Disability Services

Baroness Browning Excerpts

Thursday 10th January 2013 Lords Chamber

[Baroness Browning]

My Lords, it is a great pleasure to follow the noble Lord, Lord Boateng, who has brought this very important report to the Floor of the House today. At the beginning, I refer Members to my interests in the register concerning various disability charities.

The noble Lord, Lord Boateng, has outlined in his opening remarks some of the core challenges and problems identified by this report, so in the time available to me I would like to focus on some of the recommendations made by the report. I begin with the recommendations for local authority commissioners. It is suggested that there is a need to redesign commissioning contracts to facilitate collaboration between small and large organisations to allow more consistent, wide-ranging care that meets both personal and community needs. This is a most timely recommendation because of the changes that are taking place, as we debate, in commissioning.

It has been my experience that commissioning, whether it is done at a national level by government, by local authorities or through commissioning structures within the health service, almost inevitably follows a pattern. The pattern is usually one where those who are commissioned tend to be larger organisations, for the reason that they are easier to deal with. Larger organisations cover the ground more and the financial control is easier, rather than if the commissioning is based on a lot of small and more independently, but perhaps more accurately, focused and targeted providers.

That is really the challenge in this recommendation in the report. I do not expect the Minister, who will reply to this debate today, to have all these answers, but I will make this request. This is such a timely report at a time of great change for disabled people that if she does not have specific answers to these questions today, I hope she will consult colleagues—this will often need to be across government—on these various recommendations and perhaps agree to put something in writing in the Library. I think that would be very helpful to those of us who are concerned about how practically the Government are going to address the very timely and helpful suggestions in this report.

I turn now to the recommendations related to policymakers in the report. The report states that,

“BME disabled people’s needs and views have often fallen between the two areas of disability and race equality policy. Finding ways to bring these two policy fields together is extremely important for developing effective support for BME disabled people”.

It is almost self-evident that that needs to be addressed, but I think it is a little more complex than the report suggests, because among the disabled community per se there has for a long time been the big challenge of people who have co-morbidities—people with more than one disability. When you bring into that the additional challenge of a range of ages and, as this report addresses, the BME disabled community, you can see that when you look at how you could try to address the needs of those individuals, it is almost inevitable that you will end up with a generic service.

I say to my noble friend at the Dispatch Box today that it is a real challenge to target the services that policymakers produce on individual needs, which will almost certainly be complex. It is a challenge to provide the strategy through the policy as to how to address the myriad requirements of people who have not just one but often a range of disabilities, where two disabilities might mean, for example, someone with an autistic spectrum disorder who also has either a diagnosed mental health problem or a physical disability and is also part of the BME community. Then there are the age concerns to be taken into account.

Of course, when we talk about disabled people, we must think not just of the disabled people themselves but of their family situation. Siblings and the effect of having a severely disabled sibling are extremely important. When you are providing, commissioning and looking at appropriate services, you have to take a more holistic view at the family, the primary carers and, of course—particularly as far as children are concerned—siblings in the same household.

These are therefore complex issues that are not easily resolved, and they are not resolved well at present. We have to do better for this community. I say to my noble friend that in looking at policy-making, some of the recommendations in this report are absolutely critical. These include, for example, a theme throughout the report: involving disabled people themselves, along with their immediate carers, and the BME communities with experience and background in what the needs and solutions are.

Another recommendation for policymakers is the one to develop a national race equality strategy, which includes the needs of BME disabled people. The noble Lord touched on this in his opening remarks. My noble friend will, of course, reply at the end of this debate, but that recommendation was made in the light of the Government’s announcement that we are to expect a forthcoming disability strategy. If it is not the Government’s intention to develop a national race equality strategy, it would be helpful to know exactly what is being done at present—I assume it is being done at present—under the disability strategy. This would reassure the House that this community’s needs are being considered and will be included when that strategy is made public.

There are also recommendations for service providers. A person-centred emphasis is recommended, and I totally agree with that. One can look at a range of disabilities, and there will be a common purpose in the services provided and commonality in the way in which disabilities affect people and in how some particular disabilities, which might be degenerative, are likely to affect people in the future. One does have to look at the individual; no two people are the same. Service providers should look at the individual and take that holistic look at the individual and their immediate surroundings and life chances.

Employment was mentioned. The figures are appalling for people who could carry out paid work or—and I always emphasise this at this stage—voluntary work. I know this is not the flavour of the month. Everyone is going to be in paid work, but for some people with a disability—and I must emphasise this strongly for my noble friend on the Front Bench—just getting them to the stage where they can maintain independent living is a milestone that many would not have achieved without a lot of support. For some people—and it is only some people—to expect them additionally to take on paid employment could diminish their ability to maintain a standard of independent living that is both safe and acceptable.

We all want disabled people, including the BME community on which this report focuses, to have the opportunity for paid employment wherever possible. However, I am old enough to remember, as I am sure other colleagues in the House today are, when the life chances and quality of life of many disabled people meant that they often lived at home with increasingly elderly parents, the inevitability of which was that at some point there would be a crisis in their care when the parents were no longer able to look after them, so that they, as disabled people, had to face decisions about their future at a point of crisis. That is something which I hope my noble friend will consider.

Crime: Violence Against Women and Girls

Baroness Browning Excerpts

Thursday 8th November 2012 Lords Chamber

[Baroness Stowell of Beeston]

Yes, my Lords. One of the advantages of the new regime of PCCs and devolving decisions on policing priorities in this way is that it will, I hope, lead to greater co-ordination between local agencies. Particularly with regard to children, it is worth reminding noble Lords that the noble Lord, Lord Laming, was successful in introducing an amendment to the Police Reform and Social Responsibility Bill to ensure that police and crime commissioners hold the chief constable to account for safeguarding children and the promotion of children’s welfare.

[Baroness Browning]

Notwithstanding the work of police and crime commissioners, will my noble friend confirm that the Government will centrally continue the valuable work they are doing to combat violence against women and girls?

[Baroness Stowell of Beeston]

Yes, I absolutely can confirm that. It is worth making clear that under this Government we have set aside £40 million of secure funding until 2015, and it is guaranteed funding that will continue. Within that £40 million, £10.5 million has been allocated to rape support centres located throughout the UK.

Universal Credit

Baroness Browning Excerpts

Tuesday 6th November 2012 Lords Chamber

[Lord Freud]

The noble Baroness is absolutely right on this particular problem. It is one of the reasons we are sweeping away the existing system—it is simply too complicated for people to operate. The real difference in the new welfare system is that we do not have a distinction between out-of-work benefits and in-work tax credits. You do not have to jump from one system to the other when you move category. You stay on the same system and do not have to suffer awful delays.

[Baroness Browning]

Will my noble friend confirm that people claiming disability benefits will be reassured that when the Government calculate the minimum amount they need to live on, the cost of maintaining a computer and purchasing internet access will now be part of that computation?

Future of Specialist Disability Employment

Baroness Browning Excerpts

Tuesday 10th July 2012 Lords Chamber

[Lord Freud]

My Lords, the first claim of the noble Baroness, Lady Turner, about segregated employment being the only employment available, is undermined somewhat by the fact that many of the jobs provided by Remploy Employment Services are in the areas where the factories are situated. Indeed it is having a great deal of success in getting jobs for disabled people in non-segregated employment—I think that the figure is roughly 12,000 jobs in those areas in the past few years. Clearly it is tough to get jobs for disabled people but Remploy Employment Services’ remarkable performance shows how, with the right strategies and policies, one can be successful in getting people into non-segregated employment—which is, of course, our central strategy.

I do not think that the noble Baroness really believes that this is an ideological public/private issue. It is about segregated and non-segregated employment and trying to spread money as efficiently as possible among the disabled community. When you compare an operation which lost £70 million in 2010-11 and cost £25,000 year-on-year for each worker supported with Access to Work’s one-off investment, in many cases, of just under £3,000 to help people into non-segregated employment, you have to take these basic value-for-money considerations into account. I therefore commend this approach, which is being done with great concern and care for the individual workers involved, as a far better way of spending our budget for disabled people in work.

