(13 years, 5 months ago)
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I am glad to have secured this timely debate on the reform of the mobility component of disability living allowance—the debate could scarcely be timelier. I am also grateful to the hon. Members who are here, as well as to those who have expressed their interest but cannot be here. Lastly, I am grateful to the many organisations that have provided briefings to me and others for this debate.
Disability living allowance is highly valued. Currently, the lower rate is £18.95 and the higher rate is £49.85. As the response to the Government’s consultation states, DLA, and attendance allowance before it,
“had a major positive impact on recipients’ lives…DLA recipients of working age were unanimous in expressing views that DLA made a big difference to them.”
Many people depend on DLA. With some reservations, I say that the application and decision making processes are clear. I will refer to that later, but at least we know where we stand. Research also shows that DLA is unlikely to be subject to fraud: the Department for Work and Pensions estimates fraud at 0.5%, the lowest rate in the entire benefits system. The system seems to be working. As a rural MP in north Wales, I know that DLA is particularly valuable to people in rural areas, who generally face intense problems with mobility. The money can transform people’s lives.
My concerns about the Government’s proposals relate to the assessment system, the threats to automatic entitlement, the extension of the waiting period, mobility payments for people in residential care and assessments regarding the use of aids and adaptations. However, my overarching concern is about the prospect of cuts of up to 20%. If cuts are made, who will pay for them? I strongly suspect that it is people with a disability who will be hit.
To rehearse the history, the mobility element of DLA was introduced in its earliest form, mobility allowance, by the Conservative Government in 1973. At the time, the Government were responding to the consensus between parties and civil society organisations that something had to be done to address the changing circumstances in which people with disabilities were living. They were living, living longer and living in the community rather than in residential care, and they were often younger than the disabled people who would have been living in the community 10, 20 or 30 years earlier. The world was changing, and the attendance and mobility allowances were introduced in response.
I have personal experience of those allowances. A close relative of mine, a young person severely injured in a car accident, was in just such circumstances in the early 1970s and was living in the community after extended medical treatment. At the time, mobility allowance made all the difference. It transformed his life then, and it still does now, given that he lives in a remote rural area and depends on his own transport.
The Government say that DLA needs reform. I agree, but my grounds for reform might be somewhat different from theirs. I think that the application process can be a disincentive. Many people have come to me, as their MP, in dismay over the substantial form that must be filled in, and I have been glad to refer such people to the citizens advice bureau. I pay tribute to the CAB’s work in the benefits field in general, but its expertise in the particular instance of DLA is truly inspirational. The application process could be changed.
I worry about take-up. There are few current statistics about the level of take-up of DLA and the mobility element of DLA. I did a bit of research with a colleague and found a reference to research in 1998, more than 10 years ago. The family resources survey estimated take-up of the mobility element at between 50% and 70%. Will the Minister tell us, now or by letter, whether any more recent estimates of the take-up have been made? I think that many people do not claim DLA or DLA mobility, even though they would clearly benefit from it.
As I have said, the application process could be improved. The number of successful appeals suggests that the initial assessment is not what it should be. Also, the DLA mobility element is age-restricted. Mobility allowance was initially subject to age restrictions—it was confined to people between 25 and 45—which were gradually expanded over the years. However, as one elderly constituent said to me recently, that benefit, which would help older people with mobility problems, is deliberately denied them by the age limits, which seems somewhat paradoxical. Will personal independence payments for mobility awarded before retirement continue to be paid afterwards, as DLA is at present? People are worried, perhaps unnecessarily.
The Government are proposing changes, as we will see this afternoon, and introducing PIP. The proposals will be subjected to detailed debates. As I have said, I worry about the possibility of 20% cuts and share people’s concerns and perception that there is a problem.
I congratulate the hon. Gentleman on his success in securing this debate. He has returned to the issue raised in the press of the possibility of a 20% cut in the numbers applying. If we take that figure with his earlier figure of less than 1% fraud or abuse of the system, we see the inevitable consequence that, even if the Government’s reductions target all those who fraudulently abuse the system, more than 19% of those targeted will still be genuine claimants, who will suffer unnecessarily.
The hon. Gentleman makes an excellent point. The fundamental question is who will pay if cuts are made. The people squeezed out of the system will be genuine claimants who are disincentivised, or people with lower-level needs.
I am concerned by the Government’s conflation of the arguments about promoting the take-up of work and the need for reform. DLA literally helps some people get to work, but it is not a work-related benefit; it exists to assist with the additional costs of living with impairments or long-term health conditions. There is a coincidence between receiving DLA and experiencing difficulty finding work, but that means only that work for people with a disability is scarce. DLA is a marker rather than a cause, as the consultation paper seems to suggest. The work problems that I see confronting people with a disability involve ignorance among employers about the value of disabled workers. But perhaps, Mr Davies, I am straying into a subject beyond the strict bounds of the mobility element.
I am concerned about mobility and people in residential care. When I first thought of applying for this debate, that was the main issue that I wanted to address, as it is of concern to a great number of people. I certainly welcome the Government’s decision to delay the provision and to review it until 2013. That is unsurprising, given the view of the Social Security Advisory Committee, which said:
“This measure will substantially reduce the independence of disabled people who are being cared for in residential accommodation, which goes against the stated aim of the reform of DLA to support ‘disabled people to lead independent and active lives’.”
I very much welcome the postponement, but it is only a postponement and people are concerned.
I congratulate the hon. Gentleman on securing this debate. A Library research paper notes:
“The DLA mobility component is however not affected if a person is in a care home. In a written answer in 2005, the then DWP Minister Malcolm Wicks said that this was because ‘care homes do not cover mobility needs’.”
It is now 2011. Does the hon. Gentleman agree that nothing has changed and that more than 90% still do not provide that?
The hon. Gentleman makes an interesting point on a subject to which I shall refer later. Another concern is that the loss of the mobility component and of the Motability scheme in particular would have an effect on families with children in residential schools and their participation in family life.
The possibility of direct payment of money to claimants to fund their self-assessed mobility needs would be relatively simple compared with the complexity of ensuring that a residential setting provided similar, individually tailored mobility provision. We hardly need to think about the comparison. Many disability organisations have pointed out that current contracts do not provide an element of mobility. If the move is towards tackling duplication, as the Government see it, will we merely require the renegotiation of contracts as opposed to any other cost-saving change? Will such a renegotiation be at a further cost to the public purse?
I do not want to dwell on this issue—time is short—but I draw the Minister’s attention to the fact that health and social services in Wales are devolved. Changing the benefit system run from London does not necessarily mean that local authorities in Wales and the Welsh Government will follow what happens in England. I should perhaps point out the complications of a general welfare system that is run by two Governments—one concerned with care, the other with benefits—with possibly different priorities. I will not go down that route today, but it is a further complication that the Government need to consider between now and 2013.
