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

Lord McKenzie of Luton Excerpts

Wednesday 16th March 2011 Lords Chamber

Finally, the client should be encouraged not just to bring his own medical evidence to the work capability assessment but to make it available to the decision-maker. If the decision-maker has, say, a GP report, he is taking more responsibility and discretion for the decision and he is communicating that clearly to the client. We still have fluctuating circumstances and conditions to deal with, which has not been addressed yet, so that would not be dealt with in my suggestions. Speaking for myself, I hope that my noble friend can give assurances that the seriousness of the situation is being fully comprehended and accommodated in departmental thinking and that Harrington phase 1 will be in place without peradventure before the reassessment starts. If some of the Harrington recommendations are highlighted in the way I have suggested, I certainly think that there would be some reassurance in the disability community that the situation is not as unsafe as it suspects. I hope that the Minister can help by explaining the situation later in the debate this evening. I beg to move.

[Lord McKenzie of Luton]

My Lords, the House should be indebted to the noble Lord, Lord Kirkwood, for giving us the chance to debate the regulations this evening. Like me, and other noble Lords I see present, he has been involved in issues concerning the employment and support allowance and the WCA for a long period. The noble Lord congratulated the former Government on insisting on the annual reviews. If memory serves, that may have been an amendment that he pressed on us at the time.

I start by explaining my understanding of the rationale of why the work capability assessment and the employment and support allowance were introduced. It was part of the journey which recognised the importance of work for people's route out of poverty, their self-esteem, well-being and health. The concept was that, for the vast majority, work, or good work, is good for you and that, as a society, we should support people to get into or closer to the labour market. I think that that is common ground between the previous Government and the current one.

As we know, the work capability assessment was designed to focus on a person's capability, rather than their incapacity, as a building block to help them progress, where appropriate, towards work. The switch from incapacity benefit to employment and support allowance was more than just semantics. Although support via Pathways was available before, the introduction of the WCA signalled a determined change to support those who could towards the labour market.

The approach seeks to identify three groups of people: those considered capable of work; those who could work at some point with the right support—the work-related activity group; and those who cannot or should not be expected to work. The concept is to make those determinations by reference to application and a range of descriptors with the objective of determining an individual's functional capability.

There is nothing in the documents that we have received from the stakeholders that calls into question that fundamental approach; and I doubt whether we will hear it called into question by noble Lords this evening. Indeed, the first independent review of the WCA by Professor Malcolm Harrington concluded that the principles underpinning the new assessment remain valid. He stated his belief that the system is not broken or beyond repair; that, at least, is reassuring.

We should acknowledge and welcome the fact that the introduction of WCA has been subject to review—the internal DWP review began in March 2009—and it is the recommendations from that review which, I understand, are reflected in the regulations. Professor Harrington’s independent review, the first required under the Welfare Reform Act 2007, was responded to by the Government in November 2010. It was accepted as a vital contribution to the continuing development of the WCA, and the recommendations were accepted in full.

Although most of the recommendations were to do with process and covered customer experience, the Atos assessment, the decision-making process and the appeals process, there were important recommendations concerning descriptors—in particular, the need for further work to review the mental, intellectual and cognitive descriptors and how they are working for those with fluctuating conditions—issues which were raised at the start of the process and which have continued as the ESA has progressed. We support the recommendations, but that raises the question of how they sit alongside the outcome of the internal review, which has caused some of the challenges about which we will hear tonight.

The Government's response to Professor Harrington's report indicated that they would await a further report on mental health descriptors in late December and early January. Where does that report rest? Why is it considered appropriate to proceed with the current changes to the descriptors without the benefit of that report?

The criticism of the regulations has come from a range of sources, as we have heard from the noble Lord, Lord Kirkwood. They variously cover the points that the review has been carried out too early with limited evidence; that recommendations from the statutory review—Professor Harrington’s review—are still being worked on; and that changes to descriptors will make it more difficult to identify those with limited capability for work, those who should be in the work-related activity component.

The noble Lord, Lord Kirkwood, referred to the Social Security Advisory Committee. It recommended that certain changes be postponed, stating:

“The Committee recommends that the Department does not proceed with the remaining proposed changes to the descriptors until these have been reconsidered in the light of the findings of the independent review of the WCA and the experience of the trial of the migration of IB customers to ESA”.

Why has the department not taken that path?

Mind, and others, has raised concerns about the regulations regarding mental health descriptors. They extend to the simplification of the assessment, reducing the mental function descriptors by a third, from 10 to seven questions. Is that at the expense of comprehensiveness rather than in unison with it? There are deep concerns about how well the WCA descriptors record the impact of mental health issues. The simplification of the descriptors will exacerbate the problem.

