Work Capability Assessments

Wednesday 13th December 2017 Westminster Hall

[Siobhain McDonagh in the Chair]

00:00

[David Linden (Glasgow East) (SNP)]

I beg to move,

That this House has considered work capability assessments.

It is good to see you in the Chair, Ms McDonagh. I am really grateful for the opportunity to raise this issue in Parliament today, as flawed work capability assessments have been a major topic in my case load since my election in June this year.

May I start by thanking the many charities, organisations and individuals who have reached out to me in the run-up to this debate with an offer to share briefings and information about their experience of work capability assessments? It is only appropriate at this juncture to commend the hard-working staff in the House of Commons Library for the excellent briefing that they have supplied to all right hon. and hon. Members. I am immensely grateful to individual members of the public from across the UK who got in touch to share their own, often harrowing, experiences of undergoing assessment and the sheer distress caused to them. Time will not permit me to share every testimony, but I want to share some case studies with the House this afternoon, and I am sure that other hon. Members will wish to do the same.

From my short time as a constituency MP, it has become abundantly clear that the UK Government’s work capability assessment is not fit for purpose and requires a full, independent, root-and-branch review to ensure that it treats people with dignity and respect. As it stands, the system is failing the most vulnerable in our society and all too often plunges people into chaos and depression, and in some cases, I am afraid, to the brink of suicide.

I therefore very much welcome the decision of the Select Committee on Work and Pensions to carry out an inquiry into personal independence payment and employment and support allowance assessments. What I do not want to see, however, is a powerful report coming from the Select Committee, only for it to be ignored by the Government, as happened in late 2014 during the last inquiry. The evidence and testimony that the Committee has already received should be sounding the alarm bells at Caxton House, and that is before the Committee has even published its report.

I very much welcome the Minister to her new role. As she knows, I enjoyed a constructive working relationship with her predecessor, particularly on the campaign to end the baby benefit bar. The Minister is widely respected across the House and I have no doubt that she will be in listening mode today. I therefore hope that she will approach this sensitive topic with fresh eyes and the compassionate conservatism that we have heard so much about from the Government.

I will outline some of my major concerns about the work capability assessment process, including the number of claimants with serious health conditions or disabilities who are found fit for work or placed in the wrong ESA group because of deficiencies with the WCA descriptors or in the assessment process.

[Mr Jim Cunningham (Coventry South) (Lab)]

I think that there are two issues here. One is that private companies are not necessarily equipped to assess people. Secondly, the questionnaire form can give enough information that it does not necessitate an interview of the kind handled by private companies.

[David Linden]

I am grateful to the hon. Gentleman for that intervention, and I will come to that point in a moment.

I will talk about the difficulties faced by certain groups, in particular people with mental health conditions or learning disabilities, in navigating the WCA process; the lack of information about outcomes for individuals following fit for work determinations; and concerns about the risk of poverty and destitution as a result of incorrect decisions. I also want to touch on the relatively high success rate of appeals against ESA decisions, and the difficulties experienced by claimants seeking to challenge fit for work decisions, including the fact that ESA is not payable pending a mandatory reconsideration, meaning that the only option in the meantime is to claim jobseeker’s allowance, potentially exposing an individual to inappropriate conditionality.

[Mr Stephen Hepburn (Jarrow) (Lab)]

The hon. Gentleman mentioned mandatory reconsiderations. Is he aware that Department for Work and Pensions staff are informing people that mandatory reconsiderations will be delayed over Christmas because of the excess workload they face? Through him, can I ask the Minister to transfer staff from bringing in the sanctions and stopping the money, to the mandatory reconsiderations, so that people get their money?

[David Linden]

I know that the Minister is respected across the House for listening; I am sure she will have heard that point, and I hope the hon. Gentleman gets an answer to it in the wind-ups.

Finally, I will touch on the impact of assessments, frequent reassessments and poor decision making on the physical and mental health of claimants. We could easily spend the next hour and a half trading statistics across the Chamber, but I prefer to focus on real people and those whom I have been elected to represent. Throughout my short time as Glasgow East’s MP, I have seldom had a surgery in which a constituent has not come to me having been the subject of a flawed work capability assessment.

One such case was that of my constituent, David Stewart from Baillieston. David suffers from hidradenitis suppurativa and has had numerous abscesses over the years requiring extensive surgery and skin grafts. It is not uncommon, at times, for him to receive morphine up to six times a day. His own general practitioner stated clearly that David should not be working, yet he was found fit for work at a work capability assessment. It was only after my office intervened and helped him draft a mandatory reconsideration that that decision was finally, and justly, overturned. That brings me to the first issue I want to raise with the Minister today: the astonishingly high level of successful appeals against work capability assessment decisions.

[Stephanie Peacock (Barnsley East) (Lab)]

In my constituency, two thirds of residents who are initially rejected for PIP and ESA are shown to be eligible on appeal. Does the hon. Gentleman agree that that suggests the whole work capability system requires much more reform?

[David Linden]

The hon. Lady makes a good point; I very much agree.

The latest quarterly release on appeals of work capability assessments shows that 59% of decisions are overturned at appeal. To be blunt, that means that six in every 10 decisions are wrong. That is incredibly alarming.

There is, of course, a wider point about the undertaking of work capability assessments by a private sector provider, which I oppose on ideological grounds—I agree with the hon. Member for Coventry South (Mr Cunningham) on that point. I doubt, therefore, that it will come as much surprise that I very much welcome the commitment by the Scottish Government to ban private firms from carrying out benefit assessments. I wholly concur with the Scottish Social Security Minister Jeane Freeman, that

“profit should never be a motive nor play any part in assessing or making decisions on people’s health and eligibility for benefits.”

Over and above my ideological objection to private sector provision, I am sure that all hon. Members will be concerned to note that, according to the DWP’s own data released only last week, the ESA assessment provider has consistently failed to meet the contractual expectation for the quality of assessment reports.

[Helen Whately (Faversham and Mid Kent) (Con)]

One thing I have been calling for, for some time, is standard recording of all work capability assessments. Often there is one story from one side and another story from the other, and recording would not only provide some evidence about what really happened, but improve people’s experience of the assessments. It has been piloted, so does the hon. Gentleman agree that it would be good to push forward with the recording of assessments as one way of improving the experience for our constituents?

[David Linden]

I am grateful to the hon. Lady and will come back to how the assessments are conducted, because that forms a major part of my speech.

At this juncture, I want to commend to the House the excellent report by Rethink Mental Illness entitled “It’s broken her”. It was published just last week and makes truly harrowing reading. The report lays bare the full extent of the challenges for people with mental illness when facing assessments for both ESA and PIP. Drawing on findings from a series of interviews and focus group-style discussions, the report finds that the assessment can be “traumatising and anxiety-inducing” for the following reasons: there are numerous issues with the paper forms that claimants must submit, including their complexity and length, and the inflexible nature of the questions they ask; claimants must collect their own medical evidence, which is extremely burdensome, often expensive and time-consuming; the staff who perform face-to-face assessments frequently have a poor understanding of mental illness; and, finally, delays in mandatory reconsideration and appeals to the tribunal mean that claimants may have to wait many months for the correct result.

The report concludes that the current PIP and ESA assessment procedure

“inherently discriminates against people with mental illnesses”.

It sets out a number of policy recommendations to

“dramatically improve the benefits system for people with mental illnesses, as well as saving the Government the vast costs that are currently incurred due to persistent incorrect decisions made early in the process.”