Some Members present will be aware that the level of those with a disability in Northern Ireland is greater than it has ever been compared with other parts of the United Kingdom. Does the hon. Gentleman share my concern, as an elected representative, that, under the proposal to reduce 20% of DLA claimants, which will save £2.1 billion, it will be those people who need DLA who will lose out?
I suppose that that is the overarching concern behind all this. Eventually, some money might disappear, and the question is who will pay it. That is unclear at the moment. Many years ago, I used to repeat endlessly to some of my more starry-eyed social work students that, “It is not as simple as that,” which is a general rule for politics.
I was a young social worker in the late ’70s. I have promised the Minister that I would not use a lot of Welsh, but, inevitably, I would like to make one little point. I used to take some of my clients out on social occasions to try to improve the quality of their lives, and the only practical way to do that at that time was by minibus. It was a big, yellow minibus, which said on the side, “Cymdeithas Plant Araf eu Meddwl,” which translates as the society for mentally handicapped children. Needless to say, the people with whom I worked were neither children nor mentally handicapped, which was a loaded term even then but, for the non-Welsh-speakers present, “araf eu meddwl” is even more loaded—it literally means “slow of mind,” so I was taking people out in a big, yellow bus that said that they were slow of mind. I would say, therefore, that social security and social and health provision have developed over the past 30 to 40 years towards a more normalised provision, based on autonomy and choice.
If we depend on institutions to solve people’s problems of mobility, we will soon get institutional answers, which is something we should avoid.
I congratulate the hon. Gentleman on securing the debate. Does he not think that there is room for some standardisation or effort by central Government to ensure that those who are in residential settings and need mobility have at least some consistency of provision across the board? Surely, without that, there would be as much confusion as there would be otherwise.
I agree entirely with the hon. Gentleman. The provision in the public and private sectors of residential care needs to be looked at, but should that be done by reforming DLA in the way proposed? Would that be a blunt instrument? Are there other ways that that can be done?
As someone who lost to the hon. Gentleman in the 2005 general election—I represented, in a poor standard, the Welsh Conservatives in the former constituency of Caernarfon—I am particularly enjoying his passionate reverie of the 1970s. It is beyond question that he represents his constituency very well indeed. We all accept that there is likely to be a degree of cuts ahead. Does he accept the need for this issue to be reformed?
We can take a look at DLA, but that is the budget that I would cut almost last, because of its targeted nature and its efficiency and because of the needs of those who receive it and a host of other reasons. I accept the hon. Gentleman’s general thrust—everything should be open to review and reform—but I would start elsewhere before addressing the provision under discussion.
Surely, the real concern for many people is that 20% will become a target that must be achieved. If so, the target, rather than the people affected, will become the be-all and end-all of the achievement. Surely, the Government must say, “Let’s make improvements, but not set a target.”
The problem with targets, of course, is that they must be fulfilled, perhaps at the cost of the needs of individual claimants. I would start by looking through the other end of the telescope to see what the system of assessment and so on generates, rather than—I do not think that this is what the Government are actually doing—by imposing a rough, across-the-board 20% cut.
I must press on, because other hon. Members are anxious to contribute to the debate. My further concerns centre on the proposed assessment system. The current system assesses via a variety of sources of information—the claimant, a carer, a support worker, a GP, a specialist, a physiotherapist and so on—and I worry that, by slimming down that evidence to one assessment based on specified activities, the impact of disability on the individual may be missed. We have experience of using medical assessments in employment and support allowance applications. Like many other hon. Members, a large amount of casework in my constituency has been generated by the operation of that system.
As I said, I have received a number of briefings. An interesting and striking one came from the National Autistic Society, which suggested that those carrying out assessments will possibly fail to recognise the needs of people with conditions such as autism. I am concerned that reassessments should be fair and accurate, especially in relation to the suitability of people who have fluctuating conditions or mental health conditions. We must accept that mental health conditions are particularly difficult to assess.
Another concern relates to the proposal on delay, because increasing the waiting time to six months may cause hardship, although people with terminal illnesses will continue to have no waiting period.
Automatic payment is also a concern. I shall not go into that now, other than to say that the current system allows automatic payment in certain self-evident and extreme conditions—for example, double amputations. I am worried that automatic reassessment of those cases might lead to a waste of public money. If we remove those automatic entitlements, it may increase the cost of assessment and lead to the same outcome as we had under the original system—such people might still receive the higher rate.
On aids and appliances, it has been pointed out to me that if too much notice is taken of their use—particularly in unfamiliar situations—and that leads to a loss of money, it might be a disincentive to people using them. Will that be a disincentive?
As I said earlier, I am very happy that attention should be paid to the needs of disabled people. I am happy to consider the benefits system for disabled people at any time, but I worry that the proposals will not be much help. I am glad that the provision in respect of people in residential care has been delayed until 2013, and I look forward to contributing to the debate between now and then.
In summary, I fear that the changes might limit lives and increase disability poverty and demand for mental health services. Consequently, they might increase the demand for primary care services and lead to a loss of employment. Those fears might all be laid to rest by the Minister’s response and as the debate progresses over the next months and days—I accept that entirely—but it is important to put such concerns on the record.
As co-chair, with Baroness Pitkeathley, of the all-party group on carers, I am grateful to be given the opportunity to speak in this debate. The reforms will affect carers as much as they will affect those who are being cared for. The hon. Member for Arfon (Hywel Williams), who introduced the debate, said that his main concern is about the mobility component of DLA for those in care homes. That is the matter that I wish to discuss.
In a letter to all parliamentary colleagues, the Minister states:
“We want support for care home residents which takes account of their individual needs and safeguards some of the most vulnerable members of our society, whilst also ensuring that the taxpayer is not paying twice for this provision. It is vital that we get this reform right, and that is why we are taking the time to do so.”
It is helpful that Ministers have decided to postpone any decision until 2013. I know that the Minister has taken enormous personal care to ensure that the Government get this right. I was grateful that, following our last debate on the issue, the Minister kindly came to Banbury and visited Agnes Court, which is a home run by Leonard Cheshire in my constituency.
I am trying to sort out in my mind how we approach the matter, and I have a number of questions that I wish to ask. As I understand it, Ministers are saying that local authorities, in the contract that they have with care homes, should provide sufficient funding for residents to have the opportunity for independent living. It would be helpful for hon. Members if the Department for Work and Pensions explained that route. Where in primary legislation is the responsibility on local authorities to provide for that element when residents go into residential care? That is an important point because if one does not have an understanding of the statutory basis upon which local authorities have that responsibility, apart from anything else, it is difficult to know when one could bring judicial review on the basis that they were not providing that which Ministers say that they should provide. Part of the reason for these reforms is that Ministers say there is an overlap and duplication of funding. We need to understand exactly where it is said that such duplication is occurring.
