Improving Lives: Work, Health and Disability Green Paper

Neil Coyle Excerpts

Monday 31st October 2016 Commons Chamber

[Damian Green]

We have had five different reviews of the work capability assessment in the past six years, and the ideas I am bringing forward today are the latest response. There is no system so good that it cannot be improved, and I would welcome my hon. Friend’s input to make the system even better in future.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

The Government’s target of halving the disability employment gap is very welcome. The Green Paper offers £115 million in funding for a new model of employment support. Will the Secretary of State confirm that that figure represents less than 5% of the total cut that disabled people have experienced in disability living allowance and employment and support allowance?

[Damian Green]

The hon. Gentleman is slightly confusing apples and pears. This is a support programme to get people with a disability back into work. The best route out of poverty for people with a disability, as it is generally, is to have a job. As a society, we have been much less good at allowing and encouraging people with a disability back into work than we have for the general population. The Green Paper is intended to address that problem.

Oral Answers to Questions

Neil Coyle Excerpts

Monday 11th July 2016 Commons Chamber

[Stephen Crabb]

I agree absolutely with my hon. Friend. The work she has championed in Norwich is a good example of local action, showing where local MPs can indeed be the champions. Much as we might want to talk about national levels of poverty and social mobility, it is much more important to understand what is going on at a local level and to drive local action with effective partnerships.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

Many disadvantaged families have an older disabled relative, including 2,000 in my constituency who receive attendance allowance. The Government have said that they will scrap attendance allowance and pass funding to councils. When are the Government going to consult formally on those plans?

[Stephen Crabb]

The Government have not said that they are going to scrap attendance allowance. We are looking at options for devolving it to the local authority level, but we have been absolutely clear that this does not mean a cut to supporting attendance allowance. It is about looking at more effective ways of delivering it at the local level to achieve what it is intended to achieve.

Disability Employment Gap

Neil Coyle Excerpts

Wednesday 8th June 2016 Commons Chamber

[Owen Smith]

That was a slip of the tongue, and I regret making it. In this of all areas, we should be extremely careful with the language that we use. I did not mean to imply what the hon. Lady suggests that I was implying.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

Does my hon. Friend agree that the Department for Work and Pensions has a duty to monitor the impact of the PIP roll-out, given the projection by Disability Rights UK that it could cause about 55,000 disabled people in work to lose their Motability vehicles and thus their ability to work?

[Owen Smith]

I think it is absolutely shameful that the Government are refusing to monitor that properly. It is clear to all of us in the House that if people lose the cars that allow them to get to work, it will be harder for them to stay in work or seek employment. That, surely, is as plain as the nose on the Secretary of State’s face.

Does the Secretary of State think that taking Sarah’s Motability car away from her helps or hinders his mission to halve the disability employment gap? It seems to me that he should know the answer to that. I ask him to bring forward the review of PIP, and to think again about the 20-metre rule in particular. I ask him to look at what Atos and Capita are doing and reform their management of the system, because it is not working, and people such as Sarah are paying the price.

--- Later in debate ---

[Stephen Crabb]

There are different ways of measuring that, but around one in six people have a disability. I will come on to explain why those figures will go up and what challenges that will present to us as a society. It is a mark of the extent of our ambition as a Government that we have a commitment to halve the disability employment gap. That is exactly the right vision to have, but we are in no doubt that the challenges are both profound and complex.

The employment rate for those who are not disabled is currently 80%; for disabled people it is 47%. That is not just a gap of 33 percentage points, but a gap in the life chances of disabled people up and down the country. It is a gap that has persisted for too long. The barriers that disabled people have built up over many years will take time to break down. I am clear that, for far too long, too many have not had the right support or been given the opportunity of work. Very often they are parked on benefits, cast aside and forgotten about. That is not good enough.

[Neil Coyle]

rose—

[Stephen Crabb]

I will make a bit more progress, but I will give way later.

Emerging from this past of unfulfilled potential, there are encouraging signs that those barriers are being dismantled and that attitudes are changing. Travelling home on the Tube the other day, I saw an advert promoting a career with Shell—I can already see grimaces on Labour Members’ faces. That ad made it clear that Shell recognises that the more diverse and inclusive a team, the more varied the ideas and the better the business. Diversity drives innovation. The ad shows how a disabled person is as much a part of a business’s core vision of success as any other recruit. Recruiting disabled people should not be a bolt-on extra or a nice thing to do. As the ad says, the company is in search of “pioneers” and “remarkable people”. For me, this was more than a recruitment ad; it was a much wider advert for how society is changing and how disabled people are viewed. They are no longer patronised or diminished, but a core component of a well-performing business and of a diverse and successful society.

I see and hear that change for myself when I meet employers, charities and disabled people. I hear it from members of the Disability Charities Consortium and of the mental health expert advisory group. Just yesterday, when I was visiting the constituency of the hon. Member for Bermondsey and Old Southwark (Neil Coyle), I had the pleasure of going to a micro-brewery in Bermondsey where all the employees have learning disabilities.

[Neil Coyle]

rose—

[Stephen Crabb]

Now is probably a good moment to give way to the hon. Gentleman.

[Neil Coyle]

I thank the Secretary of State for giving way and for visiting the fantastic organisation, UBREW, in my constituency. He has spoken a lot about ambition, but does he not think that this House and disabled people were misled about the timing of the new disability support programme from next year—at the same time as the ESA cut is going to be delivered? Does he not think that it would be fairer and more reasonable if the ESA cut was delayed until his delay to deliver the new employment programme has come to an end?

[Stephen Crabb]

I do not think that the House was misled. The money has been made available from the Treasury and I have discussed it with the Chancellor. That money is there. What I have decided to do—I will explain this in more detail later—is to take a step back and work much more closely with disability organisations and disabled people. Rather than rush to push out a White Paper, I have decided to talk to those organisations that know the situation the best, and work in a new spirit to work up some proposals that we know will make a long-term difference. That decision I have taken not to rush ahead with a White Paper and to work more collaboratively on a Green Paper has been welcomed by the organisations that I have been speaking to.

--- Later in debate ---

[Stephen Crabb]

The slightly glib answer that I could give is that there is a role for all of us in this House to promote Access to Work in our communities and constituencies, but there is a broader challenge for the Department and for the Ministers as to how we get that information out. My hon. Friend the Under-Secretary, who has responsibility for disabled people, is taking the lead on that and will refer to it in his closing remarks.

[Neil Coyle]

I thank the Secretary of State for giving way. Can he explain why the number of disabled people supported by Access to Work is lower now than it was in the last full year of Labour in government? When will he publish the figures for the number of young disabled people who are supported from the £10 million fund that was meant to have been dedicated to voluntary placements from 2013?

[Stephen Crabb]

I do not have the specific figures to hand, but I heard a voice in my ear from my colleague, the Under-Secretary of State for Disabled People, my hon. Friend the Member for North Swindon (Justin Tomlinson), that those figures are not correct, so perhaps in his closing remarks he can respond directly to the question from the hon. Member for Bermondsey and Old Southwark (Neil Coyle).

