Welfare Reform and Work Bill

Baroness Tyler of Enfield Excerpts

Wednesday 9th December 2015 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I have put my name to a number of amendments in this group and shall speak briefly to them. As my noble friend Lady Howe explained, Amendment 51 would mean that people with a mental or behavioural disorder would not be mandated to take part in inappropriate activities that might be detrimental to their mental health and that the current sanctions would no longer impact on them. It is crucial that support is tailored to the individual and that it addresses a person’s main barriers to work. For people with mental health problems, I cannot stress enough how important a good relationship between a claimant and adviser is and that people must be involved in decisions being made about them.

With respect to Amendment 52 I will restrict my comments to the provision of mental health care. This amendment would mean that anyone on ESA with a mental health problem as their primary condition—as the noble Lord, Lord Layard, explained—could be fast-tracked to IAPT for therapy. That needs to be debated, but Mind is concerned about the broader implications this could have for the many people who are already on waiting lists for talking therapy.

A survey of 2,000 people from the We Need to Talk coalition last year found that one in 10 people had to wait over a year between being referred for talking therapy and having an assessment. Waiting this long can be incredibly damaging. The findings also showed that while waiting for talking treatments, four in 10 people harmed themselves, one in six attempted to take their own life and at least 6% of people ended up being admitted to hospital.

People are already trying to get treatment, but services are just not meeting demand. We would need to know what types of treatments people with mental health problems on ESA are already receiving, are likely to be waiting for or have already received. So it is difficult to know what effect this amendment would have.

The final point to tease out of this debate is to raise caution around any suggestion of mandated treatment, although I am sure that this is not the intended effect of this amendment. I am pleased to speak to the amendment to highlight the wider issues around access to mental health services. Anything we can do to improve access to mental health services for all is absolutely a good thing. The Minister defended the proposed changes to the ESA WRAG during discussion of Amendment 34 earlier this week by saying that the Government are doing more than any previous Government to improve access to mental health services —presumably those provided by the NHS. However, mental health is still the Cinderella service in healthcare and is not just the responsibility of the NHS. If I were a Minister in the Department of Health, I would be extremely worried that these proposed DWP policies would lead to an increase in or a worsening of mental disorders for people in this group and that they would lead to additional demand and escalating costs.

I will also speak briefly on the stand part debate for Clauses 13 and 14. My noble friend Lord Rix sends his apologies. It is quite a task for him to come into the House at the moment due to his current health problems, so he chose to focus his input on his excellent Second Reading speech.

I welcome the review published by my noble friends Lord Low, Lady Meacher and Lady Grey-Thompson and I urge the Minister to look closely at it. I particularly welcome the review’s inclusion of people with a learning disability. The story of Sam Jeffries, who himself has a learning disability and whom I met yesterday at the launch of the review’s publication, where he spoke, gives a human face to the concerns that noble Lords are expressing.

Sam is a 25 year-old man who lives on the Isle of Wight with his nan. He is currently in the ESA WRAG group. He has a moderate learning disability and some joint problems, so he finds it difficult and painful to walk other than for short distances. He uses some of his personal budget to go to a Mencap day service, which he enjoys, although he would like to work. He has a support worker, who is paid partly from his personal budget and partly from his benefits. Sam says that if he were to lose another £30 a week it would make a massive difference. He would struggle to pay for everything. It would mean not going to his day service and being unable to afford the taxis he sometimes needs to get around. He would like to work part-time if he could but there are not many jobs around, and sometimes 50 people are competing for each job.

I have worked with people with a learning disability for much of my life, and they need the support to look for work and ongoing job support. This should be the Government’s focus, not cutting benefits. To do so will ruin the employment prospects of many people with a learning disability while at the same time affecting their social life, their health and their self-esteem.

[Baroness Tyler of Enfield (LD)]

My Lords, I will briefly speak to Amendment 52, to which I have put my name. In so doing I express my strong support for Amendment 51, in the name of the noble Baroness, Lady Howe, which aims to improve back to work support for people with mental health problems. I also signal my strong support for the arguments that have been put forward that Clauses 13 and 14 should not stand part of the Bill.

I will briefly speak on Amendment 52. The noble Lord, Lord Layard, has already argued very powerfully that any person with a mental health problem as a primary medical condition awarded ESA in the WRAG group is immediately offered assessment and treatment in a local IAPT service. That is very important, and I will explain why I added my name to that amendment. It is about offering that treatment, not about it being compulsory—that is an important point to grab hold of, given the discussion we have had.

There is now plenty of evidence which shows that when people experience mental health problems, getting the right type of talking therapy as early as possible can make a huge difference to their recovery and their ability either to return to or enter work, and to prevent them becoming ill again. It is a very good and helpful idea that people with mental health problems in the WRAG group should get that immediate treatment. I accept that there are issues to work through here, to which the noble Baroness, Lady Hollins, drew attention, about making sure that in doing this we do not build some sort of tiered approach to mental health services, which could create difficulties.

The key point I want to underline, which was made so powerfully by the noble Lord, Lord Layard, was that an approach like this could save a very large amount of money on welfare. From listening to the debate so far, I have understood from the Government that that is what the Bill is primarily about. There is an opportunity to do that here, so we should not pass it up. I also offer my services to work with the Minister to find a way to make this amendment work, because it has great potential.

[Lord Beecham (Lab)]

My Lords, the Journal of Epidemiology and Community Health recently published a report which suggested that the work capability assessment process might have led to the large number of 600 extra suicides. It says that its study,

“provides evidence that the policy in England of reassessing the eligibility of benefit recipients using the WCA may have unintended but serious consequences for population mental health, and there is a danger that these adverse effects outweigh any benefits that may or may not arise from moving people off disability benefits”.

It goes on to say:

“Although the explicit aim of welfare reform in the UK is to reduce ‘dependency’, it is likely that targeting the people living in the most vulnerable conditions with policies that are harmful to health, will further marginalise already excluded groups, reducing, rather than increasing, their independence”.

After reading about that report I tabled a Written Question, which produced a very prompt Answer from the Minister. I am grateful about the time it took, although the Answer was not exactly informative. The Question was:

“To ask Her Majesty’s Government whether they will release data relevant to the assessment of whether Work Capability Assessment tests are connected to the incidence of suicide or mental health problems of disability benefit claimants; and if so, when”.

The reply was brief and to the point:

“The information requested is not available”.

I can understand that but surely, the issue having been raised, it is incumbent upon the Government to make inquiries into the report that the journal produced and to satisfy themselves and others that the process of the work capability assessment is not resulting in ill effects upon those undergoing the process of such assessment to any significant extent, let alone, of course, the dreadful extent of suicides resulting from it. I hope that having regard to the thrust of the amendments in this group, the Minister will indicate that the Government will again look into, or rather look into—clearly they have not looked into the possibilities here—the impact of that assessment, taking into account the report to which I refer. It is surely imperative that in recasting the system we take every opportunity to ensure that minimal harm is occasioned by the processes that are instituted to distribute the benefits in question.