I also have a slight concern that if one puts a greater responsibility on local authorities to provide an increase in the contract fee that they pay to residential care homes, a number of local authorities will say that rather than sending those who may need care in a residential setting into residential care, they will try to provide them with care at home. The Minister met one or possibly two residents of Agnes Court in relation to whom the local authority funding their place is considering withdrawing funding because it is finding it too expensive and it wants the person to be supported at home or elsewhere.
We need to have an understanding of what Ministers believe should be the model contract between local authorities and care homes, and what the obligations on the residential care homes are in relation to this. Let me make it absolutely clear that everyone is doing their best in what are often very difficult circumstances. What was clear from talking to people at Agnes Court is that they have very little contact with the local authority. The local authority obviously rightly believes that Leonard Cheshire Disability runs a fantastic home and provides a fantastic service and that there is no need for a local authority to find out what is going on there. What is the model contract? What is it that Ministers believe, first, that local authorities should be funding and, secondly, that they should be requiring of care homes?
The Minister will have met people in Agnes Court who have used the mobility component of DLA to purchase a wheelchair of superior quality to that which they could have obtained through the NHS—one person in particular has certainly done so. I am talking about a very bright man who has been a long-term resident of Agnes Court. He is almost blind, but his intellect is razor sharp, as I know from the letters and e-mails he has sent to me over many years. Indeed, at one general election, he organised a hustings for parliamentary candidates, so that we could discuss disability issues. He has used his mobility competent to buy a wheelchair, which seems a sensible thing to do given his circumstances. Would that be possible if the funding were coming through a local authority contract to the residential care home?
I entirely agree with my hon. Friend about how helpful the Minister has been in responding to constituents’ concerns on the matter—her letters have been very much appreciated. Does he agree that some of the points that are unclear relate not only to the overlap between what the local authority should fund and what is covered by DLA, but to the activities that local authorities will pay for? Constituents have told me that local authorities fund travel only to a doctor’s appointment or to day care, and not to enable disabled people to participate in everyday activities. Such activities are important to them, but might not be important to the care home or the local authority.
My hon. Friend makes an incredibly good point. I—and I suspect many hon. Members—would like and welcome a route map from the DWP. I sometimes feel that policy relating to that Department is a bit of a secret garden. I am always a bit reticent about entering into the garden, because I usually use the wrong words—the mobility component of disability living allowance for those in residential care, is in itself quite a mouthful.
What is it—I entirely agree with my hon. Friend the Member for Loughborough (Nicky Morgan)—that we, or those in residential care settings, can expect to be provided? After all, let us remember that what we have here are a very wide range of human beings who are individuals and constituents. Stephen Argyll, the person to whom I just referred, is intellectually very bright, but almost blind and has difficulty getting around. Some are in Agnes Court because they have learning difficulties, and some are there because they are suffering distressingly from degenerative illnesses, such as Parkinson’s disease. There is not just one group of people, but a large number of individual human beings who have different histories. For example, many are married and still wish to maintain their relationship with their husbands or wives, go shopping, and so on. I also understand, however, that Ministers are concerned that this can be an expensive provision, if what is being provided are individual, tailored mobility vehicles that are not being used much each week by individual people. If there is an overlap with other funding that is supposed to go to care homes from the local authority, that is also a concern.
I am conscious that lots of other hon. Members, including, I am sure, many from Northern Ireland, wish to take part in the debate.
I suspect that all of us want to engage constructively with constituents who have concerns about this matter, but we want to do so positively and be conscious of the legitimate concerns of Ministers that the system is not working. The Minister has stated:
“We will not remove the mobility of disabled people but we will remove the overlaps and gaps inherent in the current system.”
I want to understand where the Minister sees the overlaps. Where does she see the gaps? Please can we have a lay person’s guide that we, as colleagues, can take when we talk to constituents in this situation, so that they understand the issues and that we understand the examination question that we have been set. I know that there is an exam, but I am not confident yet that I fully understand the examination question.
I appreciate that the decision has been delayed until 2013, but Ministers will at some point have to be clear, and send a clear signal about post-2013, for the following reason. The Minister will have met, when she was at Agnes Court, large numbers of people who have entered into leases and other contractual arrangements for mobility vehicles. There need to be transitional arrangements so that if there is a change in the regime and the rules in 2013, people do not suddenly find themselves with a period of time to pay a contract without the wherewithal to do so. If Ministers are coming to the view that at some point they will change the rules, it would probably be helpful to give a clear signal of their intentions so that people have a clear understanding of that and make dispositions accordingly.
I should like to refer to one case in particular: that of Mr and Mrs Owen and their deaf and blind son Jordan. They attended my surgery some months ago and explained the situation in which they find themselves now and what they fear might happen in the future. Their son Jordan is a big lad—17 years of age. He currently attends the Trinity Fields special school in Ystrad Mynach and is in receipt of disability living allowance and the mobility component as well. The family put that to good use and provide mobility for him and the family. In the near future, when he becomes an adult, he will leave the special school and go to a residential home. However, it is likely that that residential home will not be anywhere near where he lives in Tir-y-Berth, Hengoed. It is likely to be in Monmouth, or possibly in England. There is a real concern among the family that, because of the changes that may come about, he will no longer be in receipt of the mobility component of DLA.
Jordan is a member of an ordinary working-class family. He has tremendous support from his parents, and from the charity Sense, which has done excellent work with the family. Naturally, however, when he does go to a residential home, the family will want to visit him and take him out from the home and give him the best experience of life possible for that young man. The family is concerned that, if the mobility component is taken away, they will not be able to visit him as frequently as they would like or to take him out from the residential home. In fact, they might have to leave to one side the opportunity of going to a residential home, even though that would probably be best for him, but ensure that he stays at home, so that they can give him proper love, care and support. That would obviously not be the best for him, and probably not the best for the family as a whole.
I should like to make it clear that I am not against welfare reform. In fact, I am strongly in favour of welfare reform. What I find difficult to understand, however, is the rationale of making someone like Jordan so fearful for his future. There could well be a cut. Of course, I can understand the financial saving to the state, but that is not what welfare reform should be about. That is why I am particularly concerned about clause 83 of the Welfare Reform Bill. It is important when we talk about welfare reform that such things are made fair and streamlined, but particular care must be taken to ensure that people such as Jordan do not lose out. For example, I was concerned that, when the Prime Minister was asked about changes to the mobility component at Prime Minister’s Question Time, he said:
“our intention is very clear: there should be a similar approach for people who are in hospital and for people who are in residential care homes.”—[Official Report, 12 January 2011; Vol. 521, c. 282.]