--- Later in debate ---

[Justin Tomlinson]

I thank my hon. Friend for that helpful intervention. I absolutely agree, and it was a great pleasure to join my hon. Friend in visiting Worcester arena, which showcased how inclusive design right from the beginning has made a genuine difference and created more opportunities. That was one of my favourite visits as a Minister.

The new employment allowance has helped more than 16,000 disabled people to start their own business, and with Access to Work we have secured funding for an additional 25,000 people. We are close to launching the digital service to bring Access to Work online, which will please employers and those who seek to claim. We have introduced specialist teams. We have the mental health support service, and we are doing further work to support apprentices, particularly those with mental health conditions. My hon. Friend the Member for Erewash (Maggie Throup) highlighted the need to increase awareness, and she is absolutely right. All too often, this has been Government’s best-kept secret. I commissioned work through KPMG to look at how we can better increase awareness so that we can, as quickly as possible, fill the 25,000 additional places. As many speakers have highlighted, it is not just about the Government; we have to look at employers, because employers will create those opportunities.

[Neil Coyle]

Before the Minister moves away from the role of the Government, can I just say how refreshing the disability organisations I am proud to have worked with over the years have found it to have a new Secretary of State, with a new and more engaging agenda, who is willing to acknowledge that there has been significant failure over the last six years at the introduction of new and better schemes?

[Justin Tomlinson]

I thank the hon. Gentleman for that comment. I find it refreshing that the Secretary of State is willing to engage, because we are talking about the individuals who see those opportunities and challenges from day to day, and who can provide us with constructive solutions. The Green Paper, which I will talk about later on, is a real opportunity for them genuinely to shape how we will improve opportunities.

We want to help encourage employers to provide such opportunities so that those who chose to engage with the Work programme, with Work Choice and with charities do not continue in the loop—yet another 12-week course to be told how to prepare a CV and go through an interview—and lose confidence as they move further away from the jobs market. The key is that if we can create those opportunities, more people will be able to get into work.

Our Disability Confident campaign has now signed up over 600 employers, and we are recruiting over 100 a month. This is about sharing best practice and signposting, but we will go further. We are working on plans with greater asks of particularly the larger employers to make sure that they include as many people as possible from their supply chain in such training days.

Several Members have highlighted reverse jobs fairs. It was a great pleasure to visit the one held by my hon. Friend the Member for North Devon (Peter Heaton-Jones). This is about bringing together all the organisations doing a huge amount of work to support disabled people in their respective communities to meet small and medium-sized businesses that are often unaware of the huge wealth of talent in the country and the support that would help people into work. I am proud that a cross-party group of over 50 MPs have signed up to hold their very own reverse jobs fairs. I thank each and every one of them because it will make a difference.

We have commissioned small employer engagement pilots, in which we are sending out representatives to talk to small and medium-sized businesses—doorstepping them, asking them to put on the kettle, and saying, “Look, we are here to support you. We can signpost you to genuine talent to fill your skills gaps.” The pilots are still in their early days, but I am very excited by the positive outcomes achieved in matching skills gaps with people who wish to work.

Some speakers talked about how vital apprenticeships are. They give people a genuine opportunity to develop real, tangible skills that will lead to work. I pay tribute to my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard), who has chaired the joint taskforce set up by the Minister for Skills, the BIS Minister with responsibility for apprenticeships, and me. The taskforce will make sure we can open the apprenticeship commitment—the Government want 3 million more people to access the apprenticeships scheme during this Parliament—to more people with disabilities, particularly those with learning difficulties who find the entry requirement of grade Cs in GCSE maths and English to be a hurdle too far. Again, I am very excited about this. We set up a one-month taskforce, and its work was completed yesterday. We will look at its recommendations, and we intend to act as quickly as possible.

This is about the importance of localising and tailoring our solutions, and we are absolutely committed to that. Several speakers highlighted the fact that only 6% of those with learning disabilities will typically achieve meaningful, tangible outcomes. That is totally unacceptable. When I visited Foxes Academy in Bridgwater, which was featured on Channel 5, I learned that over 80% of its students have been able to find work, of which 45.6% are in paid employment. That is because it has the equivalent of an apprenticeship scheme, with supported working. It works with employers to identify skills gaps and it provides the necessary training. That is something we can replicate and that I want the taskforce to highlight, and I am excited about its potential.

I attended the launch of the Resolution Foundation report yesterday, and I pay tribute to both Laura and Declan, who did a huge amount of work on it. The report highlights a lot of important issues, especially about the retention of disabled people in work, which is particularly important given that we have an ageing workforce and that 83% of people with a disability have developed that disability with age. It is right to look at all those areas to help keep as many people as possible in work. It is far easier to support people to keep them in work than it is to get them back into work.

To turn to the Green Paper, I know from my engagement with them that the stakeholders are genuinely excited at this opportunity. They understand that they will make a tangible difference to what the Government are doing, and I hope that that will secure support.

I want quickly to respond to some of the points made by the shadow Secretary of State. On mobility, there are 22,000 more people accessing the mobility scheme than before PIP was introduced. On the 20-metre rule, it is not as black and white as whether someone can do 19 metres or 21 metres; it is about being able to travel a distance reliably, safely, in a timely manner and repeatedly. On the assessment process, I urge the shadow Secretary of State to visit a centre and sit through an assessment to see what happens. There is too much hearsay, and not enough genuine knowledge. On DLA, let us remember that only 16% of claimants accessed the highest rate of benefit compared with 22.5% under PIP. We are targeting the money at the most vulnerable, and that is why the numbers are increasing and the money is being spent.

I say to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) that it is right this is done on a cross-Government basis. It has to be joined up and we genuinely need greater understanding. I say to all those who contributed to this debate that it has been an important and positive one.

Oral Answers to Questions

Neil Coyle Excerpts

Monday 9th May 2016 Commons Chamber

[Justin Tomlinson]

We have seen 22,000 more people access the Motability scheme since PIP was introduced. There is an opportunity for a mandatory reconsideration and then an independent appeal. Those who are not successful do get to keep the car for a further seven weeks and have up to £2,000 to put towards buying that car or making alternative arrangements.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

15. What estimate his Department has made of the number of families in which one or more people are in employment who will receive less support under universal credit after moving from tax credits.

[The Secretary of State for Work and Pensions (Stephen Crabb)]

Universal credit is transforming the welfare system so that work always pays. For the first time, we are providing tailored support to help people to get into, and make progress in, work. Anyone being moved to universal credit from tax credits will receive transitional protection, so that they are not a cash loser.

[Neil Coyle]

A single parent on universal credit who works full time will be up to £3,000 worse off than someone in the same situation on tax credits, as a result of cuts that are taking effect from April next year. How many single parents working full time—doing the right thing, in the Government’s vernacular—in Bermondsey and Old Southwark does the Secretary of State expect his cuts to affect, and by how much does he intend to make them worse off?

[Stephen Crabb]

I will repeat the point that people being moved from tax credits to universal credit will have transitional protections. The hon. Gentleman is making the mistake that so many of his colleagues have made of trying to compare the present position, falsely, with the previous situation under tax credits. Let us not forget that when tax credits were set up, there was no national living wage, child care support was not at the same level, and there were not higher rates of personal allowance. We are transforming the landscape of support for people on lower incomes.

