People with Disabilities: Access to Services

Baroness Andrews Excerpts

Thursday 16th May 2024 Lords Chamber

[Baroness Andrews (Lab)]

My Lords, it is a great pleasure and privilege to follow the noble Baroness, Lady Thomas of Winchester. She has fought her corner on disability issues for so many years, and it is no surprise to hear her focusing on PIP and the need for medical assessment. I am very grateful to my noble friend for introducing the debate in the way that she did, which was comprehensive, passionate and measured at the same time.

This has been an excellent debate, and I have learned a huge amount. I am not going to repeat some of the things I intended to say. The Government strike me as being very hyperactive suddenly about disability. The problem is that anything with the term “modernisation” in the title strikes the fear of God into me, because, basically, we know that modernisation means greater cuts, more difficult assessments and a narrower gate to go through. We have to be extremely careful in our response, because clearly there is so much that needs changing—goodness knows that we have heard from the noble Baroness, Lady Grey-Thompson, about the enormous scope of the things that need to be done.

One of the things that has struck me this morning, and in reading the White Paper and Green Paper, is the gap between what is being proposed and the reality of people’s lives on a day-to-day basis, when every encounter is a struggle. We are not even taking account of the impact of cost of living increases on the ability to live a decent life if you are disabled. The Trussell Trust has been measuring the increasing dependence of disabled people on food banks, for example. We know how difficult it is to find and keep a personal assistant; not only are they scarce but the effort that goes into having to employ them is enormous. These are things that can be simplified. It seems to me that the Government have taken a stiff broom to the wrong end of the problem. What we should be doing is just the sort of thing that the noble Lord, Lord Touhig, talked about—that is, making employer contracts more robust and requiring much more changes by way of specialist support being available for people looking for work and so on.

I have a question for the Minister. Why did the Government not involve experts by experience in the design of the White Paper? They are the people who know what it takes to change things effectively, and cost-effectively as well. It is pretty outrageous that they have had to go to law to make their case about not being included. It did not improve the situation as the other White Papers came forward.

I want to raise two specific challenges which are having an effect on the ability of people to seek and keep work. They are about the people who look after disabled people. Obviously, one of the outstanding issues in recent years has been the collapse of mental health services for young people and children, but compounding that is another disaster, which is less visible but really bears down on educational opportunity.

I know that school transport for disabled children is not, strictly speaking, within the Minister’s brief, but he has a colleague who is responsible for it, and I would be very grateful if he could act as a messenger in this respect. It is no secret that transport for disabled children to go to school is reaching breaking point in many local authorities. There has been an increase in the number of children who are eligible, I believe, but there have also been huge cuts in local authority budgets. Appeals are mounting up, increasing numbers are frustrated, parents are scared and children are bewildered.

I want to give the Minister one example, and I declare an interest because the parents are known to me. Their child is 16, and she has been moved to an FE college appropriate for her age and condition. It takes her working parents three to four hours a day, driving back and forth twice a day. Previously they were able to access a taxi, which was free, with a carer. That has been withdrawn. Two appeals have failed. The child has, among other chronic conditions, epilepsy, and so she cannot travel alone.

The parents, in this case, are self-employed. They are distinguished artists who work to commission, so they cannot make up the time lost during the day because they have to care for the child, who requires intensive care when she is at home. She has become increasingly frustrated and violent towards them because she cannot go to school, which she loves and where she thrives.

What is going to happen to those parents and the child? They have no other family to support them. They are both at risk of losing not only their income but their health. How will the child be able to remain in school at all? What will be her future? This is not an isolated case; I am sure many other noble Lords will know of such cases. I have one question here. There seems to be a tendency towards discriminating against self-employed parents because their work is seen as less predictable and less guaranteed. Will the Minister ask his colleague to look at that point?

My final topic is the problem of carers who are in receipt of carer’s allowance but are finding that, mostly inadvertently, they have worked too many hours and are therefore having to pay back some of that allowance. In our Select Committee report, A Gloriously Normal Life, we showed how interdependent carers were with the people they cared for—if you harm one then you harm the other. We catalogued the many different ways in which unpaid carers were suffering from invisibility. We asked the Government to look again at the carer’s allowance—at a princely £21 a week, it is the lowest benefit available—and at the hours and conditions of employment.