[Tommy Sheppard (Edinburgh East) (SNP)]

My hon. Friend is making a powerful case. May I bring to his attention the case of my constituent, Adam Brown, a 51-year-old man who suffers from epilepsy and cerebral palsy and has a learning disability? By the time Adam came to see me, he had been trying to get a work capability assessment for nine months with the assistance of benefit agencies, and had not got it. We had to intervene and got it within 10 months. It is surely shocking that it takes the intervention of a Member of Parliament for people with disabilities to get fair treatment.

[David Linden]

My hon. Friend makes a powerful point. I am glad that his office was able to help on that occasion, as mine was in the case of my constituent David Stewart. It is all well and good that as Members of Parliament we can intervene in individual cases, but so many people are affected throughout the entire process that our being able to help on a one-off basis is not good enough.

[Mr George Howarth (Knowsley) (Lab)]

The hon. Gentleman is making a fluent and powerful case. Does he agree that if there is a review of the process, two things need to happen? First, in clear, medically proven cases of mental illness, the medical evidence should be accepted without face-to-face examination. Secondly, the assessors and decision makers should be appropriately trained in mental health.

[David Linden]

I am grateful for that intervention, which leads me on to the recommendations of the Rethink Mental Illness report. The first is:

“A major reform of the PIP assessment and the WCA for ESA is needed. This should result in both assessments reducing the distress caused to people affected by mental illness and that better reflect the realities of living with a condition of this type. Such reform would reduce the need for appeals and the associated costs to the DWP and HM Courts & Tribunals Service”.

The second recommendation is that, as the right hon. Gentleman argues,

“The Government should review the way in which people with mental illness are assessed. Where clear medical evidence exists that claimants have severe forms of mental illness, they should be exempt from face-to-face assessments. Where face-to-face assessments are necessary, claimants should be encouraged to seek support from carers, friends or family members.”

I have seen numerous examples of friends, family members and carers being taken along, only to be told that they are not allowed to help.

The third recommendation is:

“All assessors and DWP decision-makers should be appropriately trained in mental health. The scandal of inappropriately trained and experienced assessors making critical decisions about the lives of people affected by mental illness must end.”

One case study in the report caught my eye, and I want to share it with the House. James, who was 53, had a work capability assessment with a physiotherapist after he lost his job because of depression—not that I can see the connection between physiotherapy and depression. This is his testimony:

“The assessor wanted yes or no answers to various questions like ‘can you leave the house?’ I tried to explain that some days I can leave the house or answer the door, and other days it’s not possible because of my mental health, and the response from the assessor was ‘is that a yes or a no then?’

I have no problem when people don’t understand mental health; it’s when they have an opinion on something they don’t know anything about.

There weren’t any specific questions exploring my mental health. At the end of the assessment, the assessor asked me to touch my toes, and I felt that the whole assessment was set up so people with mental illness fail.”

[Dr David Drew (Stroud) (Lab/Co-op)]

Does the hon. Gentleman agree that one of the problems with the process is that it lumps mental health conditions together? Epilepsy is a very different condition from depression, for example, yet people with mental health conditions all undertake the same assessment. Surely that is not fair or right.

[David Linden]

The hon. Gentleman is absolutely right.

The quotation from James ends:

“I came out of the assessment feeling let down, and not listened to, and later I made two attempts on my life. I’m still waiting for the result of my WCA.”

That should certainly sound alarm bells in this House. Closer to home, Michelle Ferns, a member of my constituency casework team, has a profoundly autistic son, Richard, who is non-verbal. During Richard’s assessment, Michelle was asked by the professional—the professional!—whether Richard still had autism. That is the kind of ridiculous behaviour that we are seeing in the process.

An ongoing case that I would like to press with the Minister is that of a constituent from Tollcross; I hope you will indulge me, Ms McDonagh, because it relates to a PIP assessment rather than a work capability assessment. My constituent was diagnosed with multiple sclerosis seven years ago. She is fiercely independent, but in the past two years her memory and physical mobility have declined steadily. She was awarded the standard rate for PIP but nothing for the mobility component. She submitted a mandatory reconsideration but, despite new information, it was still rejected. As a constituency Member of Parliament, I am certain beyond doubt that the wrong decision was made in that case, and I will be writing to the Minister to ask her to intervene personally and review it.

At this juncture, with a sense of trepidation, I must ask the Minister whether she has ever sat in on a work capability assessment. When I asked the Secretary of State that question in the main Chamber two weeks ago, I was quite shocked to learn that in his seven years as a Minister, he had never sat in on a work capability assessment.

[Mike Hill (Hartlepool) (Lab)]

The hon. Gentleman is making an excellent speech, particularly with respect to mental health, which is one of my specialities. In my constituency, Hartlepool, a man waiting for a double kidney transplant was declared fit for work despite having to make four trips a week to his local hospital. Does the hon. Gentleman agree that such cases are abhorrent?

[David Linden]

Yes. The hon. Gentleman’s point is very valid; his constituents are lucky to have such a strong representative.

Getting a work capability assessment right is vital. Wrong assessments can mean that people with a learning disability are moved to a benefit such as jobseeker’s allowance, which makes many demands that are often difficult for people with a learning disability to understand or fulfil. As a result, they are put at risk of being sanctioned.

Yesterday, Muscular Dystrophy UK shared with me the awful story of a lady with Charcot-Marie-Tooth disease who was deemed ineligible for ESA after a work capability assessment. The content of the questions resulted in the entire assessment missing several key points about how her condition affected her, such as the loss of dexterity in her hands and her inability to lift her arms above her head or use buttons. No consideration was given to the pain or fatigue she experiences daily. Many people like her are not adequately assessed during the work capability assessment because the questions that relate to its criteria are not suitable to extract the information required to help the assessor in understanding progressive conditions such as muscular dystrophy. With universal credit on the horizon, particularly in Glasgow, what plans do the Government have to alter the questions to be more appropriate and relevant for people with rare and complex conditions?

Some commentators have suggested reforming the work capability assessment to take account of how people’s functional impairments affect their ability to work, given who they are. They argue that a broader “real world” assessment that took into account factors such as skills, qualifications, experience and age would be possible and would better reflect everyday realities than the existing work capability assessment. To that end, I commend to the Minister and all hon. Members some reading for the Christmas recess: Demos’s March 2015 report “Rethinking the Work Capability Assessment”.

I am conscious that time is marching on, and I want to allow fellow Back Benchers the opportunity to speak, so I should wrap up.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

The hon. Gentleman mentions capabilities with reference to individuals. Is the Health and Safety at Work etc. Act 1974 also included in those capabilities when assessments are carried out?

[David Linden]

That is a very good question. I am sure that the hon. Gentleman, my constituency neighbour, will press that point with the Minister.

I am grateful to all hon. Members attending the debate. I especially thank the Minister for listening this afternoon; I have a huge amount of respect for her, and I look forward to her winding-up speech for the Government. However, what I want from the Government is deeds, not words. I want a full root-and-branch review of the work capability assessment process, and I want an assessment that is underpinned by professionalism, knowledge, dignity and—above all—respect.

14:39

[Peter Aldous (Waveney) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I congratulate the hon. Member for Glasgow East (David Linden) on securing this debate.

During my time in this place, listening to constituents and supporting them with their work capability and PIP assessments has been part of my constituency casework. In recent months, the number of cases handled by my constituency staff has increased, which suggests that the system is not working as well as it should and needs reviewing. The problems generally relate to the challenges that people with mental health conditions or fluctuating conditions such as multiple sclerosis and Parkinson’s face when they are given assessments, the anguish they go through and the fact that the assessments often do not reach the right decisions. The conclusion of Rethink Mental Illness’s report states:

“The current assessment system…discriminates against people with mental illnesses”.