[Baroness Browning]

I share my noble friend’s aspiration for getting the people currently with Remploy into integrated, paid employment. However, this proposal, by any other definition, is something of an experiment by putting so many people into the jobs market at this particular time. I think that he mentioned that each worker would have a mentor and assistance in getting back into work for 18 months. However, I wonder if he would agree that the House should receive a full report from him in 18 months’ time telling us how many people are in contracted paid employment and how many are not. I must say to him that, in evaluating value for money, it is not only the public money that his department spends that would come into the equation. For those who might not be in paid employment at the end of the 18 months we would have to take into account not only the money that they had perhaps drawn in unemployment benefit but also a much wider expenditure which might include things such as mental health costs, physical health costs and costs associated with family breakdown. Those sorts of things—the therapeutic values and costs associated with this group in terms of their stability in the workplace—are not only important to them personally, although that is the most important part, but also involve a cost to the public purse. I really feel that the House should be able to access that information in 18 months so that we can make a judgment on just how successful this experiment has been.

[Lord Freud]

My Lords, the monitoring of what happened in the 2008-09 closures was not very good—I appreciate my noble friend’s point, and I will look into the nature of the reporting back. There will be information and, if I may, I will specify the nature and timing of the feedback in a letter. I appreciate the point. On value for money, the assessment is that, over the current and the next spending review periods, this move will be worth just over £200 million. That is the context in which we are talking.

Mental Health: Access to Work Support Service

Baroness Browning Excerpts

Monday 18th June 2012 Lords Chamber

[Baroness Browning]

My Lords, I too would like to thank my noble friend Lady Thomas for bringing this debate to the Chamber tonight. I know that she feels passionately about this subject. She is ever diligent in making sure that we all keep up to speed with what is happening and she knows when to prod the Government if she feels that more needs to be done.

I have been quite encouraged lately by some of the television advertising that has taken place. It has depicted a situation where people have been away from an employment environment because of mental illness and has shown the way in which they and their colleagues deal with the subject. To have that kind of public information being broadcast on the subject of mental health is a breakthrough and I hope that my noble friend will agree that we need to keep up the momentum with that type of information as it goes to the heart of what we are debating tonight. There is still a stigma attached to mental health, not least in the workplace, and it is important that we ensure that employers and those who work with people who are known, or perhaps just suspected, to have had absences due to mental health problems, learn to understand the condition.

I was rather concerned, as others have been, about the statistics that have been provided for this debate. People have mentioned the Access to Work statistics of only 580 people with a mental health condition. I want to draw the Minister’s attention to the very bottom of that column on page 9 of the statistics, where it says “Other: 3,380”. Perhaps I am being imaginative, but I wonder whether among that 3,380 are people who have mental health problems but perhaps also have another diagnosis as well. Often these very complex, dual or sometimes triple-diagnosed conditions make it more difficult for people to obtain help.

My noble friend will not be surprised to hear me mention, along with mental health conditions, the condition of autism. Although autism is not a mental health condition or a learning disability, it is quite common for people with autism, particularly for the more able people on the autistic spectrum, to have mental health problems and to be under the care of the mental health services. In reply, could my noble friend say whether such people with multiple diagnoses are eligible not only for the Access to Work programme, but also for the very important service that Remploy offers? Remploy’s contract has not been in place long enough for us to evaluate properly just how much of a difference it has made. Could my noble friend share with us tonight what discussions were held around the issuing of that contract regarding expected outcomes, not just numerically but in terms of those people who have not only a mental health diagnosis but other diagnoses as well?

I am sure my noble friend is familiar with the work of companies such as BT. I remember going to a presentation by BT at least three to four years ago, when the work that they had done to create a proactive policy of deliberately recruiting people with a mental health diagnosis was outlined to Members of Parliament. They wanted to make it mainstream throughout the company. It is a big company, but one where the HR department and other employees were trained in how to work with and support people with mental health problems in the workplace.

It seemed to me that it was an exemplar that would warrant some encouragement from the top to take it more widely around other companies and, as we have also heard tonight, the public sector. The public sector is a huge employer of people and if you can do it in BT, I should think you can do it in every government department and agency around the country. If you did that you would cover quite a wide percentage of the population.

We are talking about two areas here: one is getting people into work and the other is maintaining people in work who perhaps have had an absence. A range of conditions come under the umbrella of mental health, but the biggest thing that goes when someone has had a mental illness is confidence. That often happens with due cause because such illnesses can recur. Having had one incident, there is a fear that it will happen again, and that causes people to lose confidence as individuals. The service that Remploy can offer to that group is particularly important.

Welfare Reform Bill

Baroness Browning Excerpts

Tuesday 31st January 2012 Lords Chamber

[Baroness Thomas of Winchester]

I gather that we are being asked not to rehearse all the arguments. We have, anyway, heard very full arguments from the noble Baronesses, Lady Meacher and Lady Wilkins. I shall try instead to concentrate on the amendment.

No one likes cliff edges of any sort in the benefits system, and this amendment tries to make one edge less steep over time. The cliff edge that the Government are trying to eliminate in universal credit is the amount of disability additions received, by way of different gateways, by new claimant families for a moderately disabled child under 16 and a moderately disabled adult of 16 and over. The amendment’s cliff edge is different. It tries to address the difficult and sometimes rather artificial differences between the needs of a severely disabled child—whose family will get more money under the Bill—and those of a moderately disabled child and a much less disabled child, both of whose families will get much less money. I have great sympathy with the amendment because I believe that as many families as possible with even moderately disabled children should be helped, although I acknowledge that the amendment, narrowly drawn as it is, to some extent preserves the cliff edge between the disability needs of children and adults in universal credit which the Government are trying to eliminate.

The question is whether the formula in the amendment should be locked into the Bill, or whether everything should be left to regulations. My noble friend Lord German will address that shortly.

[Baroness Browning]

My Lords, I should like to talk directly to my noble friend the Minister about money, because we all understand the imperative to reduce the deficit and how, right the way through the Bill, trying to cut back has been part of the debate on almost every clause. However, this amendment seeks to attain proportionality between that higher and lower amount of addition made to universal credit for disabled children.

I come back to a question that we have raised in previous debates: what exactly do we mean by “disability light”, because that is really what we are talking about. These are still disabled children, in the same way as, in other parts of the Bill, they are still disabled adults. It might be presumed that it is somehow like comparing a light head cold with a really nasty bout of flu, but I say to my noble friend—I should have referred to my interests in the register—that it is not like that. For children with disabilities who will lose this huge sum of money and for their carers, particularly the parents, the impact will be great. We have already heard in your Lordships' House today about the impact on some—not all—families of caring for a disabled child, as well as on the relationship between the parents and—and this should never be forgotten—on other siblings. Usually there are other people in the family. They all share in the responsibility when they share a household with a disabled child.

I have spent many years dealing with casework for what must run into hundreds, if not thousands, of adults and children on the autistic spectrum. If this is about money, I hope my noble friend will take my word for it that although they might be considered as “disabled light” in childhood, a huge proportion of them will be the big bills to the public purse later on in adolescence and adulthood. Not only is the human cost of that tragic and avoidable—because most of it is avoidable, if it is properly planned and cared for—but there is the economic aspect. Just putting in the basics early enough, some of which are very low-budget items, can prevent the very big crisis-budget bills that inevitably come. I say “inevitably” quite deliberately, because that is what we know happens; it is well recorded. We have enough evidence of this right across the whole disability spectrum, particularly in some of those spectrums that I take a particular interest in, which are not immediately visible. They are the ones where there is no obvious physical disability but which none the less have a profound impact on the individual concerned. I do not want to overegg this, but Members of the House will have seen the headlines. We see these tragic cases where parents have a disabled child who is sometimes of school age but sometimes an adult dependent child; for those parents, childhood does not end at 18 or when they leave education, it goes on year after year. I can think of some pensioner parents with pensioner-age children still living at home and wondering what is going to happen to them. This is a lifetime commitment for parents.

I am quite sure that if my noble friend, and certainly the Treasury, have done the cost-benefit analysis that I asked for when we discussed DLA in the context of this Bill, they will find that this amendment, although not what the Government are proposing, will save the public purse over the medium to longer term. If we look at it in those crude terms—because that is what I feel they are—we will save a lot of pain and anguish. We will certainly save lives. At the end of the day, it will also save the Exchequer money in some part of the public sector where it will almost certainly have to be found in a hurry.

[Baroness Hollins]

My Lords, I stand very briefly to support this amendment. As a psychiatrist who has worked for many years with families with disabled children such as those we have been hearing about, I feel very strongly about the point that the noble Baroness, Lady Browning, made about proportionality. It is very difficult to base the cost of having a disabled child on whether the child needs care at night or only during the day. This relates particularly to children who have very difficult and challenging behaviour, including those with learning disabilities who might have attention deficit syndromes or autistic spectrum disorders. This amendment needs very careful and thoughtful consideration.