Social Security (Equality)

Neil Coyle Excerpts

Tuesday 26th April 2016 Westminster Hall

[Christian Matheson (City of Chester) (Lab)]

I beg to move,

That this House has considered the effect of social security changes on equality.

It is a great pleasure to serve under your chairmanship, Mr Hollobone. When the benefits system was established, it had a couple of main aims: to provide a safety net for people in work if they lost their jobs, and to provide a springboard back into employment. Surely no one could argue with those aims; they both remain relevant today. To listen to Government rhetoric, hon. Members would be forgiven for thinking that all was fine and well, but there are two other principal aims of the system that I believe should also be considered. One is surely to give comfort and dignity to those who are unable to work for themselves, and the second is to use the levers of government to reduce inequality and make ours a more equal society.

I start by asking the Minister this: is it this Government’s view that it is their role to use the tax and benefits system to achieve a more equal and less extremely divided society? Taxation can be used to raise revenue and to nudge citizens’ behaviour—through, say, taxes on alcohol, tobacco or even sugary drinks—but also to level off the harshest divides by supporting those who cannot support themselves. For all this Government’s rhetoric, the UK is at best as unequal now as it was at the start of this decade, and according to the Institute for Fiscal Studies, it is likely to become more unequal towards the end of the decade. Perhaps that is acceptable to the Government. If the Minister concedes that equality is not a top priority, that is fine; we can accept his honesty and have a difference of opinion.

We have heard that the recent Budget will impact women most harshly, and there is still no fair transitional pension settlement for the 1950s women affected by pension changes. Young people are excluded from housing benefit and from the so-called national living wage—although, to be fair, as it is not actually a living wage, that is not much of an omission. Scandalously, state support for those affected by contaminated blood transfusions is being slashed. However, with your permission, Mr Hollobone, I will focus on the combined impact of changes to the benefits system on people with disabilities.

The Government have sought from the outset to justify cuts to benefits by demonising claimants, introducing a them-and-us atmosphere and creating a stark but false division between—in the Prime Minister’s words—shirkers and strivers. Or was it skivers and strivers? I cannot remember the exact words, but the sentiment is the same. Let me make it clear that I have absolutely no time for those who can work but do not, relying on everyone else’s work but not contributing themselves. They should be dealt with individually. However, those people are a tiny minority. Around 0.3% of the total benefits bill is spent on out-of-work benefits to those who could be working—the real shirkers or skivers—yet the Government have tarred all claimants with the same brush. I believe that they have done so deliberately, to make cuts to support for disabled people more palatable to the general public.

Nobody chooses to have a disability. Nobody chooses to have a long-term debilitating illness. I can guarantee that every single one of the people whom we are talking about would rather not be in the situation that they are in. People have disabilities for a variety of reasons, including genetic defects, pre-natal or ante-natal complications, serious illness and accidents. However, one common factor runs through all of those situations: blameless misfortune, or bad luck. It is surely the duty of the modern, compassionate state not to compound that bad luck, but to compensate for it.

Scope’s extra costs commission estimates that disabled people face average extra costs of £550 a month due to their disability. The personal independence payments system introduced to address those additional needs is failing. The extra costs are not being met, claimants are routinely being turned down, and 60% are being reinstated on appeal, but in the meantime, their worry and debt are growing exponentially.

This week I spoke to a constituent of mine, Kevin, whose wife has kidney failure and is on dialysis, as she has been for several years. It is unclear why she has kidney failure, though it could be linked to complications at the birth of her children. She receives dialysis in the morning, has something to eat and then goes to bed and sleeps until the next day. There is no possibility that she could hold down a job, and the support that she receives from the state is essential, yet when she applied for PIP after moving over from disability living allowance, she was turned down. My constituent is appealing the decision, which of course takes months. In the meantime, she and her family are being driven further into poverty, and probably into debt.

That brings me to my next main point. When PIP was introduced in the Welfare Reform Act 2012 to replace disability living allowance, we were told that it was to ensure that benefits were focused on those who needed them most. Indeed, the impact assessment for the 2012 Act said that under PIP, the number of claimants would fall by 500,000. I understand that it was designed to deliver a 20% cut to the total cost.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

The Prime Minister expressed surprise and disappointment when the former Secretary of State, the right hon. Member for Chingford and Woodford Green (Mr Duncan Smith), resigned this year. Does my hon. Friend not think that if the former Secretary of State believed in what he was saying about disabled people being affected, it would have been more appropriate for him to have resigned when he introduced PIP to begin with?

[Christian Matheson]

That certainly would have prevented a lot of heartache and difficulties for those who have been affected. My hon. Friend, who sits on the Select Committee on Work and Pensions, is an expert in this area, so I will take his word for it.

On his recent appointment, the new Secretary of State immediately used the justification of focusing benefits on those who need them the most. I admit that even previous Labour Governments have used that as an excuse. However, I believe that it is a bogus argument, and a sham to give cover to further cuts. Why should a disabled person placed in the group of greatest need when PIP was first introduced suddenly be deemed not to be in the greatest need, just a couple of years later? Are the Government seriously suggesting that someone with a lifelong disability or chronic illness can be cured of that disability? Why is my constituent who is on dialysis with double kidney failure suddenly considered not to require PIP, when there has been no change in her condition and she has not yet received a transplant?

The situation does not only economic harm by forcing the vulnerable into even greater poverty, but psychological harm by increasing their stress, and their worry that their lives will be further impoverished by reductions. My constituent Lynda Hesketh, who is wheelchair-bound and who runs the Chester People Have Abilities group, describes to me her terror—that is her word—whenever a brown envelope drops through her letterbox; she worries that it is announcing a further cut to her support.

Of course, many people with disabilities want to work and are capable of doing so, but they face cultural or physical barriers. The Government have made some progress in helping disabled people into work, but the disability employment gap has nevertheless widened slightly in recent years.

Personal Independence Payments

Neil Coyle Excerpts

Wednesday 13th April 2016 Westminster Hall

[The Parliamentary Under-Secretary of State for Disabled People (Justin Tomlinson)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I pay tribute to the hon. Member for Wrexham (Ian C. Lucas), who cares passionately about his constituents. I have enjoyed working with him on a wide range of issues relating to my role. I genuinely understand why he takes such a close interest in this subject, and I will do my very best to address the points raised both by him and in the interventions that he kindly allowed.

I want to make a few basic points absolutely clear at the beginning. This is not about reducing the number of claimants or the amount of money spent; it is a fact that the number of claimants and the amount spent will increase in every single year of this Parliament. PIP is a modern and dynamic benefit to help cover the extra costs faced by people with disabilities. By way of comparison with the old system, 16% of DLA claimants would expect to get the highest rate of benefits; it is 22.5% under PIP. An example of where there is a big difference is in hidden impairments, such as mental health conditions. Only 22% of those with a mental health condition would qualify for the highest rate of DLA, but under PIP it is 68% because the system is better designed to take such cases.

