Employment and Support Allowance (Blackpool South)

Wednesday 5th September 2012 Westminster Hall

16:43

[Mr Gordon Marsden (Blackpool South) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I welcome the Minister to his new role.

There is a paradox, in that the reason why many people move to seaside towns—this is not only about those who have lived there all their lives—is to retire, get well, and improve their physical lives but, sadly, illness and physical circumstances do not always permit that. That is the paradox in Blackpool, where the numbers of older people and those with disabilities are larger than average. Many of the disabilities and conditions are fluctuating and transient, and such transience adds to the mental and physical issues that people face.

I want to discuss what my office and I have seen of the experience of claimants who have been transferred from incapacity benefit and other benefits to the new employment and support allowance. In particular, decisions have been made about whether people go into a support group or a work-related activity group. In recent months, we have observed a gradual build-up of people bringing cases to us. There have sometimes been between three to five a week over several months, and as that has happened, I, and people from disability groups across Blackpool, have become more worried.

The concerns have related to the nature of the medical examinations, inaccurate recording and inconsistencies of judgment. Sometimes, they have been about the overall principle of the Atos assessments and what can be described only as a tick-box culture. Only half an hour ago, Advice Link in Blackpool e-mailed me to say that it was giving out advice that the ESA50 form that the claimant receives and the scoring system used by decision makers do not add up. We have seen particular problems with people who have had their Motability taken away.

It is important that I stress the nature of the conditions faced by those who have come to us. Many have chronic illnesses or deep-rooted mental problems, and a number have had degenerative conditions that, by all modern standards, are incurable. I was alarmed and concerned that two or three of the cases involved medical professionals employed by Atos whose methods and judgment we had expressed concerns about three to four years earlier. On that occasion, the Department admitted that they were inadequate.

I want to press the Minister about Atos. Who does it employ? What balance is struck between Atos and the decision maker? Research shows that the majority of decision makers do not feel that they can question much of what has been said. A research summary from the Department for Work and Pensions said:

“Some felt that they still had the ability to reach their own decision over borderline cases”,

but others felt very limited. They

“felt they had been expressly told that they could not make a decision that ran contrary to the Atos advice without securing Atos agreement to do this”,

which they had found that Atos was unwilling or unlikely to supply. What happens when the appeals process takes place, and what happens in the meantime?

One of my constituents suffers from osteoporosis of the spine, fibromyalgia, spondylosis and partial deafness. Following a medical by Atos last November, her disability living allowance claim was disallowed, which also impacted on her husband’s claim for carer’s allowance. My constituent submitted a request for reconsideration but less than 24 hours later, the decision maker rejected it, confirming the original decision. What capacity did the decision maker have to make a considered judgment on that assessment?

I stress the problems about changes to Motability. The rules now say that the Motability component has been altered, with a movement from six months to four weeks for the removal of a vehicle. That was introduced with scant publicity. I have already referred to the swiftness with which the decision makers rejected my constituent’s request, but the real problem, right across the piece, is the time that appeals now take. My constituent was told that it could be at least six months before her appeal was heard.

Another constituent, Mr L, said that his jobcentre adviser was putting him in touch with his mental health worker, but that the process had been undermined by two consecutive medicals. My constituent says, “The adviser bangs his head on the wall. His hands are tied because of the rules that the DWP are using.”

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

I recognise much of what the hon. Gentleman is saying, but will he clarify whether he supports the overall principle of reassessing the claims, or is he merely seeking to draw attention to inadequacies in the implementation?

[Mr Marsden]

I thank my constituency neighbour for that question. I do not think that the two questions are separate. The inadequacy with which some of these issues are treated inevitably casts light on the strength or otherwise of the process. If the hon. Gentleman is asking whether I am in favour of disabled people being given every opportunity to expand their capabilities and to work if that is proportionately possible, the answer is an unqualified yes—and that would be the case for most hon. Members—but that issue is not under discussion today.

The Minister also needs to think about the effects on the families and carers of people who are knocked back. One of my constituents, a lone parent of two sons in their teens, one of whom has Asperger’s, was knocked back last month. My constituent says, “Two days before being admitted after a series of operations on my shoulder, I received a letter to inform me of the results of the medical I had to attend with Atos, saying that I was fit for work and that my claim for ESA had ended from yesterday. Both my sons live with me, but my housing benefit will stop because my ESA claim has ended. I don’t want to be claiming benefits. I would rather be back working, but with the pain I am in, I am unable to do that.” I have already mentioned what happens to the income of the carers of partners judged fit for work.

Another claimant who was knocked back, who had had long-term depression, wrote to say, “Is there any way you could possibly have the appeal process speeded up? I have been told it could take up to eight months. I feel so lost and powerless.”

