Welfare Reform Bill

Baroness Morgan of Drefelin Excerpts

Wednesday 16th November 2011 Grand Committee

[Baroness Thomas of Winchester]

My Lords, I support the amendment that was powerfully moved by the noble Baroness, Lady Howe. I shall also speak to my Amendment 86A, which enables an eligible person to receive PIP after three months rather than six. The balancing corollary of that amendment is my next amendment, Amendment 86B, which changes the length of time that a person's condition is estimated to last from six to nine months, so the envelope of time in these amendments is not being stretched beyond a year. It is just being differently configured, which fulfils the Government’s desire to align PIP with the definition of long-term disability in the Equality Act.

I gather that another simplification which the Government want is to align the waiting time for PIP with attendance allowance. They have cited the approval of several organisations for this change, but is my noble friend really telling us that these organisations would rather people waited for six months for PIP just for the sake of this alignment? This is certainly not my experience.

The reason my amendment seeks to keep the qualifying period to three months is very simple: some conditions of a long-term nature may have a sudden onset; some may not have such a sudden onset but might be able to be diagnosed only several weeks after the onset of symptoms. People with rheumatoid arthritis, for example, which affects about 400,000 people in the UK, are often only given an official diagnosis after six weeks of certain specified symptoms. I mention that disease specifically because arthritis in general forms 18 per cent of the DLA case load; it is at the very top of the list.

Next on the list are mental health conditions at 17 per cent. For anyone suffering from a severe mental health condition, applying for DLA would not be the first thing they think of, and waiting for six months, when PIP comes in, to help with care is a very long time.

There are then those diseases which may have a devastating impact on people immediately, such as a severe stroke or heart attack, a serious accident, amputation or an unexpected diagnosis of cancer which demands challenging treatment straightaway. We may hear a little more about that from the noble Baroness, Lady Morgan. People with any of these conditions may need the extra help which PIP could give comparatively quickly to stop them from falling into debt as they manage their condition with all its ramifications.

This is even more important in these days when local authorities are so overstretched financially that they are becoming reluctant to carry out more than minimal adaptations to people’s homes, let alone provide adequate help with caring. Those affected may need to buy for themselves various mobility aids, safety devices and other equipment, or perhaps set up a home alarm system. Their homes may need extra heating; they may have increased laundry requirements; they may need special diets; and they may have to rely on expensive taxis to get to hospital appointments and for other purposes. If the social model of disability means anything at all, then a disabled person is likely to have to rely on taxis if they want to go out and about, particularly during the winter.

Turning to those conditions which are not sudden onset such as my own—adult onset muscular dystrophy—it would be foolish for someone to try to get PIP too early while they are still able to manage their impairments relatively easily because they will almost certainly fail the assessment. On the other hand, if they know that they will have to wait, whatever happens, for six months before receiving any extra resources, they may decide they should at least start the process, particularly if they are beginning to fall into debt with managing their condition.

So when should they start the claim? I understand from what the Minister for Disabled People said in the Public Bill Committee in the Commons that the qualifying period for PIP starts at the point where someone is first entitled to it regardless of whether a claim has been received, and that even a lengthy spell in hospital can be part of the waiting period. That may be a helpful message for someone who has had a stroke or a bad fall, but it is not always possible to know exactly when a person might qualify.

At present, the waiting time for DLA is three months. By changing it to six months, the Government have said that this is not about saving money but about the right benefit going to the right people, or words to that effect. Presumably, by doubling the waiting time, they believe that three months is too short a time to be able to assess someone’s condition. They are possibly thinking that someone who has suffered, for example, quite a severe stroke might apply straightaway for PIP but, after six months, might be much better and able to manage the impairments they still have. However, looking at the case load for DLA, only 3 per cent of claimants have stroke-related conditions. This is presumably because the majority of stroke patients are past retirement age and thus past qualifying for the first time for DLA.

If PIP is to be an in-work as well as an out-of-work benefit, which it is, surely it is better to allow a person to claim the benefit after three months, not six, as it is likely to help them get back to work and to participate once again in society more quickly, for example by travelling to work by taxi or by taking a cab to the station.

