Errol Graham: DWP and Safeguarding Adults Board Inquiry
(Limited Text - Ministerial Extracts only)
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The Minister for Disabled People, Health and Work (Tom Pursglove)
I congratulate the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) on securing this important debate. It is, of course, always tragic when a person dies having been in receipt of benefits, and my sincere condolences remain with Mr Graham’s family. I assure you, Madam Deputy Speaker, that where there is an allegation that the DWP’s actions may have in any way contributed to this outcome, we take it very seriously.
To begin with, I want to set in context the nature of the recommendations made by Nottingham City safeguarding adults board. Five recommendations were made, with three specific to Nottingham City Homes, one applying to all agencies—with an emphasis placed on Nottingham City Homes—and one specifically aimed at the DWP, working jointly with Nottingham City safeguarding adults board. I confirm to the House that the Department for Work and Pensions has accepted that recommendation, and my officials will work constructively and collaboratively with the safeguarding board on that. We will approach taking that recommendation forward in good faith and with proper dialogue.
I also want to give some background on the case in question. Mr Graham was a claimant in receipt of employment and support allowance until his claim was closed in October 2017 following non-attendance at a work capability assessment. In the interim, he had not responded to calls, text messages or two home visits by the Department. Mr Graham had ceased to engage with his family, healthcare and other statutory agencies over a number of years, and was found deceased in his flat in or around June 2018. An inquest into Mr Graham’s death was held in June 2019.
Since July 2020, my Department has co-operated fully and openly with Nottingham City safeguarding adults board on this very sad case. I am pleased to see that its report notes the “significant changes” that the DWP has made in its support of vulnerable claimants since 2019.
The board wrote to the Department in July 2021 confirming that it would be carrying out a safeguarding adults review into the death of Errol Graham. For the avoidance of doubt, it might be helpful to quote exactly how the board explained the scope of the review from its own terms of reference. It said:
“The scope period for the review is from June 2017—the date EG’s benefit review process began—until 20.06.2018, the date EG unfortunately died. However, if agencies have information of relevance to the ToR before that date…it would be helpful if they briefly summarised that as well”.
The Department complied with the board’s request, providing it with detailed information in scope of the review as well as briefly summarising information from before 2017, as we were asked to do.
Debbie Abrahams
The Minister may be coming on to this—I hope he is. Will he ensure that he responds to my point about why the details of the 2014 work capability assessment were not made available to the review?
Tom Pursglove
If I may, I will make a little progress on this point. I am aware that a journalist has claimed that officials hid information from the board, but that is simply not true. They had no reason to do so. As explained, the board had the information that it requested. The board’s published report includes a wording change stating that agencies were asked to “provide additional information” and not “briefly summarise” as in previous versions. That slight wording change could have led to the wrong impression that the DWP was asked to provide every single form and document relating to Mr Graham’s benefit claim—even those outside the scope of the review. I believe that may have contributed to claims that information was hidden.
It is important to note that we know that the board extensively reviewed the findings of the 2021 judicial review proceedings in which a former Secretary of State for Work and Pensions successfully defended a claim in the High Court, challenging some of the decisions made in this case. That judgment referred to the content of a previous work capability assessment of Mr Graham’s. The safeguarding board clearly understood from that, and the other information provided, what officials had discovered about Mr Graham’s state of mind. It is difficult to see what the DWP would have gained by hiding it when the board had stated its review of the findings. Officials continue to engage with the Nottingham City safeguarding adults board and we welcome having further conversations with it if needed.
It is important to understand the role of safeguarding adult boards in the context of Mr Graham’s case. National guidance on safeguarding adults boards states:
“The purpose of a SAR is not to hold any individual or organisation to account, because there are other processes and regulatory bodies available for that purpose; they are about learning lessons for the future”.
Those other processes include the coronial process, where coroners investigate unnatural deaths and where the cause of death is unknown. Nottingham City safeguarding adults board’s role was to look at how agencies worked together to support Mr Graham and what lessons it could learn from his tragic death, not to re-examine the court’s previous judgment or the coroner’s conclusions. My Department’s key obligation is to ensure that claimants receive the correct benefit entitlement at the right time. While we do not have a statutory duty of care or safeguarding duty, that does not mean that we do not care. We often need to consider a customer’s particular circumstances to provide the right service or ensure appropriate support. We can help direct our claimants to the most appropriate body to meet their needs.
Debbie Abrahams
Why, then, did the witness speaking on behalf of the Department at the 2019 inquest make the point that a new safeguarding policy was being developed by the Department, if the Government do not have a safeguarding policy requirement?