Welfare Reform Bill

Baroness Browning Excerpts

Tuesday 17th January 2012 Lords Chamber

[Baroness Hollis of Heigham]

In quite a lot of the publicity run in some newspapers preceding today’s debates, there has been—how can I put it—synthetic outrage about the number of DLA awards that have been made for life, as though they are somehow fraudulent, negligent or erroneous, thus apparently besmirching the entitlement of the holder of that lifetime award to it as of right, as though they have somehow manipulated or cheated the system and that the previous Administration has colluded with them at the taxpayer’s expense. That publicity has been extremely ugly and extremely unfair. Whether or not the Minister feels able to accept the amendments—and I hope he does—I hope he will accept that some conditions, on which the noble Baroness, Lady Browning, spoke so eloquently and movingly and of which two other Peers in your Lordships’ House have had intimate experience, do not change except for the worse and for which a lifetime award is a decent, sensible and cost-effective way of proceeding. Could he therefore ask his press hounds to lay off those people who have had them in the past and who ought, in all decency, to go on to enjoy them in the future?

[Baroness Browning]

There has been a suggestion that people with disabilities adjust to their condition. It is true, if you take the meaning of those words at face value, that people do adjust to their condition. For example, in one of the case studies shown in the paper produced by the Government yesterday, there is an account of a woman with epilepsy who did not meet the PIP qualification. It said that it was dangerous for her to use a cooker but she got round it because she used a microwave and therefore does not need to use a cooker. That may be a very practical suggestion—apparently when a cooker was needed her husband did the cooking on a proper cooker—but we have, in a way, failed to address what we mean by people with a range of disabilities coping or adjusting to their disability. Yes, there is an adjustment and yes, there are practical and psychological ways in which people cope with their disability, but it only requires something that is really unsettling to someone with a lifelong disability for those very important building blocks that have been put in place at the bottom to be disturbed or taken away and for the whole thing to disintegrate and come down like a house of cards.

Therefore, while I can understand why reassessment is necessary in some cases, a judgment has to be made about identifying those for whom reassessment, with the associated costs that have been mentioned, will add to their stress. Stability, as I said earlier, is important in these cases. If their stability is unsettled, there are consequences. The Government must make some sort of judgment about this. They will not save money and it is compassionate to recognise the types of disabilities that will present themselves when there will clearly be no improvement and degeneration is more likely. Quite frankly, if in some cases people adjust to their disability, are they not to be applauded for having made that adjustment, not penalised for it?

Welfare Reform Bill

Baroness Browning Excerpts

Tuesday 17th January 2012 Lords Chamber

Of course I understand the noble Baroness’s concerns, but these amendments would not restore the DLA status quo and they fail to address the more fundamental questions of how, and for whom, support is prioritised. I repeat that we are trying to make sure that the scarce resources that we have go to the people who need them most. We know that under these changes there will be shifts in provision. Some people will receive less support—

[Baroness Browning]

I am sorry to interrupt my noble friend. On the point about scarce resources, I think we all understand the financial situation and the imperative to reduce the deficit. However, if people who are currently on the lower rate of DLA lose it—a point made earlier in the debate—they will not just carry on with life as it is. If we accept that these people do not claim DLA without a need for it, then we accept that they have a genuine disability and that the lower rate of DLA is factored into their weekly budget. If it is then decided that their case is not as important as someone else’s and that that person might need the DLA, that is going to have an impact. Earlier, the point was made that if you take away the lower rate of DLA from a lot of people with a wide range of disabilities, there will be consequences for their health and well-being, which will translate into a financial cost on the public sector. Will my noble friend consider undertaking a cost-benefit analysis of that consequence?

[Lord Freud]

My Lords, I have two answers to that question. The first is that people who need the support because of a disability may happen to be on the lower rate of DLA today but that does not mean that they will not be entitled to the standard rate in the future. My noble friend gave an example of people who are really dependent on that funding. I would expect in those circumstances that it would continue. Indeed, I would regard PIP to be a failure if it did not do that. Secondly, we will be monitoring that really closely. As I have discussed, later this evening I will present an amendment to make sure that we properly monitor what happens in this area and make sure that PIP does what it should be doing, which is to stop people ending up in the situation that my noble friend is so concerned about.

I must point out that if we move to a three-tier system on the daily living component, the implications are that the caseload would be larger—possibly larger than that under DLA—and spending would increase rather than decrease against the original and revised forecast under the personal independence payment. We cannot possibly quantify such expenditure implications, mainly because we have not yet set the rates at which benefit is paid, but the implications are there. I want the House to be under no illusions that they would be anything but significant.

Before I ask the noble Baroness to withdraw her amendments, I would like to confirm that the Government see Amendments 50ZGH and 50ZJA as directly consequential upon Amendment 50ZGB. On that note, I beg the noble Baroness to withdraw the amendment.

--- Later in debate ---

[Baroness Grey-Thompson]

My Lords, the issue of the social model of disability was discussed at some great length in Committee and the noble Baroness, Lady Campbell, spoke very eloquently on it. Despite the Government’s commitment to the social model of disability, their other commitment on this issue—to provide an objective assessment—works in opposition to this aim.

The idea of an objective assessment is to ensure that people with the same functionality receive the same level of PIP. This looks only at the person’s functionality, and not at the barriers faced by that person within society. A benefit which was based on the social model of disability would look at the barriers that individuals face, not just at their functionality. Despite their stated intention to bring in a more active and enabling benefit that supports disabled people to overcome the barriers they face to lead full and independent lives, it actually takes less account of the individual barriers people face—because different people face different barriers.

The DLA has been criticised and no one would argue that it could not be improved on. However, DLA takes into account to some extent an individual's circumstances and uses—again to some extent—the social model of disability. It is claimed that, by making the criteria simpler, PIP will use the social model. However, it seems to rely much more on the medical model and appears to be going backwards in terms of taking into account someone's costs in surmounting their barriers. The charity Scope has made it clear that it considers that the Government are introducing a tick-box style medical assessment that will not help them achieve the aims they have set out to achieve.

The stated aim is to provide a more active and enabling benefit that supports disabled people to overcome the barriers they face to leading a full and independent life, yet nowhere in the assessment process is there any space for looking at the barriers that an individual faces. Disabled people face a multitude of barriers to participation and independence, many of which come as a direct result of social, practical and environmental factors. Making the test more objective and simpler will inevitably lead to a greater focus on the medical model, which will work against the stated aims and purpose.

Richard Hawkes, chief executive of the disability charity Scope, said:

“We recognise that Disability Living Allowance needs reforming and we fully support the government's ambitions to create a more active and enabling benefit. However, we are concerned that the new assessment the government is planning to use is flawed because it doesn't take into consideration all the barriers that disabled people face in daily life. Without understanding the extent of barriers people face, the government has no hope to overcome them and genuinely enable people to take part in daily life”.

At a time of limited resources, it is crucial to ensure that support is targeted as effectively and accurately as possible. This will not happen using the proposed assessment. To ensure effective targeting, the assessment process for PIP claimants must accurately measure the extra costs that individuals incur, based on an understanding of the variables that affect those costs. I beg to move.

[Baroness Browning]

My Lords, this is the first time I have contributed on Report. I declare my interest as vice-president of the National Autistic Society, patron of Research Autism and as the named carer of an autistic adult man in receipt of DLA. I am concerned about this part of the Bill and support the amendment and the detail with which it outlines what I believe are shortcomings, despite my noble friend's best efforts to identify how the assessment will affect people on the autistic spectrum.

In 1990, the House of Commons sent to this Chamber the Autism Bill, which became an Act of Parliament. It was passed as a result of a Private Member's Bill introduced by the right honourable Cheryl Gillan MP. It was supported by all parties in both Houses and was enacted in 2010 by the coalition Government. I tabled a Question for Written Answer just before Christmas asking whether the Welfare Reform Bill that is before us was compliant with the Autism Act. It is worth remembering that no other Act of Parliament has been passed that is specific to a condition. Certain medical conditions are mentioned in other Acts, but the reason for both Houses agreeing to pass the Autism Act, which is now on the statute book, was that autism is different. I make no apology—I know I bang on about it quite a lot—for drawing the attention of the House to the fact that an Act of Parliament was needed because autism is so different.

There are many aspects to the Bill, including the amendment we are now debating, which have a specific read-across to the autistic spectrum. Some years ago in another place I introduced the first debate in Parliament on Asperger's syndrome. It was not well understood then. It is far better understood now, which is a great relief to me and many others. Even so, parents and people with Asperger’s syndrome still struggle to get access to services, benefits and independent living, and to take their place in society as they would wish. The Autism Act was passed in recognition of that. I have to say to my noble friend that I was very disappointed when the reply to my Question for Written Answer in relation to this piece of legislation said that this was a matter for the relevant services by local authorities and NHS bodies and was not the subject matter of the Welfare Reform Bill.

