Personal Independence Payment: Mobility Criterion
(8 years, 7 months ago)
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Baroness Thomas of Winchester
That this House calls on Her Majesty’s Government to hold urgent talks with Disability Rights UK and the Disability Benefits Consortium to identify a mobility criterion in the Personal Independence Payment “moving around” assessment which is fairer than the current 20 metre distance, in the light of the impact on reassessed disabled claimants and the resulting large number of successful appeals.
Baroness Thomas of Winchester (LD)
My Lords, in moving this Motion I must first declare that I have a Motability car as a result of having higher-rate mobility and disability living allowance. As I am over 65, I will not be reassessed for personal independence payments. That is probably the reason why I am so keen to try to persuade the Government to hold urgent talks about the “moving around” part of the PIP assessment, because I am particularly concerned about the reassessment process for all those working-age disabled claimants who at present receive higher-rate mobility DLA and are thus entitled to a Motability car but who are now facing reassessment for PIP. Here I should make it clear that I am not talking about the care component to PIP, which was the subject of the recent climb-down by the Government over the Budget. Tabling a Motion is an unusual course to take, but I assure the House that there is nothing fatal about it. However, if it were to be agreed, it would send a powerful message that this House is very concerned about this particular government policy and is taking a constructive approach to seeing what can be done to help the situation.
Why am I so concerned about the “Moving around” section? Because the relevant walking distance test for PIP has been made much harder than the DLA test, meaning that by the Government’s own estimate the number of people on enhanced or higher-rate mobility will go down from around 1 million people to 600,000 by 2018. Some 400 to 500 Motability cars a week are now being handed back by disabled claimants whose condition may not have improved but who are losing not just their car but, in many cases, their independence. Under DLA, the walking distance was 50 metres, which was in the Department for Transport guidance on inclusive mobility. The new distance of 20 metres is just under two London bus lengths, and is unrecognised in any other setting. There is no evidence that it is a sensible distance for the test, and it is not used anywhere else by the Government.
So someone with a walking frame, say, who can just about manage 20 to 30 metres, will not usually qualify for PIP. I see the Minister even now sharpening her pencil to make a note reminding her to tell me that this is a travesty of the truth. No, I have not forgotten the reliability criteria, which were made statutory in the last Parliament—thanks, in fact, to the intervention of the Liberal Democrats. The full reliability criteria in the PIP guidance are that 20 metres must be able to be walked,
“safely … to an acceptable standard …repeatedly … and … in a reasonable time period”.
Claimants, we are assured, must be asked about these criteria during an assessment. But are we quite sure that they are asked on every occasion? Are claimants taken outside the assessment centre, and does the assessor watch while they do the walking test?
How the questions are asked is likely to have a significant impact. If someone said to me, “Could you walk this distance, not too slowly, even if the pavement was very uneven”—as they all are in London—“and crowded, and there was a gusty wind or perhaps rain? What about crossing the road, which might not have a dropped kerb except at the very end, which would be further away than 20 metres? Could you walk this distance more than once a day if you had to—say, to a local shop or pharmacy and back, or to a bus stop, which would almost certainly be more than 20 metres away? And in the dark?”. My answer would be no. However, if the criteria were mentioned quickly, with the assessor looking down and ready to tick a box on the relevant form, then I might not quite take them in. I also wonder whether every claimant actually knows what distance 20 metres is unless it is demonstrated. I have heard about walking tests being done by claimants inside the assessment centre, but that is not the right test.
In an ideal world, at the assessment all claimants would have a report from a healthcare professional setting out their mobility problems, but I gather that that is not mandatory because in many cases such reports, particularly if they come from GPs, cost the claimant money. The amount varies enormously, but even in 2013 the BMA suggested that £90 was not an unreasonable amount. It is likely that, in time, a person’s medical records may be able to be accessed online, but that is not the case at present. It is only during the tribunal appeal process—not even the mandatory reconsideration—that the DWP will pay for a medical report. This whole area could be explored in the talks that I am calling for, because there are other healthcare professionals who do not charge for their reports. We are told that claimants often produce more evidence at the appeal stage, so why not try to improve this part of the process before that stage?
Why did the Government shorten the walking distance so arbitrarily and drastically? Almost certainly, it was to wipe the slate clean before the tribunal judgments in order to save the money that the Treasury was demanding. After all, who would notice except disabled people themselves? The Government’s excuse would be that the test had changed so the money would now go only to “those most in need”. That is a very worthy-sounding phrase, but it really does not mean very much unless it is qualified. Perhaps disabled people in rural areas, where public transport is scarce, are most in need of their own transport. Perhaps disabled parents with young children are most in need of their own wheels, or those who need a large car because they have most to carry in them, such as a supply of oxygen, walking aids or even toilet equipment. Just to recap, under PIP, if a person can walk more than 20 metres, aided or unaided, they usually will not qualify for the enhanced rate mobility component and thus a Motability vehicle.
