Mesothelioma Bill [HL]

Baroness Masham of Ilton Excerpts

Monday 20th May 2013 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I will say just a few words in support of this Bill. Mesothelioma is not an easy disease to diagnose. The earliest signs of the disease are quite vague. The most common symptoms are breathlessness, chest pain, fatigue and weight loss. This occurs as a result of an effusion, when fluid accumulates in the pleural cavity, the space between the two layers of the pleural lining. The patient will often visit their GP at this stage. The cancer can spread to different parts of the body.

Mesothelioma is a cancer caused by exposure to specific types of asbestos, which are present in many homes and workplaces but no longer used for any purpose. On average, people do not develop symptoms for 30 to 40 years after exposure. Few people survive for more than two years after diagnosis. The majority of victims today are former industrial workers who were exposed before 1980. Around 2,400 people a year die from mesothelioma. Around 56,000 people are expected to die in the next 30 years unless a cure is found. No change in lifestyle will help them.

Until recently, very little was spent on research into mesothelioma in the UK. If there is to be progress and hope in treating mesothelioma, there will have to be an increase in research. I am told that the insurance industry leaders would like to see their industry continue to fund research, but it is felt that the long-term funding solution needs to see the burden shared more widely.

I hope that this Bill will pass through Parliament quickly and that the Government will accept my noble friend’s amendment when he moves it. Also, with such a devastating disease, and the rising costs of everything, I sincerely hope that the Government will not reduce compensation by 30%. In these changing circumstances, it should be increased.

Disability Services

Baroness Masham of Ilton Excerpts

Thursday 10th January 2013 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I congratulate and thank the noble Lord, Lord Boateng, on instigating this debate. It is important that this subject is being discussed today. I have spoken to several people who are involved with disability as a whole and, when I mention the services for black and minority ethnic people with disabilities, not much seems to be known. The Scope report presents some of the evidence and I am sure that your Lordships, like me, will look forward to the Minister’s response.

There are so many disabilities, many of which are complex. I want to add something to this debate which I cannot see in this report—namely, the need for prevention of disability, if possible. Disability can be a strain on families, as it can be very costly and time-consuming. Education for women who are so often the people looking after disabled people is so important.

My admiration has no bounds when I consider the bravery of the schoolgirl shot in Pakistan who was campaigning for education for girls. This outstanding girl would now be dead or disabled if it was not for the medical skill she received in Birmingham, her own hard work and will power, and the support of her family and the Government. That shows how important it is that people work together to help people with disabilities.

I mention today in this debate that the Leeds Children’s Heart Unit is fighting for its retention, as there are a high percentage of black and Asian babies born with heart defects in the area of Leeds, Bradford and West Yorkshire. The north is a special case; it needs units in both Newcastle and Leeds. I cannot understand why the consultants who perform the operations cannot travel between the two units to make the service viable. This would save stress and strain to many families with social needs, who would find long-distance travel too expensive and complicated.

Results show a range of variations between black and minority ethnic—BME—groups and white, British counterparts. Most differences are negative, which indicates that BME groups are less likely to report a positive experience. However, many areas show no difference and some show a positive difference. The research findings show that a source of dissatisfaction was that customers struggled to find out about the benefits available for a long time after they had developed their disabling condition. Many participants felt that it was very hard to find out what they were entitled to and that this applied similarly to all benefits available. Many participants felt that they could have applied for benefits and received help earlier on. This triggered some criticism of the Disability and Carers Service.

Information and forms for disability benefits are far too complicated for most disabled people, let alone black and minority ethnic groups. Language barriers often mean that BME disabled people do not know about, and cannot use, services available to others. Therefore, it is often disabled people rather than services that are perceived as hard to reach. Communication is vital in accurately translating someone’s condition or disability. Disabilities in communication can result in inaccurate or inappropriate diagnosis. A lack of information in an appropriate language can significantly hinder or prevent access to services and facilities. This is being stressed in this debate.

We must therefore take great care to send out the right information about services and impairment. This could mean simple measures such as using everyday language wherever possible, testing materials with BME disabled people, and refining these materials before publicising. Given the significance of these language and communication barriers, Scope is concerned about the proposal of the Communities Secretary, Eric Pickles, to cut translation services by printing official documents only in English as a way for local councils to save money, which claims that it undermines community cohesion by encouraging segregation. The withdrawal of such translation services will increase the already significant barriers faced by people from BME communities in accessing support. Can I ask the Minister if she understands that this will be most difficult for the growing elderly population of BME disabled people?

The Government have acknowledged the need to develop approaches to meet the specific needs of BME disabled people as part of the Fulfilling Potential—Next Steps paper on their approach to the forthcoming disability strategy. When will the disability strategy emerge? The report found that social isolation was particularly acute for women in BME communities. Many women who took part in Scope’s focus groups said that their impairment compounded the isolation effects on their household and children’s roles, with other family members rarely making adjustments to support the management of their condition.

