Work Capability Assessments

(Limited Text - Ministerial Extracts only)

Tuesday 9th February 2016 Westminster Hall

[The Minister for Employment (Priti Patel)]

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

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

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

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

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

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

[Neil Coyle]

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

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[Priti Patel]

It is fair to say—this will link to many of the forthcoming reforms in the White Paper—that we have implemented many of the recommendations. On top of that, we will continue to review them and work with the system. Any system of financial support for people who are not able to work needs to have a reliable method of assessing entitlement to that support. That is the basis of this afternoon’s debate.

I will talk about the current provider before I address the points about contracting that were raised by the hon. Member for Sheffield, Heeley (Louise Haigh). Since the Centre for Health and Disability Assessment, known as CHDA, took over the contract to carry out assessments in March 2015, it has made a number of improvements to the claimants’ experience of assessments. It has focused on increasing the number of healthcare professionals by 39% since March 2015, and it has opened up 100 new assessment rooms, so that it can see more people in more locations. I do not want to rehearse many of the points already made in the debate, but a lot of the focus has been on the new contracting arrangements with CHDA, which has reduced the backlog of assessments by 62%. It has also introduced claimant-focused improvements, including setting up a customer representative group with leading charities that have regular meetings with the chief executive and clinical leadership team.

There is also a focus, because we are speaking about people and the experience of individuals going through the process, on rolling out greater disability awareness training for all staff. The recent National Audit Office report acknowledges the progress that has been made in improving contracted-out health and disability assessments, and we have taken steps to help people with mental health conditions in their assessments following the reviews. We have trialled new awareness training for administrative staff that will now be rolled out nationally. We are also improving services on telephone engagement and how claimants are assisted; and that level of interaction has improved.

I want to address the points about contracting, which the hon. Member for Sheffield, Heeley focused on. I hope she will forgive me because I cannot speak about Maximus in 2007 and what took place in America, but I must make it abundantly clear that there is a full and transparent contracting process, undertaken with a negotiated procedure to enable the Department for Work and Pensions to fully test bidders and their propositions to meet the objectives for service delivery. I am speaking about the previous contractor, Atos, and the improvements that we seek under the new contract with CHDA.

[Louise Haigh]

I am grateful to the Minister for giving way and for her response so far, but is she seriously saying that previous fraud and theft from taxpayers cannot be taken into consideration when the Government are handing out a very similar contract in the UK?

[Priti Patel]

I cannot speak specifically to previous contracting processes and bids that took place outside the United Kingdom—it is not for me to comment on—but let us be clear. The Department is responsible for hundreds of billions of pounds of public money—taxpayers’ money. On our processes of procurement, renegotiation and accountability, we have a clear approach to the scrutiny of providers, and rightly so. That applies to all Departments, and the same applies when it comes to failure. The contract has an open-book accounting approach and a robust validation of data. I think the hon. Lady mentioned falsification of data at one point. We have a clear process on the validation of data. She also went on to comment on how providers are incentivised, but our providers are not incentivised by benefits outcomes. We have a full range of balanced performance measures that focus on quality and volumes and customer satisfaction. That brings me back to the fact that we are speaking about people and how the interaction with people through assessments actually takes place.

Performance reviews and performance are fundamental in all Government contracts to ensure governance arrangements, and the Department takes steps to implement regular weekly and daily meetings with DWP officials and the CHDA.

[Debbie Abrahams]

Will the Minister give way?

[Priti Patel]

I will give way, but I want to emphasise that service credits are applied when a supplier does not meet an agreed service level.

[Debbie Abrahams]

I am grateful to the Minister for giving way and for her response so far. Will she tell us whether there is a requirement in the tendering process for disclosure of previous legal action?

[Priti Patel]

I cannot answer that question, but I will find out and write to the hon. Lady. I would be astonished if the Department did not have a system for looking back and assessing companies’ previous conduct before we engage with them. All bidders have to be thoroughly scrutinised by not only my Department but others. Much of that work is done with the Cabinet Office, which sets out guidelines and guidance. I have no doubt that the right systems and efficacy procedures are in place for contracting and the types of contractor with which the Government engage.

Bidder’s assumptions are tested as part of the negotiated procedure, and they are provided with information as part of the dialogue that takes place. The WCA contract was originally with Atos. Since the CHDA has picked up the contract, there have been challenges and backlogs, which have been referred to throughout the debate. It is only right that the Department continues to address those challenges and sets stretching and ambitious targets for its providers. We will ensure that we deliver value for money for our contracts. Again, the assumptions are tested through the bid process, but we are clear that a new financial support model has been in place as part of the CHDA contract. We have also contracted for a more sustainable service, part of which includes more face-to-face assessment—that direct engagement which did not take place under the previous contract. The focus is also very much on reducing the backlog and improving waiting times.

