Welfare Reform Bill

Debate between Baroness Browning and Baroness Grey-Thompson

Tuesday 17th January 2012 Lords Chamber

[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.