How did Parliament allow this change in the assessment rule without challenging it? The answer is that the Government changed the distance at the very last minute without consulting on it. They then realised that no consultation on a crucial rule meant a judicial review, so they consulted in the summer of 2013. They received more than 1,000 responses, almost all saying that the 20-metre walking test was manifestly unfair, not to say meaningless, and that a longer distance should be used. The Government took absolutely no notice, using the excuse that, because there was no unanimity on what the right distance should be, they were going to stick with 20 metres. In other words, the consultation was a complete sham and the Government’s response unbelievably weak.
PIP was fraught with problems for new claimants. It was initially delayed for months, and then reassessments were delayed for months and months but they finally got going last year and are resulting, as was predicted, in hundreds of cars being handed back. Motability has done what it can to mitigate the situation, but it is the Government’s responsibility to make the assessment as fair as possible. If it is fair now, why are there so many successful appeals? Sixty per cent is the figure I have. Appeals, it must be pointed out, can be held several months after a car has been handed back and are quite expensive, costing over £200 each. It surely cannot be right for the Government to rely on appeals to bring some fairness into the situation.
I will now look briefly at just three of the other arguments that the Minister will use. First, I will be told that there is now a better balance between those with mental health problems and those with mobility problems. That is good, but there should not be a trade-off between these two groups. Is that what happens in the NHS? Parity of esteem should mean just that. I will also be told that there are more Motability cars on the road than ever before because a slightly higher percentage of PIP assessments are successful compared with those for DLA. However, the true picture will not emerge until all the reassessments are done, when it is estimated that the number of Motability cars by 2018 will be down to 602,000. Thirdly, I will be reassured that the Access to Work programme can take care of disabled people who lose their Motability car, which they need to get to work. However, it will not help those who need a car to get to a further education college for training or to university, or for volunteering or hospital appointments, or even to visit family and friends at the weekend.
As for the assessors, when one young claimant with cerebral palsy asked why she had to be tested again, she was told by her assessor that there might have been medical advances. The claimant said, “There’s no cure for cerebral palsy. I’m never going to get any better. I’ve been on a lifetime award since I was a teenager, and now someone who has never met me can take that away”. This was not just an isolated example of an uninformed assessor. Someone with muscular dystrophy, a progressive condition, was told by an assessor to get better soon. Many with this and other progressive conditions such as MS and Parkinson’s, with lifetime awards of DLA, are falling foul of this particular part of the PIP assessment. Here, again, the quality and training of assessors is another important issue for talks. It was the last thing that the late and much-lamented Lord Walton of Detchant asked about on 7 March as a supplementary to my Oral Question on that day.
To sum up, to be told that the bill for PIP is too high and must be cut by more than halving the walking distance test is a real slap in the face for thousands of disabled people, particularly those of working age with lifetime awards under DLA. Of course the bill is going up—because the disabled population is going up. The Government must have factored that into their calculations years ago. The last thing that anyone wants is for more and more disabled people to become socially isolated and totally reliant on other services for everything they need. A great deal of money could actually be saved by other government departments, such as health, social services, employment and transport, by making the PIP walking distance fairer. I beg to move.
Lord Low of Dalston (CB)
My Lords, the noble Baroness, Lady Thomas, has made an excellent case and I support it. I should declare as an interest that I have an award of disability living allowance, but it is not an interest that I have to defend because it is a lifetime award; and, since I, too, am over 65, I am not subject to reassessment. My only interest in this debate is that I wish everybody else to be able to have the same.
I want to make five points, which I think will add to what the noble Baroness said in her excellent speech. First, as I understand it, 548,000 disabled people will lose out as a result of the revision in the criteria for DLA and PIP. They are set to lose £35.65 a week as a result of this change, which is a considerable amount.
Secondly, Motability has reported that to date 45% of scheme users—over 13,000—who have been reassessed from DLA have lost their Motability car. That can have a dramatic impact on people’s employment. I heard somebody on the radio say that they would not be able to continue to work, but this does not just affect isolated individuals. Of Motability customers surveyed in 2010 who were not currently retired, permanently unable to work or in full-time education, 39% said that their Motability car had enabled them to gain employment, get better employment or maintain their current employment. A Multiple Sclerosis Society survey found that 20% of those surveyed agreed that it enabled them to stay in their job, whereas, without a Motability car, they would not have been able to do so. Making a change that means that people who need a Motability car to go to work lose their car flies in the face of the Government’s welfare-to-work agenda and their aim to halve the disability employment gap.
My third point is that the 50-metre threshold, to which the noble Baroness, Lady Thomas, would like to see us return, is a well-established and research-based measure of significant mobility impairment. It has been used for the last 35 years, notably in relation to other disability benefits, including DLA itself, the blue badge or disabled persons’ parking scheme, and in official guidance on creating an accessible built environment. The 20-metre threshold to which retreat is being sought is completely arbitrary and has no basis in established usage.
