Disabled People

Baroness Thomas of Winchester Excerpts

Thursday 5th May 2011 Lords Chamber

[Baroness Thomas of Winchester]

My Lords, I too am grateful to the noble Lord, Lord Low, for the opportunity to raise a couple of specific matters. One is very familiar to old DWP hands in this Chamber who have heard me raise it many times before: namely, the problems posed by the service user involvement of disabled people in receipt of benefits. The other matter is completely different and arises from the new descriptors of the work capability assessment, which were the subject of a debate a few weeks ago and to which the noble Lord, Lord Rix, referred.

I shall begin with this last issue. One of the matters that struck me when we debated the recent changes to the WCA was that manual wheelchair users may no longer automatically be entitled to ESA—presumably neither the employment and work-related activity side of ESA nor the support side. This change was made, I suppose, on the grounds of equality, as it was felt that if manual wheelchair users had no other particular health problems they should be treated as fit for work because they had adapted to their disability. On the face of it, that looks fair enough because we are told that the ethos of the work capability assessment is to identify claimants on the basis of their functional capability rather than their condition. We know that the WCA looks at only a person's fitness for work; it does not take into account the jobs market or, more controversially, whether a person is likely to find a job in the real world. This came out strongly in the Social Security Advisory Committee’s report.

It might be argued that most workplaces nowadays are fully adapted for wheelchair users, but that is very far from the case. Many workplaces are up steps with no alternative access and many do not have facilities such as disabled lavatories. It is true that most public buildings have adaptations nowadays, but we are talking about workplaces of every shape and size all over the country. With the emphasis now on the shedding of jobs in the public sector and the hoped-for growth of jobs in the private sector, is it really fair to put manual wheelchair users on a par with those with no mobility problems when there are not going to be so many public sector jobs? They are likely to find it many times harder to get a job than their able-bodied counterparts—and I have not mentioned the problem of discrimination at all.

The most worrying thing is that, by being entitled only to JSA rather than ESA, they will lose almost £30 a week. I know that there might be cases in which access to work will help, but this admirable scheme cannot change the access into a building, widen doorways or put in disabled loos. I have not mentioned transport, which must loom large in whether someone in a manual wheelchair can get to suitable employment. It may be said that DLA is designed to help, but it is not taken into account by the work capability assessment. If it is taken into account, so should the availability of accessible and suitable jobs. Of course those in manual wheelchairs wish to be treated as ordinary working people, but when the dice are loaded so heavily against them in a practical way, is this fair?

Before my noble friend quotes from the equality impact assessment in the relevant statutory instrument, I shall do so myself. In theory, it gives me some comfort, but I fear that I am very sceptical. It says:

“For those who have a more limited availability for work and scope to find and carry out certain types of work they can restrict their work search activity and availability for work provided those restrictions are reasonable given their condition. This is agreed between the customer and personal adviser”.

There is a sentence about the disability employment adviser later. Will Jobcentre Plus staff really have enough time to devote to those who have such practical barriers to the relatively few jobs open to them, and will they be subject to the tough sanctions regime? I should have thought that they needed the kind of help to get a job that they would receive under the ESA regime, and I would welcome the Minister’s comments.

I now turn to the second and quite separate issue of service user involvement, specifically the unresolved problem of those disabled people on benefits who help with NHS, public health and social care research. They are asked to take part in clinical trials and other health and social care research studies, not just as subjects but as active partners in the research process. Disabled people are asked to help improve the way in which research is prioritised, commissioned, undertaken, communicated and used.

The specific unresolved problem that I would dearly love to nail is that the reimbursement of out of pocket expenses, and sometimes a small fee for these people, is still taken off their benefits. Two years ago, legislation was introduced in this House by the noble Lord, Lord McKenzie of Luton, which to great rejoicing removed two significant barriers to involvement by allowing these expenses to be disregarded when benefit entitlement calculations were made. However, this change was relevant only to those whose involvement was in the field of health and social care services and not research. In other words, this new and welcome change in the legislation applied only where the involvement was required by law. The benefit changes apply to involvement with local authorities, landlord authorities, NHS trusts and health boards. They do not apply to involvement with the work of the National Institute for Health Research.

Are we talking about relatively few people who are being caught by this distinction? No, we are talking about thousands of people, as a glance at the website of the institute will show. Research is going on into every organ in the human body and into every condition. Not everyone involved in this kind of research will be on benefits, but many will be. The institute recommends as good practice the involvement of service users and carers in research, but it is not required by law, so the benefit changes do not apply to public involvement in research.

When universal credit is introduced under the Welfare Reform Bill, which is currently going through Parliament, I understand that the regulations introduced two years ago will be incorporated into UC regulations, but the changes to benefit rules on the earnings disregard will not resolve the benefit barriers to involvement in NHS research. This is because any reimbursed expenses, plus possibly a small fee and the cost of a personal assistant or a replacement carer, will be totalled and the whole amount treated as earnings and taken off benefits. Where the total amount that is treated as earnings is in excess of the earnings disregard set for UC, which will usually be in the region of £40 a week or less, the excess will lead to a 65 per cent taper of UC for every £1 over.

Then we have the outrageous matter of notional earnings, which means that if a person declines to take a small fee because they do not want to upset their benefit arrangements, they will be treated as though they had taken the fee, so they are most likely to be out of pocket as a result of helping with NHS research and are not likely to repeat the experience. I myself have helped with people taking the MRCP exam, so I know what it is like. I was not on benefits, but if I had been I would have been out of pocket. I hope the Minister will agree that this is an anomaly that we really must resolve as soon as possible. The new Bill gives us the perfect opportunity to do so.