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The Minister of State, Department for Work and Pensions (Chris Grayling)
I congratulate the hon. Member for Penistone and Stocksbridge (Angela Smith) on securing this debate. It is a useful opportunity to put on the record, once again, the things that we are doing to make sure that this is a proper, fair and appropriate process.
I should like to correct the hon. Lady on a number of things that she has mentioned where she has not got her facts right or is a little out of date. First, however, I pay tribute to her for referring to the fact that it was the previous Government who introduced this system. She has set out in detail the context for the changes that we are putting in place. I agree with her that the system that we inherited was not adequate. It did not do the job properly and in many cases led to wrong decisions about individuals. I and my colleagues in the Department for Work and Pensions have spent the past year trying to sort all that out, so that we were ready for the start of the migration process. I shall explain to the hon. Lady in some detail how that was done.
I shall begin by picking up on some of the points made about Atos, the contractors. The hon. Lady mentioned that Atos was contracted, but, as she knows, it was contracted originally by the previous Government. We have not sought to change the contracting arrangements because, frankly, it would be massively disruptive to do so in the middle of the process. What we have sought to do is address the issues surrounding Atos that have led to concerns being raised. Let me be clear—Atos has no financial targets. A myth has been circulating for some time that our contractors are incentivised to find people fit for work. That is absolutely not the case and I am happy to put that on the record.
It is also not the case that there is a target of seeing 10 people a day. The only indicators and targets that Atos has relate to the quality of the work that it does for us. We have been careful to make sure that that is the case. It would be absolutely inappropriate to have a situation in which a third-party contractor was incentivised to reach a particular outcome in an area as sensitive as this. The hon. Lady can be reassured that that is not the case.
Before moving on to the details of the Harrington review, I shall address the hon. Lady’s query about the internal review, which was carried out by the previous Government, which made a number of recommendations to us, and with which we have decided, after much thought, to proceed. The internal review was carried out over the last 12 to 18 months of the previous Government. It looked at how the assessment was working and made a number of recommendations about changes. It did a number of things in particular, and there are two or three reasons why I decided to accept the recommendations of the previous Government and to implement that set of changes—they were introduced at the start of last month—to the assessment. The first of them related to mental health. The hon. Lady is not right on the mental health issue. This is a matter of great concern to me. I am acutely aware that mental health problems and fluctuating conditions are crucial, as she rightly said. Getting them right is fundamentally important. They are the most difficult areas of health challenge to deal with as we go through the assessment process.
We looked carefully at the impact that changes to the assessment recommended by the internal review would have on people with mental health conditions. The assessment we have carried out shows, in fact, that more people with mental health conditions will find themselves in the support group with long-term unconditional support than would have previously been the case. The set of changes we have just introduced should increase the number of people who receive ongoing unconditional support for mental health conditions. That seemed the right thing to do.
The second thing we did was to address the fact that people in between periods of chemotherapy could, theoretically, be found fit for work. We did not think that that was right and therefore we have excluded people who are in between courses of chemotherapy from any kind of return-to-work process, as well as those involved in chemotherapy at a particular moment in time. Again, that seemed the right thing to do.
On the change the hon. Lady referred to in relation to people who are blind, partially sighted or in wheelchairs, we had a situation that was inappropriate and wrong. Let us think of the motivation behind these changes. Fundamentally, we are trying to help people with the potential to work to get into work and not end up spending the rest of their lives on benefits. The internal review highlighted that, under the previous system, if someone was a Paralympic athlete with a university degree, there was no obligation for them to look for a job. That is not right. Some people who are blind or partially sighted and are out of work have long since adapted to that condition and have worked before. They should be looking for another job and it is wrong to say that that should not be the case simply because they are blind or partially sighted. I am not suggesting that that is what the hon. Lady was saying, but that is what the previous system provided for. We have introduced an adaptation factor into the assessment, so that a judgment is made about how well somebody has or has not adapted to their condition. That factor will have to be considered.
I want to give the hon. Lady more detailed context on the way in which that consideration now takes place. Over the past few months, we have made big changes to the whole process precisely because of the kind of issues she has rightly identified. I have no interest whatsoever in putting anybody who is not fit for work into a position whereby they are being pushed towards trying to find work. That is not in our interests as Ministers, as a Government, as individuals or as a society. Indeed, if somebody is not fit for work, an employer will not hire them, so we would achieve nothing from such an approach.
We inherited the internal review and looked at its conclusions, which we have implemented. We set up the Harrington review precisely because we had concerns of the kind that the hon. Lady has raised. She has rightly looked at the Harrington recommendations, of which there are 25. As we stand here today, all the recommendations bar, I think, two have already been implemented and the other two are due to be implemented by the end of this month. By the time we get to the point in June when the first big wave of people will be reassessed as part of the incapacity benefit-employment and support allowance migration, all of the Harrington recommendations will be in place. The ESA50 form has already been updated and the various other recommendations have all been put in place. I reassure her that there is no question of waiting for a point much later in the year before all that happens; it is happening now. When Harrington provided his recommendations, something I insisted on with officials is that we cracked on and delivered these changes, so that they are in place for the IB-ESA migration.
