Work Capability Assessments

Lord Grayling Excerpts

Wednesday 1st February 2012 Westminster Hall

[Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship today, Mr Williams. I am following a very powerful speech from my hon. Friend the Member for Kilmarnock and Loudoun (Cathy Jamieson). In securing this debate, my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) has done a great service not just to the House but to the many thousands of people in the country who are affected by the issues. I had a number of points that I wanted to make, but as others still want to contribute, I will restrict my comments to two specific problems with the work capability assessment that arise from my constituency.

My first concern relates to people with sensory impairments. In particular, I want to raise an issue that was brought to my attention by a constituent with a visual impairment. In fact, I raised this case in a parliamentary question with a Minister a few months ago because my constituent was having problems filling in the ESA50 form through the audio systems available to people with visual impairment. After months of difficulties, which I do not have time to go into today, it turns out that my constituent may not have actually needed to go through this process because in November, the DWP changed the criteria by which people are allocated to an ESA support group. I am told that the new rules mean that someone with a hearing or a visual impairment could qualify for a place in a support group, whereas between April and November, the position was that someone had to have both a hearing and a visual impairment to qualify for the support group. That has certainly caused my constituent a great deal of concern. By giving her the wrong guidance, she felt that the DWP had sent her down the wrong road for months.

[The Minister of State, Department for Work and Pensions (Chris Grayling)]

I am grateful to the hon. Gentleman for allowing me to intervene. I will respond to all the detailed questions in my remarks. On this specific point, there have been no changes to the rules around referrals. There were no changes in November. We have updated our guidance, which we do as a matter of routine, but there have been no changes to the formal rules.

[Mark Lazarowicz]

I understand what the Minister is saying, but the guidance was updated to reflect some of the difficulties that had been raised. The view of the Royal National Institute of Blind People is that Atos may well have been wrongly assessing people between April and November. That may have been the fault not of Atos, but of the incorrect guidance. Will the Minister tell us how many people were wrongly assessed and why there was a need to issue new guidance? Why was my constituent required to go along a road which she did not need to, given the fact that new guidance was issued?

My second point covers the position of people with mental illness, which has been raised by a number of colleagues in this debate. I refer to a report produced by the Consultation and Advocacy Promotion Service, which is an independent advocacy organisation that operates from Edinburgh, Midlothian and East Lothian. The report describes the experience of people with mental health problems going through the work capability assessment process. Again, if time had been available, I would have gone into great detail. Instead, I will simply report its main conclusions.

The work capability assessment for employment and ESA is not designed to assess accurately the needs of people with mental health conditions. It causes a high level of stress and anxiety in people with mental health conditions and, in some cases, it may even make their condition worse. It does not cater for fluctuating conditions, nor does it accurately record how those conditions affect people’s ability to work. That is an experience that many Members will have heard about in their surgeries. I hope, following the Harrington review, that we will see some improvements in that area.

Finally, we are all experiencing these difficulties because of the way in which the process was hurriedly rolled out across the country. We will face, over the next few months and years, even more dramatic changes to the whole welfare system. If we do not learn from the mistakes that we have made so far, we will find that the problems relating to the work capability assessment process are repeated many times throughout the country. Many more people will suffer. Many more people who could get into work might not be able to because they will not be given the support. Many people who will not be able to get into work will be driven to desperation because of the difficulties that they will face. At the end of day, it will also cost the public purse much more money, which none of us wants to see happening.

I hope that the Minister will recognise that we are not trying to make political points. It is not a political issue; we raise it because we hear from our constituents in our surgeries throughout the country every week and we want action. Opposition Members would certainly be beating down the door of a Labour Minister if we were in government and there were the same kind of problems. We need action and assurance. We certainly do not need complacency from the Minister and I sincerely hope that we do not get it in his reply today.