I simply point out that the needs of people in hospital are not the same as those of people in care homes. That is a fundamental point. We need to move away from the mechanistic, bureaucratic approach and to recognise that people in residential care homes have particular needs, and the Prime Minister, to start with, should recognise that.
I hope that we have a respite. The Government have said that they will delay implementation for at least 12 months. I hope, however, that in the interim the Government will look at cases, such as that of Mr and Mrs Owen and their son Jordan, and recognise that welfare reform must be tailored to the needs of individuals, so that young men like Jordan do not lose out.
It is a great pleasure to speak in this debate, and I congratulate the hon. Member for Arfon (Hywel Williams) on securing it. I wish to declare an interest—I am chairman of two domiciliary care service companies. They are not in receipt of disability living allowance, but they deal with adjacent issues. I welcome the debate. In particular, I welcome the Minister to her place.
The fundamental question that went through my mind when the announcement was made was what it said about our attitude towards the decency with which we allow people to lead their lives. What does it say about how we are prepared to protect the most vulnerable in our community at this difficult time, with the significant financial challenges inherited by the Government? That was made real for me by the visits of constituents; families who care for their sons, daughters, mothers, fathers, cousins and uncles, and who have to create that sense of independence every day for their loved ones in care homes.
In particular, it is my pleasure to recognise the campaigning work of Mr and Mrs Ogaza from my constituency—Mrs Ogaza is here today—on behalf of not only their son Paul, but other families. I thank the Minister for taking the time to meet me not once but twice—the second time to listen to Mrs Ogaza—and for her visit to a care home in Shefford, near my constituency. That is emblematic of how much she is trying to reach out and listen, and to understand this complex area. Indeed, that complexity is at the root of the Government’s attempts to deal with the question of decency. There is nothing decent about the system that is in place if it provides a patchwork of services for recipients in different parts of the country. There is nothing decent about a system that does not ask our care home providers tough questions to ensure that they are actually providing the services that we would like.
Is not the biggest test for the future to have a road map where things are clearly signposted and understood? Whatever the reason for the system being in the state that it is in, comprehension and utilisation would then be much clearer.
My hon. Friend is absolutely correct. He echoes a point that was made by my hon. Friends the Members for Banbury (Tony Baldry) and for Loughborough (Nicky Morgan). This is an opportunity to provide a clear map of the requirements and also to identify, not in a naming and shaming way but in a positive way, what local authorities and care homes should provide and where evidence shows that they are falling short.
I believe that this is the second debate on disability living allowance that the hon. Member for Arfon has secured. Is that correct?
I am sorry. It is the second debate that I have attended on the subject. It shows how important it is to hon. Members that we get the correct answers. This debate is a bit more heartening in that it is not focused so much on cuts. The Minister needs to lay this to rest: the changes are not being made to reduce funding but to ensure that the funding that is available is directed in a way that gives clarity to families and the recipients of care in various care homes. It is extremely important that that message is made clear. [Interruption.] If hon. Members disagree, we need to continue to bring that to the Minister’s attention. I fundamentally do not believe that that is the intent of the policy, and I look forward to listening to those who think differently.
I should like to thank the 27 charities—the number is growing—that have provided information to other hon. Members and to me in their reports, “Don’t Limit Mobility”, and, more recently, “DLA mobility: sorting the facts from the fiction”. A number of them are in an expert position because they also operate care homes. I would be interested to hear from the Minister how many of them have come forward with examples from their own experience of the uniformity of provision across their network of homes. Has she received such representations or evidence from them about whether they experience differences in the various local authority areas in which they operate? That would be a useful body of evidence, and it behoves the charities to provide such information to the Minister, so that we can have a clearer picture.
In their reports, the charities provide some information about the rationales for the changes. I admit that several have been presented over the months, but I should like to pick up on two that are particularly pertinent and germane. I thought that the first one they listed was very interesting:
“The responsibility for mobility/transport costs should be met by the care home provider”.
What struck me in the evidence that the charities provided was that they saw a lack of clarity in what has been provided. They stated:
“Related legislation and guidance make no specific reference to mobility… While guidance places a responsibility…it contains nothing about how this is paid for… This guidance is not contract terms… the guidance does not provide a legal requirement.”
That points to the comments that were made earlier by my hon. Friend the Member for Banbury and others about the need for clarity and a road map.
I would echo my hon. Friend’s comments about the Minister. She has gone far out of her way to reach out to colleagues across the House, and I pay credit to her for that.
My hon. Friend the Member for Banbury spoke about contracts and specifics being written down. The Winchester and District Mencap Society has made the point to me many times that the mobility component is not necessarily used just for appointments at doctors or care homes, or for visits to friends or the hairdresser. Sometimes, for their own physical and mental health, people use it to get away from those with whom they live. Is not the key point that if we reform the system and move to personal independence payments, we will put power in the hands of disabled people who are individuals in their own right? They do not want the Government or the House to prescribe how they do everything, or how and where they spend their money.
My hon. Friend makes a good point. However, there are also requirements on the part of the Government to provide some guidance and clarity. If we can get clear evidence of the original intent—the changes are required because of differences in provision—people could move forward more confidently, empowered to exercise their rights. We are going through a process that we have not yet completed.
The second rationale that I wish to discuss—I will not take too much of hon. Members’ time—is No. 7 on the charities’ list:
“Local authorities’ contracts with care homes should cover personal mobility needs”.
The charities’ response focuses very much on ability to pay. Local authorities do not have the money; care home providers are not in a position to pay. That comes again to my earlier point: this issue should not be driven by the need to make cost reductions, but by the need to ensure that there is clarity about what we expect to provide on both a local authority and care home basis. If insufficient money is being provided, that should be the answer. If too much money is being provided and there is a better way of getting value for money, that should be the answer. That is what we are driving for in achieving an answer.
My final point is that this is not just about mobility. The issue is independence. A personal expenditure allowance of £22 a week is not sufficient for the broad range of an individual’s requirements. That measure was not set by this Government—they inherited it. It is a little insulting to tell someone, particularly someone who is vulnerable or people who have spent much of their own lives looking after a child or a mother who is in need and thereby saving the Government so much money, that we will leave them with just £22 a week to cover the wide range of their personal expenditure.
I ask the Minister, as she looks at the mobility component, to bear in mind the broader picture of providing decency overall for people in care. She has done an excellent job in reaching out and listening to people, and I hope that she will listen to the contributions to the debate.
Like the hon. Member for Bedford (Richard Fuller), I was present for the previous debate, which was specifically about the mobility component for those in residential care homes. There is a danger in this wider debate today that we will focus too much on that issue. My concerns about that issue are no less than they were before, but I do not want to concentrate on it today, as other hon. Members have adequately done so.