After the 2014 judicial review decision, I am inclined to agree.

I shall briefly outline three cases with which I have been involved. Two relate to PIP rather than work capability assessments, but I believe that there are clear parallels to be drawn. All three relate to constituents whom I or my staff have known for some time. Previously, they had no problem in obtaining the support that they needed and it is only in recent months that they have experienced problems that have caused them and their families a lot of distress and worry.

The first case involves a constituent who took a supporting letter from her doctor to her assessment, which confirmed that she suffered from a long-standing mental health disorder and concluded that she would find it difficult to cope with any work commitment at the current time. The doctor added that her case should be reviewed in six months’ time.

In reviewing the assessor’s decision, the Department for Work and Pensions decision maker referred to the doctor’s letter but commented that

“at the time of your assessment, your mood did not appear to be low”.

The remainder of the review concentrated on physical issues and included comments such as:

“You appeared to be of average build and well-nourished…You said that you did not need prompting to dress or undress”.

The decision maker concluded that, because my constituent could plan a route of journey unaided, she was able to cope with anxiety. To my mind, the case demonstrates that currently assessors do not have the necessary training to assess accurately people’s mental wellbeing, and that the assessment form does not properly take account of mental conditions as well as physical conditions, and needs to be reviewed.

The second case involves a man who, along with his family, I have known personally for some time. He faces a variety of challenges, including a heart condition, kidney problems, diabetes and hypoglycaemia, as well as mental health challenges. Again, his doctor wrote a letter expressing the professional opinion that he was unfit for work at the current time. While my constituent’s assessment was going on, first, his mother was in hospital to be treated for cancer and then, very sadly, his father died. When he went for his assessment, he collapsed and was admitted to hospital. When such an awful chain of events unfolds, there should be an in-built mechanism in the work capability assessment process so that reviews are put on hold and suspended.

The third case involves a constituent of mine whom I first met some years ago. At that time, she was clearly not fit for work and was duly placed in the support group of employment and support allowance. Her case was reviewed this summer. Her condition has not improved at all in the time I have known her, yet the initial outcome of that assessment was that she should be placed in the work-related activity group. The first mandatory reconsideration upheld that decision. There was then a second mandatory reconsideration and the decision was revised. During this time, my constituent suffered a great deal of worry and distress, and was utterly perplexed as to why this was happening to her.

I have other cases that reveal similar concerns and lead me to conclude that the work capability assessment process needs to be overhauled. I suggest that this could be done in three ways. First, the Government should fully engage with charities and support groups in the sector. Mind and Rethink Mental Illness have interesting proposals that should be considered, while organisations such as the Multiple Sclerosis Society and Parkinson’s UK can provide feedback regarding fluctuating conditions.

Secondly, Parliament has a key role to play in making changes to the assessment. The Work and Pensions Committee is currently undertaking an inquiry and its findings should be considered very carefully.

Thirdly and finally, in future the system needs to be subject to its own form of continuing professional development. Reviews such as those carried out in the past by Professor Harrington and Dr Litchfield should not take place periodically—they should be an ongoing part of the process.

We need work capability assessments, but in their current form they are causing a lot of turmoil in people’s lives and need to be reformed.

[Several hon. Members rose—]

[Siobhain McDonagh (in the Chair)]

Order. May I just inform Members that there are about six people who want to speak? If you could consider limiting your contributions to five or six minutes, that would get everybody in.

14:55

[Eleanor Smith (Wolverhampton South West) (Lab)]

I thank the hon. Member for Glasgow East (David Linden) for securing this debate. Many of my constituents have written to me regarding the degrading process of the work capability assessment and the effect it has on their mental health. They have complained about the lack of mental health expertise and the insensitive way that the questions are worded, which has led many of my constituents to feel as though there is no compassion.

My constituents have criticised the process, saying that assessors have not asked questions about how often they can undertake activities or about the kind of support they need to undertake them. Often, the way questions are worded makes it difficult for people with mental health problems to explain how their condition fluctuates.

One of my constituents—she gave me permission to highlight her case—has said she felt broken by the work capability assessment. She suffers from dissociative disorder and a complex post-traumatic stress disorder, and due to a reassessment she had violent flashbacks, which triggered self-harming behaviour. Although her case has now been dealt with, after she appealed the decision by the Department for Work and Pensions and won the case, she feels that the system is broken and has left her broken. Like many of us, she says the system needs reform.

As a nurse, I understand that people who have mental health problems need to be treated with care. That should also be the priority for the assessors. While the Government have announced the Green Paper on work, health and disability, will they commit to take on board the recommendations from mental health charities such as Mind to increase the use of specialist assessors and to train the current assessors, who are the people dealing with the clients who have mental health issues?

14:57

[Justin Tomlinson (North Swindon) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh, and to follow the hon. Member for Wolverhampton South West (Eleanor Smith)—I have many happy childhood memories of visiting Wolverhampton. I pay tribute to the hon. Member for Glasgow East (David Linden), who demonstrated his passion for this very important subject. He is clearly representing his constituents in a very strong way.

The importance of this debate is shown by how well-attended it is, particularly with other things going on in the main Chamber. That is because there is an opportunity to influence what the Government are doing. Following the Green Paper, they have demonstrated that they are willing to listen, engage, consult and make changes. We have a new Minister—the Minister for Disabled People, Health and Work—who is widely respected and who is determined to be accessible, to listen and learn, and to improve the situation.

The work capability assessment is not a new thing—it was introduced in 2008. There have been five independent reviews, more than 100 recommendations to improve it have been made and more than 100 recommendations have been enacted. Almost weekly, the Government are considering ways to make further changes. Each and every hon. Member, through our experiences of casework and of sitting through work capability assessments, can feed into the process and suggest changes.

I am a former disabilities Minister. The work capability assessment was not in my remit, but I made representations on behalf of many of the groups that have already been mentioned—Parkinson’s UK, Multiple Sclerosis Therapy Groups, Mind and others—and found that the policy makers and experts are willing to listen and change the scripts, including on how questions are asked and how things are identified, particularly when people have fluctuating health conditions and when health conditions are less common, such that an assessor does not regularly come across them. We have come along in leaps and bounds.

It is clear to me that the examples given today by Members—I presume other examples will be given by the Members who follow me—show that the system is still not right. That is why it is so important to have a Minister who is keen to engage.

I will make a couple of broad points, and then I have some asks. Many people ask why we have assessments. I wondered that myself when I arrived as a Minister. I thought, “I could save the Government a fortune. We could do away with assessments. They are expensive. The Treasury—George Osborne—is very keen for us to find savings, and this is a bit of an easy win.” The reality—we saw this as we transferred from disability living allowance to PIP—is that the assessments, ignoring the cases where they have gone wrong, are there to help build the case.

Under DLA it was purely a paper form. In that written document, most of us here would have articulated the challenges we face in our everyday lives pretty well, and we almost certainly would have got the benefits to which we were entitled, but many people navigating the system were not able to do that for a variety of reasons. Only 16% of claimants under DLA accessed the highest rate of benefit. Under PIP, that figure is 26%. That is because in some parts, the assessment has helped build people’s cases, particularly those with deteriorating health conditions at the beginning of that journey. The assessors are able to say, “At the moment, your day-to-day life is not too affected, but it is likely to be before too long.” The system triggers the ability to reassess and, in the majority of cases, that benefit and support is increased. The principle of the assessments is good. That is why the then Labour Government introduced them in 2008. The assessments are not Conservative ideology, but are done to assist people. Where the assessments go wrong, there is a problem, and that is why it is absolutely right to have this debate to engage and help shape the future.