The Government rejected those recommendations, and things have got worse. All the evidence suggests that the health of unpaid carers is getting worse, and they have little access to information. That bears down on the point I want to make. Carers who have managed to hang on to a part-time job are desperate to maintain their links with work and with normality. They are allowed to earn up to £151 a week—13 hours at the minimum wage. To add insult to injury, thousands of carers are now being pursued by the DWP for breaching the income threshold and are being criminalised. Let me explain why that is so unfair.

The DWP has an IT system that flags up when a carer’s income breaches a threshold but fails to trigger action, so that they know and can pay back their debt as soon as possible. Debts pile up. In 2022-23, 26,000 carers were asked to repay sums relating to earning breaches. Some of the sums were tiny, at £1.50, while 800 people owed between £5,000 and £20,000 and 36 people owed over £20,000. Carers have told me they cannot understand why the DWP has not been notifying carers of overpayments in a timely manner. It is very difficult to get hold of the DWP about the carer’s allowance, so they have to sort out these mistakes themselves. The impact is devastating. Many carers are now thinking of giving up their carer’s allowance because it is too risky. It is a very serious situation.

One carer says:

“This is an additional stress you choose to go without on an already stressful life. We are neither heroes or scroungers but people who care and who are doing a complex job we have no training or experience of and very little support for”.


I ask the Minister to consider with his colleagues whether the whole system should be paused so it can be reviewed at this point.

--- Later in debate ---

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Viscount Younger of Leckie) (Con)]

My Lords, I thank all noble Lords for their very valuable contributions to this important and wide-ranging debate. As it has highlighted, disabled people share the same hopes, aspirations and ambitions as non-disabled people to fulfil their potential and play a full part in society. However, I acknowledge that they often experience barriers that can prevent them realising this.

I pay tribute to the noble Baroness, Lady Hughes, who provided a good overview of the many issues that are challenges for disabled people. Although she would not expect me to agree with many of her conclusions, she raised a number of questions which I will attempt to cover. As the noble Baroness, Lady Donaghy, acknowledged, it may not be possible to cover all the many themes encompassing disability that were raised today. Having said all that, the noble Baroness, Lady Grey-Thompson, in her usual style, won the verbal marathon to canter through most of the issues.

Over the last 25 years, this country has made important progress in tackling the barriers, through the work of campaigners and across different Governments, from the Disability Discrimination Act 1995, which was alluded to by the noble Lord, Lord Addington—he was here in the House for that, which is interesting—to the Equality Act 2010 and, more recently, the British Sign Language Act and Down Syndrome Act. Today, in Mental Health Awareness Week and on Global Accessibility Awareness Day—I have a badge to match—I reflect that these are reminders of how far we have come in talking about, and having awareness of, disability and accessibility issues. They also highlight what still needs to be done.

I have listened carefully to all the issues raised. Let me say clearly that there is more to be done. My noble friend Lord Holmes is right that I should be aware— I reassure him and others that I am—of the lived experience of those who are disabled. I will take back to the relevant channels his points about floating bus stops, black taxi cabs and the bank issue; I very much noted that.

Having said all that, I am proud that this Government have continued to tackle the barriers faced by disabled people. As a bit of a pushback, let me say that there are now 2 million more disabled people in work when compared to 2010. We have 20 Ministers across government committed to championing accessibility and opportunity for disabled people within their departments. Our Disability Action Plan, which we published in February, sets out the actions that we are taking this year across these and other areas, and lays the foundations for longer-term change. I will talk more about this later.

To ensure that this country is the most accessible place in the world for them to live, work and thrive, we are going further through the support delivered through the benefits system, helping disabled people to start, stay and succeed in a more flexible and accessible labour market. We are also ensuring that disabled children—also mentioned today—get the best start in life, creating more accessible homes, which I will allude to later, and improving health and care outcomes.