The NAO report has been mentioned several times. The report recognised that the Department has made particular progress and acknowledged the fact that there is now a relentless focus on performance when it comes to reducing backlogs and driving down delays. It also recognised the increased performance management capacity. Although there is more to do—we can never stand still in this space—we have learned from our experiences in the contracting process and will ensure that we continue to make improvements.

A number of Members mentioned cases from their constituencies. I would, of course, be happy to look at any individual cases that Members would like to refer to me, but I should emphasise that we clearly do support people through the system. A great deal of money has been put into providing support to help people to go back to work. Over the next three years, £43 million is being invested in trialling the provision of specialist support for people with mental health conditions. The Government also recognise the importance of promoting positive attitudes among employers when it comes to them employing people with disabilities or health conditions. That will be at the heart of the White Paper that will be published—

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On resuming—

[Priti Patel]

I acknowledge that there is more to do to support people with health and disability issues. In the recent spending review, we outlined our commitment to support people with disabilities into work. We announced a real-terms increase in funding for Access to Work, which will enable up to 25,000 additional disabled people to receive support. We will expand the Fit for Work service to support more people on long-term sickness absence with return to work plans, and we will provide at least £115 million for the new joint work and health unit, including £40 million for a work and health innovation fund. We will set out some new long-term reforms in the White Paper, which will be published in the spring.

This is about not reinventing the wheel, but learning from insights. Hon. Members spoke about evidence, support and insights from charities, stakeholders and third parties, which the hon. Member for Banff and Buchan mentioned. My Department is working with stakeholders through the joint work and health unit, and a new taskforce has been set up to gain insights into providing support for individuals in a more targeted, tailored and personalised way. If people are assessed and put on a benefit, we do not want there to be no dialogue and interaction with them during that period about the additional support that they require to get back into work. The White Paper will be published in the spring, but we are open to thoughts and comments through the consultation process.

This not just about the WCA; we must have a much more holistic approach to supporting individuals. Before the Division, I mentioned employers, and there is a lot more that can be done to promote positive attitudes to employing people with disabilities and health conditions. Employers must find the right balance and the right way to support people in the workplace. For example, they can utilise occupational health and look at our Disability Confident campaign and the work that my hon. Friend the Minister with responsibility for disabled people is doing.

Looking at this issue holistically, our reforms are all aimed at improving the quality of life of those who need the support the most. It is right that we recognise that there is no single method for each individual and their particular circumstances. Every person in the benefits system is an individual and their situations will be different, difficult and challenging. No system can offer a one-size-fits-all interaction, but we must ensure that the system works with individuals and recognises their particular backgrounds and circumstances. Protecting the most vulnerable in society is this Government’s priority.

[Debbie Abrahams]

Given that 90% of disabilities are acquired, I recognise and support all that the Minister has said about ensuring that people can stay in work as much as possible and that people are helped back into work, but that does not currently happen. Some half a million disabled people will be affected by the change in the employment and support allowance and the cuts. How can the cuts be justified before the support to enable people to stay in or get into work is in place?

[Priti Patel]

The hon. Lady mentioned the current changes and referred to the Welfare Reform and Work Bill that is being considered in the House of Lords this afternoon. She will recall that this issue was debated extensively in Committee. I have emphasised that the Government have a clear commitment to protect the most vulnerable in society, including disabled people. No one who is currently in receipt of ESA will see a financial loss; the changes will not affect anyone whose capacity to work is significantly limited. The personal independence payment will also continue to help meet the extra costs of living that disabled people face, and exempted benefits contribute to the additional costs of disability and care resulting from the benefits freeze.

Looking at the debate holistically, we know that the WCA has caused many previous challenges. Yes, reforms are coming and, yes, changes are afoot, but I think hon. Members will agree that we cannot write off the people who, for various reasons, have not been supported into work. If they can work, we want to support and encourage them.

The Government spend a great deal of money on protecting the vulnerable not only through benefits, but through additional support to help with living costs. It is right that we provide that support and safety net. I hope that future debates and the White Paper will help to introduce new suggestions, new ways of working and new practices to ensure that we do not again see the situation that we had in 2008, 2009 or 2010 with Atos and the WCA. We should broaden the interface of support available through not only agencies or Government Departments, but specialist support organisations, stakeholders, practitioners and those in the care sector, recognising that we can always do more to support people. I am conscious of the time, Mrs Moon, so I will close my remarks there.