That situation comes about because, under DLA, claimants were predominantly assessed on the form they filled in—it was a long, complicated form. I accept that the PIP form is still not the simplest form, but it is better than the old DLA form. Some 70% of people who were given a benefit under DLA had no medical evidence, and the problem with that is that people will often under-diagnose, particularly if they have a hidden impairment. They might take for granted the challenges that they face and think that they are the norm and not something for which they should get support, whereas we recognise as a society that they should get that support.

The job of the assessors is, in effect, to help people fill in their form to a better standard than under the old DLA system. The Government determine how much is paid and how many points people need in order to qualify, so we are at the end of the system, but the assessors are there to assist claimants in making the very best case that they can make.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I appreciate that people with mental health conditions or learning disabilities are likely to do better, but the 2010 Budget clearly set out, on page 40, table 2.1, line 23, that DLA reform was solely designed to reduce spending on working-age DLA expenditure by £360 million by 2013-14 and by more than £1 billion by 2014-15. To claim that PIP is about being more generous to disabled people is just plain dodgy.

[Justin Tomlinson]

No, it is the reality that every year the number of people either on DLA or PIP—as Members can imagine, people are increasingly switching to PIP from DLA—is rising and the amount being spent is rising. That is what is happening. As things stand today, 1.32 million people have gone through the PIP process. About 745,000 claimants are now on PIP, and about 1.5 million claimants remain on DLA.

--- Later in debate ---

[Justin Tomlinson]

Let me make some progress and then, if I have time, I will take some more interventions.

The hon. Member for Wrexham made a fair point about the limited time for a claim. It is actually a month, but people can ask for longer. They automatically get two weeks without any questions, and further extensions are considered depending on the circumstances. For example, if somebody says, “I will need assistance in filling the form in”, additional time will be given. If people struggle to fill in the initial forms on their own for a variety of reasons, the Department will send people to help them do so as quickly as possible.

As I highlighted earlier, the PIP forms are shorter and simpler than the old DLA forms. That does not mean that they are absolutely perfect yet. However, part of my role and my officials’ role is that we regularly meet charities, other stakeholders and users of the service, who make suggestions. There are continuous improvements, and I would expect that to keep happening. The hon. Gentleman raised a fair point, and we have a taskforce on our wider communication, with representatives from all the major charities going through things with a fine-toothed comb. I am grateful for all their help and support in that regard.

At the very beginning of the process, if an individual has a condition that means that we have concerns about their ability to return forms, that is flagged up so that we do not just automatically let them drop off the system. We can then be proactive in trying to contact them and contract people who can provide support for them, to make sure, as I say, that they do not simply drop out of the system. That is a very important point.

We are constantly reviewing the quality of the system—that is really important—and one change we made recently was to add a further 10 days for the assessment providers to be able to gather and consider further evidence. That came about because of the 60%-odd success rate in the appeal process, which a number of Members have mentioned. To put that into context, it involves about 2% of total claimants; as I have said, about 1.3 million people have gone through the system. When I first became the Minister and I saw the figure on successful appeals, the first thing I did was to visit the Cardiff office. I said, “Right. Presumably every time one of these is assessed on appeal, you down tools, sit down, analyse what we have done and make sure we never do that again.” Actually, more often than not a decision is overturned because of additional evidence that has been provided—the key word is “additional”—either oral or written. So in theory the decision at the beginning was right, based on the evidence that was given, but we as a Department rightly provide people with two further opportunities to submit additional evidence for a reconsideration.

All Members will share our frustration in this sense—in an ideal world someone would phone up for a claim, give their national insurance number, we would have full access to all their medical records and they would not have to go and find the reports from their doctor or occupational therapist. Former Governments had a good go at achieving that, but for a variety of reasons it has not happened. We therefore ask people to submit new evidence.

A typical example of what can go wrong for a claimant is that they get their GP’s evidence and put that in with their application, but they do not think to get the evidence from their occupational therapist. However, when we send them the letter that does not give them the benefit rate that they were hoping for, the information in it is clear enough for them to think, “Ah! If only I had done that.” They then have those two further opportunities to submit evidence. So the majority of the 65% or so successful appeals are because of additional evidence being submitted, not because of mistakes in the system.

[Neil Coyle]

rose—

[Justin Tomlinson]

I will take just one last intervention, because I have a bit more to say.

[Neil Coyle]

I am grateful to the Minister. His position seems to be that the process is right and that it is the fault of individuals for not submitting information at the right time. Would it not be in the Department’s best interests to save money by ensuring that the decisions are right first time, by allowing individuals enough time to get their medical information in.

[Justin Tomlinson]

I think we agree—

[Neil Coyle]

But you control the process.

[Justin Tomlinson]

We have just added a further 10 days to the process, recognising that point. We want to get the right decision for the claimant first time. That is an absolute given, but we rely on individuals to present evidence. Everyone is unique. Everyone involved is facing a different challenge, which is why they are applying for the benefit. In an ideal world, we would have access to all their information and no one would have to provide it, but as I have explained, that information is not available. My colleagues in the Scottish Parliament are doing some interesting work in this area, and we will look carefully at how that progresses, but we have added that extra time and are trying to be as clear as we can in the letters.

Beyond this debate, I will be interested to look more closely at the points that the hon. Member for Wrexham made about how the information that comes back to people is sometimes not clear enough. However, all claimants can request a copy of the full health professional’s report at any stage in the decision-making process. That is automatically triggered at the independent appeal stage, but it is available before that if people wish to have it.

We are also working on the online application process, to put all the information in one place. A lot of people want to be able to apply online for convenience. An added benefit will be that we can put additional help and support online, but people will still be able to claim in the traditional way if they want to.

I do not have long, but I want to address the point that was made about locations. All claimants in north Wales are offered—

Oral Answers to Questions

Neil Coyle Excerpts

Monday 14th March 2016 Commons Chamber

[Priti Patel]

My hon. Friend is right to mention the Corby site. Again, support from the rapid response service and the Department’s team was offered to Tata workers following the announcement of the job losses. On top of that, at this very difficult time, we are giving those individuals support through our DWP network—for example, guidance on job applications, training and support—to enable them to get into work all over again.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

6. How many people his Department expects to be naturally migrated on to universal credit during this Parliament.

[The Secretary of State for Work and Pensions (Mr Iain Duncan Smith)]

Universal credit is rolling out, with the live service available in over 90% of jobcentres, and full roll-out will continue according to the published plan. It is worth reminding everybody that it is complete in London, and very shortly—probably by the end of this month or the beginning of next—universal credit will be in pretty much every single jobcentre in the country.

[Neil Coyle]

The Secretary of State made reference earlier to unreliable predictions. He predicted that by today’s date 8 million people would be on universal credit, but the DWP confirmed last week that fewer than 365,000 people are on universal credit—a staggeringly pathetic success rate of 4.4%. The only reason why the Government are pushing out universal credit now is to deliver the tax credit cut that will hit thousands of working families in my constituency, so is it not time the quiet man went silent on pretending that universal credit is a success?

[Mr Duncan Smith]

I bet that looked good when the hon. Gentleman wrote it down. It is utter rubbish.