The Government paper that heralded these changes, “Welfare reform: Disability Living Allowance for the 21st century”, discusses focusing on those with the greatest need. We also know that the target is to achieve a 20% cut. I was struck by the comments of the hon. Member for Banbury (Tony Baldry) about the different people he knows at Agnes Court and the range of conditions that they have. Would any MP be able to say who of such a group of constituents is in greatest need, or where we could make a 20% cut? If we are not prepared to do that or to envisage others doing that, we should not support the Government in this measure and proposal.
Several issues arise. The first is assessment and, of course, reassessment in the future, which will come with it. The fact that particular conditions will not be screened out from assessment and reassessment—everyone will have to go through the process—raises fundamental concerns for those who are currently on benefits and their carers. We need to remember carers as well. They all think that they are facing a grand national, where everyone needs to try to get over and on to the benefit. As we have heard, that will cause great problems for citizens advice bureaux and the many others to whom people are turning for advice on what is likely to happen and the implications for them.
If the Government will not allow any specific conditions to be screened automatically from having to go through the assessment test now, or in the future, we need more clarity about what forms of evidence will be considered particularly telling in the context of the assessment test. What evidence from experts in neuromuscular conditions and so on will tell in that setting, or will the interview setting count more? On the cost of administering the assessment and reassessment process, many of us know that some people will pass every time, because of their circumstances. Should they have to go through the ordeal of assessment and reassessment every time, and should the Government carry the cost of that?
On moving to a six-month qualifying period, the hon. Member for Arfon (Hywel Williams) referred to cancer patients. We must question whether it is enough to tell people that if their illness is terminal, they will automatically qualify. Many cancer patients do not want to think of themselves or present themselves as terminal cases, and we might send out a dangerous message. If the Government are determined to remove the mobility component as was and to introduce a six-month qualifying period for the personal independence payment, perhaps there should be a distinct allowance for those who have been diagnosed with cancer and have been referred for chemotherapy or radiotherapy. Perhaps there should be a cancer care and support allowance that takes care of such circumstances, instead of cancer patients finding themselves caught up in the pursuit of personal independence payments, particularly as the system will become congested when the changes are introduced.
How will people with variable conditions be measured in the context of assessment and reassessment? Will they be unlucky if they are interviewed on a good day, or lucky to be seen and reported on on a bad day? The Government must tell us more about that.
There will be an impact on other entitlements. For example, currently the mobility allowance is a passport to the blue badge, road tax exemption and disability premium. What thought has been given to the implications of the move to personal independence payments? Will people who lose out in the change also lose out on those other benefits and entitlements? Will the conditionality link between the new benefit and the old benefit remain? If so, have the Government factored into their impact assessment the effect on other entitlements?
As the hon. Member for Arfon has said, there will be an impact on carers. We need to know, for example, whether eligibility for carers allowance will come from both levels of the personal independence payment daily living component, or only from one level. Those who are entitled to carers allowance will see the circumstances not only of the person they care for being jeopardised by the change, but their own. Entitlement to carers allowance may be affected, and we must consider that.
We have not heard enough from the Government about some age-related issues. For example, pensioners who received the mobility component of the disabled living allowance before pension age continue to receive it when they reach pension age. Will that continue to be the case with the personal independence payment?
Does the hon. Gentleman agree that we also need clarity on how the changes will impact on children, especially those with sudden impact conditions such as acute myeloid leukaemia? Will they have to wait six months, by which time their treatment will be well and truly finished?
I thank the hon. Lady for making that point. I introduced my comments about pensioners by referring to age-related considerations, and I was coming to children, including children in residential care, residential schools, and on holidays. What periods will qualify? Again, there is not enough in the Government’s papers and subsequent answers about those issues. The hon. Lady has rightly pointed to circumstances in which children may suddenly be affected by a condition. Will they have to wait for six months? Will families who receive a disability premium receive the universal credit when their child is in residential care? We do not know what is happening.
We must remember that families must cope with the concerns, needs and often the emotional upset not only of the child who is affected by a condition, but of the other children. Families must not be mired in new difficulties and complexities by the change. We must ensure that people of all ages are supported, not least children and families. The Government must provide more clarification, and I hope that the debate will present the opportunity for the Minister to do so.
Two more colleagues are seeking to catch my eye, and I intend to call the Front-Bench speakers at 10.40 am at the latest, so co-operation would be much appreciated.
I congratulate the hon. Member for Arfon (Hywel Williams) on securing this important and timely debate, and I thank the Minister for her attendance. The Government’s proposals on welfare reform are undeniably substantial, but reform is undeniably due. The best elements of the wider proposals have the potential to create a simpler, fairer and more efficient system than the current array of credits, benefits and allowances that developed under the previous Government. However, the proposals that caused the greatest consternation among my constituents—that consternation is clear from today’s attendance by colleagues from both sides of the House—are the proposed changes to the mobility component of disability living allowance. The issue presents a particularly difficult balancing act to reform a complex welfare system, but never to jeopardise the ability of disabled people to live full, independent and active lives. We have been right today to determine what is a modern, efficient and, most importantly, fair system to meet disabled people’s mobility needs.
I have actively expressed my opposition to the proposed withdrawal of the mobility component of disability living allowance for those living in residential care homes, and I am grateful for the time that the Minister has spent listening and talking to me about that on the Floor of the House and separately. Without the mobility component, many of the most vulnerable people in our society would be unable to meet the cost of living independent and fulfilling lives, and to engage in the social activities that most of us take for granted. As I politely suggested to the Prime Minister, parallels drawn between those in hospitals and residential care homes are crude and unfair. It is clear that the Minister in her investigation of the matter has reached much wider, and those of us who have had most reservations should recognise her efforts to obtain a clearer handle on the matter than those who considered it previously.
I associate myself with the comments of the hon. Member for Banbury (Tony Baldry), who demonstrated a clear understanding of some of the issues concerning care home funding. In the light of the responses to the proposals that the Government first tabled, and the representations from me and many others in the House, I warmly welcome the Minister’s decision to postpone the change until the nature of mobility funding for those in care homes is fully understood. It is absolutely essential that we do not rush into any of the changes, and it is good news that the Minister is listening and accepts that we must take a longer, clearer look at the issue.
Given the Minister’s intention to give due consideration to the mobility needs of those in residential care homes before moving forward with any changes, I ask her to consider two issues in particular as part of the development of wider changes to DLA: first, the process of medical assessment for personal independence payments; and secondly, how the support given to those in residential care homes can be most effectively personalised.