Under the Autism Act, there is now a statutory responsibility on health and social services to implement the autism strategy which will require them to work with partners; for example, local authority housing departments. The Health Minister will be in a strong position to call to account local authorities and health authorities that do not implement this strategy. I know it is not the subject of this clause but if you are going to say that people under 35 will have restrictions placed on them as to where and with whom they live, that is a total contravention of what local authorities are being asked to do to implement the Autism Act. Equally, in the assessments for people on the autism spectrum, Asperger’s syndrome is not “autism-lite”.

Some years ago the National Autistic Society produced a report on autism called Ignored or Ineligible?. It is a 10 year-old report but sadly a lot of it is still relevant today, especially for those trying to get support for people on the autism spectrum, particularly those at the end of the spectrum who are more able—people with higher than average IQs. The anomaly about this condition is that you can have people with Masters degrees who cannot cope with some of the day-to-day detail of looking after themselves. The House has put on the statute book the Autism Act because autism is so different. The amendment before us picks up on some of those defects in the assessment.

I had time to read the case study—unfortunately it was number 13—in the information that my noble friend published yesterday, which related to a young man with autism and how his assessment had been carried out. Yes, he scored highly and one would take a lot of comfort from that. But I want to bring my noble friend back to the situation of what is sometimes regarded as quirky behaviour—sometimes threatening or challenging behaviour—but in the main non-threatening behaviour; odd behaviour, yes, with the inability to do certain things sometimes but able to do much more difficult things at other times. It is a very strange and complex condition. Therefore, in an assessment process, it is absolutely essential that people are viewed as individuals in the way in which their condition affects their day-to-day lives, whether it is their medical condition, the way they live socially or their housing conditions. It is that sort of complex condition. It is sometimes associated with other things such as learning disabilities and/or mental health issues as well, which makes it much more specialised in terms of understanding the behaviour that is presented.

I do not want to focus on my own situation but, as I am sure noble Lords can imagine, as a mum I am pretty worried. I want to take this opportunity to say on behalf of other mums—if I do not say it, who is going to say it for them?—that when you have a child who is born with a lifelong disability and you know they are going to die with that disability, as a parent your relationship with that child is very different from your relationship with other children you may have. When they are little children, you agonise about things like education. As they get older, life skills and whether they can cope for themselves become far more important to you than whether they ever got a GCSE. As they and you get older, your waking moments are haunted by how they will cope when you are no longer there to support and help them. I think that most parents of disabled children—whatever the nature of their disability —would understand that. Therefore, when you feel after many years that you have them in what I would describe as a stable situation—and how important, particularly for autism, stability is—it is so worrying when you suddenly look into the future and find that actually it is not stable at all. It is not stable for you—as you are growing older with goodness knows how many years left—and you see that it is not stable for them.

I have every respect for the amount of time my noble friend has put into autism. I am totally in favour of what he is trying to do to get more autistic people into work, because there are many who could work if they were given the right support and back-up to do it. I fully support that. But Asperger’s syndrome and those people on one end of the spectrum of autistic spectrum disorders are not “autism-lite”. I mentioned the report Ignored or Ineligible?. It showed that for people between 20 and 30 the suicide rate was 8 per cent. The reason it was 8 per cent was that the people on that spectrum try like mad to be part of society and try to be like everybody else. However, there comes a point at which, for many of them, they give up that struggle. I am very concerned that if they are not assessed as individuals, with all the quirkiness and strangeness of this very complex condition, we will go back to people on the more able end of the autistic spectrum being either ignored or ineligible, with all that that means. That is why I support the amendment tonight.

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[Lord Freud]

My Lords, let me start by referring to the moving speech made by my noble friend Lady Browning. I confess to a real concern about autism generally and I am very proud that my maiden speech was on the Autism Bill. I have undertaken a number of initiatives in the autism area because we do not look after people with autism and Asperger’s properly. I also strongly believe that it would not take a huge effort to make sure that we look after those people much better. As my noble friend knows, there is currently a major initiative to try to ramp up the number of such people who have and keep jobs. Currently only around 15 per cent have jobs, which is ludicrous, and I am determined to double that figure.

As part of that concern for this particular group, we wish to make sure that this assessment takes people with autism and with Asperger’s properly into account. I am hopeful that PIP will do a better job than DLA, and, furthermore, that we will make sure that we have the right processes in place to look after this group. As we refine processes during the next consultation period, which we are running until the end of April, one of the things that I want to make absolutely sure of is that we have the right measures in place for autism. I know that everyone in this Chamber feels similarly on this issue, and feels very strongly that we should get this right for that particular group.

I shall now turn to the more technical aspects of this issue—that is, looking at what we are doing with the PIP and its assessment. Is it a medical assessment, as the noble Baroness suggested? It absolutely is not. In fact, as I said in Committee, our approach is—and this is rather a mouthful—akin to the biopsychosocial model. I shall try to draw this out a bit—I do not mean in time: I shall try to draw the themes out. A medical assessment would be something like the industrial injuries disablement benefit, where there is a direct correlation between the injury sustained and its severity and the amount of benefit or compensation received. Nor will the PIP assessment focus on the functional limitations of the individual in the way that the work capability assessment does. Instead, it will assess how the individual’s health condition or impairment impacts on his or her everyday life by looking at their ability to carry out a series of key and holistic activities, all of which are essential for participation and independent living. In such an approach, the type of condition or impairment an individual has is of limited relevance.

It is not, however, a full social model assessment. I accept that. That is something that many noble Lords and disability organisations would like, but I have to point out that it was not our intention to develop it in this way. As a department, we do support the social model. As the noble Baroness, Lady Wilkins, said, we are on record as supporting it. While we want to ensure that the PIP assessment better reflects it than previous assessments, that does not mean that the full social model is relevant for assessment, although it is relevant for some things. I sent round a rather interesting piece of analysis to many noble Lords in the Committee, called Models of Sickness and Disability, which showed the differences between the models, explaining the medical model, the reaction of the social model against the pure medical model and the synthesis of the biopsychosocial model. The summary of the biopsychosocial model in the analysis is that:

“Sickness and disability are best overcome by an appropriate combination of healthcare, rehabilitation, personal effort and social/work adjustments”.

There is a coherent theory behind this assessment.

[Baroness Browning]

Will my noble friend confirm whether, when people on the autistic spectrum are assessed, there will be somebody present as part of that assessment who is expert in cognitive specialisms?

[Lord Freud]

People will be able to bring anyone with them to the assessment, whether it is a parent, adviser or anyone else. For the WCA, the person doing the assessment can call in that support where they need it. We are now entering the consultation phase on the PIP assessment. Wrapping in that support will be one of the elements that we will look at. I accept that the assessor needs to understand how those factors reduce the ability of the person in front of them to run their lives.

[Baroness Browning]

It has been suggested—I hope that this is an opportunity for my noble friend to put this straight—that the assessor will be able to call somebody on the telephone in making the cognitive assessment. I hope that he is able to assure me tonight that that is not the case.

[Lord Freud]

Clearly, the system will be elaborated and developed, and we are at an early stage. Although the WCA is a very different test from the PIP assessment, one of the useful lessons that we have drawn from Professor Harrington’s recommendations for it is that mental health champions are available on site for assessors. That is the way in which that test has developed, and there are some valuable lessons there for when we look at how we elaborate the PIP assessment.

If we were to go with the full social model assessment along the lines suggested by Scope, looking at the full range of factors that potentially cause barriers and cost, it would require a very long, intrusive and costly assessment, putting significant cost burdens on the state and, more importantly, very large burdens on the individuals involved. They would also inevitably require much more regular assessment, as the social factors that would be taken into consideration would change more regularly than the impact of a health condition or impairment. You might, for instance, get to the ludicrous position where every time a local bus service changed, you would have to do a reassessment on that model. In meeting after meeting with noble Lords, I have been left under no illusion that having too many reassessments is one of the things that they dislike the most. We will try to provide later on some reassurance that there will be decent gaps wherever possible between reassessments.