Tom Pursglove
What I will do is set out the actions the Department is taking to ensure that our safeguarding obligations are upheld and that we support claimants in an appropriate way that is responsive to their needs and circumstances. The concrete actions the Department has taken to improve matters relating to this issue in recent years reflect previous learning.
I would also like to deal specifically with the point the hon. Lady made about holding a public inquiry. I am not in a position today to be able to commit to that. Clearly, attempted suicides and suicides are very complex issues. Where there is an allegation that the Department’s actions may have contributed to that outcome, we take it very seriously. There already exists a wide, independent and transparent system for investigating such issues. Causes of death are determined by a doctor or coroner. Where a coroner identifies a risk of other deaths occurring in similar circumstances, they will issue a prevention of future deaths report to highlight that. The independent case examiner investigates serious complaints relating to the DWP. They report to the complainant and publish case studies of findings in the ICE annual report. The parliamentary and health service ombudsman also looks at serious cases and publishes reports on its website. For those reasons it is not our intention to set up an independent inquiry, but there are steps we have taken as a Department to improve matters in relation to safeguarding and I just want to set those out for the House, because they have already been implemented to support vulnerable customers. The initiatives were also highlighted, as I say, in Nottingham City safeguarding adults board report as changes the Department has implemented to improve services, and that point was acknowledged.
First, we have introduced more than 30 advanced customer support senior leaders to support colleagues when dealing with customers who may be vulnerable or at-risk. Central to the role of those senior leaders is the work they take forward with external partners and organisations, creating relationships to support citizens and providing the critical link into external agencies’ escalation routes and enabling cross-agency case collaboration. The Department also conducts internal process reviews, which form a core part of the Department’s overall approach to learning and help inform improvement activities across all DWP product lines. Internal process reviews can make recommendations to help the Department to improve its processes, policies or quality of service. We commission them in response to a range of claimant circumstances or events, which include, but are not limited to, suicides, suicide attempts and self-harm. Not all internal process reviews conducted after a death relate to suicide. Therefore, those classified as relating to a death should not automatically be read as suicide cases. Furthermore, the fact that an internal process review is being carried out does not mean that the DWP has been found culpable in the circumstances or events leading to a claimant’s death or a serious incident.
Similarly, the serious harm that prompts an internal process review investigation may relate to self-harm or a suicide attempt, or may also refer to other events that are considered to merit investigation. We have also broadened the range of circumstances where an internal process review is carried out, to increase our learning from cases where outcomes have been poor for claimants.
The Department has also set up the serious case panel, which meets quarterly to consider themes and issues that have arisen across DWP service lines, in order to agree changes and improvements. The panel has commissioned and implemented several changes since it was introduced. They include changes made to visiting vulnerable customers, where they have ceased to engage with the Department. Following two unsuccessful visits where concerns about the customer remain, the claim will no longer automatically be closed. Instead, the case will be escalated to an advanced customer support senior leader, who will liaise with relevant external agencies to assure the customer’s safety.
The Department has also made changes to guidance on administering large payments to customers who may face challenges receiving or handling such payments. The panel has also prioritised the delivery of mental health awareness training to customer-facing colleagues. The training will build colleague capability and confidence in supporting customers with mental health conditions. Going forward, I am keen to engage with stakeholders, including from mental health charities and other organisations, to continue to make improvements to our services for our customers. I recently met Rethink, a mental health charity that was representing the families of some benefit claimants who have passed away. It is my intention to organise a future meeting with a representative member of the families, in partnership with Rethink.
I want to address a specific point that the hon. Lady has raised a number of times in this House about the Equality and Human Rights Commission in relation to the ongoing section 23 agreement discussions. We continue to engage with that in good faith, but we must act in accordance with our legal obligations. The negotiations provided for under the Equality Act 2006 have been expressly confidential. Therefore, I cannot give a running update on the contents of the discussions. There are legal provisions under section 6 of the Equality Act that prevent disclosure of further details. Discussions are subject to general law principles. Parts of the discussions are also subject to legal privilege.
Debbie Abrahams
I have two brief points. First, if we have had all the updates on safeguarding, why have 140 more people died in the intervening period? The Minister seems to be saying, “Everything is fine, we’ve done this,” but still, the Department is investigating 140 people, and we do not know the true figure. Secondly, there is nothing in the 2006 Act that says that the Department has to take 14 months to reach an agreement on how to improve the services and not discriminate against disabled people. There is nothing—I have gone through it.