The stigma attached to disabled people can be widespread and acute. It is far from limited to BME communities, yet Scope’s report found that many people in BME communities felt that it was a particular problem for them. The report also found cases where the most acute source of discrimination was from family members themselves, demonstrating the need to improve attitudes towards disabled people within BME communities. There is a lot for these communities to do to improve their attitudes towards their disabled people. It is possible to change attitudes. It has taken a long time to reach the support and enthusiasm which surrounded the 2012 Paralympics—but it happened. Therefore, I hope that better facilities will emerge for the BME population.

Health: Needlestick Injuries

Baroness Masham of Ilton Excerpts

Tuesday 12th June 2012 Lords Chamber

[Lord Freud]

This applies to human health and not to other industries such as waste and veterinary.

[Baroness Masham of Ilton]

My Lords, will the Minister consider expanding the directive to include patients living in the community, because there is so much emphasis now on care in the community? It is very difficult to get rid of sharps boxes, and if people have to inject themselves before going on an aeroplane there are no sharps boxes at airports.

Employment: Sickness Absence

Baroness Masham of Ilton Excerpts

Wednesday 25th January 2012 Lords Chamber

[Lord Freud]

My Lords, the department has an enormous workload; I am absolutely conscious of that. It is driving through one of the biggest social changes that this country has seen for many decades. At the same time, we are decreasing the numbers in the department at the centre. That does not mean that it is happening at Jobcentre Plus, which is the client-facing area. We are confident that the department, which I have now been in for some time and genuinely find admirable, is able to fulfil these objectives.

[Baroness Masham of Ilton]

My Lords, does the Minister agree that it is sometimes easier for GPs just to write a sick note, rather than find the real cause; and that this is very difficult for employers?

[Lord Freud]

One of the things that the sickness absence review did was to look at the mismatch in what people were trying to do. The worst of the mismatches was that GPs were signing people off on their sick notes because they could not do a particular job, while the work capability assessment later looked at whether they could do any job. It is those mismatches that we need to stop and sort out.

Employment and Support Allowance (Limited Capability for Work and Limited Capability for Work-Related Activity) (Amendment) Regulations 2011

Baroness Masham of Ilton Excerpts

Wednesday 16th March 2011 Lords Chamber

[Baroness Wilkins]

My Lords, most of the points that I wanted to make have been made, so I will be brief. I emphasise the serious concerns that have been expressed by disability organisations, most particularly that these changes are premature. As we have heard, the second phase of the independent review led by Professor Harrington is still under way, and the advice on refining the mental, intellectual and cognitive descriptors has not yet been seen by Ministers, so in all likelihood we will be faced with two major, costly and confusing changes to the WCA to be made in a single year.

I emphasise that the cost of these changes has not been covered. The cost of people having to go to tribunals when their assessment needs to be overturned is enormous in terms of stress, worry and consequent ill health, but it is also a waste of time and money for the country. As the CAB has pointed out, the current WCA assessment routinely fails to identify disabled people’s genuine needs and inappropriately allocates them to jobseeker’s allowance, only to have that decision overturned on appeal. Currently 40 per cent of cases are overturned on appeal, which must cost the state a considerable amount.

According to the Welfare Reform Bill documents, almost £20 million was spent in 2009-10 on appeals to the tribunal service and, according to figures from the Disability Alliance, that means that roughly £8 million was spent on appeals to rectify the failings in the current WCA. There is now a nine-month backlog for appeals in some areas. If the new descriptors go ahead as planned, these changes could lead to even greater pressure on the system, especially since, as the noble Lord, Lord Kirkwood, pointed out, new ESA claimants will be joined by an estimated 10,000 people per week being migrated off incapacity benefits from April 2011.

The Government’s expert independent body, the Social Security Advisory Committee, has recommended that these plans are not implemented now. I urge the Government to follow their advice.

[Baroness Masham of Ilton]

My Lords, I thank the noble Lord, Lord Kirkwood of Kirkhope, for bringing up this matter. He understands these matters so well and I support what he has said. This is a complex matter. Disability is complex, as it differs in so many ways.

There is great concern from many disability groups, as has been said, as well as the national AIDS group, which has not been mentioned. HIV is a very complex condition. People with it have to live on drugs for the rest of their lives. On some days they are better than on other days, and some drugs work in different ways on different people. This is a complex matter.

I hope that the Minister will get these regulations right. I have two questions for him. Who will be doing the assessments? Will these people be adequate? This is of great concern to many people, and this debate has illustrated how very complex the whole matter is.

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)]

My Lords, this is an important opportunity to discuss the regulations. A lot of points have been raised and I will try to deal with as many as possible. However, I take this opportunity to lay out the position coherently. I take the criticism of the noble Lord, Lord Kirkwood, that communication has been less than perfect. I shall try to describe what is happening to reinforce that communication programme and I commit to ensure that it is maintained.