The situation could go very dramatically the other way and lead inevitably to inconsistency, with factors considered varying from person to person and affected by local factors or service provision. With PIP, we are looking at something that is universal and where entitlement is based on the same criteria wherever individuals are and whatever their circumstances. This discussion carries echoes of our ring-fencing debate earlier today in relation to the Social Fund. If we move to a kind of local needs-testing, which is what the amendment implies, it would be at odds with how we deliver a national benefit. Clearly, we could do something else. We could localise it as a benefit, but then it would be a very different benefit. I suspect that many noble Lords would be very concerned about moving in that direction.

Most importantly, we think that a social-model approach would be more subjective. Benefit entitlement needs to be based on clearly defined and transparent criteria which we need to be able to set down in legislation and apply to individuals consistently, whatever their circumstances and wherever they are in the country. If you cannot do that there would be a level of unfairness and uncertainty, high levels of appeals and a system in disrepute. Under the type of assessment proposed, it would be harder to define the criteria that individuals would be assessed against and less clear whether they had met the thresholds for entitlement.

Finally, we do not think that an assessment along these lines would allow us to control expenditure and keep that benefit spend sustainable, making sure that it goes where it is needed most. I do not think that I can really reach a figure on how much it might cost, but our estimate is that it would be very substantial.

Although the social model approach is superficially attractive—and I emphasise that we support it in many ways—we have decided that it is not the right way to go with this assessment. We have not gone for the medical model; we have gone for the biopsychosocial model. That model has now garnered very significant academic support, as those noble Lords to whom I sent that very interesting piece of research will recognise. It recognises the diverse range of biological, psychological and social factors that impact upon an individual and cause variation in need. We think that approach—of looking at activities and outcomes—matches the requirement.

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[Baroness Meacher]

My Lords, I support Amendment 50ZR, tabled by the noble Baroness, Lady Grey-Thompson, and to which I have added my name. The noble Baroness has made the case comprehensively so I will be brief. She referred to the alarming error rate in benefits decisions. At the same time, I am aware that steps are being taken to improve the accuracy of those decisions.

Here I want to make sure that we do not forget the particular problems of people with learning difficulties and mental health problems, who may not adequately convey their limitations in a face-to-face assessment. These groups have to spend their lives concealing their symptoms. They are embarrassed by them, and the last thing they want to do is to spell them out. They are acutely aware of the stigma associated with those symptoms. The Government are ensuring that claimants can take someone along to their assessment. There is no doubt that that will help and in some cases lead to appropriate outcomes. However, for many having a companion simply will not be enough. The companion cannot conduct the interview and the pressure on these individuals to conceal their problems is very difficult to overcome in these one-off assessment interviews.

There are also people for whom the very idea of one of these assessments is completely unacceptable. The obvious example is of people with agoraphobia, for whom just going out of the house can present real problems, as can getting on a bus or whatever it is. It is a real problem for this particular group. These people would benefit massively from having a psychiatric assessment at the start of the process, which would eliminate the need for them to go through all the distress of having to do something that they find completely intolerable. It is very fashionable to knock medical assessments but, having worked in mental health for a quarter of a century, in my experience psychiatric assessments are bio-psycho-social assessments. I think that was the term that the Minister used. They do look at the biological, the social, the genetic and every other aspect of someone’s functioning.

Also, any self-respecting psychiatrist will not do an assessment in a single sitting. They expect to assess someone over a period of time. They will bring in the views of social workers, nurses and others who have seen someone over a period. There is no way that a one-to-one assessment by someone who may be a nurse but not a psychiatric nurse—even if they call in someone who might be a psychiatric nurse but does not know the patient—can meet the need to make sure that someone is properly assessed, gets the benefits to which they are entitled and does not get benefits to which they are not entitled. It works both ways. This is an important issue.

Other examples include people with a psychosis whose symptoms are not controlled by medication. Many people’s symptoms are controlled but some people’s, tragically, are not. Those people should be able to have a medical—a bio-psycho-social—assessment and, on the basis of that assessment showing that such a person may not be able to function at all, it should be sufficient. I would have thought that the Government would accept that view.

There are physical diagnoses to which the same sort of arguments would apply. For example, those undergoing treatment for cancer, who again have uncontrolled and uncontrollable symptoms, would fall into this category. I referred to this group in connection with an earlier set of amendments. An early medical certificate for those people would avoid enormous distress and the gross injustice of requiring them to do things that none of us would wish them to do if we saw them face-to-face.

I understand the issue of medical fees, which has been referred to. GPs will not tolerate an inundation of requests for medical assessments without a fee. One of my daughters is a GP. I discussed it with her and she was not impressed by the idea. I am also aware that the Government have introduced an important new element in that the claimant can seek a report from their favoured clinician, who could be anybody—it might not be a doctor. This is helpful but it raises the issue, which has already been raised, of a two-tier system. Some people may be able to afford such a thing; others may not. It is a great step forward and I wish to acknowledge that, but it does not detract from the importance of this amendment. I look forward to hearing the Minister’s response.

[Baroness Browning]

My Lords, I am sorry to come in on Asperger’s syndrome again. I know that the Government involved people on the autistic spectrum in some trials that they carried out over the summer. I just wanted to encourage my noble friend to take the feedback from some of the people who took part in that, in a mock PIP assessment. Because the spectrum, particularly at the more able end, includes people who may be very articulate, on a good day it may be quite difficult to see that this is a communication disorder. On the other hand, you could have an assessment in which, even with the benefit of someone in support in the same room, the person on the autistic spectrum may have some difficulty in answering any question themselves as they struggle to put the words together or to make eye contact with the assessor.

On this group of amendments, I would encourage my noble friend to be aware of the variation in how people can present. However confident they may appear, it will inevitably be a very stressful situation for them to be in a room, answering questions from someone they are unfamiliar with. However they present, there will be stress behind it. I just reiterate something that I asked my noble friend a little earlier. I ask him to make absolutely sure that the people doing these assessments have not just mugged up on what autism or any other disability is from some book, but really understand and have a working knowledge of the disciplines in which they are assessing people. I will leave it at that.

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[Lord Freud]

My Lords, I could summarise my speech in about three sentences. I am in agreement with virtually everything said in the Chamber. I hope that after my three sentences I will be able to provide assurances. My only point of real disagreement is that I do not want it to be mandatory—in primary legislation. This is in regard to the point made by my noble friend Lord Kirkwood that it reduces flexibility and we are much better off setting it up in regulations and guides and in the contracts. That is our proposed approach but fundamentally we are absorbing all the valuable points made on this group. I will try now with some speed to go through those assurances. I ask noble Lords to stop me with the precise assurance they want if I am not making the assurance well enough.

Amendment 50A was semi-withdrawn by the noble Lord, Lord Touhig, but I will try to deal with it because it is a building block. People being assessed can bring in someone with them—a relation, a friend or a professional—to help them. That is really important in the group we spent a lot of time on this afternoon relating to autism and Asperger’s. When people are over-bright their relation can make the point about the reality and the over-anxiety of the person being assessed. That would be an active role in the process.

I turn now to Amendment 50B. Clearly, we need to make sure that assessors have all the appropriate training to interpret the evidence that they are provided with. I have to make the point that it is not a medical assessment PIP. It does not ask the assessor to diagnose a condition or to recommend treatment options. It is different. It looks at how the conditions or impairments affect individuals’ everyday lives. That is a different skill set from that involved in treatment. There is not quite the same level of need for specialist skills but it is our intention that assessors will have a broad training in disability analysis as well as training in mental, intellectual and cognitive impairments. That level of training will be stipulated in our contracts with any providers and we will be responsible for signing off the training syllabuses. There will be occasions when assessors need more specialist support in the course of making these assessments. We will ensure that they have access to and support from individuals who have the in-depth knowledge that the noble Baroness, Lady Meacher, mentioned with regard to mental health conditions.

[Baroness Browning]

I am sorry to interrupt again. Can my noble friend give us any hope that when an assessment is called there will be any publication of the qualifications and background of the assessors so that the people being assessed at least have some view of what their expertise actually is?

[Lord Freud]

It is a nice idea. I do not think I will make an utter commitment to it here and now but it is a cute idea and maybe we should put it in the contract. I will take it away and think about it.

We do not think that we should prescribe this in the Bill or even in regulations because it is important that assessors have an understanding of the limits of their knowledge so they know when to bring in the expert advice. I think the noble Baroness, Lady Healy, got that absolutely right.

I will now go on to Amendments 50C, 50D and 50ZR. We know that individuals can have a wealth of material, knowledge and evidence that will help in the assessment process and we need to get the right material and evidence from them at the right time and we need to encourage that evidence to come forward. We will not create a two-tier system where the poorest and the most vulnerable have less chance of receiving benefit because they cannot afford to pay for the evidence. We are going to make sure that does not happen.