[Neil Gray (Airdrie and Shotts) (SNP)]

When the hon. Gentleman was a Minister, we had a very constructive relationship on the points we are debating. Does he accept that one problem with the assessments is that they assess people on their best days and make an assumption on what their best days look like, not their worst days? If there was a change in assumption, that might help.

[Justin Tomlinson]

I thank the hon. Gentleman for his intervention, and in particular for his very kind words. It was always a pleasure working with him. He is certainly one of my favourite Members on the Opposition Benches in the way he engages and shapes things, although my comment might not help him in Scotland. The theory is that, if the assessments are done correctly, they are a judgment over a period of time. They should not be a judgment just of the isolated moment someone is in the assessment. It is meant to make a judgment on the typical challenges someone has to overcome over a period of time. That is an important point to make, and the system should be recognising it.

The first concern people raise is why the appeal rates are so high. They say, “If the rates are so high, there must be a fundamental problem.” Actually, if we drill down, the vast majority of successful appeals are where additional evidence is provided late, whether orally or in writing. The solution is that we must do more to access people’s health records in advance. Before data protection people come down on me like a tonne of bricks, that can be voluntary, but it should be a given.

[Stephen Lloyd (Eastbourne) (LD)]

One solution could be for consultants’ records rather than doctors’ to be considered right at the beginning. I appreciate the challenges around GPs, but a consultant could say that Mr A or Mrs B was not capable of doing x, y and z because of their impairment. If that was acceptable, it would make life a lot easier, and it would deal with some of the anxiety some GPs feel about being intimidated into agreeing such and such a position.

[Justin Tomlinson]

That is an important intervention. Those records are already taken into consideration, but other things that I am about to come on to strengthen that point.

On the high appeal rates, it would help if we could get permission to automatically access those health records. Far too many people are going through the system and only realise they need those pieces of supporting evidence after they have failed and received the helpful communication saying, “This is why you have not accessed that particular level of benefits.” That is an inefficient way of doing it, and we should be more proactive. We have started to see that, but it should be emphasised.

I agree with my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) about recording sessions. That should be a given and would help deal with questions asked in appeals. There should be more videos setting out what is going on. That would help deal with the anxiety and allow people to see what is coming forward. One of the successes under the PIP assessments is that the assessors go out of their way to encourage a claimant to bring a colleague, friend or family member to support them. The same principle should apply.

Many MPs understandably get work capability assessments and PIP assessments mixed up because they are so similar. It would be a good idea if we aligned them more closely, and I know the Government are looking at that.

Getting the work capability assessment right is only part of the journey. The idea is that that assessment identifies what support people need and how we can help them move forward. Mind has said that the Government should have an emphasis on removing the real-world barriers to work. That is why I said at the beginning of my remarks that the debate is an opportunity. We have 3 million new jobs created and 776,000 vacancies available, which is a record high.

[Rosie Cooper (West Lancashire) (Lab)]

Earlier in the hon. Gentleman’s speech, he said that things should not go wrong. My problem is that one of my constituents lost more than £300 after she had to cancel an appointment because of urgent ill health. For four months, she has not been able to resolve that. It is okay saying things should not go wrong, but when they do, the system is not there. What action can be taken to ensure that the work capability system is responsive to applicants and considers their concerns, especially when it goes wrong?

[Justin Tomlinson]

None of us wants it go wrong ever—no one would argue for that. Four months is not acceptable. The hon. Lady has raised the issue. I suspect that our helpful Minister will diligently make a note and that the hon. Lady will be contacted shortly about that case.

The majority of those out of work have been away from work for a very long time. They are desperate for an opportunity. As part of the assessment, assessors look at what someone can do. More than 50% of those people will have a health condition, which will make it harder to find work than it is for the majority of people. The system needs to identify the support needed in terms of financial benefits as well as embracing the principle of offering the tailored support that is at the core of universal credit.

We have to look at matching things with what they can do. For some people, it may be an hour a week. Some people with fluctuating health conditions may be fine for months and then have to dip in and out of work. We have to ensure that support is provided to the individual person, co-ordinated by their named job coach, looking at issues to do with their health, confidence and skills. The Government have to get smarter at talking to employers, particularly the small and medium-sized employers that create 45% of jobs in this country. The big organisations and big businesses are pretty good. They have human resources departments and are good at dealing with this issue on the whole, but small and medium-sized businesses without HR or personnel departments need more support. [Interruption.] I am being reminded to be quick; I will be.

I encourage the Government not to lose sight of the need to create those opportunities for people. I am encouraged that the Government are making improvements, and each and every one of us can help to shape those.

15:07

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I thank the hon. Member for Glasgow East (David Linden) for presenting the case so well. I will refer to many of the things he mentioned, but purely from a constituency point of view.

The issues to do with ESA, DLA and PIP appeals that Members have referred to come into my office every day of the week. On my staff I have a lady, Yvonne, who is blessed with the talent of being able to listen to someone, be compassionate and help put into words what people are frightened to write down. The forms are beyond off-putting. Sometimes the format of the forms is disappointing. Yvonne works hard and there is never a day that she is not up to her eyes in the crux of the matter. Housing and planning used to be the major issues in my office, but the major issue of the day now is benefits. We have a full-time staff member who deals with nothing else, and other staff members do so on a part-time basis. Whenever she takes annual leave, I try to keep on top of the most pressing appeals, and that tells me much about her character and what she is able to do.

Our local citizens advice bureau points people to our office as it is simply unable to process the sheer volume of cases of people appealing. I have the deepest respect for the Minister, and I want to put that on record, but does everyone understand how immense the issue is? I invite her to come to my office in Newtownards, if she is ever in the area, to speak to some of my staff. They will tell her clearly what the issues are.

I will quickly run through the system. If a claimant wishes to appeal a decision, they must request a mandatory reconsideration. Guess what happens next? More often than not, the original decision is upheld. Then, the claimant goes through the appeals process. If 64% of ESA tribunal cases find in favour of the claimant—in other words, the original decision is overturned—that indicates that there is something wrong with the system to start with. Two thirds of appeals are successfully appealed. The same thing applies to the DLA and the PIPs as well. It frustrates me greatly when constituents I have known for umpteen years—I have known their physical illnesses and health problems—get a form back that says, “We have decided you can work.” Well, they are not able to work. They do not see the same person sitting across the table from them. They are asked, “Can you jump up and down? Can you walk 100 yards? Can you make your tea?” There are issues with mental health as well; the hon. Member for Glasgow East referred to that.

People ring our offices in genuine distress and actually crying over the issues. Even the hardest heart in this Chamber would have to acknowledge that and take note. The problem is that the unwell person feels as though they have been dragged across hot coals. Their illness is exacerbated by the stress and they become even more ill. I have seen that happening so often.

[Alison Thewliss (Glasgow Central) (SNP)]

The hon. Gentleman is making a very good case that chimes with my constituent, Mr Ramsey, who had his ESA terminated. He has arthritis, kidney and heart problems, type 2 diabetes and colitis, and he receives DLA at the higher rate. He is at risk of a heart attack and a stroke if he is made to go back to work, but he was told he could not get what he was entitled to. He has now been placed in the WRAG, so he continues to have great stress and worry about whether he will be hauled back in again.