There is still a lot of misunderstanding about the assessment and what we are doing to make it fairer and more effective. The first point to make is that these regulations seek to take the first step in improving the work capability assessment. They were developed in conjunction with technical experts and with considerable input from specialist disability groups. As noble Lords have acknowledged, they will ensure that individuals awaiting, or between courses of, certain chemotherapy will be placed in the support group without face-to-face assessment. They will expand the support group to cover people with severe disability due to mental health problems and communication problems—that includes people with autistic spectrum disorder, about whom the noble Baroness, Lady Browning, was concerned—and they will ensure that the descriptors take account of someone’s adaptation to a condition or disability so that we can provide them with the right support.

Before proceeding to debate the finer points of the regulations, I would like to put the reform into a context. The legislation before us today is part of a far broader commitment by the Government to tackle worklessness and intergenerational poverty. This is a very real and very urgent problem for us all, especially given that there are now 2.6 million working-age people claiming incapacity benefits, of whom some 850,000 have been claiming for a decade. This is a massive brake on the economy, costing the taxpayer billions of pounds every year, but that is not the most important point. The true cost of this level of inactivity is paid for by individuals left languishing on long-term benefits without hope or opportunity for a better life. I echo what the noble Lord, Lord Kirkwood, said about the scourge of inactivity. If we abandon these people, we fail in our duty as Members of this House. For too long, too many people have had to pay for our failure to act.

Before the recession, there were 63 consecutive quarters of economic growth—that is the longest growth period the economy has enjoyed, as historians can best work it out—and the economy created 4 million additional jobs. Yet under the previous Government—I am not being political—just over half those jobs went to foreign nationals. The result was that, even before the recession hit, we still had 4 million inactive people. Millions of people were without jobs in a growing economy, yet the system was trapping them. That is why we were sucking labour from abroad. The system offered too few people the opportunity to escape and to make a better life for themselves. We must not fail them again, because the country cannot afford it, and neither can the individuals, their families or our society.

Studies have shown that welfare dependency, social isolation and lack of purpose in life have a debilitating affect on individuals. Decades ago, the late Aaron Antonovsky argued that the purpose in life—what he called coherence—was crucial to understanding human health and well-being. More recently, Waddell and Burton’s excellent review of the issue, written four and a half years ago, reinforced the evidence that showed that work is generally good for you. There is ample evidence that prolonged periods of inactivity and unemployment contribute to declining mental health. That is why the welfare reforms that we are introducing are so important, and that is why the regulations are such an essential element in transforming the lives of millions of people at risk of being abandoned to welfare dependency.

These reforms are the key to providing the lost with a path out of the cycle of dependency and poverty, and helping them on to the path to new opportunities. That is why we are embarking on a large-scale re-evaluation of those on incapacity benefits through the work capability assessment that will take in some 1.5 million people—not the 2.6 million on incapacity benefit who the noble Lord, Lord Kirkwood, mentioned —over the next three years. It is also why we are introducing the universal credit to make sure that work pays, and why we are introducing the largest welfare-to-work programme that this country has ever witnessed.

This is designed not to badger or bear down on the vulnerable but to give them a road map to a better life. It is only by tackling welfare dependency and starting to dismantle the benefits trap that we can help people escape the huge social costs of worklessness, social exclusion and intergenerational poverty. Many noble Lords will know how difficult it is to wrestle with the issue of child poverty without this kind of route.

Those who cannot work will of course continue to get the support they need. However, for those who can make the journey back towards the workplace, we will offer them structured support to become work-ready. This will provide real help for many of those who have previously been abandoned by the system—those who were simply labelled as incapacitated and largely ignored, whether they wanted to work or not.

The work capability assessment was introduced in October 2008 as a key part of the assessment process to determine entitlement to employment and support allowance. It replaced the personal capability assessment and represented a significant and overdue change in assessing an individual’s ability to work. It was developed in conjunction with technical experts, along with considerable input from specialist disability groups.

However, it was clear from the outset that, unlike the PCA, the WCA should be subject to an ongoing process of review, evaluation and refinement. Indeed, it was this House that passed the amendment that introduced the requirement for an independent review of the WCA for the first five years after its introduction—a point made by the noble Lord, Lord Kirkwood. It was the only amendment from this House that made its way into the original legislation for the work capability assessment, and it received support from all sides. That was slightly before my time, but I know many noble Lords will remember it well.