Baroness Masham of Ilton (CB)
My Lords, I congratulate the noble Baroness, Lady Thomas of Winchester, on securing this debate and on her persistence over this important matter. Under PIP, those who can reliably walk more than 20 metres will no longer qualify for the highest rate of the mobility component. This support is crucial to the lives of many disabled people, allowing them to live more independent lives and to access suitable transport and adapted vehicles, such as through the Motability scheme. I must declare an interest as I have been a vice-president of Motability for many years. The chairman, the noble Lord, Lord Sterling, recently told me that there had been an increase in take-up of the scheme. Therefore, there must be an increase in the number of disabled people, because with this new restriction, organisations for disabled people say that more than 5,000 people will no longer qualify for the enhanced rate of the mobility component of PIP. Some people have already lost support after being reassessed from DLA.
This is a desperate situation for some disabled people living in rural districts who have no public transport. If they have employment, they will lose it. They will also lose the independence needed for a social life and will have to use hospital transport for hospital visits, costing the NHS much-needed funds.
A few years ago, the Rheumatoid Arthritis Society linked parliamentarians with members of the society to learn about how they live. I was linked with a splendid young woman from Suffolk who had a Motability car. She also had a job. She might be the sort of person who would not qualify because she can walk a little. I ask the Minister: what is the definition of those who can reliably walk more than 20 metres? Could she define “reliably” to the House? There are so many people with rheumatoid arthritis, multiple sclerosis, Parkinson’s disease and all sorts of other orthopaedic and neurological conditions. This is a very complex matter. Will the Minister tell your Lordships about the people who do the assessments? Are they trained occupational therapists or physiotherapists? Surely, they should be trained in these complex disability conditions.
I made my maiden speech in 1970 on the Chronically Sick and Disabled Persons Bill. That legislation was to lift restrictions in many ways so that disabled people could live better lives. In 2016, it is of great concern if we are going backwards and taking independence away from people with disabilities. I hope that the Minister and the Government will have a very serious look at how they can help make disabled people as mobile as possible.
Baroness Grey-Thompson (CB)
My Lords, I am delighted that the noble Baroness, Lady Thomas of Winchester, has tabled this debate. I also congratulate her on her persistence. I declare an interest in that I am a recipient of DLA and am eagerly awaiting the call for my PIP reassessment. It will be very interesting to experience it for myself. I do not have a Motability car, but in the early years of learning to drive I did. For me, it made a massive difference to what I was able to do. Because of my condition I can only drive an automatic car. The cost of hand controls is now around £1,000 and the cost of insurance would have made any other way of being mobile totally prohibitive.
I am very sorry that my noble friend Lady Campbell of Surbiton is not able to be here tonight because of the lateness of the hour. She asked that I ask the Minister about how people with hidden impairments would be affected, particularly those with haemophilia. One day they can walk but, if they have a bleed, they may have to use a wheelchair; so for them, this arbitrary 20 metres makes a significant difference to how they are able to live their lives.
We are starting to see a significant impact from the Government’s Welfare Reform Bill, and it is affecting a huge number of people. I believe that the 20-metre guideline is an arbitrary number—where does 20 metres get you? It is barely the distance from one wall of the Chamber to the other. How can we reasonably expect people who can walk only 20 metres not to require some sort of assistance?
I live in the north-east of England, where public transport is not particularly accessible. If I did not have a car, I would not be able to take my daughter to school or to work. As a wheelchair user, the knock-on effect is significant. For me to come to London, I have to use a train. As a wheelchair user, I am meant to book a train journey 24 hours in advance. This week, I was not able to, and so the only way that I could get on the train was to get out of my chair, crawl on board and pull my chair on to the train, and do the same at the other end. The impact on disabled people if they are not able to drive is quite significant.
I have a number of concerns, and not just around the 20-metre rule but around the process of assessment. My inbox is consistently full of emails from people with issues relating to the assessment process, and I have three examples that I would like to give. One person had their car taken away, and in the documents that they received back to go to tribunal it said that because they did not look undernourished, were able to communicate and could arrange for the payment of bills, they were not eligible for the enhanced rate. However, removing the car while the process is going on is very short-sighted. That person was unable to carry on working. This individual is now going through the process of applying to the Access to Work programme, which is apparently willing to pay £32 a day for a taxi to take them back and forth to work. That seems ludicrous. We are just talking about money coming from different budgets rather than the total sum. It must make greater sense to allow the person to keep the car until the full process has been gone through.
Another person who spoke to me is someone with cerebral palsy who is a wheelchair user. In the assessment process, it was written down that they could stand for an hour and no mention was made of the 20 metres. However, they were not even asked that question in the assessment process.
My final example is a woman who, on her first assessment, had a home visit and then a medical with a doctor. As her condition deteriorated, she asked for the mobility section to be reassessed. She was informed that the only way in which this was possible was to go through a full reassessment—there was no other option, so she had to agree to it. However, the full reassessment was 20 minutes with a medical professional at a walk-in centre; no home assessment was considered or took place. In the second assessment, her points changed quite drastically, but the real difficulty was that she was told that the mobility criterion had changed and that she had lost points. They assessed the wrong side of her body. She is a hemiplegic. In the assessment process, they said that there was nothing wrong with her left side—that was because she is hemiplegic on her right side. It seems crazy that the assessment process is doing this to individuals. A number of people say that it is very stressful and painful—they worry about it—but if they cannot even have assurance that the assessment is being carried out properly, what are we doing?