The Government have stated their intention medically to assess all those currently in receipt of DLA. Assessment can bring advantages and ensure that help goes to those who need it most. Potentially, it can make it easier for some disabled people to claim and allow the provision of more individualised support. However, there are also pitfalls and possible side effects to assessment such as the cost, both of contracting out the assessments and of financing the appeals that are bound to follow in the wake of any large-scale assessment programme. There is also the pain that face-to-face assessment may inflict on those suffering from autism and similar disabilities, and the danger that an assessment of the mobility needs of those with spectrum disorders, mental health issues and fluctuating conditions such as Parkinson’s, may be prone to error unless conducted by specialists. We have seen that problem in the conduct of work capability assessments for employment and support allowance.
Does the hon. Gentleman agree—he may be about to cover this point—that there is a question mark over the need for repeated assessments of certain conditions? I speak as the vice-chair of the all-party group on eye health and visual impairment, and I think particularly of those who are blind. Some conditions, such as the loss of a limb, will never change and more costs may be incurred in reassessment than are necessary.
The hon. Lady makes an exceptionally good point. Certainly, it is written in my notes that there is the potential for certain conditions, such as blindness, to benefit from an automatic entitlement.
I suggest it is worth examining a tiered approach in which a paper-based assessment would be sufficient for those with the most obvious need, thus eliminating the requirement for a detailed and stressful face-to-face assessment. I support the emphasis on personalisation in many of the Government’s statements about the reforms. That could prove helpful in addressing the alleged duplication that has been mentioned with regard to funding for care home residents.
I have suggested to the Minister previously, and continue to believe, that if those funds currently allocated by local authorities to care homes for meeting the assessed needs of residents were transferred directly to residents as part of their personal independence payment, that would ensure that the freedom, choice and independence currently offered by the mobility component of DLA is maintained. It would also ensure that money given to care homes for use by their residents is used by those residents, and not lost in administration or meeting other costs. That is not what has been proposed to date, but it is in tune with the thrust of many Government changes, and I hope that it will be considered. The current confusion over where responsibility lies for the funding of mobility needs for those in residential care homes points to the need for reform. However, the fundamental reference point for that reform must be a guarantee that people who live with disabilities should be supported to live active and fulfilling lives.
I conclude by reiterating my welcome to the Minister’s decision to look again at the support given to those in local authority funded care homes, and by repeating my hope that she will investigate the suggestions I have made today, which are among several constructive suggestions raised during the debate.
I, too, congratulate the hon. Member for Arfon (Hywel Williams) on securing this debate. I feel nervous about contributing to the discussion that he has led, as he understands the issue and the field extremely well. I associate myself with the comments of my hon. Friend the Member for Banbury (Tony Baldry): although I feel unqualified to comment on the issue, as an MP, I respect the fact that people come to my surgeries with concerns, and it is important to raise those concerns with the Minister.
I also associate myself with the comments made about the active way in which the Minister has responded to correspondence, especially in relation to constituency matters that I have raised. An effort has been made to communicate, and that communication has been detailed and worth while, and it has been appreciated by constituents. The fact that we are looking at delaying changes to the mobility component until 2013 is welcome. It is a difficult and complex area, and that complexity must be looked at carefully before we implement any changes.
Before I look at the mobility component of DLA, I would like to make a point about the work capability assessment process. I am MP for a constituency where about 42% of the population are first-language Welsh speakers. Time and again, people who come to my surgeries are expected to attend a work capability assessment in which they must explain their position and say whether they are capable of working. Often, they have to do that in English, even though the Welsh Language Act 1993 requires them to be able to do it in Welsh. When someone is in a stressful situation such as that, it is unacceptable that the Department is unable to provide a bilingual service. I have received assurances that the Department is working within the demands of the Welsh Language Act, but time and again the situation on the ground in north Wales does not correspond with those assurances. I would like the Minister to respond to that point.
When I received a letter from the Minister, I almost felt as if she had been in my constituency surgery. The arguments about the complexity of the mobility care component in care homes show that the current situation is not coherent. From talking to people in care homes, it becomes clear that each care home deals with the mobility component in a different way. I have been quite proactive on this issue because I represent a constituency with a high average age—I think I am right to say that the constituency of Aberconwy has the highest average age of any constituency in Wales—and as a result, there are a lot of care homes. My office has spoken to 17 care homes to discuss how they deal with the mobility component and whether it is funded by the local authority. From those 17 care homes, we have had 17 different answers, so the chaos surrounding the issue is clear. It is difficult to move forward with a policy unless we acknowledge that the duplication mentioned by the Department is not constant or ongoing, and that the situation is very different from one case to another. The Government, and the Minister in particular, are trying extremely hard to address the issue in a fair and coherent manner, but to do that we need a long consultation process, which I will certainly feed into.
On a more personal level, it is crucial that consultations take place in a responsible manner. It was distressing to see the parents of a 57-year-old individual who has been in a care home all her adult life come into my surgery. Both those parents are over 80 years old, and are distressed because they believe that the mobility component will be lost. They feel distressed by that, and it is important to point out to constituents that we are genuinely undergoing a consultation process. It is important to ensure that that process is understood and communicated.
The hon. Gentleman makes an excellent point as part of an excellent speech. These are real anxieties and concerns because people see that the mobility component is scheduled to be removed. I welcome the fact that the consultation period has been extended, but that compounds the period of great uncertainty for people. There is a bit of a dilemma.
There is, but I am sure the right hon. Gentleman would agree that a Government who consult and listen are a Government who will succeed. The Department is genuine about the consultation and about listening, and that must be communicated to individuals. We do not want to create undue distress, but I do not think that the Government have communicated well on this issue, and we must take responsibility for that.
I understand that I must conclude my comments before 10.40 am, so I will raise a couple of important points. As I have said, the Minister has been good in responding to almost all my questions, but one question about the discussions the Department has held with the Welsh Assembly Government on this issue has not yet received a response. An excellent point was made about the fact that we are dealing with a complex situation in which the Welsh Assembly Government are responsible for care and social care, but the benefit system is with Westminster. I am slightly concerned that, as yet, the question about what discussions have been held between the Welsh Assembly Government and the coalition Government has not received a response. I am sure that the Minister will write to me or confirm that there have been discussions. We are trying to ensure that the system works, and it is imperative that the social care element and the benefit system interact positively. Part of that interaction in a Welsh context involves good, positive discussion between the Government in Westminster and the Government in Cardiff Bay.
I am pleased to be back in this Chamber debating this issue; I was at the earlier debate. I congratulate the hon. Member for Arfon (Hywel Williams) on initiating this debate. He gave a passionate and eloquent description of the challenges in this field, and his knowledge will be of great assistance to this Parliament as we proceed. Of course, his timing is perfect, as the Second Reading of the Welfare Reform Bill takes place today. This subject includes many challenges and issues, and I am grateful to him for giving us the opportunity to focus on particular issues in this debate.
I shall say a few introductory words about welfare reform generally, but I want to focus on the mobility component of disability living allowance, particularly in relation to residential care, because the issue is of imminent importance. It presents a great challenge and is of great concern to many people. I still require much more clarity from the Government about the position, but I shall return to that, because a few hares have been set running this morning that we may need to catch.
