is a huge difference between a customer making an application de novo for employment and support allowance and somebody in Glasgow who has been unemployed for 10 years, who has been on incapacity benefit, and who gets a letter asking him to call at the Atos Healthcare professional centre to have his benefit assessed. He will know that if he does not get the continuing levels of support that he currently enjoys he could be £30 per week worse off at a stroke.

I go back to where I came in. I am absolutely in favour of ensuring that everybody who can contribute to the world of work should do so. There is no doubt in anybody’s mind that there are people who need a wake-up call, to use the expression of my American friends. Indeed, there are people who swing the lead, do not play the game and act in bad faith. I know all these things. However, to take 2.6 million over three years and put them through a process where the model has not been absolutely rigorously road-tested to everybody’s satisfaction is not safe. That is the case that the disability organisations have been making to me.

If that is not hard enough we have the deficit reduction programme, which I also support. We cannot ignore the fact that this country is now poorer than it was a while ago. There are also regional and spatial dimensions because labour markets vary. The labour market in Reading is very different from that in downtown Glasgow, which must be borne in mind. On top of that, the work programme, which again I support, is still in gestation. We do not know the detail of how the work programme will serve the client group that we are seeking to help. I think that the identified concerns about the functional capability assessment—it is not a medical assessment—are well founded. If anybody has any doubt that there are problems around it, I point out that the successful appeal rate against decisions on the current scheme is high, suggesting that attention must be paid to these provisions, particularly for mental health and fluctuating condition clients.

There are advantages in the regulations. I certainly welcome the chemotherapy and residential drug changes. They are not to be diminished in any way because they will help substantially the group that they are designed to serve. The biggest complaint comes from the disability stakeholder pressure group community. Professor Harrington has published his phase 1 report, which is truly an excellent piece of work. It offers a series of recommendations which really deal in a much more real-world way with the kind of problems that people face. The complaint is that we are not waiting for the totality of the Harrington work to be put in place. He is already starting on the second annual independent assessment, where he will look at the descriptors for fluctuating circumstances and the like. The results of that will be available probably in late 2011. We should not be opening the gate to the national reassessment of incapacity benefit claimants until we see what Professor Harrington can come up with. That is what the disability organisations say and it is a prima facie valid claim.

Colleagues will know this because we spent a lot of time on the Welfare Reform Act 2007, when the previous Government sensibly required a five-year annual set of reviews. Some of the complaints that the disability groups make is that this will be a piecemeal change, which is the legislators’ fault. We rightly felt that it was not safe to do it without getting independent reviews. The previous Government were right to do that and this Government were right to get Professor Harrington on the case. He brings hope to the whole situation—he certainly does to me.

--- Later in debate ---

[Lord Freud]

My Lords, I am pleased to answer that question. I am rather surprised by the actions of the groups. I have seen a lot of correspondence and a lot of internal work. There was very full engagement by both sides, and a lot of correspondence about fine-tuning the regulations. At the end of the process there seemed to be real agreement. Therefore I am genuinely surprised that, after the passage of some months, the consensus seems to have been significantly eroded. Income elements may have come to the fore, whereas the technical analysis that was the subject of the interplay between the department and the groups was perhaps easier to get to grips with.

I will go back to describing the system. The wider system that we inherited, after the measures that the internal reviews described, contained flaws that we as a new Government have looked to put right as quickly as possible. In June we launched the first of the five annual independent reviews of the work capability assessment—the first of the reviews that this House legislated for. It was carried out by Professor Malcolm Harrington, a highly respected occupational physician. He reported last November. He did not consider that the work capability assessment was broken but felt that it was not working as well as it should and made a series of recommendations to improve its fairness and effectiveness. We have fully endorsed his review, as the noble Baroness, Lady Thomas, pointed out, and we have committed to implementing his recommendations as quickly as possible.

The first key element of those recommendations—I am borrowing, again, from the description of the noble Baroness, Lady Thomas—is that we empower Jobcentre Plus decision-makers to make the right decision. They will have clear responsibility for the decisions they make and will be given the support that they need to ensure that those decisions are independent and considered. I hope that that is one of the reassurances for which the noble Lord, Lord Kirkwood, was looking.

The second recommendation is to ensure that individuals are treated with compassion by clearly explaining everything to them, helping them to fully understand the process they will go through and ensuring that they know that they can provide additional evidence, including medical evidence, for consideration at any time. I hope that that is the second of the reassurances for which the noble Lord, Lord Kirkwood, was looking.