The stress falls not just on the person with a disability, but on the partner, particularly when, as a number of my constituents have told me, they were discouraged from going to the assessment because of the restrictions of the venue. That is a denial of human rights, as well as, practically, a very silly thing to do.

Another constituent with chronic pain has been through this revolving door and says, “I am now mentally preparing myself for the fact I will have to take my case to a tribunal. I have been without any payment from DWP since April and although my partner has taken on extra duties during the lunch hour, we still cannot meet our outgoings—full-time hours where she works will not be available.” That is the reality of these people’s lives in Blackpool; it is the reality of the work process there.

Ministers and officials needs to address some fundamental questions. Leaving aside the individual inadequacies of the Atos process, what are the jobs for which these people are alleged to be fit? How much will it cost the Government and the taxpayer to support them properly in those jobs and, in particular, given some of the new Government restrictions on working tax credit, will they ever be able to earn from them a living wage? I have already said that I fully support proportionate and fully rounded initiatives to enable such people to use their abilities, and I feel strongly about that, having had a mother disabled by osteoporosis for 25 years. However, there is a balance to be struck.

Yesterday, in my local newspaper, The Blackpool Gazette, in a piece written by the feature writer Jacqui Morley, the wife of one of the constituents who had come to me, who is a gentleman with a severe degenerative condition akin to motor neurone disease, said that her husband’s former bosses had moved heaven and earth to keep him until he had realised that he was taking more than he was giving. She said that unless the Government were prepared to give disabled people all the support they need—in her husband’s case, certain facilities, personal assistants, and aids and equipment that cost a fortune—this is just a tick-box exercise about integration, not real inclusion. The system also dictates that the man will have to go through the process again in three years’ time to be reassessed on that progressive degenerative condition.

Alan Reid, who manages Disability First, our Blackpool disability information service, has commented that many people in the town who are genuinely in need are being dumped by these assessments. He says, “They come to us desperate and, in some cases, suicidal.”

Some of these concerns were raised during pilots of the process—indeed, disability group representatives in the Blackpool area took part in those pilots—so it is not entirely surprising that some of the problems have come to pass. I strongly stress that there is a sense of waste and people saying, “Working for what?”

The same constituent’s wife who was quoted in the Gazette put her finger on the problem in the letter that she wrote to the decision maker at Jobcentre Plus. When talking about the test, she said that the question should be about to what end people could press a button and use a keyboard and mouse, and whether they could do so at a speed—and without the need for continued support—that would facilitate meaningful input and a financially viable outcome such that their employment could be sustained by an employer. Surely that should be one of the elements considered in the process.

I have cited all those examples in the context of Blackpool, but the truth, of course, is that this is a country-wide issue. That is why various disability groups, such as the disability benefits consortium, the Royal National Institute of Blind People, Parkinson’s UK and Scope, have all raised serious doubts. The DBC has said that the work-capability assessment is poor at identifying disabled people’s needs.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on illustrating very clearly the position in Blackpool South. He is right to say that the situation is replicated across the whole country. Does he feel that when it comes to ESA appeals and the medical evidence that is used, there should be direct contact with the GP and consultant as a matter of course? That is not always the case, but if it happened, there would be better knowledge of the person’s medical condition for the tribunal and the appeal.

[Mr Marsden]

I thank the hon. Gentleman for his intervention. He leads me to the series of recommendations that the disability benefits consortium makes in that area. They include the fact that evidence is not routinely gathered from the health-care professionals who know the claimant best, such as consultants and nurses; that evidence is often ignored. I accept that that cannot be the sole deciding factor, but it certainly seems ludicrous that it should be excluded entirely. The other side of the coin, as I have mentioned in relation to an individual we had concerns about in Blackpool, is that some of the health-care professionals who carry out the process that we are discussing have limited knowledge of complex or uncommon conditions.

The DBC also discussed the issue of people with long-term degenerative conditions, especially progressive forms of multiple sclerosis, being reassessed far too frequently. Even people in the support group are being reassessed very regularly. Of course, there has been the revelation—this was subject to freedom of information—that more than 1,000 people died shortly after their work capability assessment. That does not take into account the others who died shortly before.

Those mistakes—they are mistakes—must not be replicated when personal independence payments are introduced in 2013. It is no surprise that disability organisations have expressed concern about that. I want to quote just a couple. Mr Ford, chief executive of Parkinson’s UK, has said:

“It is hugely concerning to see that Atos have been given the green light for the Personal Independence Payment contract.”

He says that its assessments

“have led to many people being forced to appeal against decisions that are plainly wrong. How can someone with Parkinson’s—a progressive neurological condition—have an assessment report that implies they will be ready for work again in six, 12 or 18 months?”

Others have written in the same vein.