Assessment of an individual's awareness of hazards will now simply focus on the need for supervision, rather than the significance and frequency of the risk posed. Ability to get about and cope with change will no longer be assessed in terms of frequency, which will impact negatively on people with variable or fluctuating conditions. The loss of the propriety behaviour descriptor means that the assessment fails to capture the significant distress caused to people with depression, anxiety and paranoia by misinterpreting or overreacting to the behaviour of others.

The National Autistic Society has expressed similar concerns about reducing the 10 mental health descriptors to seven. It states:

“This reduces opportunities for people to score sufficient points to receive the benefit. Five descriptors which specifically address the needs of people with autism have been reduced to 2. The lower-scoring elements of several descriptors have been removed, and many have been simplified. This makes it much harder to represent the complexity of needs many people with autism experience, and barriers to employment they face, through the assessment”.

It has raised many other points.

Doubtless, noble Lords will also have read the brief from the Disability Benefits Consortium, referred to by the noble Lord, Lord Kirkwood. It asserts:

“An individual who ‘cannot mount or descend two steps even with the support of a handrail’ could now be classed ‘fit for work’ … Someone unable to stand at a workstation for more than ten minutes could now be deemed ‘fit for work’… The descriptors for turning star headed sink tap have been removed, consequently there is no functional assessment for the ability to turn or rotate the hand, despite this representing a form of manual dexterity vital in many workplaces … The changes remove all lower-level descriptors in some categories, for example, there are now no six point descriptors within manual dexterity, making it hard for people with multiple impairments to qualify”.

The noble Lord may not be able to deal with each of those points tonight, but those are genuine, practical, real issues raised by people who know. If they are right, that clearly undermines the thrust of the assessment, which we agree that we should be making.

We should have common cause in getting the descriptors and the process right. The Government must convince us that they have not jumped the gun on these changes and answer the searching questions raised by the various lobby groups, which will doubtless be raised further tonight.

We look forward to receiving the Minister’s reply on these issues. The noble Lord, Lord Kirkwood, has initiated a very important debate, because these issues have run with the WCA and the employment and support allowance from day one. I believe progress is being made and certainly can be made, but there is some way to go yet.

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[Lord Low of Dalston]

My Lords, many speakers have already gone over the new regulations in great detail, and I do not wish to repeat what others have said and go into all the ramifications. I propose just to talk about the impact of the new regulations on blind and partially sighted people, which is likely to be quite serious and which illustrates that the regulations as we have them at the moment are not fit for purpose. I think that other speakers have been unduly kind about the regulations. The noble Lord, Lord McKenzie, said that he was in favour of them. I have to say that I am not in favour of them as they stand. I am more with the Social Security Advisory Committee, which has said that they are not yet fit for purpose in a number of respects, that they were being rushed through prematurely, and that the department should take them back to await the second phase of Professor Harrington’s review. There should be more mature reflection on some of the points that have been made about the regulations and further consultation with the stakeholders who have been so critical of them, about which we have heard.

As has been stated by the noble Baroness, Lady Thomas, these regulations fundamentally undermine the structure of the employment and support allowance where claimants with limited capability for work are put into either the work-related activity group or the support group. The new descriptors make the limited capability for work test, the gateway to the benefit, unreasonably difficult to pass for many disabled people, certainly for blind and partially sighted people. By setting such a high threshold for eligibility for the ESA, they transform the limited capability for work test into a limited capability for work-related activity test, which large numbers are bound to fail. This in effect erodes the distinction between the two tests, undermining the intention of the Welfare Reform Act 2007 that there should be two distinct groups of claimants, one moving towards work—the work-related activity group—and the other with no conditionality—the support group. Under these regulations, the number of disabled people able to qualify for the work-related activity group will drop dramatically, as whole groups are largely excluded by the eligibility threshold.

The Merits Committee, in its first report of this Session, stated that the department itself estimates that 23 per cent will be found fit for work and will be required to make a new claim for jobseeker’s allowance, with its obligation to participate in activities to improve job prospects. The Social Security Advisory Committee believes that the DWP has underestimated the support required by this vulnerable group of claimants. It has also said a number of other things: first, that the current descriptors are also inadequate for measuring the capacity of those with mental health conditions, sensory disabilities or fluctuating conditions; and, secondly, that there needs to be a closer correlation between the tests and normal work situations. For example, someone who needs to be accompanied to familiar places by a helper is not sufficiently adapted to their condition to be capable of work, yet this would score only nine points under the proposed new descriptors and would therefore not enable that person to get through the gateway and qualify for the benefit.