This Government are delivering for disabled people. The noble Baronesses, Lady Hughes and Lady Sherlock, asked when disabled people can expect an update on the national disability strategy and the disability action plan. The actions set out in the disability action plan are planned to be delivered over 12 months, to lay the foundations for longer-term change. To track our progress, we will publish updates on the progress of actions from the disability action plan after six months and 12 months. The six-month update will also include an update on the delivery of the national disability strategy.

The noble Baronesses, Lady Sherlock and Lady Hughes, raised the differences between the documents. The disability action plan will be taken forward in parallel with the national disability strategy and is designed to complement the long-term vision set out in the strategy. In a Written Ministerial Statement of 18 September 2023, we announced how work on the strategy would be taken forward. Other significant work being taken forward by individual government departments in areas that disabled people have told us are a priority include reforms to employment and welfare via the DWP’s Transforming Support: The Health and Disability White Paper and strategies to address health and social care via the DHSC’s People at the Heart of Care White Paper, which the House will be aware of.

I turn to the support provided through our benefits system. I am proud that we have a strong and generous safety net for those who need it. We expect to provide £88 billion worth of support for disabled people through the benefits system this year. Last month, we increased the extra cost disability benefits by a further 6.7%. I have listened carefully to comments today on access to the benefits system. We know that, in some cases, people may not be able to engage effectively with the claim process due to various vulnerabilities. That is why the DWP has a range of different support measures at every stage of the benefit claim. This includes a “move to universal credit” helpline, a “help to claim” service delivered independently by Citizens Advice and face-to-face support in local jobcentres, where the staff will have been specifically trained and prepared for this work. Where a claimant cannot manage their claim due to a lack of capacity, they can appoint a third party to manage the claim on their behalf.

Our wider reforms look more fundamentally at different options to reshape the current welfare system. As the House will know, we have published a Green Paper, which was much spoken about today. It considers options to provide better-targeted support to those who need it most, ensuring that it is fit for the future. This subject was raised by my noble friend Lady Browning and the noble Baroness, Lady Sherlock. I was particularly pleased to hear the remarks from the noble Baroness, Lady Thomas—it is good to hear from her again.

My noble friend Lady Browning asked how PIP provides support to claimants with mental illness. PIP was designed to help disabled people and people with long-term health conditions by making a cash contribution towards their extra costs. As part of this consultation, we want to understand whether there are other forms of support that may be more suitable for people with mental health conditions. We know that being in suitable work is good for people’s physical and mental health, well-being and financial security. As we set out in 2023 in Transforming Support: The Health and Disability White Paper, the Government aim to support more people to start, stay and succeed in work.

The noble Baroness, Lady Hughes, asked about the reason for the rise in PIP, suggesting that it was not due to the increased prevalence of disability and health conditions but was perhaps linked to NHS waiting times. I reassure her and the House that cutting waiting lists is one of the Prime Minister’s top priorities. We are making good progress in tackling the longest waiting lists, to ensure that patients get the care that they need when they need it. This is incredibly important. Thanks to the incredible work of NHS staff, we have virtually eliminated waits of 18 months. NHSE management information from March 2024 suggests that these waits have been reduced by over 95% since September 2021, but there is clearly more to do.

Alongside the support available through the welfare system, the Government also recognise the valuable work and the needs of those who care for disabled people while holding down a job. My noble friend Lady Browning and the noble Baroness, Lady Donaghy, asked whether the PIP consultation was simply a money-saving exercise. It is not a money-saving exercise; this is about the Government’s long-standing approach to supporting disabled people and people with long-term health conditions. We want the system to provide the right support to those who really need it. It is right that we should look at this after 10 years or so—as I said, we introduced it in 2013.

As the House will know, the Carer’s Leave Act came into force in April, giving a new unpaid leave entitlement that is available from day one of employment for employed unpaid carers. I will briefly touch on the point raised by the noble Baroness, Lady Andrews. I am very aware of the issues surrounding overpayments for carers; the Government are taking this extremely seriously. It is the responsibility of individuals who receive the carer’s allowance to let us know if their earnings exceed £151 per week. We are looking very seriously at it, particularly to see how we can improve the communications exercise. Everyone will receive a letter every year to remind them, but I believe there is more that we can do. As was said the other day in the media, we are already ringing as many people as we can, from the information that we have received, to remind them of what happens if their earnings go over the threshold, so that they understand what to do.

