Welfare Reform Bill

Debate between Baroness Meacher and Baroness Browning

Tuesday 17th January 2012 Lords Chamber

[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.

Police Reform and Social Responsibility Bill

Debate between Baroness Meacher and Baroness Browning

Thursday 14th July 2011 Lords Chamber

[Baroness Browning]

My Lords, I commend the noble Baroness, Lady Meacher, for ensuring that we keep an open mind and consider all options available to best respond to the threat of new psychoactive substances—sometimes referred to as legal highs—which are specifically designed to get around existing legislation.

As I explained in Committee, the temporary class drug orders will constitute a UK legislative response that is appropriate to the immediate threat that a new drug poses while its nature is still in question. As the noble Baroness is aware, some of these new substances present harms equivalent to those from class A and class B drug use. In these circumstances, the appropriate response is to disrupt the supply chain and protect the public as a priority while giving the Advisory Council on the Misuse of Drugs time to consider evidence of a drug and its harms. The proposals before the House will help us achieve that aim. Of course, our response to both the general issue and individual new substances must be both preventive and proportionate.

These amendments seek to ensure that the Government amend and consider alternative legislation to tackle the threat of new psychoactive substances, alongside control under the Misuse of Drugs Act 1971. We are keen to see all existing legislation used to curb the availability of these substances, though not as a substitute regime for harmful drugs whose proper place is under control under the 1971 Act. The UK needs a legislative response that is appropriate to the immediate threat that a new drug poses when there is evidence that its harms are commensurate with class A or class B drug use. Temporary class drug orders will provide a preventive and proportionate response to the threat posed by disrupting the supply chain and protecting the public as a priority while giving the ACMD time to assess the drug and its harms.

On the point made by the noble Lord, Lord Judd, the noble Baroness will of course be aware that in bringing in these temporary orders while a substance is evaluated, we are not in any way criminalising the user. I also draw noble Lords’ attention to Section 1(2) of the 1971 Act by which the Advisory Council on the Misuse of Drugs already has the remit to provide,

“advice on measures (whether or not involving alteration of law) which in the opinion of the Council ought to be taken for preventing the misuse of such drugs”.

We will not prejudge the advice that the ACMD is preparing, including its thematic advice on new psychoactive substances.

On government Amendments 307C and 307D, the Government have always been committed to proper scrutiny of our drugs laws. We accept the recommendation of this House’s Delegated Powers and Regulatory Reform Committee that the affirmative procedure is preferred while still enabling us to take swift action against the threat of a new psychoactive substance throughout the year. The advice sometimes comes forward very quickly and there are periods when the House is in long Recess through the summer. The amendments take account of the concerns of the House’s committee but at the same time ensure that we are not tardy with the harms that we are notified of by the ACMD. To remain in force, a temporary class drug order will need to have been approved in both Houses within 40 sitting days.

I am sorry that I cannot accept the noble Baroness’s amendments. I would be very concerned that we would potentially deal with psychoactive substances which would ultimately fall within the class A or class B category. Notwithstanding that, it is up to the ACMD to offer the Government alternative advice as to other routes if it felt that was appropriate. On that basis, I ask the noble Lords to withdraw their amendments.

[Baroness Meacher]

I am grateful for the Minister’s response. I am not at all clear how she envisages the less dangerous substances should be regulated. I am not at all clear that this can be done under current legislation other than through the Misuse of Drugs Act. That is the concern reflected in these amendments. I believe that there is no alternative as the Bill stands, so I wonder whether the Minister could respond to that point.

[Baroness Browning]

I am very happy to write to the noble Baroness. As I explained, the ACMD in making its recommendations to the Government is able to indicate any routes that it thinks that the Government should take. I am very happy to explore that with her. We are awaiting a report from the ACMD on these new psychoactive substances, and it may well be that that will inform the Government better as to the range of options available to us.

[Baroness Meacher]

I thank the Minister for that response. My understanding is that in fact there will be a need for further legislation and it is my concern that the Government do all they can to take steps to prepare for that so that there is no gap or delay before these substances can be appropriately controlled through regulatory mechanisms other than the Misuse of Drugs Act. But with that point made, I beg leave to withdraw my amendment.