The disability organisations that have made submissions to the Merits Committee have also made a number of other points. The perspective on work skills needs to be wider. Someone might be able to pack boxes all day, but not be able competently to find their way to the factory canteen; or again, people with a limited capability for work—blind people are actually instanced for this—may be able to work, but in a very circumscribed set of jobs. There is an insufficient supply of those jobs in a depressed job market.

I wish to concentrate on the impact of the regulations on the situation of blind and partially sighted people, and in doing so I declare my interest, although at my time of life I am not likely to be applying for employment and support allowance. However, I am a vice-president of the RNIB, which has had a certain amount to say about these regulations. Those who know about these things are clear that the new regulations will have a disastrous impact on blind and partially sighted people, who will in all likelihood fail to qualify for the ESA if the regulations come into force. This is deeply concerning, they say, considering that many blind and partially sighted people have limited capability for work and so should be able to qualify for the ESA, where limited capability for work can be demonstrated—which, I repeat, will be very difficult to do under the new regulations.

A person of working age who loses their sight will need to learn new skills such as independent mobility and how to use a computer using screen magnification or speech output software, as well as new everyday living skills such as cooking, dressing, cleaning and so on. It is not appropriate to require someone in this position to end up claiming jobseeker’s allowance, yet that will be the impact of these regulations. Under the proposed limited capability for work test, a blind person’s difficulties in performing most work-related activities would be ignored and only extreme difficulties in navigation and maintaining safety would be assessed. A visually impaired person would be considered to have a limited capability for work only if they were unable to navigate around unfamiliar surroundings without being accompanied by another person.

The RNIB says that it does not believe that Atos has the specialist knowledge and expertise in a medical test centre environment to carry out functional assessments of the mobility of people with sight loss. It says:

“For example, we are unclear how they would determine whether or not a person is unable, due to sight loss, to navigate a familiar route without support, when they will be assessed in an unfamiliar environment at the test centre, under conditions of limited time for the assessment to be completed”.

The department’s internal review stated that it was the department’s intention to continue to work with experts and specialist disability organisations to refine the descriptors related to sight loss. However, this has not happened, despite requests to meet officials. For that reason, the department really ought to look further at the regulations before it has these discussions with interested organisations that it says in its internal review it is its firm intention to have.

For many blind and partially sighted people, the regulations, if brought into force, could see them denied the ESA. This is due to the high qualifying threshold being put in place around limited capability for work and the failure properly to assess the effects of sight loss. The regulations will seriously undermine the distinction between the work-related activity group and the support group, and force people who should be eligible for the ESA on to the JSA, which is not the appropriate benefit for people with limited capability for work. I do not believe that this is either appropriate or that it was the intention behind the Welfare Reform Act 2007.

[Lord McKenzie of Luton]

My Lords, I did not want to interrupt the noble Lord, but I think he said that I had said I was in support of these regulations. I am not and I do not believe I said that—if I did it was certainly not my intention. I tried to play back some of the concerns that have been raised with us. I certainly support the concept of the ESA and of the WCA, but I do not support these particular regulations.

[Baroness Murphy]

I will be very brief because the debate has gone on for quite some time now. Other noble Lords have eloquently described the present difficulties with these regulations. However, I sympathise in some ways with the difficulties that the Government have, because we all share the intention that we should get more people who are currently receiving disability support into work; and what the Government are trying to do—and the previous Government were trying to do—is exceptionally difficult to get right. The development of those descriptors and an assessment tool is going to take more than the time allowed.

I am not saying that you should not pilot, try or try to revise the assessment tool, which is actually what the Government have tried to do. That seems perfectly legitimate, so I am not entirely in support of withdrawing these regulations, because unless we continually try to improve them, we will never get to the point at which they are adequate. However, I return finally to what the noble Baroness, Lady Thomas of Winchester, has said, because it is not the descriptors or the work capacity assessment that are the real problem. The real problem, which I think Professor Harrington described so beautifully, is that the process is,

“mechanistic, impersonal and lacks empathy”.

Here we have a population of worried, anxious people with a profound range of difficult disabilities to try to assess accurately, and there needs to be a culture change within Jobcentre Plus, Atos Healthcare and the healthcare assessments themselves. That is the fundamental problem. We could work on these descriptors. I know that the Government are doing so with extra help from specialists in the mental health field. I ought to declare an interest here as a psychiatrist. The work that is going on is essential, but unless we can change the culture of these assessments to make them more user-friendly we will not get people back into the work that would help them to lead better, fulfilled lives.