Welfare Reform and Work Bill

Neil Coyle Excerpts

Wednesday 2nd March 2016 Commons Chamber

[Priti Patel]

The hon. Lady will know from the Bill and the impact assessments the fiscal savings that will result from the measure. Fundamentally, we are making the change so that we can provide long-term support. For that reason, I think that all hon. Members will look forward to it.

We are committed to tackling the problem that too few people are moving off benefits and being supported into employment. There are economic, social and moral arguments for ensuring that those who are able to work can work, and that they are supported into work. Work is the most effective way to improve the wellbeing of individuals, their families and their communities.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

The Government’s equalities watchdog has said that there is

“very little in the way of evidence”

to show that what the Government are trying to do will support disabled people back into work. In the last five years, the number of working-age disabled people has fallen, and the Government speak from a track record of failure. Are disabled people not right to be sceptical about what is about to happen? What direct evidence can the Minister offer about the support that will be delivered to disabled people?

[Priti Patel]

As the hon. Gentleman will be aware from his participation in the Public Bill Committee and during the Bill’s passage through the House, the Government are committed to bringing in reforms. As I will shortly come on to say, the reforms will be set out in a White Paper later this year. Importantly—we are optimistic; we really are—the White Paper will outline our plans to reform further the help to support people with health conditions and disabilities into work.

A large body of evidence shows that work is good for physical and mental wellbeing. There is also a growing awareness, as I am sure all Members recognise, that long-term worklessness is harmful to both physical and mental health. Reform is therefore vital in itself, but we will go further. We are ambitious; we do not believe in writing people off. Importantly, we will ensure that the welfare system incentivises and supports people into employment.

[Neil Coyle]

rose—

[Priti Patel]

I will give way one more time.

[Neil Coyle]

In the past five years—in fact, in the past six years, during which the coalition and this Government have been in office—the number of disabled people of working age in work has fallen, the Government have closed Remploy factories, the number of disability employment advisers in Jobcentre Plus has fallen by 20% and the number of people supported by the Access to Work programme has fallen.

[Priti Patel]

I will repeat my starting premise: we are more positive and optimistic for people with health conditions and disabilities. Support through the Access to Work programme has increased. We have great initiatives, such as the Disability Confident campaign, which is supporting people back into work. The hon. Gentleman may want to join us, perhaps by hosting a Disability Confident event in his constituency. I would very much welcome such support. I think that we should be optimists. This Government are committed to halving the employment disability gap, which all Members of the House should welcome.

Work Capability Assessments

Neil Coyle Excerpts

Tuesday 9th February 2016 Westminster Hall

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I thank my hon. Friend for securing the debate. Is there not also an issue about the significant waste of taxpayers’ money in the Government failing to address the fundamental flaws in the system, which lead to an over-reliance on appeals and reconsiderations and the Department for Work and Pensions having to prop up a private company that is failing to deal with assessments appropriately the first time?

[Louise Haigh]

I could not agree more, and I will come on to that issue.

This is about providing not just a good-quality service for clients, but best value for money for the taxpayer. As I said, when one side is trying to cut costs and another is employed to maximise profit, something has to give. As report after report has identified, the contractors that the Government have employed to carry out cuts have been anything but successful. They have presided over failure after failure. There has been poor performance, a disregard for vulnerable people and, in this new age of outsourcing, a total lack of accountability for Government and operator alike.

[Louise Haigh]

Again, I completely agree with my hon. Friend, and I thank him for that intervention. The contractors continue to get paid despite repeated failures. Even worse, after being deemed unfit to perform in relation to one contract, contractors simply get to continue with another lucrative long-term deal, as Atos has done. After failing to handle the work capability assessments contract, it is still running a seven-year contract for personal independence payment assessments for the same Department. Now Maximus is failing to meet a range of key targets—targets that, importantly, put far greater emphasis on saving money than on meeting the needs of people who unjustifiably suffer. Whatever the rhetoric about service quality, this is still a system designed to cut costs for the Government and maximise profit for Maximus.

We have undoubtedly all read last month’s report by the National Audit Office, but some of the figures deserve to be rehearsed. Despite the new contract—which followed Atos’s spectacular failure—being worth some £570 million a year, there is still a backlog of 280,000 employment and support allowance claims. The average cost of each individual assessment is now almost £200, and that is for a 15-minute assessment. One in 10 disability benefit claimants’ reports are rejected as below standard by the Government, compared with one in 25 when the shamed Atos was running the show.

Individuals have to wait an average of 23 weeks for a decision to be made on their benefits; there has been a huge rise in that timescale—almost a trebling—in recent years. For each person, that can and almost always does mean hardship, but the number being referred keeps rocketing as the Government, desperate to clear the books at any cost, lay the bill for clearing the deficit squarely at the door of the sick and disabled. The Government are forcing away from ESA people who need and rely on it, and the failing contractors are being overwhelmed. Despite all that undeniable pain, unbelievably, the Department is not expected to meet the initial £5.4 billion savings target originally envisaged for the 10 years to 2019-20.

[Neil Coyle]

I thank my hon. Friend for generously giving way again. Does she agree that the failure at ministerial level to get a grip on the backlog, the rising costs and the incompetence in the Department for Work and Pensions has led to the Treasury’s demand to take even more money from disabled people on employment and support allowance, which is why the Government are seeking to cut £30 a week from half a million of the most disadvantaged people in the country?

[Louise Haigh]

Again, my hon. Friend has neatly anticipated my next point, which is that the Office for Budget Responsibility has identified ESA and PIP as a major risk to planned public spending targets, given the uncertainty of the estimates. The NAO has gone so far as to say that PIP and disability living allowance performance issues have been the main contributing factor in the Department’s inability to save any money in the spending review period up to 2015.

It is clear that both the Government and contractors are failing on their own terms, yet still the cash is handed over to failing contractors. We are locked into long contracts whereby Departments do not have the capability to improve performance. The original policy itself is flawed, but it is in the treatment of individuals unlucky enough to come into contact with the system that the whole rotten trade-off between cost cutting by the Government and profit maximisation by Maximus is most apparent. Specific cases abound, and I am sure that hon. Members on both sides of the House would be able to relay evidence of deeply concerning practice, which is why it is interesting to note that not a single Government Back Bencher is in the Chamber today. I will list a few from my case load.

One man with learning difficulties whose case was highlighted to me attended his work capability assessment, but during the assessment his support worker was shocked at the lack of care and attention given to him. When the assessment came through, there were some glaring factual errors, but none the less his ESA was docked, just in case he was in any doubt about what comes first—the person or the profit. On making his request for mandatory reconsideration, he was appalled to find out that he would be ineligible for ESA, which was his lifeline, until the reconsideration decision was made, and he was unable to meet the conditions placed on him for jobseeker’s allowance. He now faces months of waiting until his tribunal, and potentially an annual battle if assessors continue to lack understanding of his learning difficulty.

--- Later in debate ---

[Gerald Jones]

My hon. Friend illustrates a valid point that is replicated across the country.

I am sure that hon. Members are as concerned as I am when they hear that, according to the DWP’s own figures, around 50% of assessments are overturned on appeal. That surely calls into question the reliability of the initial assessments and raises the question why we are putting people through such unnecessary stress, which has undoubtedly had a negative impact on the mental health of many claimants.

