Employment and Support Allowance (Limited Capability for Work and Limited Capability for Work-Related Activity) (Amendment) Regulations 2011
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Baroness Masham of Ilton
My Lords, I thank the noble Lord, Lord Kirkwood of Kirkhope, for bringing up this matter. He understands these matters so well and I support what he has said. This is a complex matter. Disability is complex, as it differs in so many ways.
There is great concern from many disability groups, as has been said, as well as the national AIDS group, which has not been mentioned. HIV is a very complex condition. People with it have to live on drugs for the rest of their lives. On some days they are better than on other days, and some drugs work in different ways on different people. This is a complex matter.
I hope that the Minister will get these regulations right. I have two questions for him. Who will be doing the assessments? Will these people be adequate? This is of great concern to many people, and this debate has illustrated how very complex the whole matter is.
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)
My Lords, this is an important opportunity to discuss the regulations. A lot of points have been raised and I will try to deal with as many as possible. However, I take this opportunity to lay out the position coherently. I take the criticism of the noble Lord, Lord Kirkwood, that communication has been less than perfect. I shall try to describe what is happening to reinforce that communication programme and I commit to ensure that it is maintained.
There is still a lot of misunderstanding about the assessment and what we are doing to make it fairer and more effective. The first point to make is that these regulations seek to take the first step in improving the work capability assessment. They were developed in conjunction with technical experts and with considerable input from specialist disability groups. As noble Lords have acknowledged, they will ensure that individuals awaiting, or between courses of, certain chemotherapy will be placed in the support group without face-to-face assessment. They will expand the support group to cover people with severe disability due to mental health problems and communication problems—that includes people with autistic spectrum disorder, about whom the noble Baroness, Lady Browning, was concerned—and they will ensure that the descriptors take account of someone’s adaptation to a condition or disability so that we can provide them with the right support.
Before proceeding to debate the finer points of the regulations, I would like to put the reform into a context. The legislation before us today is part of a far broader commitment by the Government to tackle worklessness and intergenerational poverty. This is a very real and very urgent problem for us all, especially given that there are now 2.6 million working-age people claiming incapacity benefits, of whom some 850,000 have been claiming for a decade. This is a massive brake on the economy, costing the taxpayer billions of pounds every year, but that is not the most important point. The true cost of this level of inactivity is paid for by individuals left languishing on long-term benefits without hope or opportunity for a better life. I echo what the noble Lord, Lord Kirkwood, said about the scourge of inactivity. If we abandon these people, we fail in our duty as Members of this House. For too long, too many people have had to pay for our failure to act.
Before the recession, there were 63 consecutive quarters of economic growth—that is the longest growth period the economy has enjoyed, as historians can best work it out—and the economy created 4 million additional jobs. Yet under the previous Government—I am not being political—just over half those jobs went to foreign nationals. The result was that, even before the recession hit, we still had 4 million inactive people. Millions of people were without jobs in a growing economy, yet the system was trapping them. That is why we were sucking labour from abroad. The system offered too few people the opportunity to escape and to make a better life for themselves. We must not fail them again, because the country cannot afford it, and neither can the individuals, their families or our society.
Studies have shown that welfare dependency, social isolation and lack of purpose in life have a debilitating affect on individuals. Decades ago, the late Aaron Antonovsky argued that the purpose in life—what he called coherence—was crucial to understanding human health and well-being. More recently, Waddell and Burton’s excellent review of the issue, written four and a half years ago, reinforced the evidence that showed that work is generally good for you. There is ample evidence that prolonged periods of inactivity and unemployment contribute to declining mental health. That is why the welfare reforms that we are introducing are so important, and that is why the regulations are such an essential element in transforming the lives of millions of people at risk of being abandoned to welfare dependency.
These reforms are the key to providing the lost with a path out of the cycle of dependency and poverty, and helping them on to the path to new opportunities. That is why we are embarking on a large-scale re-evaluation of those on incapacity benefits through the work capability assessment that will take in some 1.5 million people—not the 2.6 million on incapacity benefit who the noble Lord, Lord Kirkwood, mentioned —over the next three years. It is also why we are introducing the universal credit to make sure that work pays, and why we are introducing the largest welfare-to-work programme that this country has ever witnessed.