[Jim Shannon]

I thank the hon. Lady for her intervention, which will be mirrored by me and everyone else in this Chamber. Indeed, I do not see how anyone could have a different opinion. We see the reality in our offices every day.

The vicious cycle continues. Although it might look good on paper for the decision makers to meet their quotas, it does not look good to the doctor who has to care for the person. We need a system that lends adequate weight to the illnesses that people have without having to tax doctors even more. We all know how difficult it is for doctors to make appointments, and we are asking them to provide additional information that puts more strain on local GP practices. I understand that system. GPs in my constituency have decided to inform patients they will no longer provide letters for PIP or ESA, and will give information only if requested by ESA or by PIP. Again, that happens irregularly.

On the other hand, ESA and PIP request only certain information, so the whole case is not heard and the loser is the person applying. What comes first—the chicken or the egg? People are bouncing back and forth between the benefits office and the GP. It really frustrates me.

[Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)]

On becoming a new Member of Parliament I had a stark introduction when I held a street surgery in Dennistoun the day after my election. Some of the massive problems highlighted by the hon. Gentleman came to light for me when a woman approached me in tears in the street and said that she had to support her son who had a high-grade brain tumour—a terminal brain tumour—and yet was still deemed fit to work. In that context, in the face of all the medical evidence, we still see flaws happening in the most degrading and humiliating way. In the face of the most vindictive box-ticking exercise, we see such hard-hearted approaches. Medical opinion must take greater weight in the process. Does the hon. Gentleman agree with that?

[Jim Shannon]

I absolutely agree with that. The evidence is very clear from the overturning of cases at tribunals. There are people who have complex medical conditions, who are obviously unwell, and there are even wards of court where the court has decided a person is unable to look after their financial affairs, and yet the ESA writes to the person and all of a sudden we have myriad problems.

Delays in mandatory reconsideration and appeals to the tribunal mean that claimants may have to wait many months for the correct result. As the hon. Member for Glasgow Central (Alison Thewliss) says, that adds to the strain that the appellant faces. It does not affect just a single person, but the family as well. As the hon. Member for Glasgow North East (Mr Sweeney) mentioned, it affects the family and everybody coming together.

I am glad to say we have a food bank in our area. Thank the Lord for food banks. One of the biggest reasons why my office points people in the direction of the local food bank is because of benefit delay. The DWP has failed to make reasonable adjustments in line with the Equality Act 2010. The 2017 Green Paper “Improving Lives: the Future of Work, Health and Disability” contained no proposals to substantially reform assessments. I ask the Minister why.

15:14

[Alex Burghart (Brentwood and Ongar) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I congratulate the hon. Member for Glasgow East (David Linden) on securing this important debate. It is always refreshing to be in a debate where there are so many shared views from different parties. I congratulate him on the tone with which he conducted his speech.

I echo some of the comments that remind us of how we have come to this position. There is absolutely a need for a work capability assessment within our benefits system. It is extremely important that people who suffer from physical and mental conditions have their conditions assessed to see whether they are able to work today or tomorrow. It allows the state to give them the requisite support that they need and deserve.

When the Labour party introduced the system in 2008, it did so with the laudable intention of creating a benefits system that identified what people could do rather than what they could not. That is a value to which we should remain attached. I am not sure that between 2008 and 2010 the then Government managed to achieve that. To be honest, I am not sure that we have managed to achieve it since, but the value of that principle is one that we should hold dear.

I should prefix what I say with my belief that there is substantial room for improvement within the system and perhaps a need to go back to some basic values. One thing that I find often gets lost in the powerful and personal stories that I come across in my surgery, and that colleagues from all parties come across in theirs, is that the system works well for a great many people. Of the 1.6 million people who completed the assessment process between October 2013 and December 2016, 85% did not appeal, so the vast majority were content with the decision that was made. Only 3.5% of the 1.6 million had a successful appeal. I do not wish to belittle those numbers because that 3.5% still represents tens of thousands of people, many of whom have very serious conditions, and many of whom will have been left substantially worse off by a negative decision. I want us to remember that the system is not wholly bad, but that there is substantial room for improvement within it.

[Neil Gray]

The hon. Gentleman quotes figures that I am happy to accept, but does he accept that many people who have been through the system, particularly with work capability assessments, feel so frustrated by the process they have gone through that they self-deny the support that might be available to them, and that that is perhaps part of the reason why there is a low appeal rate in some periods?

[Alex Burghart]

I absolutely accept what the hon. Gentleman says, but I think he would accept that some people do not appeal because they are pleased with the outcome. That is why my hon. Friend the Member for North Swindon (Justin Tomlinson) mentioned that the Government and the previous Government have always been in a process of ongoing review—we have had annual reviews and a Green Paper. I am sure everyone has read “Improving Lives”, published last month, which sets out the Government’s future commitment to reform, and that we all welcome it.

As a member of the Work and Pensions Committee, I have been fortunate enough to come across a great many cases and a great amount of submitted evidence. It is becoming clear to me that there are four key areas in which we should seek to improve the system. The first, which resonates with a lot of what has been said, is the accuracy of the assessments. I have had people through my surgery in my constituency who have presented me with information that is clearly wrong and clearly relates to somebody else. Basic errors creep in before we even get to the validity of the assessment process. That makes me think that the accountability system for the accuracy of the reports should also be revised. If an assessment company sees its assessments overturned, there should be consequences. I would certainly like, at the very least, the cost of the assessment process to be charged to that assessment company, and I would certainly be open to the idea of compensation for people who had been wrongfully denied benefits because assessments had been mishandled.

The matter is bound up with the question of expertise. The Work and Pensions Committee questioned witnesses from the major companies the other day about the level of expertise that they employed.

[Hannah Bardell (Livingston) (SNP)]

The hon. Gentleman talks about compensation, but how does he think people can be compensated for damage to their mental health? A constituent who contacted me has been on Valium since her last ESA assessment because it was so devastating. Another constituent, who is affected by the issues covered by the Women Against State Pension Inequality Campaign and is therefore already missing out, has multiple sclerosis. She was so damaged and upset by the assessment that she and her husband cannot bear to go through the experience again.

[Alex Burghart]

The hon. Lady gives powerful examples. As I have said, the most important thing that we can do is improve the accuracy and quality of the assessments to prevent such cases.

Schizophrenia is a complex condition that can manifest in many different ways from case to case. Consequently, it will vary in its impact on the ability to work, depending on the individual case. To my mind, it would be difficult for an individual assessor without expertise in schizophrenia to make an accurate judgment about whether someone with schizophrenia would be capable of working, whether on a daily or temporary basis. I urge the Government to consider how we can encourage or oblige assessment companies to employ people with the requisite expertise.

There is a substantial point to be made about simplicity. I have been through all the application papers. I do not like filling in forms at the best of times, but those things are the stuff of nightmares. They have a huge number of pages and fields, and contain requests for information that the Government must hold. I find it strange that that peculiar bureaucracy is asking for information that other bits of our state system must have.

[Deidre Brock (Edinburgh North and Leith) (SNP)]

I appreciate the fact that the hon. Gentleman has raised the difficulty with forms. The inadequate and inflexible nature of the questions that are asked has been raised with me. I have heard of people with epilepsy being asked, “Can you lift a glass to your lips?” The answer was “Yes, if I am not having a fit,” but there was no room on the form to add that important additional fact. “Can you walk 25 yards?” “Yes, if I am not having a fit,” and so on. Will the hon. Gentleman comment on that?