The hon. Member for Arfon made very significant and reflective comments in relation to welfare reform. I am on record as having said during the last debate and in many of my exchanges with the Minister that I believe passionately in welfare reform. I have a background in this field and have been dealing with it for many years. Welfare reform will always be required, and we should never be frightened of it. Sometimes it is difficult. I absolutely accept that it presents challenges, because it affects so many people of great vulnerability. None the less, I have substantial criticisms of the way in which the reform has been conducted.
As the hon. Member for Foyle (Mark Durkan) said, many questions are still outstanding about the reform and the impact that it will have. In particular, many disabled organisations will tell you that they are very worried about the premise of the reform. Rather than being cuts-based reform, it should be evidence-based reform. We should work with disability organisations and try to take them through this. Fundamentally, it should be based on the social model of disability, but the Chancellor of the Exchequer and other people are espousing a medical model of disability, so there are tensions in what the Government are telling us.
We are told that the driving factor behind welfare reform is simplicity. That has been mentioned today. However, if you go along with the Welfare Reform Bill as it stands, you could end up with greater complexity. I have heard this directly from disability organisations, and the hon. Member for Foyle also pointed it out. You could have children under 16 on DLA. You will have adults between 16 and 64 on PIP—the personal independence payment. Then you will have attendance allowance. Elderly people are now saying that they have to get attendance allowance even when they reach that threshold age. There is some confusion from the Government about that, but perhaps the Minister will clarify it.
There are big issues about how we are doing reform, and the Government must think carefully before they charge around telling everyone else that they must just follow suit on the reform. They cannot criticise those of us who are in favour of reform if we say, “This is not how it’s done.” Many people are saying that the reform has been rushed and not thought through and that some of the implications, if the Government go ahead, will be very far-reaching for the most vulnerable members of our society. The Government must take stock and demonstrate that they are listening to people, but a demonstration that they are listening to people has not been evidenced yet.
Would the hon. Lady maintain the current spending of £12.3 billion on DLA under her own model of reform? She says that she is keen to see reform, but would she keep the spending at £12.3 billion? Obviously, it will increase, but can she tell us about any proposals for what she would do?
I can tell the hon. Gentleman what I would not do—I would not start from the premise of a 20% cut. I would work with disability organisations under a partnership approach. We do need to manage costs. Disabled people and their organisations agree with you that we need to manage costs. We do need to look at how the budget is increasing. I would be the first to acknowledge that, but we need to do it in a completely different way from how it is being done at the moment. You should not rush at it and you should not say that your only motive is cuts. I take the point made earlier. I intended to say that I would be polite in this debate. I may not have managed that so far and I may not manage it later, either.
Thank you very much. Of course we shall be polite to one another in the House, but we must remind ourselves of the scale of the anger in the country about what is happening, particularly on the mobility component of DLA in relation to residential homes. People’s concerns are deeply felt. People are deeply worried, but there is also anger about how it is being done. We have all received representations from the voluntary sector, the charitable sector and local authorities that are confused about what is happening. The debate has also involved Members of Parliament. I had thought that it was cross-party—that it went across many parties, including the Government parties. Perhaps not, but we shall come back to that.
I have not yet heard the case for the reform. This morning, some hon. Members have said that we need to introduce the cut in relation to residential care homes because all of a sudden care homes are very confused by the funding and all of a sudden local authorities are very confused by the funding. I have not had any representations in all my time as a Member of the Scottish Parliament or in my time in this Parliament about that confusion. It seems to me that yet another argument is being put forward for why we are doing this.
I have asked the Minister a parliamentary question about how many people have advocated the change to the Government. How many people have gone to the Government and said, “This is a real problem and it needs to be sorted out”? I have not had an answer yet. Perhaps the Minister could give me an answer later today.
Many interesting points have been made in the debate. We have been given individual examples by the hon. Member for Caerphilly (Mr David). We heard from the hon. Member for the secret garden—I do not know whether I can call him that. I am referring to the hon. Member for Banbury (Tony Baldry), who also talked about the secret garden of policy in the previous debate. He has raised many significant questions that have still to be answered.
Perhaps the most substantial point came from the hon. Member for Arfon, who said that the mobility component of DLA for people in residential care is about normalisation. I have not heard any Government Member be able to challenge that. You do not give that payment to an institution; you give it to the person so that the person can make their own personal choices. With the greatest respect, ironing out the so-called overlap or trying to ensure that you give it to a care home does not address that fundamental point. That is the issue—the payment goes to the person.
Let me establish a few of the facts. Some 80,000 people are affected by the cut, and it is a cut. It represents a saving of £160 million. I fundamentally believe that it is driven by the need for that saving. It will affect not only people living in residential care homes, but young people in residential schools. I accept the comments made about the Minister. They were very flattering and positive, and I am sure that they are all true. I also welcome the review. However, I am not as optimistic as some people are that somehow we are going to see a change. Therefore, I would like to ask the Minister a few questions about the review. Who is involved in the review? What is being considered? Do you have on the agenda the option of completely cancelling the cut?
Order. May I gently remind the hon. Lady to refer to people in the third person, rather than dragging me into the debate?
I apologise, Mr Davies. I will not drag you into the debate. I am referring to the Minister. I would be grateful if she could outline the parameters of the review. Is there any possibility that the cut could be cancelled as a result of the review? Will she clarify that?
As other hon. Members have said, a document has today been published by 40 organisations in the sector, which represent a vast swathe of opinion in this field. Those very credible organisations have told us that the Government’s arguments have shifted eight times. I think that they will need to issue another document, because I think that there has been another shift in the argument. I say that because the “road map” has been presented to us today. Somehow that is the solution to the cut; everything will be solved by a road map. As long as people know exactly where the funding is coming from, all will be solved. I think that that is fundamentally wrong and I hope that we are not seeing yet another attempt to explain an unjustifiable cut. The cut is wrong. It should be off the agenda now. We have the opportunity in the Welfare Reform Bill to ensure that that is the case. Labour will be arguing very strongly that we reject the cut. We need to ensure that we continue to give people in residential homes the personal independence that they have now. That should be maintained. That is what the Government should be doing.
It is a great pleasure to serve under your chairmanship for the first time, Mr Davies. I am grateful to the hon. Member for Arfon (Hywel Williams) for calling the debate, which has given Members from across the House the opportunity to talk about their personal experiences on this issue.
I am sure that everyone here shares a deep concern to ensure that we get provisions right for disabled people in all our communities, and the coalition Government are certainly absolutely committed to doing so. That is why we have taken the Equality Act 2010 through to Royal Assent, put in place the right to control for thousands of people, driven a personalisation agenda and promoted a new project on access to elected office to help more disabled people to be involved in debates such as this, because, all too often, they are not.