I am also concerned that the work capability assessments do not seem to take account of individuals who have a limiting long-term illness that means their condition often fluctuates, such as kidney dialysis patients or people with Parkinson’s. I visited the kidney dialysis patients support group in Merthyr Tydfil last weekend, and a number of people told me of their concerns about the work capability assessment and the lack of understanding of their condition. Dialysis patients often feel reasonably all right on certain days between dialysis, but on the day following treatment they can feel very low, which means that if they are receiving treatment three days a week, the number of days when they feel okay are few and far between. The Government need to address that lack of understanding.

If the original clauses 13 and 14 of the Welfare Reform and Work Bill are reinserted, financial support for new claimants in the work-related activity group will be cut by around 25% from £102 to £73, which will have a drastic impact on disabled people. The Government have said that they are committed to protecting support for disabled people, so the clauses are deeply worrying. The cut will not incentivise people, as the Government say they want.

[Neil Coyle]

Could the Government’s proposed cut to half a million people, including people with learning disabilities or cancer, have the perverse incentive that those people will then try to go into the support group when there is already a 280,000 backlog due to the Government’s incompetence in handling that contract?

[Gerald Jones]

I agree, and it shows how ill thought out the Government’s proposals are.

--- Later in debate ---

[Patricia Gibson]

I am afraid the only possible reason I can think of for that is that the information does not present the work capability assessments in a flattering light. I leave others to draw their own conclusions about how bad it might be.

The worst thing about the system is that those caught up in the controversy and confusion are people with long-term health conditions, and some of the most vulnerable people in our communities. There is a lot of consensus in the Chamber about the need for an urgent review of the work capability assessment. As the hon. Member for Sheffield, Heeley (Louise Haigh) pointed out, the cost is increasing, and it is expected that £595 million will be paid for 3.4 million assessments—about £190 per assessment. There has also been a problem with the recruitment of enough medical professionals to meet the demands of the assessments. At least £76 million of taxpayers’ money has been wasted through the failure to get a new IT system up and running more than two years after it was supposed to be in place. As has been mentioned, the National Audit Office report, which was released only last month, revealed that

“recent performance shows the Department has not tackled—and may even have exacerbated—some of these problems when setting up recent contracts”.

[Neil Coyle]

The points about rising costs and the backlog are well made. Perhaps we can help the Minister by asking her to consider removing some of the routine retests for those with progressive conditions and conditions that will not change. We have all had the excellent briefings from Parkinson’s UK and Mencap, for example. Perhaps the Minister should look again at the frequency of testing for some people, to save the taxpayer money and save some of the stress and anxiety that the hon. Lady has mentioned.

[Patricia Gibson]

That is an excellent, well made point and I thank the hon. Gentleman.

There is also a problem with transparency. In December, the Work and Pensions Committee concluded that it was unable to scrutinise benefit delays fully because of lack of available data. Its report said that

“if the DWP has this data, they should publish them. If they do not, then they are making policy decisions in the dark. The Department should address the lack of data immediately.”

Chillingly, in answer to parliamentary questions about the connection between assessment tests and the incidence of suicide or mental health problems in disability claimants, the Department has admitted that it neither holds such information nor has any plans to collect it. I think that is significant. There has also been an admission that it does not have information on how much, on average, it costs the Department to fund an appeal against a fit for work decision. It is clear—and becoming increasingly clear to claimants—that the system is in a mess. There is clear capacity shortage; there are also wildly optimistic targets, a lack of transparency and problems with hiring and training staff—within the context of dealing with individuals with long-term and serious health problems who are simply trying to access the support they need to survive. The National Audit Office has concluded that this system has

“significant financial and human costs”.

The current situation is cruel, inhumane and demeaning; as has repeatedly been pointed out in the debate, the system is not fit for purpose. I sincerely hope that the Minister will respond to the debate in a positive way and consider the significant financial and human costs to those who need, rather than bureaucracy and judgment, our support and compassion. The debate is about much more than simple work capability assessments. Ultimately, it is about the kind of society we want to create, and the society we aspire to be.

--- Later in debate ---

[Dr Whiteford]

As ever, the hon. Gentleman makes an important point clearly. There is no reason why people’s medical history should not be included in the assessments. Often, consultants—sometimes it is a GP, but in cases of serious illness it is more likely to be a consultant—are in a position to provide insight into the longevity of a condition as well as its immediate acute effects.

[Neil Coyle]

Is the hon. Lady aware that the Government, during the last Parliament, also shortened the timeframe within which individuals can provide independent medical evidence? As it takes longer to see a consultant or specialist, that inevitably means that some people cannot provide that information in time, which contributes to the number of reassessments, the backlog and the cost to the taxpayer.

[Dr Whiteford]

The hon. Gentleman is absolutely right. The shortening of the timeframe makes it extremely difficult for people to contribute, which is why that opportunity needs to be included right at the start. If people can nominate someone—an advocate, a consultant, a GP or a community nurse—to provide such information as part of the application process, we could get around a lot of those problems.

For people with complex disabilities, people who suffer from more than one condition or people whose condition fluctuates, the tick-box exercise of the work capability assessment fails to capture the impact of their health on their ability to work. Around half of those in receipt of employment and support allowance have a mental health condition, yet the work capability assessment has proved poor at accurately assessing conditions that are not visible, and people with mental health or incapacity issues are not always able to articulate well the effects of their condition.

I pressed hard during the last Parliament for improvements to how mental function champions operate within the assessment process, but there is increasing evidence that as things stand, the work capability assessment causes so much distress and anxiety for some people that it is actively harming their health, pushing them further away from being able to work and—in extreme cases such as the ones mentioned by the hon. Member for Glasgow East—towards harming themselves.

The Royal College of Psychiatrists has expressed serious concerns for some years about the impact of the work capability assessment on the health of people with mental illness, but as evidence of harm grows, the college is becoming more outspoken. As my hon. Friend the Member for North Ayrshire and Arran pointed out, robust research conducted at the universities of Liverpool and Oxford suggests a correlation between mental health problems and the roll-out of work capability assessments. That backs up the findings of voluntary sector service providers such as the Scottish Association for Mental Health, which has extensive experience of people who use its services suffering setbacks in their recovery due to the assessment process.

The bottom line is that too many people are still being wrongly assessed. We know that because of the extraordinary success rate when claimants who have been found fit for work appeal that decision. Between 2010 and 2013, it hovered around the 40% mark; since the introduction of mandatory reconsideration in 2013, it has shot up to around 54%. In other words, more than half of those who appeal are likely to get the original decision overturned. Successful appeals on that scale indicate major underlying flaws in the assessment process, and they cost the Government a lot of needless time and money. More than that, they mean that sick and disabled people are left feeling abandoned and desperate for months without the support that they need. The human cost is enormous, as is the financial cost, as the National Audit Office has pointed out.