[Alex Burghart]

I appreciate that it is the nature of bureaucracy to be inflexible, so I take the hon. Lady’s point.

I am keen for the Government to go back to the central principle of finding out what people can do rather than what they cannot do. With greater expertise in the assessment process it would be possible to identify the sorts of jobs that other people with the condition in question have managed to hold down. That would bring the principles of universal support into the assessment process, helping people to identify their barriers to work and overcome them.

15:23

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am delighted to speak and thank my hon. Friend the Member for Glasgow East (David Linden) for bringing this important debate forward. I last spoke on the issue in February. Many of the problems that were raised then have been highlighted again today. We know about the negative experiences people have in assessments. I know of them from my constituents. The hon. Member for North Swindon (Justin Tomlinson) talked about the system having come on in leaps and bounds, but I am afraid that when 59% of assessments that go to appeal are overturned, it does not sound like leaps and bounds to me or to the system’s victims—I use that word advisedly.

The fact that the system as it currently operates completely fails the vulnerable who rely on it is borne out by the current inquiry by the Work and Pensions Committee. Some appalling and shameful experiences have come to light—we have heard much about them today. There are reports of assessors not being sufficiently qualified to carry out assessments, and not possessing sufficient medical expertise on the medical condition in question. We have heard about physiotherapists assessing mental health problems, and claimants feeling that their responses are not recorded accurately. Assessment methods vary widely in quality and—this comes up a lot—those assessed feel that they are not being listened to. There is a lack of understanding of disability and the hidden impact of mental health challenges.

Anyone who doubts or rejects that analysis must find another explanation of why so many—59%—of appeals against DWP decisions are successful. That figure alone shows that the initial decisions are often wrong—they are wrong in the majority of cases.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Will the hon. Lady give way?

[Patricia Gibson]

I cannot give way because so many hon. Members have taken far more time than courtesy permitted.

I know from constituents who have been through the process that lodging an appeal is a huge cause of stress and anxiety, and does nothing to improve the health and wellbeing of those who go through it. Indeed, many simply give up, feeling abandoned and betrayed by a system that they believed would be there in their time of need, when they most needed support. The assessments are so traumatic for some people that they may be hospitalised or have to increase their medication. Some people may even attempt suicide, as my hon. Friend the Member for Glasgow East pointed out. He also eloquently pointed out that about half of ESA claimants have a mental health condition, but that the system seems actively to discriminate against people living with such conditions. The system is clearly not fit for purpose, despite any amount of pretence about how it has improved. It may well have improved, but that is no comfort to the people who live with those decisions day in, day out.

The impact of the flawed system on those who are disabled can be profound. Work done by the Scottish Government found that between 7,000 and 10,000 disabled people a year are affected by the removal of their support. The SNP Scottish Government have completely mitigated the bedroom tax, saving 40,000 disabled people in Scotland who claim ESA from that hated and unjust tax. I trust that the Minister will seek improvements to the system, and I ask her as she does so to remember and reflect on the fact that the United Nations committee on the rights of persons with disabilities has slammed the Government’s record. In contrast to the current stressful, poorly carried out and often humiliating assessments, there will, when Scotland has control over some benefits—it will not have control of work capability assessments, because ESA has not been devolved—be an end to the tick-box assessments that are now used. They cannot and do not take proper account of complex conditions.

Several times in the debate hon. Members have said that the principle of assessment is important, but no one said that assessments should be carried out by private companies. Those who believe that they should be should be prepared to come here and defend that decision. The assessments are carried out by private companies, which by their nature are driven by the profit motive. That is the end of the story. When people’s mental health is being assessed, the profit motive cannot be a factor in the equation. I ask the Minister to consider that carefully.

Time prevents me from continuing, but I urge the Minister to look seriously at the system and overhaul it completely. I hope she will feed back to the Government the concerns expressed by so many hon. Members today.

15:29

[Drew Hendry (Inverness, Nairn, Badenoch and Strathspey) (SNP)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I congratulate my hon. Friend the Member for Glasgow East (David Linden) on securing this vital debate.

We have heard today that work capability assessments are not working for people and that they cause problems. That is borne out across my constituency. People often struggle to get into my surgeries to tell me their difficulties, and they may have combinations of conditions. There are people who are blind, and who are also coping with mental illness or sometimes cancer treatment. To be asked to attend a work capability assessment is an incredible situation to be in, and it leads to people being absolutely petrified—we have heard that word before. People are terrified about what they will have to go through. They have to sit down in front of people and be challenged on their conditions, when it is self-evident that they are not capable of doing the things that the assessors would like them to do. For many people, the process escalates and compounds the difficulties that they face in their daily lives. It is—this may be an overused word in this place—genuinely heartbreaking when people present themselves in that way. How on earth can we have a system that puts people through that kind of torture? It is not right and we must challenge it.

Members have spoken about work capability assessments and the kinds of questions that put people under pressure. Constituents have told me that they have been asked whether they can do something and they have said “no”. They are then asked again, “What about on a good day? What about when the sun is shining outside and it is great? Can you do this then?” People have a natural instinct to say, “Yes I can do that,” even if they cannot. They want to be seen to be trying to do something, so they are put in a horrible place and are caught between what they would like to do and think they might be able to do in certain circumstances, and what they absolutely cannot do. That is the problem, and I hope that the Minister trusts the words of my hon. Friend the Member for Glasgow East and is listening, because people are being put through the mill.

Work capability assessments are problematic and inefficient. Appointments have been cancelled, and there are delays for people who cannot stand the stress or cope with the process. It is vital that they get the support they need. As has been said, people are petrified; they are afraid to appeal in case they lose what they have got. Those moving from employment and support allowance to universal credit have already lost their severe disablement allowance—£62 a week does not sound a lot when said like that, but for someone who depends on that it is an enormous amount, and those people are being put through hardship.

I know there is limited time so I will be brief, but I must point out that those on the frontline in citizens advice bureaux and constituency offices see this problem on a daily basis. Lesley Newton from my local CAB stated:

“The assessment examination has significant weaknesses leading to chronically ill people both physically and mental health challenged being given zero points at assessment.”

That is not right; it should not happen. She continues:

“Many of these clients have had ESA in payment for a number of years and following these assessments are deemed fit for work.”

She said that with the introduction of universal credit, those clients face the challenge of replacing that benefit income while the decision is challenged and they are required to claim universal credit. She continued:

“Many ESA claimants also receive PIP so they lose the premiums that are paid within ESA linked to their PIP award when forced to claim UC… We have a high success rate when we challenge ESA decisions at appeal but”—

this is critical because we are talking about those who have access to the appeal system—

“we are struggling with the volume of these due to our own resource restrictions”.

This is such a difficult process for people to cope with that even those who support them are finding it incredibly difficult, leading to stress in their own workplaces.

I could go on but I will not because time is limited. However, I appeal to the Minister to listen carefully to the words of my hon. Friend the Member for Glasgow East. What is needed is professionalism, knowledge and—most importantly—dignity and respect.

15:34

[Neil Gray (Airdrie and Shotts) (SNP)]

I am pleased to sum up this important debate on behalf of the Scottish National party with you in the Chair, Ms McDonagh. I congratulate my hon. Friend the Member for Glasgow East (David Linden) on securing it. I pay tribute to the way that he has started his time in Parliament because he has, without doubt, been one of the most active and effective Members of the 2017 intake, and I am proud to work alongside him.