Will Her Majesty’s Government look at the failings in the assessment process? It is ludicrous that so many people are rejected only for the decision to be overturned on appeal. How much money is being spent on mandatory reconsiderations and tribunals for the award to be given in the end? It seems to be a total waste of money. Finally, I ask the Minister to talk with Disability Rights UK and the Disability Benefits Consortium to prevent the current criterion assessment process costing us all far more money in the long run than we are trying to save.
Baroness Brinton (LD)
My Lords, I, too, thank the noble Baroness, Lady Thomas of Winchester, for bringing forward this important Motion for us to debate tonight. Although I am not in receipt of any benefits, I have already hit the problem of the 20-metre distancing, as I have mentioned in Oral Questions before, because the NHS in my area has decided that you are not entitled to an NHS electric wheelchair if you can get from one side of your house to the other, with no concept that keeping independent, having an electric wheelchair and getting to work might be important as well.
I, too, want to pick up on some of the anomalous cases that have arisen. Tom Carter reported to the Disability News Service last year that he had lost his enhanced mobility rate. The assessor refused to acknowledge that he could not walk long distances without discomfort and pain—he had said it in the written questionnaire and the consultation. He was not wearing his prosthetic leg for the assessment and the assessor said that he had,
“no evidence of functional problems”.
In her written report, she also ignored his need to have the car to drive himself to his medical appointments, which, as the noble Baroness, Lady Grey-Thompson, has mentioned, is vital in rural areas because bus services are frequently inappropriate and many rural buses cannot yet accept wheelchair users.
The assessment of the 20 metres is very focused on people who have a manifestation of running out of breath, which might be COPD or heart conditions; it does not recognise those with musculoskeletal problems. I have rheumatoid arthritis—there are others as well—where although it is perfectly possible to walk 20 metres one ends up in a lot of pain, and physiotherapists get very cross because the more you walk the more damage you do to joints. So using that as an example is completely unhelpful.
The National Rheumatoid Arthritis Society has pointed out that no comprehensive assessment has been made by the DWP of what impact the measure will have on disabled people, but from work done by NRAS and the Disability Rights Commission it is clear that the loss of money or easy access to a vehicle will lead to unemployment, isolation and depression.
I want briefly to discuss Motability and what it does. It is more like a business than a charity—I agree that it provides an extremely valuable service. It declares in its annual report for 2015 that it has a “unique arrangement” with the DWP whereby,
“disability allowances can be diverted directly to Motability Operations”.
It makes further money on re-selling at the end of the lease. In fact, 77% of vehicles are sold online at the end of what is usually a three-year, but sometimes a five-year, lease. It declares itself as,
“the largest supplier of used cars to the motor trade in the UK, selling around 220,000 cars each year”.
Its turnover is nearly £4 billion a year. It made a profit of £210 million last year and its assets sit at more than £2 billion.
I raise this because I wonder whether the Government have the wrong target in their sights. It seems to me that rather than to ask to halve the PIP bill, making a Motability contract that worked for disabled people would be more appropriate. Most people with Motability contracts go nowhere near the average mileage per year on a car. A three-year to five-year lease seems short for many people who might go no more than 5,000 miles a year. My question for the Minister is: are the Government beginning to look seriously at the effective use of their money to make sure that disabled people can get access to the cars and wheelchairs they need to be able to lead completely independent lives? The numbers that we have heard from other speakers seem to demonstrate that the exact opposite is the case. The unintended consequence of the 20-metre rule and halving the PIP bill will mean that far too many people with disabilities will end up out of work and isolated in their homes, and no longer able to lead anywhere near independent lives.
The Lord Bishop of Peterborough
My Lords, I support the noble Baroness, Lady Thomas of Winchester, and thank her for bringing this Motion before the House. I have a simple point to make.
The tick-box approach is rarely the right one. People are individuals and wherever possible should be treated as such. While it is clear that the 20-metre rule is too restrictive, setting a replacement figure, whether the old one of 50 metres or some other, is still arbitrary and a matter of ticking boxes instead of treating people as people. The high number of successful appeals, whatever the reasons, shows that the 20-metre rule simply does not work.
If a distance has to be used to make this assessment, I would prefer, with the evidence, to return to the figure of 50 metres. But surely that is not the best way to make an assessment of the needs of a real person. We need a careful assessment by a professional, who already knows the claimant or who can take the time to get to know them, of what they really require in their context given the ups and downs of their condition, allowing for where they live, work, shop, take their recreation and meet their friends. This would mean a well-trained cadre of assessors allowed a reasonable degree of discretion and flexibility, and able to assess each claimant as an individual and allow to each the dignity and worth of a human being.