This is designed not to badger or bear down on the vulnerable but to give them a road map to a better life. It is only by tackling welfare dependency and starting to dismantle the benefits trap that we can help people escape the huge social costs of worklessness, social exclusion and intergenerational poverty. Many noble Lords will know how difficult it is to wrestle with the issue of child poverty without this kind of route.
Those who cannot work will of course continue to get the support they need. However, for those who can make the journey back towards the workplace, we will offer them structured support to become work-ready. This will provide real help for many of those who have previously been abandoned by the system—those who were simply labelled as incapacitated and largely ignored, whether they wanted to work or not.
The work capability assessment was introduced in October 2008 as a key part of the assessment process to determine entitlement to employment and support allowance. It replaced the personal capability assessment and represented a significant and overdue change in assessing an individual’s ability to work. It was developed in conjunction with technical experts, along with considerable input from specialist disability groups.
However, it was clear from the outset that, unlike the PCA, the WCA should be subject to an ongoing process of review, evaluation and refinement. Indeed, it was this House that passed the amendment that introduced the requirement for an independent review of the WCA for the first five years after its introduction—a point made by the noble Lord, Lord Kirkwood. It was the only amendment from this House that made its way into the original legislation for the work capability assessment, and it received support from all sides. That was slightly before my time, but I know many noble Lords will remember it well.
The Countess of Mar
The noble Lord said that the department worked with disability groups. Why have those groups unanimously dissociated themselves from the internal report?
Lord Freud
My Lords, I am pleased to answer that question. I am rather surprised by the actions of the groups. I have seen a lot of correspondence and a lot of internal work. There was very full engagement by both sides, and a lot of correspondence about fine-tuning the regulations. At the end of the process there seemed to be real agreement. Therefore I am genuinely surprised that, after the passage of some months, the consensus seems to have been significantly eroded. Income elements may have come to the fore, whereas the technical analysis that was the subject of the interplay between the department and the groups was perhaps easier to get to grips with.
I will go back to describing the system. The wider system that we inherited, after the measures that the internal reviews described, contained flaws that we as a new Government have looked to put right as quickly as possible. In June we launched the first of the five annual independent reviews of the work capability assessment—the first of the reviews that this House legislated for. It was carried out by Professor Malcolm Harrington, a highly respected occupational physician. He reported last November. He did not consider that the work capability assessment was broken but felt that it was not working as well as it should and made a series of recommendations to improve its fairness and effectiveness. We have fully endorsed his review, as the noble Baroness, Lady Thomas, pointed out, and we have committed to implementing his recommendations as quickly as possible.
The first key element of those recommendations—I am borrowing, again, from the description of the noble Baroness, Lady Thomas—is that we empower Jobcentre Plus decision-makers to make the right decision. They will have clear responsibility for the decisions they make and will be given the support that they need to ensure that those decisions are independent and considered. I hope that that is one of the reassurances for which the noble Lord, Lord Kirkwood, was looking.
The second recommendation is to ensure that individuals are treated with compassion by clearly explaining everything to them, helping them to fully understand the process they will go through and ensuring that they know that they can provide additional evidence, including medical evidence, for consideration at any time. I hope that that is the second of the reassurances for which the noble Lord, Lord Kirkwood, was looking.
The third major change is to improve the transparency of the Atos assessment by ensuring the audio recording of assessments in the Atos pilot. The other element involving the Atos process is that we will account for the particular difficulties in assessing mental health conditions by ensuring that Atos employs “mental health champions” at every centre.
Nearly all these changes will be in place for the start of the reassessment, with the remainder completed in time for the summer. We have also appointed Professor Harrington to conduct the second independent review. He will now examine the assessment in more detail, particularly focusing on mental health descriptors and fluctuating conditions.