The third major change is to improve the transparency of the Atos assessment by ensuring the audio recording of assessments in the Atos pilot. The other element involving the Atos process is that we will account for the particular difficulties in assessing mental health conditions by ensuring that Atos employs “mental health champions” at every centre.

Nearly all these changes will be in place for the start of the reassessment, with the remainder completed in time for the summer. We have also appointed Professor Harrington to conduct the second independent review. He will now examine the assessment in more detail, particularly focusing on mental health descriptors and fluctuating conditions.

I shall now respond to the questions of the noble Baroness, Lady Finlay, on fluctuating conditions. The fact that conditions fluctuate is now embedded in the descriptors. We just want to make sure in this next piece of work that we get that absolutely right. We look forward to Professor Harrington’s recommendations following the second review in due course.

The regulations before us today are part of this improvement process. They come from the internal review undertaken and fully supported by the previous Government. That review suggested a number of changes to clarify and improve the technical descriptors; noble Lords have made these points so I will go through them quickly. The changes include placing individuals awaiting or between courses of chemotherapy in the support group; expanding the support group to cover people with certain communication problems and severe disability due to mental health conditions; greater provision for individuals who are in residential rehabilitation due to drug or alcohol misuse; ensuring the descriptors take account of someone’s adaptation to a condition or disability; and simplifying the language of the descriptors to ensure fair, consistent and transparent applications. These changes will improve the work capability assessment. They will increase the number of people with severe disabilities who are provided with unconditional support in the support group. They will ensure that we do not deny employment support to individuals who, with our help, can get back to work.

The internal review consulted a range of experts and groups and, as I described just now, tried to reach consensus. Significant concerns were expressed by the groups around the descriptors. I will not go into those because I am short of time, but I can respond to the noble Countess, Lady Mar, on fluctuating conditions. It must be possible for all the descriptors to be completed reliably, repeatedly and safely, otherwise the individual is considered unable to complete the activity.

The Department for Work and Pensions has undertaken rigorous testing of these changes to understand their effects. The department modelled the impact of the changes on data from almost 60,000 assessments, and a panel of experts was brought together to examine the changes in significant detail. Where any issues were identified during this process, further refinements were made to the descriptors. From this analysis we expect the changes to increase the number of new claimants who are put in the support group, specifically, those who are awaiting or are between courses of chemotherapy, and some whose limited capability relates to certain mental functions and communication difficulties.

I have run out of time, but I hope that the House will indulge me for two more minutes as this is really important. We are committed to the principle of continuous review and refinement of the work capability assessment. As part of that principle, we have reviewed in detail the working of the work capability assessment and consulted in depth with specialist disability groups to improve the assessment. The addendum to the original report shows how far such concerns were taken on board in these regulations. We are committed to taking Professor Harrington’s review to improve the sensitivity of the process. Of the 17 recommendations that he made, we will have 15 in place in time for April and the other two in a couple of months. I hope that that is a final reassurance for the noble Lord, Lord Kirkwood, and the noble Countess, Lady Mar.

The changes that we are making in the regulations will improve the work capability assessment. They will expand the support group to cover people with severe disability due to mental health conditions and communication problems. They will ensure that the descriptors take account of someone’s adaptation to a condition or disability and accepting these regulations means that we can make these important improvements now. We remain committed to the principle of continuous improvement to the work capability assessment. I trust that the noble Lord, Lord Kirkwood, will feel able to withdraw his Prayer to Annul these important regulations.

[Lord Kirkwood of Kirkhope]

My Lords, I am grateful to the Minister. It has been a long but excellent debate. I thank all noble Lords who have participated. I shall certainly look carefully at the record tomorrow to ensure that we learn the lessons that have been laid in front of the House during the debate. I am pretty sure that the Minister will do the same—that he will take the opportunity of reflecting very carefully on what he has heard and the tone in which some of these powerful speeches have been made.

Knowing the Minister as I do, I know that he will also take away from the debate the fact that he may have some work to do to reconnect the department properly with the disability community and the pressures groups that represent it. I hope he will take that commitment on personally and not leave it to his senior officials, very highly regarded as they may be. I hope that he will personally invest time to make that connection good, otherwise it will fall foul of broken communications in future if it is not put right.

Reflecting on the debate, I think the Minister has got an amber light; he did not get a red light, but he still can in future if he does not complete the commitments he made—speaking for myself, I am willing to accept them—but he has not got a green light. I hope I am reflecting the tone of our excellent debate in seeking the leave of the House to withdraw this Prayer.

Motion withdrawn.