Chronically Sick and Disabled Persons Act 1970: 40th Anniversary

Baroness Masham of Ilton Excerpts

Thursday 17th June 2010 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I thank the noble Lord, Lord Corbett of Castle Vale, for introducing this debate, and for his excellent speech. This debate is to mark the 40th anniversary of the Chronically Sick and Disabled Persons Act. It is also the 40th anniversary of my becoming a Member of your Lordships’ House. The noble Lord, Lord Morris of Manchester, was in 1970 a Member of Parliament for one of the Manchester constituencies, and was lucky to win the ballot to enable him to introduce the Bill. It took much hard work and persuasion to get the Bill accepted in another place, and the noble Lord must be congratulated on his doggedly determined way of not giving up on such matters.

Looking back over the past 40 years and discussing this Act of Parliament, I am filled with nostalgia. Four of us who were disabled Members of your Lordships’ House made our maiden speeches on that Bill. We all used wheelchairs. A Cross Bench was removed and we became known as the mobile Bench. My sadness is that I am the only remaining Member of that first mobile Bench, all of whom were very close friends of mine. They were Viscount Ingleby, Lord Crawshaw and Baroness Darcy de Knayth, all of whom have sadly died.

The Bill was led in this House by the late Lord Longford. Many amendments were moved in your Lordships’ House and the Bill was improved. We moved amendments such as one requiring that public buildings with access for wheelchairs should be signposted. The Chief Whip from another place used to come through because he was so concerned about the amendments we were discussing. This was the first significant legislation to improve the lives of disabled people. Many people were uneasy about the Bill, as people who do not understand disability fear the unknown. They thought that we were going to change society. Indeed, the Bill did improve society for many people.

Disability covers so many different aspects of daily living that non-disabled people take for granted. A disabled person, who may be a child, can mean a family being disabled if adequate housing and suitable aids—as well as access to public buildings, public lavatories and transport, including trains, airplanes, buses, taxis and ships—are not available. Disabled people using wheelchairs often had to travel in the guards van. The provision of telephones, the recognition of dyslexia and access to places of entertainment were all in the Bill. Now, 40 years on, we have to look forward. Aspects of life have changed. We have a new mobile Bench with other Members of your Lordships' House who are well qualified to provide their knowledge and expertise on many aspects of life.

So much has improved over the years but there is still a great deal to do, and much of it is due to the attitudes of some people. I give an example. In my local village of Masham in north Yorkshire, the chemist’s has a four-inch step with no ramp. Many elderly people with varying disabilities find that step impossible to negotiate without help, but because Masham is not a large town, the chemist was told by the PCT that a ramp was not necessary. That is not satisfactory when many residents and visitors to this most attractive part of Yorkshire have a disability. Legislation is being flouted. I know how hard many Members of both Houses of Parliament worked on this legislation, so it is disappointing when a pharmacist, of all places, takes this attitude.

Many disabled people are living much longer. They are often treated as elderly but their disability is forgotten. When disabled people visit hospitals, they very often find that there is no suitable equipment for their disability. Again, it is often a question of the attitude of staff who need better training about the multitude of different disabilities. Disabled people want to be treated as persons first. However, their disability needs to be taken into consideration and they should be helped when necessary. Police and other professional people need to recognise disability so that unfortunate mistakes do not occur. It is still not possible for disabled people to use many facilities. For example, a passport photograph booth has a fixed stool, so disabled people in a wheelchair have to hunt around to find an accessible booth to have photographs taken for the many passes for which they may have to produce photographs as identification, such as the blue badge scheme.

I visited the mobile X-ray unit in London that takes X-rays of people who may have tuberculosis from among the homeless living in hostels and people in prison. It is a great asset to public health. I was pleased to see that this mobile unit had a lift to enable a person using a wheelchair, or who has difficulty climbing steps, to enter the vehicle. The mobile unit was built in Holland. I was told that the mobile units in Holland all have lifts; not so in the UK. The breast cancer units that travel round all have steps and no lifts. We have a great deal to learn from other countries which remember the needs of their disabled members—sometimes better than us. It can be a major problem for disabled people in a rural area who sometimes have to travel for miles to have a mammogram.

On Tuesday there was a debate on poverty. The Minister, the noble Lord, Lord Freud, said:

“Disabled people are at a substantially higher risk of poverty than non-disabled people. Nearly one in four families with a disabled member live in poverty, compared with less than one in six for families where no one is disabled”.—[Official Report, 15/6/10; col. 947.]

I want your Lordships to know that many disabled people have extra expenses for wear and tear to clothes, extra heating, extra equipment that can be very expensive—such as light wheelchairs to help their carers—special food when needed, and extra help to enable them to lead a normal life if they need help getting up, going to bed, dressing and going to the lavatory. Disability can happen at any time to anyone. They can have an accident which leaves them paralysed, a stroke, a condition such as motor neurone disease, or they are born with a condition which leaves them disabled.

The Chronically Sick and Disabled Persons Act 1970 has helped a great deal, but there is much to do to educate new Members of Parliament, councillors, medical staff and educators to understand the very varied and sometimes complex needs of disability.