The table of conditions that people who claim DLA are diagnosed with is very illuminating. People with both osteo- and rheumatoid arthritis, which as I said come top of the list, are very unlikely to get better after three months. Those with stroke-related conditions and malignant diseases are each just 3 per cent of the total. It is not as though a large number of DLA claimants with these conditions are trying to claim after their condition has improved. In fact, the table shows that the Government’s argument about a person’s condition not being stable after three months does not really stack up. I read from the table that most people almost certainly do not apply for DLA at present until they really feel they have to.

To sum up, six months is a long time to wait for extra resources if a person has had a diagnosis of a long-term severe condition. The Minister in another place talked about a person’s condition settling down. However, for many of us our conditions never settle down—they go on progressing. If the Government are implacably opposed to retaining the three-month waiting time for PIP, maybe they would agree to, say, an assessment on the papers after a year so that a person’s entitlement can be looked at properly again. I think this will come up later on.

If the Government insist on the six-month waiting time for all applicants, I fear it will be understood to be about saving money in the short term in the hope that people will be put off from applying. I am encouraged to hear that my noble friend and his fellow Ministers are still listening and I hope this means they are hearing all the arguments for changing the qualifying period back from six months to three.

[Baroness Morgan of Drefelin]

My Lords, this is a very important debate. I support the idea of keeping the qualifying period for PIP at three months. I also hope this debate will look at the idea of the prospective period moving from six to nine months if the Minister sees that as an appropriate practical way of dealing with the Government’s intention to align the qualification period for PIP with the Equality Act, as I understand it.

I, like many, am extremely concerned that the proposals here will have a devastating impact on disabled people, especially those with sudden-onset conditions such as cancer. Cancer patients often see sudden changes in their household income combined with significant cost escalation on diagnosis. This can make cancer patients particularly vulnerable to financial difficulties and in need of immediate financial support.

Why do people with sudden-onset conditions need support immediately? We know that cancer treatment and its debilitating effects can often begin very quickly after diagnosis, as the noble Baroness, Lady Thomas, has already explained. The associated support needs arising from that treatment are often immediate and, importantly, the first six months can be the period when extra costs are at their greatest as people try to adjust their outgoings to their reduced income. Research by Macmillan found that 80 per cent of cancer patients who experienced increased costs reported that they were greatest in the first six months.

--- Later in debate ---

[Lord Freud]

My Lords, among the elements available in the shorter term are healthcare, travel costs, free prescriptions or aids and appliances provided by the NHS or the local authority. Following the request by the noble Lord, Lord McKenzie, it may be easier for me to write with a list of particular supports.

[Baroness Morgan of Drefelin]

If the Minister is going to write, would he also look at explaining how many of those are dependent on local authority provision? Much of the kind of help that he is talking about is sometimes dependent on having DLA.

[Lord Freud]

My Lords, when I write I will try to do a full breakdown of what is available.

--- Later in debate ---

[Baroness Morgan of Drefelin]

I am sorry to interrupt the Minister again. Does he agree that one of the thrusts of modern health care—particularly in cancer care, where I have an interest—is to try to keep people at home for as long as possible and not requiring hospitalisation? One of the brilliant aspects of the DLA that I was trying to describe means that determined, independent people going through tough treatment can stay at home, saving the NHS thousands and thousands of pounds on hotel fees. We have to look at this issue in a joined up way.

[Lord Freud]

I am trying to make the point that it is the responsibility of the NHS to deal with rehabilitation and treatment issues. It is not the function of DLA to do that, nor will it be the function of PIP. It is a different support mechanism. It may be that noble Lords would like to put in a particular support function in those circumstances, but it is not what PIP is meant to be.

[Baroness Morgan of Drefelin]

In that case, perhaps I may ask another question. If this is not what it is for, we need to understand what the implications are. People who have DLA now and are being treated for cancer—to give an example of a sudden-onset condition—are utilising the benefit in that way. As I understand it, DLA is meant to be used in a way decided by the client. It is important for people to keep their independence—to stay at home and look after themselves—and to stay positive. Surely we want to encourage that.

I understand the Minister says that that is not the purpose of the benefit, but I am confused: it is a product of the benefit which is of benefit to all of us. If it is being changed, we need to understand the implications and the evidence of what the knock-on effects might be elsewhere in the system.