--- Later in debate ---

[The Minister of State, Department for Work and Pensions (Chris Grayling)]

Let me be absolutely clear—particularly in relation to the comments made by the hon. Member for Rutherglen and Hamilton West (Tom Greatrex), who proposed the debate, and the hon. Member for Ogmore (Huw Irranca-Davies)—that we are trying to do the right thing. We are trying to identify people with the potential to go back to work and provide them with the help to do so. Sometimes, those people will have a health condition—in the United Kingdom, 7 million people with a health condition are in work—so the number of points that people receive in the work capability assessment does not automatically mean that they do or do not have a health condition. The judgment is all about helping people return to work, perhaps in different roles. Their health condition might prevent them doing what they did before, but that does not mean that there is nothing they can do.

I approach this debate in a non-partisan spirit, but I want to explain the time lines to hon. Members, so that they understand exactly where we are in the process. In June 2010, 18 months ago, prompted partly by a report from Citizens Advice but also by concerns such as those raised by hon. Members, I asked Professor Harrington to take a careful look at a process that was already well under way. Employment and support allowance and the work capability assessment were established in 2008. The work capability assessment had been working since 2008. Statistics on the growth of appeals matched the flow of new claimants into ESA and worked down to some change 18 months ago, but I was unhappy that the process did not seem to be right, so Professor Harrington went away, reported in November 2010—interestingly, the date at the end of the period that the hon. Member for Kilmarnock and Loudoun (Cathy Jamieson) mentioned when she quoted the Parkinson’s statistics—and made several recommendations to us.

The right hon. Member for East Ham (Stephen Timms) made a point about pilots and roll-outs. Crucially, we did not simply pilot the work capability assessment and then start it. At that time, the questions that we were addressing were whether we could sort out the process and whether we should go ahead and roll out incapacity benefits, which would increase the number of people going through the work capability assessment.

Professor Harrington went away and made his recommendations to us, which we accepted in full and have implemented. He told me, “I believe the system is in sufficient shape for you to proceed with incapacity benefit reassessment.” We set ourselves a goal to put his recommendations in place, improve the quality of the process and address many of the issues to which hon. Members have referred today by the end of last May, when the assessments in the incapacity benefit reassessment were to start alongside the existing process of assessing ESA new claimants. We did that, and we started.

I have heard a lot today about the number of people who have sat through appeals and the number of cases overturned. It is crucial for hon. Members to understand this. I am almost certainly right in saying—I could not swear to being absolutely, 100% right, because there may be a small number of exceptions—that since the Harrington changes were introduced last summer, not a single appeal has been completed. Therefore, all the examples cited today that relate to the appeals process refer to what took place before the Harrington changes to the system that we inherited, which I accept was not doing the job as it should have done. I want everyone to understand that.

As a result of the Harrington changes, we tried to create a more humane, careful and thoughtful system. We have sought to change systems to provide greater protection to those with long-term problems. The right hon. Member for East Ham referred to the internal review that his Government carried out and that we implemented in the belief that it would increase the size of the support group—those who receive long-term unconditional support—and that is what has happened. We believe that the changes that we have introduced will lead to more people receiving long-term support.

[Dr Whiteford]

One issue that I raised with the Minister was that of people turning up for appointments and being turned away because they were double-booked. My constituents who were part of the pilot scheme travel, on average, three or four hours to get to and from an assessment. To be turned away when they have had to rely to get there on family and friends who have taken time off work is a real problem. The Minister has apologised to one of my constituents, but has the policy of triple-booking appointments been changed?

[Chris Grayling]

A situation in which people are treated like that can never be acceptable. Of course, we have an issue with some people not turning up to appointments, and because it is an intensive programme, we do not want a health care professional sitting there without anything to do. Sometimes, we will get it wrong. We will try hard not to, but there is no such thing as a perfect system. That is true of all parts of the system. I openly accept that we will sometimes get it wrong, but we have done everything that we can to create a system that gets it right as often as possible. We have changed the nature of the work capability assessment in the process.