I want to pick up the very valuable point raised by the noble Countess, Lady Mar. If we have a mandatory process to involve the individual’s health professionals it may very well be an entirely nugatory and expensive process in the many situations where the GP is not up to date with what is happening. That is the inflexibility of having something in the Bill which adds nothing except cost. If someone who has a learning disability has not visited a health professional for many years, why go through the expense of getting evidence? It would be unnecessary; it would slow the process down; and there may be someone else whom we would not have thought of including in the Bill who is much better placed to provide information and evidence for the assessor. We need to pull out the cumbersome implications of the mandatory process—the point made so precisely by my noble friend Lord Kirkwood.

We have made it clear that face-to-face consultation should form part of the claim process for most—but absolutely not for all—claimants. Ultimately, consultation will play a key role in creating a fairer and more objective assessment. It needs to be done sensitively and proportionately, but where sufficient evidence is available, we are in absolute agreement that there does not have to be face-to-face consultation. There will be many examples where that is unnecessary.

We are talking about something very close to, if not exactly, the tiered process recommended by the National Autistic Society. That is what we are planning to adopt. We have flexibility in the Bill to do that.

--- Later in debate ---

[Lord Newton of Braintree]

My Lords, for the second time today I feel that I need to say something, however brief, because of my history. Just as I engaged in badinage earlier with the noble Baroness, Lady Lister, about the Social Fund, I now have to declare to the House—possibly as a proud boast—that as a Minister I was responsible for introducing the disability living allowance in the early 1990s. I was given huge help by someone who deserves a great deal of credit, namely my former and unhappily now late colleague, Nick Scott, whom some noble Lords in the House today will remember with respect and affection.

On that occasion, we cobbled together a slightly curious construction based on the existing benefits of mobility allowance and attendance allowance, using the maximum amount of money I could extract from the Treasury at the time, to extend help to various groups who had previously been excluded, including the mentally ill. Perhaps we did a better job than I thought at the time because it has not only stood the test of 20 years but has survived with people now seeking to defend it against all comers, in much the same way as they defend the Social Fund.

What I say to the House may be uncomfortable for the noble Baroness, Lady Grey-Thompson, and the noble Lord, Lord Low, for whom I genuinely have huge respect. This is not flannel; they are immensely valuable Members of this House. However, I have been taken down a different path. If somebody had told me 20 years ago that that structure was to be seen as anything near a settled state for 20 years, I would have been surprised, because there were obvious ways in which it could have been developed and carried forward to build on what we had achieved at the time. That is what the Government now seek to do. I say to the noble Baroness that I am not sure that it is right now to try to slow down the process by yet another review after the many that we have had.

Only yesterday the Government published a revised review of the assessment process. I accept that neither I nor anybody else has had a chance to digest it. However, it makes it crystal clear—this picks up on the second half of the noble Baroness's amendment—that this will be worked through steadily and carefully, in conjunction with organisations representing disabled people. I assume that account will be taken of the results of that consultation. Of course I accept that it would be nicer in a perfect world if we had all the details now, and that there will need to be a good deal of tweaking—or perhaps more than tweaking—as the consultation proceeds. However, I also accept that we have a Minister who knows his stuff, who cares about the subject and who has shown himself to be willing to listen to those representations. We should let him get on with it.

I do not accept the tenor of the e-mails that jammed my system from yesterday through the early hours of the morning into today, which suggested that the Government had a dastardly plot to do down disabled people. It is not the case, and I would not say this if I believed that for a moment. It is clear to me, having glanced at some of the e-mails—I have not been able to read them—that a number of them came from people who will not only not lose but may well gain from the proposals that the Government made. I hope that the senders will reflect on that.

This is not the moment for the House to agree this amendment. If we want to agree amendments, I suggest that between now and Report both the Minister and the House might reflect on the desirability of some extra-affirmative procedure of the kind used in the Public Bodies Bill for affirmative resolutions—I hope that they will be affirmative—that will come forward as a result of all the consultation. That would be far more productive than trying to slow the whole thing down with another review.

I have other points to make but the hour is late and the House wants to get on, so I will conclude by saying that at the end of the day I speak only for myself when I say that this would certainly cause delay, and would almost certainly add to the cost of an already expensive government programme. There may be smaller issues later, including those espoused by my noble and learned friend Lord Mackay, on which I may take a different view; but this amendment is strategic, damaging and mistaken, and I hope that noble Lords in all quarters of the House will join me in opposing it if it is pressed to a Division.

[Baroness Browning]

In the context of this amendment and the ability of health and social services to carry out their statutory responsibilities under the Autism Act, will my noble friend agree to take a look the number of people who currently have DLA but are predicted to lose it? There is a read-across here, because small levels of support have been identified as having prevented people taking their place in society and gaining independent living.

As I mentioned previously, I am concerned that as regards those who will lose the allowance—some will and others who apply in the future will not get it—the measure is going to have an impact on the way in which we have required health and social services to implement the Autism Act. Does my noble friend agree that there will be some hardship for those who lose it and that we have to face up to that reality, and that the Government should have a clear and examined view of how they are going to square that with the new statutory responsibility?

[Lord McKenzie of Luton]

My Lords, we support this amendment, moved so comprehensively by the noble Baroness, Lady Grey-Thompson, and spoken to so effectively by the noble Lord, Lord Low. I would say to the noble Lord, Lord Newton, that in doing so we are not motivated by a belief that this is all some dastardly plot, but a belief that we need to be assured that the system does not just need to be tweaked but that it is fit for purpose before this major change is introduced.

This amendment is aimed at helping the Government get right the process of transfer from DLA to the personal independence payment. It calls for an added layer of safeguards within the process of reform, with an independent review of the plans for operation of the assessments before they start and a trial period when the assessment process first comes into effect. Crucially, it calls for the full involvement of disabled people and their organisations in this process, ensuring that they have confidence that the assessment process for the new benefit will be fair. The need for safeguards in this area has been all too fully revealed with the experience of the employment and support allowance. The noble Lord, Lord Newton, told us that he was responsible for introducing DLA—which in Committee the noble Lord, Lord Low, called an “iconic” benefit—and he should be proud of that achievement. I have some responsibility for having introduced the employment and support allowance so I cannot claim any such accolade.

It is clear that the assessment process has not been working and has caused not only distress to too many disabled people but considerable headaches for the Government. We all know that 39 per cent of appeals have led to a decision about ESA being overturned in favour of the claimant, and the unreliability of the assessment procedure has also made it difficult for the Government accurately to budget for the cost of these reforms. The Office for Budget Responsibility’s November economic and fiscal outlook states:

“ESA changes have resulted in an increase in expenditure of £1 billion by 2015-16”,

and the latest administrative data suggest that fewer people than previously assumed will be judged fit for work as a result of the initial ESA work capability assessment and the reassessment of incapacity benefit cases, and more will be placed in the support group. This accounts for around four-fifths of the increase. Other changes arise from a change in assumptions about the composition of the ESA caseload, which results in higher average benefit payments per person and higher inflows. The costs of getting this process wrong can therefore be high, and we know that the Government have benefited from the independent review of the ESA assessment process undertaken by Professor Harrington.

As other noble Lords have said, we received just yesterday the document providing further information about the second draft of the PIP assessment criteria, together with proposals on entitlement thresholds, impact modelling and case studies. While this technically fulfils the Minister’s commitment that we should get it before the Report day, as we have previously noted, there has hardly been time for detailed study and analysis—although it is hard to miss the startling figure that some half a million disabled people will be excluded from the new benefit in comparison to existing DLA arrangements. Before causing this to happen, the Government should be called to account for the impact that this may have on the disabled people who are missing out.

Welfare Reform Bill

Baroness Browning Excerpts

Wednesday 16th November 2011 Grand Committee

[Lord Touhig]

My Lords, like many noble Lords I am a great fan of pre-legislative scrutiny, because I think it improves the quality of the legislation we pass. I also have great faith in this Committee system, because we go through a Bill line by line in order to improve it, amend it, and make good law as a result. I certainly support this amendment, because a trial period does make sense.

I look across at my good colleague the noble Baroness, Lady Browning. She and I sat on the Public Accounts Committee in the other place. Time and again we considered reports from the National Audit Office which showed that some great government scheme, some great initiative, had gone billions of pounds over budget, or gone over time. Inevitably we found that these things had not been trialled beforehand, to see if key elements of the proposals would work effectively.