Baroness Doocey (LD)
My Lords, my noble friend Lady Thomas of Winchester has been a tireless advocate for disabled people, using her skills, knowledge and empathy to try to influence government’s attitude to disabled people, their independence and their well-being. However, the 20-metre rule has little to do either with well-being or independence; it is a crude measure to save money. Once again, the Treasury’s guns are trained on those of working age.
Ministers must know, when they reflect privately, that it is short-sighted in the extreme to take away from disabled people who are at an age where it is hoped they could get paid work the very thing that might help get them to and from work. The Motability scheme is well known and understood by its users, and hinges on providing their independence. The Access to Work scheme is a much more limited scheme than Motability and will never be considered a substitute by the people who matter in this—the end-users. What money is saved by snatching cars away from disabled people will almost certainly be lost again in reduced tax revenues as people slip away from employment through no fault of their own. The Government have said that they are sticking with 20 metres because there is “no consensus” around an alternative distance. Other government departments use 50 metres, so it is not that there is a lack of consensus but that the DWP refuses to join the consensus.
As a former local councillor, I know only too well the problems that used to be associated with blue badge parking discs. Yet when the regulations around eligibility and enforcement were tightened up by the coalition Government, the key criterion that they chose to maintain was that a person should be unable to walk more than 50 metres. The Minister must recognise the sense of having some symmetry in the rules about who has special parking rights because of their lack of mobility and who is entitled to some help with having a car in the first instance—also because of their lack of mobility. Do the Government seriously suppose that a person capable of walking only 25 metres, for example, can access public transport with ease? The suggestion beggars belief.
The 20-metre rule is an appalling change, which will be keenly felt in the lives of the hundreds of thousands of people whom it will affect. My noble friend has given the House a clear opportunity to send a strong message to the Government that they must think again. I hope that noble Lords on all sides of the House will make sure that that message is loud and clear.
Lord McKenzie of Luton (Lab)
My Lords, I congratulate the noble Baroness, Lady Thomas, on securing this debate tonight. As others have said, she is tenacious on this issue. I have been on the receiving end of some of that at former times when I was a Minister, so I know it is for real. The issue that has been raised tonight was debated intensely when we considered the Welfare Reform Bill in 2012. The usual voices have been heard again tonight. We had an extensive debate around the nature of disability in the social and medical model and there were concerns that the approach to PIP would become very much a tick-box exercise. That has proved to be the case.
As other noble Lords said, the 50-metre threshold is used in the DLA and in ESA. The criteria are not necessarily directed in the same manner, but it is a tried and tested threshold. The Government at the time prayed in aid for the 20-metre rule that they had had discussions with people, eventually. If that is the Government’s justification, it is impossible for them now to argue against having urgent discussions with those same people to address the problems that are clearly emerging from the application of what has turned out to be a pernicious rule.
This Motion has our wholehearted support. My noble friend will reinforce that in a moment, but I congratulate the noble Baroness, Lady Thomas: this is a real issue and she should stick at it.
Baroness Sherlock (Lab)
My Lords, I thank the noble Baroness, Lady Thomas of Winchester, for moving this Motion and for explaining carefully the nature of the problem that we address tonight. I am also grateful to all noble Lords who have spoken, many of whom I have heard address the same issue repeatedly. It is very good to hear them again tonight and I pay tribute to them and to the noble Lord, Lord Alton—he is in his place but has not spoken tonight—who again has been tenacious in his support of the issues around Motability for some time.
I hope very much that the Minister has come here tonight in a constructive spirit and ready to listen, because she has heard stories from people who know a great deal about this, have a great deal of experience and who know whereof they speak. As we have heard, the shift from DLA with its qualifying threshold of 50 metres to PIP where 20 metres became the new rule for the enhanced component has been very controversial from the outset. The change was hugely unpopular. The Disability Benefits Consortium reminded us in its briefing for this debate that when the Government consulted, 914 of the 1,142 respondents indicated a clear preference for extending the qualifying distance for the enhanced rate from 20 metres up to 50 metres. The arguments were compelling. As my noble friend Lord McKenzie has just made clear, 50 metres was a widely recognised, established benchmark based on research used by many other government departments and other measures around the world. It is clearly a sensible choice. By comparison, no case was ever made for 20 metres. It became increasingly clear to all concerned that in practice what was sought was a criterion that more people would fail, and that would therefore result in less money paid out. It was designed to save money, or more precisely to transfer money from disabled people to the Exchequer.
This is a significant loss. The noble Lord, Lord Low, pointed out that some half a million people could lose money and that this could be over £30 a week. But I want to reinforce the point that this is one of those benefits explicitly designed to deal with the extra cost of disability. We really risk losing that dimension of social security at our peril. This is not simply a handout: it is about recognising that for disabled people to do the things that other people take for granted—to take their children to school, have a social life and have a job—they need access to transport that is not provided for them by the state. There are two ways that we can deal with this. We can make our public transport system dramatically more accessible and cover the entire country or, for a fraction of that cost, we can carry on making payments to enable disabled people who qualify for this to go to Motability or elsewhere to get access to transport.