We make a much greater effort to ensure that we have proper medical evidence at each stage of the process from the consultants and specialists working with the people concerned. One reason why so many appeals were successful was that new evidence was emerging only at the appeal stage. We have worked hard to ensure that such evidence comes in much earlier in the process, so if we get it wrong in Jobcentre Plus, we will get new evidence there at a point of reconsideration. That is a crucial change. We are now ensuring that we seek out additional information in Jobcentre Plus before we take the first decision, but we have bolstered the reconsideration process to make it much quicker and more straightforward, so that if we get it wrong the first time, people can get a quick second opinion in Jobcentre Plus. That is crucial to getting the process right.

[Katy Clark (North Ayrshire and Arran) (Lab)]

Will the Minister give way?

[Chris Grayling]

I will not take interventions, because I have only five minutes and must get through a lot.

We have also tried to make the process more humane. People now get phone calls instead of the generated, standard letters that I regard as impersonal and inhuman. All our measures are part of a process of change that I hope will make a real difference to individuals’ experiences—and it is. Indeed, in his second report, Professor Harrington praises those involved in the process for creating a system that he, as an independent figure, regards as much improved.

As constituency MPs, we will always have people coming to our doors saying, “I am being done wrong by,” because sometimes, in an imperfect system, we will not have got it right. Equally, however, some people will still think that we have done wrong by them, but three years later, when they are back in work, they will say that it was the best thing that ever happened to them.

About a month ago, I sat with a woman in a Work programme centre who said that she had been off work with chronic depression for 13 years. She told me that she had arrived on her first day in the Work programme and said, “I can’t possibly work. This is ridiculous. I don’t know why I am here. I am being traduced.” A month later, she was doing voluntary work in a charity shop, applying for jobs and beginning to say, “Actually, this is good.” We are taking people through a difficult period in their lives.

I said “rubbish” to the final comment made by the hon. Member for Rutherglen and Hamilton West not because he is not raising genuine issues—although I hope that I have explained their context—but because the system is not about forcing people into work. It is about finding the right number of people whom we can help into work. The alternative is to leave them on benefits for the rest of their lives, doing nothing. I do not believe that they benefit from that.

[Tom Greatrex]

I was making the point that, given the lack of confidence in the system, many people feel as though they are being hounded rather than helped. That is the crucial matter that must be addressed in the coming period.

[Chris Grayling]

I accept that, but I genuinely hope that hon. Members will take note of what I said about the time lines and the changes that we have introduced. Professor Harrington said of the concerns highlighted in the Citizens Advice report to which hon. Members referred, “This happened before my changes.” I hope that we can send the message that the system is changing and improving and that we are making genuine efforts and will continue to do so. That is why we changed the guidance in November. It is a process of continuous improvement. We want to get it right as far as we possibly can.

I shall try to answer one or two specific questions before I finish. On audio recording, we will offer everyone who wants it the opportunity to have their session recorded. We decided not to implement universal recording because, based on the trial experience, people did not want it. Few people wanted their sessions recorded, and some said that they definitely did not. We decided therefore to offer recording as an option to those who want it. That seems entirely sensible.

Contact between Atos health care professionals and decision makers will be done by telephone. What matters is not the contact between a single person and a block of decision makers, but trying to phone up the decision maker themselves. On capacity issues, as we stand here today, the incapacity benefit reassessment is on time. New claims for ESA have fallen a bit behind, mostly because of the introduction of the personalised statement following Professor Harrington’s report. We discovered in the first few weeks that it took health care professionals much longer to complete the statement than expected, so the number of completed assessments dropped. That has changed. They have caught up again, and we are chasing through to clear the backlog, as we are doing with the appeals backlog that we inherited.

Finally, the right hon. Member for East Ham asked about the Work programme. Incapacity benefit reassessments are progressing according to time. The biggest impact on numbers in the programme has been created by the different mix of people coming through and the bigger support group. I am quite relaxed about having a bigger support group, because if we need to provide long-term unconditional support to a larger group of people than we had expected, it shows that we are making a genuine effort to get it right and are being sensitive to the needs of people with disabilities. We want to help them into work, but we want to do it in the right way.