Some unfortunate Permanent Secretary would be brought before the Public Accounts Committee, and like modern-day Draculas, we drew a lot of blood in our interrogations. Inevitably, this Permanent Secretary was not responsible for what the department had got wrong, anyway; it was the previous incumbent, but that is by the by. We were seeking to learn lessons, but inevitably it was like closing the door after the horse had bolted. If only more care had been taken, or things had been trialled and piloted beforehand, then things would not have gone wrong in the way that they did.

If the Government take this amendment on board, it has the potential to save millions of pounds. If the Bill does not take account of this, then somewhere down the track the NAO will come in, in two or three years, and find that there has been some great failure, or some great cost. The Public Accounts Committee will have to investigate, and the Department for Work and Pensions will be held up again as having failed to pilot or introduce a scheme in a good or effective way, as it promised it would. The amendment makes a lot of sense, and I hope the Minister will see that.

[Baroness Browning]

My Lords, this is the first opportunity I have had to contribute to the Committee. I declare my interest both as the named carer of an adult with autism and as, I believe, somebody who will need to attend the assessment meeting with him. I am that other person, so I am more than personally interested in this legislation.

My friend the noble Lord, Lord Touhig, made a good point about getting good value for money and making sure a system works. However, there is another point about trialling it with new applicants. I remain cautious about the ability of a lot of people newly recruited for the purpose to carry out what will be really quite difficult balances of judgment across a wide section of people, particularly those with learning disabilities, mental health conditions and autistic spectrum disorders, some of whom will have two or all three of the conditions.

I refer the Minister to my personal experience over many years: I am very proud to have raised the very first debate on Asperger’s syndrome in the House of Commons many years ago. When it came to getting contracts signed for people to get people into paid employment, one of the contract requirements was that the various agencies and commercial companies had a full understanding of this range of really quite difficult disabilities. All too often that training and preparation was based on reading up and taking a bit of advice. It never, ever, made the mark.

To give an example, in the case of people on the autistic spectrum it is well known—if I am to generalise and as has been said quite rightly they are individuals who will all display individual characteristics—that their lack of imagination and inability to express and understand non-factual things, as opposed to in some cases a quite high level of ability in understanding factual information, very often leads one to read in manuals and books about autism that if you converse with somebody on the spectrum it is best not to deal in generalities but to deal with specific questions that require specific answers. Some of the contracts that have been issued in the past to get people with autism into work have led the people assessing their aptitude for employment to carry out conversations that frankly beggar belief. I have had some personal experience of this. The questioning would be very much along the line not of, “How are you?”—that is a difficult question to answer—but “Do you live in your own home?”, “How many chairs do you have in your sitting room?” and “What size is your television screen?”. There was a mistaken belief that this was a normal conversation that somebody on the autistic spectrum would feel comfortable with. In one example the person being questioned was actually very intelligent and felt straightaway that they were being patronised, as any of us in this Room would have done.

Therefore, a lead-in period is needed to assess not just the value for money and the way in which this new system is working but also to allow for time, which is really needed, to make sure that the people carrying out these assessments have a working knowledge of some of the more complex conditions and a much better understanding to be able to make their judgment.

I hope the Minister will listen carefully to the points that are being made to allow a lead-in time for new applicants so that we can get this right.

Housing Benefit (Amendment) Regulations 2011

Baroness Browning Excerpts

Wednesday 12th October 2011 Grand Committee

This is very difficult legislation which is hitting people who are particularly vulnerable and least able to speak up for themselves. That is why I am speaking in this debate.

[Baroness Browning]

I am grateful to my noble friend Lord Kirkwood for initiating this debate, because it gives me an opportunity—my noble friend the Minister will not be surprised to hear me say this—to raise the case of people on the autistic spectrum, particularly in respect of the exemptions as outlined in the order.

Reference has already been made to the fact that there are exemptions. The exemption that would particularly affect people with autism is the one applicable to people who had been able to live independently and are entitled to severe disability premium. However, severe disability premium requires people to be in receipt of the middle or higher rate of the care component of disability living allowance, a benefit which is itself under review. The regulations are due to come into force in January next year. How will this timescale fit in with those people who are currently in receipt of the middle or higher of DLA care component but who may when decisions are being made about their eligibility for exemption under these regulations suddenly find that they are no longer in receipt of DLA at all or have been downgraded to a lower rate?

I know that my noble friend has great knowledge about autism. He has taken particular care to make sure that he understands the way in which autism manifests itself. He will therefore understand, I know only too well, that somebody who has been able to achieve independent living will have been through a journey to reach that point. For somebody on the autistic spectrum to be expected to share accommodation with another person would almost certainly be traumatic. It would affect their whole demeanour and well-being. The consequences of disturbing what for people with autism is very often a rigid way of life may be serious. Getting them to the point where they can maintain independent living is achievable and we are seeing more and more of it. It is sometimes but not always done with some external support—very often, voluntary support comes from family members and others; it is not necessarily an official package of care from social services. However, we aspire as a Government and a society to get more people on the spectrum to live independently.

I am extremely concerned about the impact of these changes, and I have made available to my noble friend’s officials a letter which I received only this week from the mother of a 32 year-old man who has been living independently for three years and who is in receipt of £93.45 a week. That is income support and the lower DLA rate, so he certainly would not qualify for the exemption. At the moment he is being paid £103.56 in housing benefit and it is calculated that he will lose £43 of that when this change comes in. Forty-three pounds out of an income of £93.45 a week is a significant amount. His mother is clearly aware of these changes and what the impact will be for her son. She writes a very moving three-page letter about what she thinks might happen to him as a result, concluding,

“local authorities will have available a pot of money that they can, at their discretion, use to help people make up the shortfalls in their benefit. Knowing this, though, will condemn those with autism to months of anxiety over whether they would be successful in benefiting from this. These months of anxiety will overwhelm many. The waiting is certainly causing James untold worry”.

I note that the Merits Committee report talks about the discretionary sum and expresses some concern. In paragraph 5 on page 5 it states:

“That increase must be used to cover all calls on the discretionary budget; no additional provision has been made to address any demands arising from these changes to the SAR regulations”.

My noble friend will understand immediately my concern about the way in which this might affect those living independently with a diagnosis of autism or Asperger’s syndrome. Many will not qualify for the exemption. The disruption to their lives will not only be severe in terms of their well-being and health but will, like a pack of cards, ripple out to other services that may have been involved in providing for them. Once you destabilise them in one area of their life, everything else starts to fall down like a pack of cards. So I hope my noble friend will take a look at this mother’s letter and perhaps take another look at how we might mitigate the distress that will almost certainly be caused to this very vulnerable group of people.

[Lord McAvoy]

My Lords, I join the ranks of those thanking the noble Lord, Lord Kirkwood of Kirkhope, for bringing this forward for discussion, to make sure that it is aired, and for taking the opportunity to try to mitigate some of the effect of the regulation. The deficit has been mentioned. The point was made by the noble Lord, Lord Stoneham, that these are not the broadest backs that the pressure is falling on. The pressure is falling on these vulnerable people for an annual saving of £200 million. I believe in fiscal rectitude and I do not have any bother saving money, but with a group of people like this, whose vulnerability has been described by several colleagues, I think the deficit is the excuse for bringing out this measure. A colleague mentioned that perhaps it has been a long-term ambition of the department—not the particular individuals who happen to be here. But the consequences here are so drastic more serious consideration should have been given to pilots. I know that when a new Government come in, there is a determination not to be caught up in delays. The Government are in a hurry and they want to get things through. I have seen it happen and been part of it and I have the experience to regret some of it. I think that is what is happening here. They have been saying, “Get a decision. Get it made. Get it through”. I think it is pretty poor that people like these are in that position.

Although I have no intention of repeating the valuable comments made by colleagues, I will rely heavily on the reports produced by the Social Security Advisory Committee and the Merits Committee. The SSAC report makes a plea for delay by stating:

“We recommend that the proposals do not go ahead in their current form”.

In paragraph 23 of the Government’s response to the advisory committee’s report, after mentioning that the Government,

“does not accept the Committee’s view that the proposals are driven solely by the need to reduce the Housing Benefit budget”,

the Government claim that the changes will remove a “potential work disincentive”. Now, I have seen some daft and totally irrelevant things put into official documents—I might even have put in one or two myself—but what is a “potential work disincentive”? I do not know what that means. Perhaps the Minister could give us examples of where he imagines that might happen; it will be difficult for him to provide proof as there is very little evidence for anything in this measure. I would like to hear some examples of where this disincentive would take place.

Indeed, the Social Security Advisory Committee report states:

“On work incentives the Committee contends”—

and I think that normal life would confirm this—

“that the impact of the changes for Housing Benefit claimants already in work could result in a move to a location some distance from their place of work”.