I pray that the day will come when the noble Baroness, Lady Grey-Thompson, will never have to drag herself on to a train again. Only she could manage it: those who are not Paralympic athletes might struggle. But I hope very much that that will not be the situation for very much longer. In the mean time, people need access to vehicles.
Crucially, we have already heard that some 14,000 people have lost their Motability vehicles after being reassessed for PIP. That is cracking on for half of all the reassessments, so there are some significant losses ahead of us. Also, we have heard compelling cases from various noble Lords, including the noble Baronesses, Lady Grey-Thompson and Lady Brinton, of cases where the assessment has gone spectacularly, farcically wrong. When the Minister comes to respond, I am sure the temptation in the brief at this point will be to say that these are isolated cases and things can always go wrong, but if they can go that wrong, something has gone wrong with the quality process somewhere down the line. It means that something systemic has to be addressed. The reality is that the system is not working. It is broken. Disabled people have suffered significantly already. They have suffered very badly from social security spending cuts in the last Parliament and in this one. While the U-turn in the Budget on PIP was very welcome, the Government are still cutting spending on disability benefits by £1.2 billion by the end of this Parliament.
I have some questions for the Minister. How many people does she now predict will lose the higher rate mobility component by 2020? How many will lose their Motability cars as a result of the PIP reassessment? Is she satisfied with the way that the “moving around” assessments are conducted? Finally, is she happy with the outcomes of the reduction to 20 metres? Is it working as the Government planned? I asked the Minister on 7 March how she felt the loss of Motability cars and other access to support would help the Government to tackle the disability employment gap. She reassured me that the Government were committed to halving the disability employment gap and said that the PIP approach was more consistent and fairer than DLA. The Government, we understand, will produce a White Paper on disability. If they are serious about tackling the disability employment gap and increasing opportunities for disabled people to participate fully in our society, they have to do something about this. I am pleased to support this Motion.
The Minister of State, Department for Work and Pensions (Baroness Altmann) (Con)
My Lords, I first assure the noble Baroness and the House that this Government have always been, and continue to be, fully committed to engaging with disabled people and organisations such as Disability Benefits Consortium and Disability Rights UK. I know that the Minister for Disabled People met the noble Baroness on 18 April to discuss the very issue raised in this debate. I also echo the sentiments of the Secretary of State during his Statement to Parliament last month. We are a one-nation Government committed to supporting everyone to achieve their full potential and to live independent lives.
Integral to that vision is ensuring that those with the greatest need are supported the most. We introduced the personal independence payment because disability living allowance was no longer fit for purpose. Under DLA, we assessed people purely on the basis of a disability, rather than considering individuals’ needs.
Baroness Thomas of Winchester
My Lords, I must disagree with the Minister on that point. I had an assessment, and nobody took any notice of the fact that I had a serious progressive condition. Therefore, my named disability did not count for anything, which is what the Minister just said.
Baroness Altmann
My Lords, I can only assure the House again that the aim of PIP is to make sure that the assessment looks at the individual and their needs, unlike the previous system, where there was no face-to-face assessment and decisions were made without the professional medical advice which we have brought in under PIP. Under DLA, too many people were given lifetime awards—that is at the heart of some of the problems we have been hearing about this evening—whereas under PIP claimants have regular reviews to make sure that the support they get reflects their current circumstances.
Unlike DLA, PIP considers mental health, cognitive impairments and other non-physical disabilities equally, but this is not just about trading off between mental and physical conditions, as the noble Baroness may have feared. It is about getting the right support that reflects current circumstances. Under DLA, people were not necessarily seen by an assessor. Neither is this about saving money—we are spending more on PIP, and more people have Motability cars now than when PIP started.
The system is working. Some 22% of claimants now receive the highest rates of both components compared to only 15% under DLA. Therefore, under PIP more people are getting more help. Some 22,000 more people are using the Motability scheme since PIP was introduced, and as noble Lords will be aware, for DLA claimants leaving the Motability scheme following a PIP reassessment, we have agreed a £175 million package of transitional support with Motability, including a £2,000 payment for most claimants.
PIP is performing well. We have now cleared well over 1 million claims for PIP, and the majority of claimants appear to be happy with their PIP decision. The suggestion that so many people are appealing and overturning their assessment is simply not the case. Only 5% of PIP claims have gone to appeal, and 40% of those appeals—not the 60% figure mentioned by the noble Baroness—were successful. Therefore, the proportion of PIP assessments which are overturned on appeal is 2%. When a decision is overturned it does not automatically mean that the original decision was wrong. Often claimants provide additional evidence not available to the original DWP decision-makers.
We are committed to engaging with disabled people, and that was fundamental to the design of PIP in the first place. We held a widespread consultation on the very topic of this debate—the moving around criteria.