We must also remember those who do not appeal but who are nevertheless extremely unwell or seriously disabled. Many people in our constituencies who are destitute or living in extreme poverty are people whose access to ESA has expired, or who have been found fit for work but cannot qualify for jobseeker’s allowance—because they really are not fit for work and cannot comply with the conditions attached to JSA, or because they have tried to comply but have been sanctioned, or because they have disengaged from the system altogether and have simply dropped out of view.

I have no idea how many people fall into that latter category, but I know that I am meeting such people regularly. They live off other family members or friends, some of whom are themselves not wealthy, and they depend on food parcels from church voluntary groups or food banks. Consequently, when the Government consider how they might proceed with a replacement for the WCA, they need to take on board the systemic failures of the current approach and think beyond simplistic functionality.

The first and probably the most valuable thing that the Government could do is to work with disabled people and their representatives from the outset. Throughout the past few years, health and disability organisations have been coming forward with constructive suggestions to improve the existing system, and contributing to the successive reviews. Some of their ideas have been taken on board, at least partially, but the opportunity presented by a new White Paper to get stakeholders around the table and—more significantly—really listen to what they say has never been more important.

I also urge the Government to go back to the work that was done around the evidence-based review of 2012-13 and the alternative assessment that was developed under that process. I know that Ministers were not convinced by that review at the time, but a lot of water has flowed under the bridge since then, a much stronger evidence base has been developed and I think there is a lot of substance in that review, not least in the way that it suggests descriptors that would account for the impact of pain and fatigue on a person with an illness or a long-term condition. That review could really usefully inform a new approach.

Lastly, I urge the Government to learn from international experiences. The UK does not have a disproportionately high number of sick and disabled people compared with the rest of the OECD. Clearly, there are regional variations, even within the UK, with higher numbers of claimants in economically deprived or heavily industrialised areas, where health outcomes and life expectancy are significantly lower than average. On the whole, however, we are grappling with the same challenges as other industrialised countries and on a broadly similar scale.

A number of countries have used what have been called “real world incapacity assessments” that take account of a person’s age, skills and work experience, as well as their health or disability, when assessing their fitness for work and considering what kind of work they might be able to do. This seems just to be common sense and means that someone is assessed as a rounded human being. The same condition with the same severity will affect two people differently in relation to their ability to work, depending on whether their work experience has been in physically demanding manual jobs, whether they sit at a desk or whatever. The Government should explore the models used in other countries to see what is working well.

We all agree with the Government that the social security system needs to support people to move towards work, but it also needs to provide a safety net and a dignified life for those who are not fit for work, and not only those who will never return to work but those with long-term conditions and those who need time to recover from serious illness or injury.

The work capability assessment has failed a lot of sick and disabled people, and it has proved extremely inefficient. What follows must be better, and I hope that the Government’s keenly anticipated White Paper will reflect the concerns that have been raised today.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

May I reiterate what other people have commented—that it is lovely to see you in the Chair today, Mrs Moon? I congratulate my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) not only on securing this debate but on an excellent speech; it really was very informative.

We have already heard a number of Members say that the current work capability assessment, which was introduced under the coalition Government, is failing on a number of counts and needs to be overhauled. I share the view of the hon. Member for Banff and Buchan (Dr Whiteford) that the fact no Government Members have spoken, and the imminent White Paper, suggest that the Government are finally getting it. I really hope that is the case. However, I need to reiterate some of the points that have been made about why the Government need to think again.

The WCA needs a complete overhaul. It is not fit for purpose, and we have heard that it is failing to assess a person’s fitness for work, or work-related activity, accurately or reliably. We have heard the figures about appeals. More than half of people—54%—who appeal against a decision that they are fit to work have the decision overturned. We have also heard about how the costs of the WCA have spiralled out of control, which reflects the woeful performance. Obviously, the National Audit Office report last month was very damning indeed, although I have to say that it came several weeks after it was clear what was going to happen.

Fundamentally, the WCA fails the most important requirement of any Government policy—that it will not knowingly harm citizens. For almost a year now, the Government have obfuscated and tried to evade revealing the toll that the WCA process is having on the people being subjected to it, even after stark warnings from the Select Committee on Work and Pensions. The mounting evidence against the WCA cannot be ignored any longer; hopefully the Government are listening to it.

There have been five independent reviews of the WCA since 2010. The Work and Pensions Committee undertook two of them in the last Parliament; I was pleased to be serving on the Committee when it undertook the review in 2014. The most recent report from that Committee included evidence taken from the reviewers, who warned the Government that in spite of all the reviews that had happened before—Professor Harrington and Dr Litchfield have produced reviews—the process was still flawed. They said that people with progressive and fluctuating conditions, such as Parkinson’s, were particularly likely to fall foul of the process. I will never forget taking evidence from people in Newcastle as part of that Select Committee inquiry in 2014 and hearing their personal testimonies. The evident pain and humiliation that they had experienced as part of the process was quite shocking.

Like other hon. Members we have heard from today, I have had evidence from my own constituents. A man who came to see me had a serious heart condition. In a WCA, he was told by the nurse undertaking it that he was in the process of having a heart attack; that was how stressful the WCA was. He was told to go to hospital, but two weeks later he received a letter telling him that he had been sanctioned because he had left the WCA. There are similar examples up and down the country.

The former chair of the Work and Pensions Committee, Dame Anne Begg, spoke on the issue and said:

“When my constituent, who has lost his job because he has motor neurone disease, scores zero on his WCA and is found fully fit for work, there is something wrong with the system. When that same constituent appears in front of a tribunal and in less than five minutes is awarded 15 points”—

that is the maximum score, which means the person is completely unfit for work—

“there is something wrong”.

I hope that we are seeing a different view from the Government now, but in their response to the Work and Pensions Committee at the end of 2014 they were having none of its report; there was the usual rhetoric. I would be interested to know what the Minister would say today if Dame Anne’s former constituent was standing here in Parliament now.

The Committee said that simply rebranding the WCA by taking on a new provider would not work, and it recommended a complete overhaul of the system. We still believe that that is needed, and such an overhaul is Labour party policy; I have said that consistently since my appointment to the Front Bench. What is required is not just a process to determine eligibility for employment and support allowance but an examination of health-related barriers to work. I agree with the hon. Member for Banff and Buchan that we need to look at the international data. I know that work has already been done to compare different processes, and adopting a more personalised and holistic approach is important. I remember producing such a piece of work before I came to the House, and there are lessons to be learned from elsewhere. However, as I have said, at the time of the Select Committee inquiry, the Department for Work and Pensions was not particularly inclined to consider those lessons.

When the Minister responds to the debate today, I am sure she will talk about the new work and health unit. However, I would also like her to describe, if she can, the discussions that the Government have had with the royal colleges, because I have some concerns. For example, the Royal College of Psychiatrists has raised the issues of medical ethics, treatments and interventions, the principle of consent, and the qualifications of the staff involved in WCAs. I would be grateful if she referred to those points in her wind-up.

My next point is about poor performance. We know that last month’s National Audit Office report reiterated that the WCA is not only unfit for purpose but poor value for money, as many of my hon. Friends have already mentioned. The Government have failed in their fiduciary responsibility to ensure that taxpayers’ money is spent wisely. They have failed to monitor and performance-manage work capability assessment contracts and hold the providers to account.