My hon. Friend made a typically forthright and incisive speech, drawing on his constituency experience and the expert testimony of groups who support and campaign for people with disabilities or long-term health conditions. He rightly called out a number of the flaws in the current work capability assessment process and the running of employment and support allowance, and he is right about the lack of information and data collection by the UK Government on the impact of cuts to ESA and wrong decision making at WCA level.

I am sure that the new Minister will question the high success rate of appeals against decisions made after work capability assessments. As has been said, a two-thirds success rate for appeals calls into question whether the system is working for those it is supposed to support, and I am sure she will raise that issue with her Department. Those who appeal against WCA decisions can only claim jobseeker’s allowance to receive an income, which adds additional conditionality and stress.

Other Members have made valuable contributions. The right hon. Member for Knowsley (Mr Howarth) made an important intervention about the way people with mental health conditions are treated, and I hope the Minister will consider and respond to that in her closing remarks. The hon. Member for Waveney (Peter Aldous) was typically challenging of the Government, and he based those challenges on casework experience that will be familiar to us all. The hon. Member for Wolverhampton South West (Eleanor Smith) spoke from her practical experience in healthcare and made a critical intervention.

The hon. Member for North Swindon (Justin Tomlinson) —a former Minister—made a typically considered speech and accepted that there are issues with WCAs. He also made a good point about access to medical information, which we all agree is a constructive change that the Minister could consider. That issue is a major stumbling block for constituents I have represented who have problems with the WCA.

The hon. Member for Strangford (Jim Shannon) made a strong case and did what too few of us do in this House, which is to pay tribute to the efforts made by staff. In my office, Lawrie, Margaret, Carrie, Adam, Michael and Lesley see and deal with these issues on a daily basis, and they do a power of work to support affected constituents.

This is the first—and perhaps only—time that I will say I agree with the hon. Member for Brentwood and Ongar (Alex Burghart), but there has been cross-party consensus in this debate that work capability assessments are not working. I hope that the Minister will take that on board.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson), as always, made a passionate and erudite speech. She was right to say that not much has changed in debates on this issue since I have been in Parliament, but the Minister has an opportunity to make changes, based on the suggestions that have been put forward today.

My hon. Friend the Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry) was also right, because the people who I see before an assessment in my constituency surgeries and office are petrified. They are terrified because this process has the potential to rip security away from them. It is a fundamental point in their journey through the process, and it is a difficult time because of their experiences and those of people around them who have previously gone through it.

In conclusion, I hope that the Minister came to this debate in listening mode, has engaged with it, and will leave in action mode. The personal and expert testimony that she has heard today should give her all the ammunition she needs to instruct a full review of work capability assessments, as called for by my hon. Friend the Member for Glasgow East. The system clearly is not working and is not fit for purpose. We welcome the move to exempt people with certain conditions from having to suffer reassessment for ESA, but that highlights the need for a proper and full review of the whole system. Such a review should be based on the Scottish Government’s principle of establishing a system that is fundamentally based on dignity and respect for those who need its help.

[Siobhain McDonagh (in the Chair)]

Order. We are grateful to the hon. Member for Glasgow East (David Linden) for withdrawing his right to sum up at the end of the debate, so the shadow Minister and the Minister have until 4 o’clock.

15:40

[Marsha De Cordova (Battersea) (Lab)]

I congratulate the hon. Member for Glasgow East (David Linden) on securing this important debate. He made some very valuable points, particularly about inaccurate decision making leading to a very high success rate at tribunal. I also share his hope that finally the Government will actually take some action following the inquiry that the Work and Pensions Committee are currently carrying out, which has had an overwhelming response.

I also thank all other hon. Members for their powerful contributions, particularly those sharing real-life examples of people’s experiences with work capability assessments. The Government have overseen the unnecessary suffering of many of the most vulnerable in society with these assessments, which have proven to be unfair and unfit for purpose. Despite the many Chamber debates, Westminster Hall debates and Select Committee hearings, we have seen little or negligible action.

[Justin Tomlinson]

Will the hon. Lady give way?

[Marsha De Cordova]

No, I will not be taking any interventions.

There is now a broad consensus that the work capability assessment needs to be reformed. Disabled people, disabled people’s organisations, and charities have been clear that it is a blunt instrument that often gets it wrong and frequently fails to link people to the appropriate support. Labour has made it clear that we will scrap both the work capability assessment and the personal independence payment assessments, and replace them with a holistic, supportive and enabling approach. Until then, we need to mitigate the most adverse effects of the work capability assessment.

We are all familiar with disabled people who wish to be in work and to have a career, but are left without the high-quality, impairment-specific employment support that they need to make that a reality. We are also familiar with disabled people who have no realistic prospect of work, but have been put in the wrong group—the work-related activity group of employment and support allowance. Some have even been found fit for work and put on jobseeker’s allowance or universal credit equivalents—forced on to lower rates of social security support for long periods.

There has always been tension regarding ESA and its predecessors on whether the main objective is to help those with the potential to move into work to find suitable employment, or just to save money by getting claimants on to the lowest rates of social security support wherever possible. Both objectives run side by side in uneasy co-existence, but the latter aim seems to have dominated recently, as poor-quality assessments and decisions have increased. A culture seems to have developed in which a good number of the Department’s contracted-out, private assessors seem to have a perception that the Government want to make a minimum award. There also seem to be parallel views among many DWP decision makers, even at the mandatory reconsideration stage, that that is indeed what their managers possibly require.

Some of the cases are truly appalling. A lady with muscular dystrophy was deemed ineligible for ESA after a WCA. The content of the questions in that WCA resulted in the entire assessment missing several key points about how her condition affects her, such as the dexterity in her hands, and her ability to lift her arms above her head or to use buttons. There was also no consideration of the pain or fatigue she experiences on a daily basis.

On Monday, the Work and Pensions Committee heard about a visually impaired woman with a medical certificate to prove her condition—the certificate of visual impairment—being asked by her assessor to read it out, and then asked to read other documents as a test. Disability organisations have raised the issue of a lack of knowledge and understanding among assessors, particularly of equality and the social model of disability. There is a lack of understanding about health conditions, and often inappropriate or unreasonable questions and treatment of those with disabilities. Assessment locations are often far away or inaccessible to people. Alternative forms and formats vary across providers. Questions that form the criteria of the WCA are often unsuitable to extract the information required to help the assessor to understand certain conditions. For some people, face-to-face assessments can also be unhelpful and counterproductive. Patients suffering from mental health conditions downplay their conditions, particularly if they have had negative experiences or fear being sectioned. Others have had their condition exacerbated by the process.

The Government have argued that as only a modest proportion of decisions are appealed, the rest must be right. That assumption is clearly unsound. More than 90% of mandatory reconsiderations are upheld, with some decisions made within 48 hours. That is not reconsideration; it is rubber-stamping. When we look at the results of those who go on to appeal, the success rate is drastically different: 60% for ESA appeals between 2013 and 2016. Clearly, many people simply accept decisions that are likely to be incorrect, and suffer as a result. We can all agree, across the parties, that the system is broken and unfit for purpose.

What assessment have the Government made of how many incorrect decisions go un-appealed? Faulty assessments and decisions not only penalise claimants, but swamp advice surgeries and services, and appeal tribunals. There are beginning to be concerns among the judiciary. Britain’s most senior tribunal judge has said that most of the benefits cases that reach court are based on bad decisions, where the Government have had no case at all.

Any work capability assessment should be rooted in the real world. In each case, the genuine employment prospects of that individual in the light of their disability or health condition, age, work history, qualifications, and so on, should be the subject of a skilled assessment. It should also not be a one-off event. Certainly, pointless reassessments of people whose disability or health condition is not going to improve should be avoided, but for those who have genuine future employment prospects, there should be positive engagement.