Tom Pursglove
I do not accept the hon. Lady’s initial point. I take these matters incredibly seriously. I am engaging thoroughly with stakeholders around these issues. She will recognise my approach to meeting Rethink and bereaved family members to discuss these issues and to work out what more we can do to improve these processes and in an open, transparent and constructive way. That is how I approach my responsibilities, and that will continue to be the case. These structures have been put in place, as the safeguarding board recognises, which are considerable improvements in recent times. Of course, we must always keep under review the appropriateness of these structures. We must make sure that learning from specific cases is captured. Processes and the way in which we go about our activities as a Department must be responsive to the issues raised through those formal structures.
On the section 23 discussions that are ongoing, the hon. Lady will recognise that this is a matter not just for the DWP. The discussions are going on between two parties, and both sides need to act in good faith in reaching conclusions. It is right that we do that in response to the commission from the EHRC, and in a way that is compatible with the requirements under the Equality Act. That is what we will continue to do. As I have said before, when I have a substantive update that I am able to provide to the House, I will do that. I have made that undertaking, which I reiterate today. It would be inappropriate for the Department to discuss the contents of what may or may not be included within an agreement, or the contents of any information that may be published in future, while confidential discussions are ongoing.
My Department strives to be a learning organisation, continually seeking to better understand the experiences of our customers and any challenges that they may face in their interactions with us. We are committed to using that learning to develop our systems and processes and to make improvements to the experience of our customers. In fact, that underpins all the work we are doing through our White Paper reforms, to ensure that people have a better experience of the journey within the benefits system and that we provide benefits that are more flexible.
Lilian Greenwood
I have listened with interest to what the Minister has said. As a result of the changes that the Department has made, is he confident that no one else will face the same position Errol faced because he disengaged? Nobody denies that he was not engaging with his GP, housing provider or the DWP, but the tragic fact is that he starved to death as a result of that failure to engage. The Minister described the new layer that is now in place if there are two failed safeguarding visits, but is he confident that someone whose mental ill health prevents them from engaging, as is set out so clearly and poignantly in the letter, would not face the same position of having their benefits withdrawn and, as a result, having nothing to eat, in a freezing cold home, with no utilities connected?
Tom Pursglove
It is impossible not to be incredibly moved and concerned by what happened to Errol Graham. Both Ministers and officials in the Department are absolutely determined that the learning that comes out of this case, which is reflected in the recommendation that has been made by the safeguarding adults board, must be acted upon. We must continue to consistently ensure that where issues that require improvement are highlighted, we take steps in reality, in terms of our processes, to make sure that that follows on.
It is significant that there are now checks that ensure people’s cases are not suspended or terminated when we have not heard back from them, and that we have senior customer service leaders who work on a cross-agency basis to ensure that people are properly supported. They were the right steps to take and they have been informed by cases like this. It is right that we continue to constantly monitor and understand our claimants’ circumstances and needs, and that we improve the journey through the benefits system more generally, wherever there is an opportunity to do that.
That is why I am passionate about the reforms that were announced through the White Paper, including matching expert assessors with particular conditions, monitoring fluctuating conditions more effectively and ensuring that people have the smoothest possible journey in their experience and interaction with the DWP. The hon. Lady has my commitment that we will continue to learn. We will undertake to make sure that all our processes are fit for purpose and kept under review, and to make changes when they are required.
That is the constructive spirit in which I am approaching our conversations with Rethink, for example, which has an insight into mental health conditions, so that we can understand what more we can do to ensure our processes are responsive to those with mental health conditions. I know Rethink participated in some engagement with my officials only yesterday.
Debbie Abrahams
My final point is that Rethink is calling for an independent public inquiry into the death. Will the Minister be supporting that campaign by Rethink?
Tom Pursglove
The position relating to a public inquiry is the position that I set out earlier, but within our existing processes and the transparency applying to them, I am keen to hear from Rethink and other charities what more they think we can do, or which parts of those processes they think could be improved. I approach those conversations very much in that spirit.
Ultimately, our measures will ensure that we provide benefits for, in particular, our most vulnerable customers in a more flexible and compassionate manner, and that their interactions with us constitute a positive experience. We will continue to drive forward change within the Department on the basis of what we have learnt. I appreciate the opportunity I have had this afternoon to describe some of the work that the Department is doing, “on the ground floor”, to ensure that our systems are as responsive as possible, and that all learning is captured and acted upon.
Question put and agreed to.