The concerns in this area have been emphasised by the sheer complacency and smugness—I use the words advisedly—with which Atos has responded in relation to these processes. I received, as no doubt have other hon. Members in the north-west, a very bland letter from its general manager that told me that it had been awarded the contract for the north-west of England. It said:

“Engagement with MPs and the wider stakeholder community was an important element of our successful bid”.

As far as engagement with MPs is concerned, I am not aware that it ever engaged with me in any way, shape or form whatever. As far as the wider stakeholder community is concerned, it may well have engaged with them. That stakeholder community expressed concerns and reservations, most of which it completely ignored. The British Medical Association has also expressed serious concerns in this area.

Blackpool offers a sample what is going on nationally. It may be a particularly strong sample, for the demographic reasons that I have described, but it is a sample. The comments made in yesterday’s debate by my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) and others showed the depth of concern in the House about the process. My hon. Friend the Member for Birmingham, Northfield (Richard Burden) put his finger on it when he talked about “a weird revolving door”: people get assessments, question them and wait ages for an appeal. He said that they

“may or may not win the appeal, but by the time the appeal comes up, they have had another assessment and…they go through”

another

“revolving door”.—[Official Report, 4 September 2012; Vol. 549, c. 19WH.]

My hon. Friend the Member for Aberdeen South (Dame Anne Begg) who, as most Members will know, knows a great deal about such things, not least through her chairmanship of the Select Committee on Work and Pensions, said that she did not think that this

“Government have grasped how disastrous the ESA assessment system is…In too many cases, genuine claimants are not scoring any points in their initial assessment. There is something fundamentally wrong with the system and the contract that Atos is delivering.” —[Official Report, 4 September 2012; Vol. 549, c. 27-28WH.]

The Minister and his officials could and should take notice of the proposals on the table, not least those from the DBC. They should think about proactively gathering relevant written evidence, about reassessing it only when changes in circumstances are likely and ensure that there is an appropriate assessment venue for the full range of disabled people. Atos decision-makers should be trained in a wide range of conditions and share their reports and observational evidence with claimants. The supreme irony in all of this is that the storm is gathering during the Paralympics. Atos is one of the sponsors of the Paralympics. I will leave others to judge the appropriateness of that, but as Prime Minister’s questions demonstrated today, it is a major issue.

I have already welcomed the Minister to his position. He has come from the Treasury, and is, I am afraid, inheriting this mess. I do not envy him. I urge him to reflect not only on what I have told him about the situation in Blackpool and the individual miseries of the affected constituents who have come to me, but on what so many organisations are telling him. It is rare that Ministers are given the opportunity to have an open mind and open the books—normally, it is only at the beginning of their tenure. I ask him to look at what the RNIB and the DBC have said. I urge him to consider whether the Select Committee on Health and others should not look at the quality of some of the doctors; at empowering decision-markers; and at seriously re-examining the target-based approach, considering a qualitative, not only a quantitative, approach.

The Minister should be in no doubt that if he does not address the problems, that will be on his head, and on his reputation—the fiasco will indelibly imprint itself on his record. Seventy years ago, the great parliamentarian, Nye Bevan, laid down the principle that Ministers should not allow outsourced officialdom to play with or ruin people’s lives without a source of redress. The buck very much rests with the Minister.

17:09

[The Minister of State, Department for Work and Pensions (Mr Mark Hoban)]

I congratulate the hon. Member for Blackpool South (Mr Marsden) on securing the debate. I sense that this might not be the last debate that I will have deal with on this matter. I assure him that we are committed to continuously improving the work capability assessment and appeals processes.

Many people with disabilities or health conditions want to work, which is why our reforms distinguish between those who are able to work, those who could work at some point with the right support, and those who cannot work due to health-related problems. The WCA is crucial in ensuring that those people are identified properly. We believe that the principles of the assessment are right, but the system we inherited from the previous Government contains flaws that undermine its effectiveness.

The hon. Gentleman is right: new Governments have an opportunity to make changes. We have made changes. We inherited a flawed system, which we are reforming to ensure that we get it right. We have moved swiftly to put things right, and have worked closely with a wide range of organisations to do so. We are trying to identify where claimants need additional support to prepare for work and ensure that they receive it as part of the ESA work-related activity group.

We have a statutory commitment to review the WCA for the first five years of its implementation. In June 2010, we appointed Professor Malcolm Harrington—a highly respected occupational physician—to undertake independent reviews of the assessment. He has completed two reviews and is currently undertaking the third. Those reviews set out a series of recommendations for improving the assessment. We fully endorsed the recommendations and are committed to making the changes as quickly as possible. For example, we have improved the standards and consistency of decision making through additional training of Atos employees and the better use of evidence. The hon. Gentleman made a point about communicating the findings of assessments to claimants. We have improved the way in which we do that, by providing personalised statements that summarise the key points of the assessment and by ensuring that we implement the customer charter. We have also changed the claims process better to support the claimant at each step of the process and ensure that they understand what is required of them.