Since April 2017, new claimants in the employment and support allowance work-related activity group have been paid the same rate as JSA—a reduction of £29 per week. That measure removes any recognition of the barriers to work and the additional costs of undertaking work-related activity faced by many disabled people. The change also creates a cliff-edge of about £59 between the ESA support group and the WRAG.

This approach, linked to high-quality, impairment-specific, real-world assessments, points the way towards a much better system. I hope the Government listen to the judiciary, disabled people and disabled people’s organisations, and commit to scrapping the work capability assessment. They should also listen to Labour. We will replace the WCA with a personalised, holistic process. We will end the privatisation of assessments and the pointless stress of reassessments for people with severe long-term conditions. We will change the culture of the social security system, from one that demonises people not in work to one that is supportive and enabling. The Government must listen and ensure that there is “nothing about us without us”.

15:48

[The Minister for Disabled People, Health and Work (Sarah Newton)]

It is a great pleasure to serve under your chairmanship, Ms McDonagh. I very much welcome this afternoon’s debate, and congratulate my hon. Friend the Member for Glasgow East (David Linden)—I hope I can call him that—on the manner in which he introduced it. Making sure that the most vulnerable people in our society have the support that they need must be something that rises above all party politics. I appreciate the contributions from so many Members today: 11 speakers, with 16 interventions. That shows how important this issue is to Members of all parties across the House.

Today’s debate is also very timely. Only last week, we published our response to the Green Paper consultation proposals for reform in “Improving Lives: the Future of Work, Health and Disability”. I will not have time today to give detailed responses to all the points that have been raised, but if hon. Members were to read that response they would see that many of their ideas for improving the work capability assessment are reflected in the plans we have set out. We have set out a very ambitious programme of testing and learning to make sure that we get this right. I will of course write to Members if I have not been able to address their individual concerns.

We have heard passionate contributions from Members who have rightly talked about their constituents’ experiences. I am a constituency MP first and foremost, as is every Minister. I have had similarly harrowing experiences with my constituents and I have listened to their concerns about the process. I assure hon. Members that I am as motivated as them to make sure the process is as good as it can possibly be. I invite them to send me the individual cases they talked about today so I can take a closer look at them and respond fully.

I have had a month in my new role. After dealing with a number of colleagues who have spoken to me and reading the correspondence I have received, I think it is important that I set up a series of meetings about PIP and ESA so Members and their caseworkers can meet me and the officials in my Department. It will be a kind of teach-in. We will listen to their concerns, explain the improvements we are putting in place and communicate the support that is available. That series of meetings, which will be available to all Members of Parliament, will start in January.

[Jim Shannon]

Will the Minister give way?

[Sarah Newton]

I will not—I have very little time. I can of course follow up the hon. Gentleman’s point after the debate.

The timing of the debate is important for another reason. I welcome the fact that the Work and Pensions Committee is doing an inquiry into ESA and PIP assessments. I assure hon. Members that I will not only participate in that inquiry—I look forward to going along to the Committee next week—but pay attention to its findings and consider them. It is clear from this debate that we are all committed to ensuring that people with health conditions and disabilities have the right support.

In the past couple of weeks, I have visited assessment centres that are undertaking work capability and PIP assessments, and I have seen NHS doctors, nurses and health professionals bring their professionalism and compassion to their work. They are the same people we could meet if we go to an appointment to see a GP or are treated in our local hospital. I have seen compassion and professionalism in the assessments, but I accept that there are improvements to make. We can always do a lot more.

Returning to some of the fundamental points that hon. Members made, it is right that our system focuses on what people can do, not on what they cannot do. We embrace the social model of disability. We want to break down barriers to work and ensure that people can truly reach their full potential in our society and in work, because we know that good work is good for health. I have met many people who would be considered severely disabled, and they tell me that they want an opportunity to participate in society and to work. In my few short weeks as a Minister, I have already seen inspirational work in our NHS and among providers of support for people with disabilities that enables people to have a role in our society. People who have been cast aside, rejected and put on the scrap heap for the past 30 years are now being supported into work.

I am pleased to see the Under-Secretary of State for Health, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), with whom I work in partnership in the Department of Health, here today. We visited a fantastic project run by a mental health trust in London. The doctors said, “We had written off these patients. We never thought that somebody with such a severe mental health problem would ever work, but we have changed our minds because of the programmes we have been putting in place in our hospitals.” We have to focus on listening, learning and developing our systems so that more people like those my hon. Friend and I saw last week have an opportunity to play their full part in society.

Of course, some people are too poorly to work, much as they would like to do so. Every year, the Government spend more money on disability benefits and benefits for people with heath conditions, and it is clearly set out in our spending that we will continue to do so. We are spending more than £50 billion—more than the defence budget—on such benefits, so the idea that we are cutting support to people, as many hon. Members said, is simply wrong.

Any financial support system has to go through a process of evaluation to ensure we get the right support for the right person, and it must be individually based. My vision is very clear: each person is an individual, and no two people are the same. People who on paper have the same medical reports for the same condition will have very different prospects and will be able to do different things. The system must be tailor-made to support them. That is what we are doing in our future strategy, which we set up last week.

Labour introduced the work capability assessment in 2008, and we all agreed that it was not good enough and was not fit for purpose. Since then, it has been under constant review, and we have made more than 100 recommendations. Whenever we find good new ideas to improve it, we implement them. We regularly engage with disabled people and stakeholder groups to ensure that we listen, learn and make improvements. Probably the most significant improvements have been in mental health. Work capability and PIP assessors, and frontline staff in the DWP—the people in the jobcentres and those who make decisions about benefits—have all undertaken mental health training to ensure they are sensitive to the needs of people with mental health conditions.

There is a person behind every statistic, so I am leery about using statistics, but I cannot allow some of the misinformation we have heard today to remain unchallenged. We undertake 1 million ESA assessments every year. Since April, 8% have been appealed and only 4% have been upheld. I know there is a person behind every statistic, and I know the impact that that can have on people, but it is not fair to say that, in the majority of cases, the system does not work. In the majority of cases, it does work.

[Neil Gray]

Will the Minister give way?

[Sarah Newton]

I want to answer the points that have been raised.

We are not satisfied with the appeal rate. That is not a “good enough for me” measurement of the process. I am interested in the experience of the individual claimant and their journey through the process. Independent customer satisfaction surveys are undertaken, and the latest shows an 83% highly satisfied or satisfied rate. I am not going to be satisfied until it is 100% of claimants, but hon. Members have indicated that everybody is having the most terrible experience, which is simply not the case.

I am not complacent, and I want to highlight some of the improvements that are under way. We have representative groups that include charities and disabled people, and we are always looking at what more we can do with the forms and the process. Videos are going to be put up on our contractors’ websites so that, before people go along to the assessments, they have got information about what to expect, what they can bring with them and the people they can bring along to support them so they are not scared. I do not want anybody to be terrified about going to the assessments. We are doing a lot of work with healthcare professionals to ensure that they have continuous improvement. We are particularly focusing on mental health.

I am sorry that I have not been able to address all the concerns that were raised. As I say, I will write to hon. Members, and I am taking careful note of the Work and Pensions Committee’s work. I agree with everyone that we want a system that treats people with respect and dignity, gives them the personal, tailor-made service that they richly deserve, and enables them to play a full part in our society.

Question put and agreed to.

Resolved,

That this House has considered work capability assessments.