I would like to clarify what appears to be a widespread misconception regarding the differences between the mobility assessment in PIP and the mobility assessment in DLA. Many noble Lords have spoken of a “20-metre rule”, but there is no such rule. Some people believe that we have changed the assessment of a distance a claimant is able to walk from 50 metres to 20 metres. This is not the case. The higher rate of DLA was always intended to be for claimants who were unable, or virtually unable, to walk. This is still the case in PIP, but we have gone further. Under PIP, if a claimant cannot walk up to 20 metres safely, reliably, repeatedly and in a timely manner, they are guaranteed to receive the enhanced rate of the mobility component. If a claimant cannot walk up to 50 metres safely, reliably, repeatedly and in a timely manner, then they are guaranteed to receive the enhanced rate of the mobility component. I can assure the noble Baroness, Lady Brinton, that if a claimant is in extreme pain, they will be assessed as not reliably able to walk that distance. The reliability criteria are a key protection for claimants.
It was after my department’s work with the noble Baroness and noble Lords in 2013 that we set out these terms, not just in guidance but in regulations, confirming our commitment to getting this right. If a claimant cannot walk up to 50 metres without such problems, they will still be entitled to the mobility component at the standard rate. If they cannot walk that distance reliably and in the other ways in which we have protected it, they will be entitled to the enhanced rate. Therefore, the enhanced mobility component of PIP goes to those people who are most severely impacted and who struggle to walk without difficulty.
Lord Kirkwood of Kirkhope (LD)
The Minister is doing a comprehensive job of explaining the background, and that is important. However, will she accept that there is a great deal of frustration within the disabled community? In spite of repeated freedom of information requests to get some of the data and the metrics around the things she has just been describing, the department has hidden behind the view that these are ONS-qualified statistics and therefore it has to wait until they have been properly digested and published. My point is that this Motion is a request for urgent talks. We believe that this policy is going badly wrong. Will the Minister use her good offices to get the meeting that is being asked for so that the talks can look at what the data are telling us about the level of losses, which we have only the word of Motability to go on? It is doing the best that it can, but these are not comprehensive statistics. The fact is that, as we sit and speak this afternoon, we do not know the extent to which this policy is taking away the enhanced mobility component in PIP. That is dangerous, because if we do not get in touch with that information and use it to assess what is going on, we will not make this change early enough, and this policy will need to change.
Baroness Altmann
I thank the noble Lord for his question. I can assure him from my own experience that it is important that we have any statistics properly verified before they are released as official statistics. We will release relevant data, and if we have any further information, I will be happy to write to the noble Lord with any other data we can provide.
As regards the information that the noble Baroness, Lady Grey-Thompson, asked for on the amount of money spent on mandatory reconsiderations and appeals, we will provide written details of those costs.
Baroness Sherlock
My Lords, when the Minister was describing the 20-metre rule and 50-metre rule, I could see a lot of puzzlement around the Chamber. It may just be that I was not keeping up with her, so will she indulge the House for a moment and clarify that? I understood from the Government’s justification, included in the House of Commons briefing on Motability, that,
“We recognise that people who are unable to reliably walk more than 50 metres”—
and it goes on to say that they will get the standard rate, which will go,
“to those who cannot reliably walk between 20 and 50 metres”,
and the enhanced rate will be for below 20 metres. Therefore, can the Minister explain to us whether what I have described is not true? That is what the House of Commons briefing on this says.
Baroness Altmann
To reiterate for the noble Baroness, if a claimant cannot walk up to 50 metres safely, reliably, repeatedly and in a timely manner, they are guaranteed to receive the enhanced rate of the mobility component. Therefore, there is not a strict 20-metre rule. There is discretion, and an individual assessment is made. We take into account whether the person is in pain and whether they can reliably walk or manage on their own.
I can also reassure noble Lords that our door is open. We are happy to engage. The Secretary of State and the Minister for Disabled People regularly engage with disability groups. We would like to continue to do so. Clearly, we want to make sure that this new process is working. As far as we can see at the moment, it appears to be.
Lord Low of Dalston
I am aware that Ministers have regular talks with disability organisations, but the request behind the Motion is not that Ministers engage in general talks with them about a range of issues. The point of the Motion is to call on the Government to have specific talks directed at addressing the particular problem identified in the Motion and in the speech of the noble Baroness, Lady Thomas.
Baroness Altmann
I thank the noble Lord. The general point I am trying to make is that we are not convinced that there is the problem being identified or described by many noble Lords. If there are problems in the assessment process—of course, it relies on human beings and it is possible that, from time to time, an assessment may not be done correctly—that is why we have the appeals process. But the figure I quoted to the House, that 2% of the assessment appeals are upheld, does not currently suggest that there is a big problem. Indeed, it appears that the PIP assessment process is doing what we want it to.
The noble Baroness, Lady Grey-Thompson, asked about the healthcare professionals carrying out the assessment. They have to consider the reliability criteria as part of the assessment process, and they also have to be registered with a relevant professional body, such as the General Medical Council. They have to have a minimum of two years’ post-registration experience. They also undergo rigorous training and assessment. It is early days, but it seems that the process is working.