I welcome the support across the House for the need for welfare reform. I think the hon. Member for Glasgow East (Margaret Curran) supports it—at least, the leader of her party does—and we obviously need to debate some of the details today. I certainly welcome the support of the hon. Members for Arfon and for Caerphilly (Mr David).
When it comes to the Welfare Reform Bill, what is certain is that the Government have inherited a mess after 13 years of Labour, and nowhere is that more evident than with DLA, which is almost a case study in how not to run a benefit. DLA lacks any objective test; it has no in-built system to check people’s continued needs for support; and there is a real chance that some people will continue to claim it when they are no longer entitled to. That is no way to manage a really important means of supporting disabled people, and it is certainly no way to manage the spending of £12 billion of taxpayers’ money—an amount that was never envisaged when DLA was first outlined.
It is good to hear the hon. Lady accept that we need to manage costs, and I welcome that acceptance. The previous Government allowed spending on DLA to spiral unchecked. This Government firmly support the principle behind DLA of providing a non-means-tested benefit to support independent living, but the simple truth is that we cannot let DLA go on as it has, especially at a time when we are committed to making the welfare system fit for the 21st century. DLA reform is long overdue, which is why we are proposing in the Welfare Reform Bill today that the personal independence payment should replace DLA, creating a more transparent benefit that is better targeted and more affordable in the long term.
On transparency, the BBC carried a statement from the Government this morning saying that they had no intention of extending the entitlement onset from three months to six months. Can the Minister confirm that that is the case?
Extending entitlement onset from three months to six months.
The hon. Lady will know that it is absolutely our intention to make changes so that the new PIP assessment supports people with long-term conditions. That is the—[Interruption.] I cannot possibly comment on something reported in the media that I do not have sight of. It is probably easier for me to get back to the hon. Lady to clarify the point than to debate it today.
As part of the wider DLA reform, we have looked at how the mobility component affects people in care homes. As many hon. Members have indicated, we discovered that, much like DLA, the mobility element is characterised by a lot of uncertainty and red tape, and my hon. Friend the Member for Aberconwy (Guto Bebb) picked up on that extremely well. Like him, I have talked to care homes, and every one I have been to has had a different experience of trying to tackle what is one of the most fundamental issues for disabled people—how to get about. That is driving me to make sure that we not only reform DLA correctly, but ensure that people living in our care homes get the support that they need.
When it comes to determining care homes’ duties and contractual obligations, the interpretation is very wide. It is not that people thought it was all rosy in the garden in the past, as the hon. Member for Glasgow East perhaps implied, because there is long-term concern about the lack of clarity over these obligations. There has been almost a sticking-plaster, pragmatic approach to trying to ensure that disabled people, who are some of the most vulnerable people in our community, get the support that they need. The situation has not been helped by an array of very different legal duties and contractual responsibilities, which mean that service providers and residents are unclear in practice about where responsibility lies. Indeed, the hon. Lady might pick that up if she talks to even more of her constituents.
My hon. Friend the Member for Banbury (Tony Baldry) picked up on this issue in his contribution. I do not pretend to be able to give him answers to all his questions, but part of the problem is that responsibility for provision of mobility is spread across at least three separate pieces of legislation in a not entirely consistent manner. That is one of the issues that I will be looking at. We have the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We also have the 2008 Act itself, which deals with the registration of care homes. It includes a clear obligation on care homes to promote independence, and mobility is part of that. There is also an important role for the Social Security Contributions and Benefits Act 1992, which makes it clear that local authorities should not take account of DLA when assessing people’s needs. All those things mean that care homes and local authorities have a complex set of measures to deal with. The previous Government could have taken time to provide more joined-up thinking on the issue, and we have put our efforts and energies into dealing with the issue.
If the hon. Lady will forgive me, I am trying to reply to as many points as I can. Perhaps she can raise any points that she has separately with me.
I have been told of cases where DLA payments have not been passed on to the person who should have been in receipt of them. As hon. Members will know, that is a serious offence. Some people have told me that they are having to pay charges for basic services in care homes, which should, by rights, be freely available. I am sorry if all that is anecdotal, but it paints a worryingly consistent picture of arrangements that are no way to ensure the best support for the most vulnerable people in our society, no way to ensure accountability and no way to ensure the best value for disabled people or taxpayers. In short, the situation is really unsatisfactory.
As much as the hon. Lady may not agree, it is my job as Minister with responsibility for disabled people to stand up and speak about these things and to ensure that we get some action. I want a far clearer approach in the future, so that disabled people everywhere in the country can know what they can reasonably expect. That was one of the issues that was usefully raised in the “Don’t limit mobility” report. Only with a clearer approach will we achieve the outcome that all hon. Members present want.
In the remaining couple of minutes, let me move on to some of the detailed points that I hope to cover. The hon. Member for Arfon raised a number of issues, but he focused particularly on budgets. It might be useful for hon. Members to know that when we talk about the DLA budget, we are talking about ensuring that we keep control of the growth in it. The expenditure that we are talking about for the future will be the same as we had last year for DLA, after a 30% increase in the number of people claiming DLA over the past eight years. I hope that that reassures hon. Members that we are not talking about the sort of swingeing cuts that have been painted by some less responsible Members, but just trying to ensure that the rapid growth that we have seen is brought under some control.
The hon. Gentleman also raised important issues about the application process. Let me reassure him that this will not involve a medical test, but an objective test built on the social model of understanding the barriers that people face when they have disabilities that they need to cope with. He raised a number of other issues, including, in particular, eligibility after 65, and I assure him that the personal independence payment will continue past retirement, as long as an individual continues to be entitled to it. If I have not picked up any of the issues that the hon. Gentleman has raised, I am sure that my officials will ensure that I write to him.
The hon. Member for Foyle (Mark Durkan) raised a number of extremely important issues, some of which I have already covered. He also mentioned children, and I draw his attention to the report that my Department is doing with the Department for Education. It looks at how my Department will assess children in future in conjunction with the DFE, rather than putting children through multiple assessments, as at present.
My hon. Friend the Member for Aberconwy made an important contribution. I agree with his characterisation of the situation as chaotic. I will make sure that I get back to him about our communications with the Welsh Assembly and about the importance of making the work capability assessment available in a way that is consistent with legislation on the Welsh language.
My hon. Friend the Member for Chippenham (Duncan Hames) made a number of important and constructive suggestions, and I thank him for that. I will perhaps talk to him separately.
In an important intervention, my hon. Friend the Member for Winchester (Mr Brine) reiterated the importance of treating people as individuals. I am sure that he, too, will welcome the commitment to personalisation given by the Minister with responsibility for these issues in the Department of Health—