[Baroness Andrews (Lab)]

My Lords, I am extremely grateful for what the Minister has said. Do I understand correctly that this is the response to the issue of the IT system not automatically triggering any action that would lead to information being sent immediately to the carer? Does the Minister think that this will address that issue?

[Viscount Younger of Leckie (Con)]

I think that it will go a very long way. We are looking seriously at getting the information out quickly—the link with HMRC is incredibly important here. We already get real-time information from HMRC anyway. We are asking the same question: what more can we do to be sure that those who do not let us know, for whatever reason, will do so? We also must not forget that the vast majority do let us know. This is a very important point. I believe that there will be a Question in the House next week on this issue, which I will be willing and ready to answer.

The subject of work was raised in particular by my noble friend Lord Shinkwin. This Government will always protect the most vulnerable, but we must also do everything possible to support those who can to move into work. I echo the Prime Minister’s speech at the Centre for Social Justice on 19 April, which I attended:

“The role of the welfare state should never be merely to provide financial support … but to help people overcome whatever barriers they might face to living an independent, fulfilling life”.


That is why we are supporting thousands more disabled people to start, stay and succeed in work through our £2.5 billion back to work plan. That includes exploring reforms to the fit-note process through the call for evidence—another theme raised today—and rolling out WorkWell, to bring together local health and employment support. Questions were raised today about who is best placed to make health assessments for work. I do not intend to go further on that, but we may well receive some information through the conversation and the PIP consultation on that subject.

From 2025, we will reform the work capability assessment to reflect new flexibilities in the labour market while maintaining protections for those with the most serious conditions. My noble friend Lord Holmes of Richmond and others raised the disability employment gap. The Government have an ambitious programme of initiatives to support disabled people and people with health conditions. The disability employment rate was 52.9% in the first quarter of 2024, compared to 81.7% for non-disabled people. For disabled people, that is an increase of 0.1 percentage points. The disability employment gap was 28.8 percentage points in the first quarter of 2024, a decrease of 0.6 percentage points on the year before.

We are also expanding access to mental health treatment, with nearly 400,000 additional places through NHS talking therapies, which I think the House will be well aware of. All this builds on existing support, such as Access to Work grants, our Disability Confident scheme and disability employment advisers in jobcentres.

The noble Baronesses, Lady Donaghy and Lady Hughes, asked what the Government are doing to help those in poverty. There is a long answer I could give, but the short answer, which I think I have given in the House before, is that we are committed to supporting people on lower incomes and expect to spend around £303 billion through the welfare system in Great Britain in 2024-25, including around £138 billion on people of working age and their children. These statistics cover 2022-23, a year when inflation averaged 10% and benefits were uprated by 3.1%, in line with the CPI.

On the disabled, the latest statistics show that the number of people in families where someone is disabled and in absolute poverty—which is our preferred measure—fell by 100,000 between 2021-22 and 2022-23. The proportion of people in families where someone is disabled and in absolute poverty after housing costs has decreased by two percentage points since 2019-20, and the number of people in such families has increased slightly due to an increase in the number of people in families where someone is disabled.

Briefly, on education, which I think was mentioned by the noble Baroness, Lady Sherlock, and others, in the special educational needs and disability sector our improvement plan will establish a single national system so that children can achieve good outcomes. We have increased high-needs revenue funding for children and young people with complex needs to cover £10.5 billion this year, up 60% over the last five years. The Law Commission is also undertaking a review of disabled children’s social care legislation to help clarify the law and to ensure that families of disabled children receive the support that they need. I hope that this may help address the remarks from the noble Lord, Lord Addington.

I will go further on the question of what the Government are doing to achieve greater national equality in the support offered to children. Our improvement plan outlines our commitment to establish a single national SEND system with a proposal to deliver national standards. National standards will improve mainstream education by setting standards for early and accurate identification of SEND need, and they will include clarifying the types of support that should be available in mainstream settings and who is responsible for securing the support. Finally, national standards will create a more consistent SEND system. That may not provide the whole answer, but I hope that helps.