The most important of Professor Harrington’s key recommendations was about the decision-making process. We had a situation whereby, up until the past few months, the final decision about whether somebody was found fit for work was technically taken by a decision maker who was a senior member of staff within Jobcentre Plus. Those members of staff had tended to view the outcome of the Atos assessment—the work capability assessment—as gospel because it was carried out by a health care professional. They thought such assessments just had to be rubber-stamped.
We have changed that totally and have created a process through which the decision makers are told not only that it is their decision, but that they have to look at other evidence—for example, the hon. Lady referred to GPs’ evidence. Our decision makers are expected to look at other medical evidence submitted by the individual concerned and at the GP’s and consultant’s comments to form a rounded view. Indeed, if they believe that they do not have enough evidence, they have the freedom to go back and ask for more. That is a big change. We have effectively downgraded the role of the work capability assessment in the process. It is an important part of the decision, but it is no longer the only part of the decision. That will make a big difference.
Professor Harrington highlighted precisely the situation the hon. Lady identified surrounding mental health conditions. That issue is a hugely complex and sensitive area that needs to be dealt with carefully. Within the Atos health care professional network, Professor Harrington recommended that we introduce mental health champions to whom the assessors can turn for advice if they are uncertain about how to react to particular responses. Those champions are already in place. In fact, we have gone back to Atos and said, “We’d like some more of them please.” The numbers will be increased by the early summer. I am very keen to ensure that we provide a proper focus on and expertise in the mental health field.
Guto Bebb (Aberconwy) (Con)
On the decision makers and support for mental health, could the Minister provide some numbers and the geographical basis of those numbers, because it is an issue of real concern in north Wales?
Chris Grayling
In terms of the mental health champions, there are I think about 50 in the network. The number will rise further and is rising; they are being recruited all the time. By the time the process is finished, there will be one champion for about every two to two-and-a-half assessment centres. Someone will be constantly on call. In some cases, those champions will be present and, in other cases, they will be at the end of a phone line. The hon. Lady made reference to the Harrington recommendation on the individualised statement—the summary of the assessment. We want the champions to be involved when the individual concerned picks the phone up and says, “I’m not quite sure about this.” That view can be reflected in that statement, which will be introduced later this month. So that recommendation will have been dealt with as well.
Angela Smith
I am very pleased with the fullness of the Minister’s response, but will he comment on the situation that threatens individuals with long-term and sometimes terminal conditions, such as emphysema, who may be fit for some form of work, albeit only for a few hours a week? Those people are currently failed by the system.
Chris Grayling
I will come on to that because I want to make another point in response to the hon. Lady’s question about fluctuating conditions. Professor Harrington is currently working on that to see if there is anything else we need to do. However, we are trying to ensure that there is expertise within the Atos network of individuals and that training is provided to both decision makers and Atos professionals about fluctuating conditions.
On the hon. Lady’s other point, a crucial part of this jigsaw puzzle is the Work programme that will start in about three or four weeks’ time. That programme is designed to provide specialist support for precisely the kind of person she has mentioned. She said that the person concerned wants to work, but that he clearly cannot work in the job he had before. If we put him into the sickness benefits environment and leave him there, he will probably never work again. We can offer him the opportunity to have specialist support through the Work programme, with providers who are contracted on a payment-by-results basis and in a system where we pay different amounts for different levels of challenge. For example, somebody who is coming off sickness benefits will command a higher tariff than somebody who is a conventional job seeker without sickness challenges. The aim is to encourage the providers to work with somebody in that position to find a job that he can fulfil.
I do not regard it as acceptable—I am sure that the hon. Lady and I share this view—to have a situation whereby anyone who has the potential to work is parked on the sidelines and is unable to get the support that they need to get into work. From our point of view, the most fundamental part of the change is not to try to find people who cannot work fit for work. Indeed, those who end up in the support group—the group that needs ongoing unconditional support—will get more money as a result of the change.
The key goal is to identify those people who have the potential to return to work so that, through the Work programme and other support provided by Jobcentre Plus, we can give them the help they need to get into the workplace. That is what this is all about. We will do our best to get it right, but I am sure that we will make some mistakes along the way. We have introduced a reconsideration stage at Jobcentre Plus to try to ensure that we catch our mistakes early. However, it is important to realise that this is all about helping people who could work to do so. Otherwise, the only alternative is for them to spend the rest of their life on benefits, and I do not believe that that is in their interests or in any of our interests.