Colleagues should be clear that, in many people’s lives, this could result in a big disruption, which should not be underestimated. A pilot would have been useful.

We are in danger of creating an itinerant population—a phrase that I have used elsewhere—who will be easily identifiable because they will be vulnerable for many reasons. As I have seen for myself, for people suffering from alcohol problems and from various degrees of mental ill health, security and permanence are very important. Moving people about in this way is not something that any British Government should be doing to part of its population.

I may be a touch cynical, but I wonder whether the reason that this particular group has been selected to bear £200 million-worth of cuts is that these people are not a very effectively organised part of the community: they are invariably not members of trade unions or interested in getting involved with trade union activity; they are not involved with community councils or politics; instead, they are on their own trying to cope with the situation in which they find themselves. Like the Government, I have no evidence for saying this, but it would be realistic to say that the percentage of these people who vote will not be too high, because not many of them will have any faith in politics—I would find it hard to argue with them when they say that. The Government would have picked an easy target for cutting £200 million, were it not for the Motion moved by the noble Lord, Lord Kirkwood.

Another interesting, and depressing, point is that, according to my reading of the Government’s response to the Social Security Advisory Committee’s report—if I am wrong, the Minister will contradict me—not one of the advisory committee’s recommendations was agreed to. Where is the listening to, or taking account of, the terrific experience of the people who serve on that committee? Not one of the committee’s recommendations was agreed to even partially. There is just a total blank.

Others will no doubt speak about their own areas, but I believe that the danger point here is likely to be the cities, where the drifters seem to congregate. For example, page 70 of the advisory committee’s report lists the number of claimants by area and the average amount lost per week. In the City of Edinburgh, 590 people, or 17 per cent of the caseload, will on average lose £37 a week. In Glasgow City—I am not a Glaswegian, but I live next to that city and know that it has many problems—800 people, or 25 per cent of the caseload, will on average lose £22 a week. In my own council area of South Lanarkshire, which does not have a big city but nevertheless includes some big towns, some 270 people, or 23 per cent of that sector of the population, will on average lose £11 a week. I know that some might say, “That’s up to them. It’s just £11 and they will manage with that”. However, as has been mentioned by the noble Lord, Lord Kirkwood, given the current situation in which utility costs and all the rest of it are rocketing up, losing £11 a week against that background of rising prices will be really difficult.

It will not make any difference to the Government, but a lot of us are worried about the availability of accommodation. Will they get accommodation? Will it be suitable? There is no evidence that the landlord sector will be able to guarantee availability of alternative accommodation. Folk will have to deal with that. They will face an upheaval in their lives plus cash losses. Collectively, we should not be proud of doing that to this sector of society. Having mentioned society, I shall finish with this statement. We are told by the Prime Minister—and the Chancellor of the Exchequer in particular—that they want to establish the big society. They say that we are all in it together. I do not see many people in society who will feel in it together with these vulnerable people.

[The Parliamentary Under-Secretary of State (Lord Freud)]

My Lords, I thank the noble Lord, Lord Kirkwood of Kirkhope, for providing this opportunity to discuss planned changes to housing benefit that will affect certain young people currently living in the private sector in self-contained accommodation. These changes are contained in the regulations we are debating.

The change to the shared accommodation rate was announced last October as part of the spending review in the context of reining back welfare expenditure in general and housing benefit in particular. Difficult decisions have had to be made about spending priorities. At the heart of those decisions is fairness and affordability. We need to be fair to taxpayers and mindful of the choices those not in receipt of benefits make when considering what they can afford to pay in rent and the type of accommodation they choose to live in.

The shared accommodation rate reflects local private sector rent levels of accommodation where at least one facility is shared, for example a bathroom, kitchen or living room. The current rules for under-25s avoids the situation in which those in receipt of housing benefit could afford a level of accommodation that they would not be able to maintain were they employed. It also reflects the fact that sharing accommodation is common among younger people. We want work to be people’s first choice and do not think it unreasonable to extend the application of this rate from those aged up to 25 to those aged up to 35 for those who have recourse to public funds. This will realise savings of around £200 million per annum from 2013. That does not necessarily mean that people will have to move, although it is likely that some will need to do so—they will have to make the same sorts of choices about affordability as those who are not on benefits.

Many in this age group already share. Over one-third of the 25 to 34 year-old local housing allowance claimants who are potentially affected by this measure are already choosing shared accommodation and claiming the shared rate. In this age group, 40 per cent of private renters who are not on benefits also share. The Social Security Advisory Committee put forward the view that the majority of older sharers are either professionals or mature students, but the 40 per cent figure that I just cited specifically excludes students, and our survey data indicate that there are people sharing across all types of occupations.

The recent report by the Merits Committee posed the question: if savings are to be made, why choose the age of 35? Why not go higher? Such a move would not be supported by the evidence, which shows that sharing accommodation tails off significantly after age 35. Our equality impact assessment looked at the accommodation arrangements of all single and childless adults. Less than half of 25 to 34 year-olds have their own place, and a third live with their parents. When we look at those over 35, we find that 84 per cent have their own place and that only 6 per cent live with their parents.

We realise that, for some, it is neither desirable nor appropriate to live in shared accommodation. There are already a number of exemptions from the shared accommodation rate for those in vulnerable situations, such as care leavers below the age of 22, those entitled to the severe disability premium and those who have an extra bedroom for a non-resident carer with a home elsewhere who provides overnight care. Those living in social housing and in certain types of supported accommodation are also not subject to that rate. Those exemptions will continue to apply, where appropriate, to claimants in the increased age group of 25 to 34.

Since the announcement of the measure, we have been listening to people's concerns. I and my officials have met with interested parties, and the Social Security Advisory Committee has consulted and reported on the draft regulations. We decided to introduce two further exemptions for the extended age group. Those have been welcomed by several commentators and organisations, as well as by noble Lords who have spoken today.

The first additional exemption is for those who have lived for at least three months in a specialist hostel for the homeless and, while living there, received support to resettle in the community. That exemption addresses the concerns raised by several commentators about the impact of the changes on rough sleepers—in particular, the silting up of hostel accommodation. We accept that, without that exemption, it would be difficult to secure suitable move-on accommodation for that group to help them into a more settled way of life, which could undermine our ambition to end rough sleeping.

That exemption has been targeted at people aged over 25, who are at greater risk of rough sleeping. We believe that the current exemption is well targeted at people who are ready to move on to an independent life, but those people leaving hostels will have to have undergone some support and rehabilitation. That strikes the right balance between cost and fairness. We think that many former rough sleepers will be helped by that.

My noble friend Lord Kirkwood asked about the ministerial homelessness committee, of which I am a member. It was with that ministerial hat on that we framed this support, working closely with my colleague Grant Shapps.

The second new exemption is for those ex-offenders who present a serious risk to the public and who are subject to active multi-agency management under the multi-agency public protection arrangements—MAPPA—in England and Wales or are considered to present similar risks in Scotland. That exemption covers a very small group of ex-offenders who are to be excluded on the grounds of public safety. It is not extended to all ex-offenders because many of them pose no risk to the public. Perversely, the risk is that one might provide an incentive to commit modest crime, which we would not want to encourage.

Other specific groups have been put forward as needing exemption. They include people with disabilities, those with mental health problems, those with a history of substance misuse and those seeking to maintain contact arrangements with their children. The case for those who have shared care of children is complex. We estimate that, of those who will be affected by this measure, around 10,000 have some contact with a child who lives elsewhere. Of these, it is not known how many would normally stay overnight, so the numbers are relatively low. But living in shared accommodation should not preclude both parents from playing a full part in a child’s life. Parents living in hostels or other non-mainstream accommodation will, I am sure, be striving to maintain quality relationships with their children. Ultimately, it is for individual maintenance and custody arrangements to reflect living arrangements, and it is not appropriate for the state to fund two homes for a child. To pick up the question that my noble friend Lord Kirkwood asked, I can assure him that this arrangement does not contravene Article 9 of the UN convention.

We thought long and hard about other exemptions, but the blunt answer is that our analysis suggested that it is better to rely on discretionary housing payments than on specific exemptions because of the difficulty in defining and administering them. Our belief is that the local authority is best placed to consider individual circumstances.

The point raised by my noble friend Lady Browning about the autistic is very moving. I have had a chance to read the letter sent to her from Mrs—

[Baroness Browning]

I am sorry to interrupt the Minister, but I quite deliberately did not mention the person’s name.