I shall now respond to the questions of the noble Baroness, Lady Finlay, on fluctuating conditions. The fact that conditions fluctuate is now embedded in the descriptors. We just want to make sure in this next piece of work that we get that absolutely right. We look forward to Professor Harrington’s recommendations following the second review in due course.
The regulations before us today are part of this improvement process. They come from the internal review undertaken and fully supported by the previous Government. That review suggested a number of changes to clarify and improve the technical descriptors; noble Lords have made these points so I will go through them quickly. The changes include placing individuals awaiting or between courses of chemotherapy in the support group; expanding the support group to cover people with certain communication problems and severe disability due to mental health conditions; greater provision for individuals who are in residential rehabilitation due to drug or alcohol misuse; ensuring the descriptors take account of someone’s adaptation to a condition or disability; and simplifying the language of the descriptors to ensure fair, consistent and transparent applications. These changes will improve the work capability assessment. They will increase the number of people with severe disabilities who are provided with unconditional support in the support group. They will ensure that we do not deny employment support to individuals who, with our help, can get back to work.
The internal review consulted a range of experts and groups and, as I described just now, tried to reach consensus. Significant concerns were expressed by the groups around the descriptors. I will not go into those because I am short of time, but I can respond to the noble Countess, Lady Mar, on fluctuating conditions. It must be possible for all the descriptors to be completed reliably, repeatedly and safely, otherwise the individual is considered unable to complete the activity.
The Department for Work and Pensions has undertaken rigorous testing of these changes to understand their effects. The department modelled the impact of the changes on data from almost 60,000 assessments, and a panel of experts was brought together to examine the changes in significant detail. Where any issues were identified during this process, further refinements were made to the descriptors. From this analysis we expect the changes to increase the number of new claimants who are put in the support group, specifically, those who are awaiting or are between courses of chemotherapy, and some whose limited capability relates to certain mental functions and communication difficulties.
I have run out of time, but I hope that the House will indulge me for two more minutes as this is really important. We are committed to the principle of continuous review and refinement of the work capability assessment. As part of that principle, we have reviewed in detail the working of the work capability assessment and consulted in depth with specialist disability groups to improve the assessment. The addendum to the original report shows how far such concerns were taken on board in these regulations. We are committed to taking Professor Harrington’s review to improve the sensitivity of the process. Of the 17 recommendations that he made, we will have 15 in place in time for April and the other two in a couple of months. I hope that that is a final reassurance for the noble Lord, Lord Kirkwood, and the noble Countess, Lady Mar.
The changes that we are making in the regulations will improve the work capability assessment. They will expand the support group to cover people with severe disability due to mental health conditions and communication problems. They will ensure that the descriptors take account of someone’s adaptation to a condition or disability and accepting these regulations means that we can make these important improvements now. We remain committed to the principle of continuous improvement to the work capability assessment. I trust that the noble Lord, Lord Kirkwood, will feel able to withdraw his Prayer to Annul these important regulations.
Lord Kirkwood of Kirkhope
My Lords, I am grateful to the Minister. It has been a long but excellent debate. I thank all noble Lords who have participated. I shall certainly look carefully at the record tomorrow to ensure that we learn the lessons that have been laid in front of the House during the debate. I am pretty sure that the Minister will do the same—that he will take the opportunity of reflecting very carefully on what he has heard and the tone in which some of these powerful speeches have been made.
Knowing the Minister as I do, I know that he will also take away from the debate the fact that he may have some work to do to reconnect the department properly with the disability community and the pressures groups that represent it. I hope he will take that commitment on personally and not leave it to his senior officials, very highly regarded as they may be. I hope that he will personally invest time to make that connection good, otherwise it will fall foul of broken communications in future if it is not put right.
Reflecting on the debate, I think the Minister has got an amber light; he did not get a red light, but he still can in future if he does not complete the commitments he made—speaking for myself, I am willing to accept them—but he has not got a green light. I hope I am reflecting the tone of our excellent debate in seeking the leave of the House to withdraw this Prayer.