The NAO report stated that under contract with the Centre for Health and Disability Assessments, which is a subsidiary of Maximus, the cost of each assessment has risen to approximately £190, compared with £115 under the previous contract with Atos. If that was an investment in greater efficiency and a smoother process, one might possibly say that it was value for money, but the NAO described the performance output issues, with a backlog of 280,000 assessments and the contractor not being expected to meet its performance targets for last year.

The NAO went on to describe how the Department for Work and Pensions was struggling with target setting and had failed to test bidders’ assumptions during the tender process—for example, on staff recruitment and training. Will the Minister describes how that is being addressed? After six years, it is a real problem if we are trying to ensure that we live within our means.

The biggest indictment of the Government’s work capability assessment process is the potential harm it does to people who are put through it. As we have heard, last November the University of Liverpool and the University of Oxford published a study in the Journal of Epidemiology & Community Health. It is a peer-reviewed journal, and papers with Mickey Mouse statistics are not published in such journals—they would not be tolerated. It is a robust—[Interruption.] I hear some chuntering from the Government Benches. These are robust data; papers would not be allowed if the data were not robust—[Interruption.] There is still chuntering, but I will carry on. That study showed that between 2010 and 2013 the Government’s work capability assessment regime was independently associated with an additional 590 suicides, 280,000 cases of self-reported mental health issues and 725,000 antidepressant prescriptions.

The Royal College of Psychiatrists has raised the concern that, for people with mental health conditions, the work capability assessment process can cause a relapse, thus hindering rather than helping in their recovery. Just before I came to the debate I was provided with a list of coroners’ reports containing concerns that the deaths, including suicides, were associated with the work capability assessment. I am particularly concerned about the case of Stephen Carre, which has already been mentioned, in which the coroner wrote to Ministers and the Department and apparently did not receive a response, as required by law. I would be grateful for the Minister’s response to that point.

The findings reported in the paper in the Journal of Epidemiology & Community Health—in a paper entitled “First, do no harm”—came on top of published data relating to the deaths of incapacity benefit and ESA claimants between November 2011 and May 2014. The Government were compelled by the Information Commissioner to publish those figures. At the end of April, an appeal went to that body, which ruled in favour of the appellant and required the Government to produce the figures. But when did they produce them? Just before the end-of-August bank holiday.

The figures showed that the overall death rate for people on IB or ESA was 4.3 times higher than in the general population—an increase from 3.6 times higher in 2003. People in the support group are 6.3 times more likely to die than the general population, and people in the work-related activity group, from whom the Government want to take £30 more a week via the Welfare Reform and Work Bill, which is going through the House, are 2.2 times more likely to die.

The Government’s innuendo that people with a disability or illness might be “faking it” or are “feckless” or, as the Prime Minister said shockingly last week, are “making a lifestyle choice”, is grotesque and belies the epidemiological data. IB and ESA are recognised as good population health indicators, in that they reflect areas with an industrial backgrounds and areas of poor health.

[Neil Coyle]

My hon. Friend describes the impact on people. One of my constituents has referred to it as the Secretary of State adopting a pterodactyl style of management, flapping around high above, making a lot of noise and—pardon the expression—dumping on the little people down below. Does my hon. Friend share that view?

[Debbie Abrahams]

I would not put it in quite those words, perhaps, but I know exactly what my hon. Friend is getting at.

The Government’s own data show that the people involved are sick and disabled. They need support; they do not need vilification. Unfortunately, that is too often what happens, as at last week’s Prime Minister’s questions.

Being disabled or being ill is not a lifestyle choice. Alarmingly, we now hear reports of people in the ESA support group—people who have been found not fit for work, including people who are terminally ill—being required to go to work-focused interviews. The Minister might be aware of that. We have evidence only from England so far, but I would be grateful if she gave us an explanation.

For me, that latest revelation says it all. It is about cuts for disabled people and the seriously ill. The Government are not content with having cut £23.8 billion from 3.7 million disabled people since 2013 under the Welfare Reform Act 2012; they are going for more cuts, and the work capability assessment and the Welfare Reform and Work Bill are another way of achieving them.

The Government have tried to regenerate the economy on the backs of the poor and disabled. Their modus operandi is division and blame, deserving and undeserving. Like the NHS, our social security system is based on principles of inclusion, support and security for all, assuring us all our dignity and the basics of life should any one of us become ill and disabled. The Government need to remember that and stop their attacks on disabled people.

--- Later in debate ---

[The Minister for Employment (Priti Patel)]

It is a pleasure to serve under your chairmanship, Mrs Moon. I start my remarks by commenting that the debate has been wide-ranging, and I thank everyone who has contributed. This is obviously an important subject, and we must put it in the context of the overall commitment we all feel should rightly be in place to support people who cannot work because of health conditions and disabilities. We must also reflect on the fact that we have a system that obviously seeks to support such individuals.

A range of comments have been made that pre-date me as a Department for Work and Pensions Minister. I will do my utmost to address as many of them as I can, but it would only be fair to write to hon. Members whose points I do not address directly. The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) mentioned the very tragic case of Mr Carre, and it might be more appropriate if I write to her about that.

We all recognise that work is good for individuals—it enhances physical and mental well being—and we also recognise that being out of work, for whatever reason and whatever the condition, can exacerbate poor health conditions and make people’s situations even worse. A system that supports people is vital. I will talk about contracting later, but we want to move away from a system that tells people they cannot do any work to one that supports them in what they can do. The hon. Member for Banff and Buchan (Dr Whiteford) touched on the forthcoming White Paper that will focus on the support that can be given to individuals, and I will address that shortly.

The work capability assessment was established under the previous Labour Government in 2008 and it has had quite a journey, not just in relation to the contracting process; the assessments have come under scrutiny under previous Governments and under the present Government. There have been more than 100 recommendations in response to the five independent reviews of the work capability assessment. That has made the assessment process more reliable and has improved the claimant experience

In the final independent review of the work capability assessment, Dr Litchfield commented that, having looked at the systems in comparable countries, there was

“no better replacement that can be pulled off the shelf”.

[Neil Coyle]

There is a concern among the disability and advice sector that the Government continue to say they have accepted the recommendations of the independent reviews. Will the Minister outline how many of the recommendations have been fully implemented?

Oral Answers to Questions

Neil Coyle Excerpts

Monday 1st February 2016 Commons Chamber

[Mr Duncan Smith]

A huge amount can be done locally. Universal support, which is now part of universal credit, is being trialled with a lot of councils to look at the families with the greatest difficulties. It involves councils in getting financial support to those families and in helping them to sort out drug and alcohol abuse. As they receive the special payments, we expect councils to work with us to ensure that their problems are put right, rather than ignored and left to one side.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

The Department is responsible for providing support to some people who, sadly, are at the end of their lives and have a prognosis of six months or less to live. Will the Minister update the House on progress to remove the 28-day waiting rule for terminally ill people who are transferring from the disability living allowance to the personal independence payment?

[Mr Duncan Smith]

May I write to the hon. Gentleman about that? We are considering that issue but have not quite made a decision, so I will provide a full answer in due course.