We are confident that the improvements we are making to the assessment following the reviews will ensure that we increase the number of decisions that are right first time and improve the service provided to claimants. In addition, we are working with the relevant charities to build an evidence base for changes to the mental function and fluctuating condition descriptors—known as the evidence-based review.

[Mr Marsden]

Will the Minister give way?

[Mr Hoban]

The hon. Gentleman spoke for slightly longer than 15 minutes and raised issues that I want to cover in the time available.

We are consulting on changes to the cancer provisions. Individuals being treated for cancer should be placed in the support group. Professor Harrington recommended increasing the time taken to conduct WCAs, which we have accepted. It should improve the quality of decision-making. We seek to tackle and reduce the backlog that has been generated—indeed, clearance times have improved since January 2012.

The hon. Gentleman asked about training for Atos employees. All health-care professionals are registered with a professional body such as the General Medical Council or the Nursing and Midwifery Council, and must have at least three years post-qualification experience. All the health-care professionals are fully trained in disability assessment. They receive comprehensive training, ranging from eight days for a doctor to 24 days for a physiotherapist, before being approved by the Department’s chief medical adviser. Once approved, all health-care professionals are subject to ongoing quality checks through audit, which the Department itself validates. Approximately 20,000 such checks have taken place this year.

The hon. Gentleman suggested that DWP decision makers were decision makers in name only, and had to follow Atos guidance. Let me be clear: they are decision-makers, and they are able to look at the evidence supplied to them and to make the right decisions. They are empowered to divert from the conclusions that Atos reaches. I hope that that reassures him; it is a proper decision-making process, not a rubber-stamping exercise.

The hon. Gentleman raised the important issue of access to assessment centres. There are 123 permanent assessment locations and an additional 25 sites are used on a casual basis. I understand that 27 of those sites do not have ground-floor assessment rooms. Where Atos identifies individuals who have mobility problems, we try to ensure that such problems are accommodated and we will offer an alternative assessment centre. We are aware of the issue and Atos is working to resolve it.

The Courts and Tribunals Service received over 181,000 appeals in 2011-12. That is a reduction of 8% on the previous year, but I assure the hon. Gentleman that we are not complacent and have introduced various initiatives to reduce that figure further. We will maintain a firm focus on decision making and continue working with the Courts and Tribunals Service to ensure that processes are as efficient as possible where an appeal cannot be avoided. The Department makes millions of social security benefit decisions each year, the majority of which are not appealed.

To give an example, more than 1 million decisions on new employment and support allowance claims were made between October 2008 and May 2011 following the receipt of work capability assessments from Atos. Some 258,000 appeals were heard against decisions that the claimant was fit for work, and the tribunal upheld the DWP decision in 161,000 of those cases. That means that only 9% of the 1 million decisions made by the DWP in that period were overturned by the tribunal service, which speaks for itself in terms of our approach to ensuring that we get the best-quality evidence and make the best-quality assessments.

One reason why tribunals overturn decisions is that claimants sometimes present new evidence at the hearing. I would ask colleagues and others to encourage constituents to provide the DWP with such evidence as early as possible, because that would enable us to review and potentially revise earlier decisions, and to provide the claimant with the correct level of benefit sooner. We want claimants to provide evidence from their GP or consultant as early as possible, rather than wait for an appeal. We proactively seek evidence from GPs, but they sometimes do not respond to such requests, and medical professionals who are entrusted with the care of claimants also have responsibilities in that area.

We are trying to introduce, from 2013, a mandatory reconsideration process for social security benefits, which will be extended to remaining benefits, including ESA, at a later date. The new process will help to improve outcomes. It will allow the DWP to provide a full explanation of decisions with which claimants disagree, encourage claimants to identify and provide any additional evidence that may affect decisions and enable the DWP to review and, if appropriate, revise decisions. However, if claimants still disagree with the amount of benefit in payment, they can appeal to the tribunal. We are trying to beef up that reconsideration process to avoid the need for people to go to a tribunal, because we recognise the time that that takes. We are also trying to work closely with Her Majesty’s Courts and Tribunals Service to improve feedback from tribunals to understand better why decisions are overturned, which will help us to make further improvements to decision making.

I am conscious that time is running out. I hope that the hon. Gentleman recognises that we inherited quite a poor situation from the previous Government. The issues are difficult to resolve, but we are making progress, which is why we have asked Professor Harrington to undertake reviews—two are complete and he is now doing a third. Our approach is to make continuous improvements to the process to get the right outcomes for claimants, ensuring that those who can work receive the support that they need to get back into work and that those who are unable to work receive the support that they need through the welfare system. We are committed to making improvements. That is the path on which my predecessor set out and which I will continue to follow.

17:13

Sitting adjourned without Question put (Standing Order No. 10(11)).