We would indeed expect the haemophilia example that the noble Baroness, Lady Grey-Thompson, asked about to be taken into account properly by the assessment process. All the evidence presented by the claimant, along with any obtained by the healthcare professional undertaking the PIP assessment, will be fully considered. Therefore, if a claimant is exposed to a high level of risk when undertaking certain activities, that will be taken into account. Claimants who require supervision when completing activities will receive the appropriate PIP award. I can also assure the noble Baroness that providers can undertake home visits where necessary.
The noble Baroness, Lady Brinton, asked the Government whether we are looking at effective value for money for taxpayers. This is indeed why we are moving from DLA to PIP. We want to ensure that we look at people and their condition with a face-to-face assessment, rather than under the previous system, so that we can spend the public money we spend on disabled people in the most appropriate manner. This issue was also raised by the right reverend Prelate the Bishop of Peterborough. We certainly agree that individuals must be treated as individuals, which, again, is the aim of PIP assessment as well as the Access to Work scheme.
The noble Lord, Lord Low, mentioned the consultation. We have undertaken extensive consultation. The department does not consider further consultation necessary, but as I said, we are more than happy to meet with stakeholders to discuss the PIP assessment and any suggested improvements to the guidance or working practices of the assessment providers.
I hope that I have addressed the points from the noble Baroness, Lady Masham, about the assessors we use. They are health professionals. Indeed, they must have knowledge of the clinical aspects and the likely functional effects of a wide range of health conditions and impairments. I can also inform the House that we have just implemented a new contractual regime that will drive further improvements to the assessment through independent audit and revised audit criteria, and that we regularly review the guidance for the PIP assessors.
As the noble Baroness, Lady Sherlock, rightly said, PIP is specifically designed to help disabled people meet the additional costs of a disability. We believe that the current assessment process is working. Indeed, as I stressed, more than 22% of claimants now receive the highest rate of both components, compared with only 15% under DLA.
Lord Alton of Liverpool (CB)
I have listened patiently to the Minister’s remarks during the course of the debate. Does she dispute the figure given by the 60 different disabled people’s charities that have made representations: that 13,000 scheme users have already lost their vehicles? Putting aside all the other arguments, some of which, as the noble Lord, Lord Kirkwood, said are impossible to dispute, that surely demonstrates that the scheme is not working and that people are suffering. Surely, on that basis, she will concede the point that the noble Baroness, Lady Thomas, made that there should at least be a meeting with those organisations that have expressed concerns to your Lordships.
Baroness Altmann
I thank the noble Lord, and I stress again that we were always aware that there would be people who would lose their Motability cars when we changed from a system that relied on lifetime awards and did not assess people’s current circumstances, to one that does. If someone’s is going through a PIP assessment whose circumstances have changed—who previously was not seen face to face, perhaps, and who had a lifetime award—and they are judged no longer to be unable, or almost unable, to walk, they will therefore not be entitled to the enhanced rate component and will lose their car. We knew that that was a result, but that is part of the process.
When making his Statement to Parliament, the Secretary of State said:
“I want to start a new conversation with disabled people”,—[Official Report, Commons, 21/3/16; col. 1269.]
and disability organisations. So I say once again that we are listening; our door is open. We have recently changed the rules, for example, for terminally ill claimants to ensure they no longer have to wait 28 days to receive the enhanced rates of PIP if they transfer from DLA. We are also revisiting our approach to award reviews to make better use of the evidence we already have, so that claimants do not have to give us the same information again if their circumstances have not changed. We are listening to the views of noble Lords; we want their views and those of disability groups; we value the expertise of noble Lords in this House and I say again that we are happy to meet the organisations.
Lord McKenzie of Luton
Before the Minister sits down, can we just revert to the discussion about the 20-metre and 50-metre rule, and whether it is a rule or not? As I understand it, she was saying that it is possible for somebody who can walk more than 20 metres to qualify for the highest mobility component. Of the total number of people who qualify, how many qualify on that basis and how many qualify because the 20-metre rule operates?
Baroness Altmann
Of course, I do not have those figures to hand and I do not know whether they are available. It is not a strict 20-metre rule—it is an indication—and I repeat that if somebody can walk more than 20 metres, they can still get the enhanced rate component; it does depend on the assessment.
I close by stressing once again that we—the department, the Secretary of State and Ministers—are happy to meet disability groups to discuss this issue, which is clearly very important and causing significant concern. I thank noble Lords for their contributions to the debate.
Baroness Thomas of Winchester
My Lords, I am extremely grateful to all noble Lords who have contributed to this short debate. It has been very illuminating. All the speakers have painted one picture; the Minister has painted a different picture, and we must have some meeting in the middle, somewhere, because it is not right to leave it as it is. I have heard from Citizens Advice, which is, after all, independent, as everyone knows. It says: “Our experience is that the quality of assessment continues to be poor and our advisers in local Citizens Advice across the country have identified the reduction of disability-related benefits generally, and the loss of Motability eligibility specifically, as an emerging and increasing issue in the past few months”. Something is clearly going wrong, but I am extremely pleased that the Minister has said that the department is willing to meet those groups that I referred to in my Motion, and I therefore commend my Motion to the House.