Universal Credit Regulations 2013

Debate between Countess of Mar and Lord Eden of Winton

Wednesday 13th February 2013 Lords Chamber

[The Countess of Mar]

My Lords, I propose to confine myself to Part 5 of these regulations on the capability for work or work-related activity. The Minister will recall many occasions when he has assured me that people with ME/CFS are judged on what they can and cannot do in their condition. Memo DMG 1/13, entitled, ESA: LCW and LCWRA Changes, has been brought to my notice very recently. Part 16 of these changes, which I will read out completely so that we understand them, states:

“DMG 42114 advises that a claimant’s LCW must be due to a specific bodily disease, mental illness or disablement. This means that a claimant could satisfy the mental, cognitive and intellectual function descriptors if they had a physical health condition, without having a mental health condition. The law is amended to make it clear that physical descriptors can only be satisfied by a person with a physical health condition, and mental descriptors can only be satisfied by a person with a mental health condition”.

The document then indicates the difference between limited capability for work and limited capability for work-related activity. Both the sections are the same, so I will just read out one:

“when assessing the extent of the claimant’s LCWRA, it is a condition that the claimant’s inability to perform¹

1. physical descriptors² arises”—

I assume the figures refer to the notes—

“1. 1.1 from a specific bodily (i.e. physical) disease or disablement or

2. 1.2 as a direct result of treatment by a registered medical practitioner for such a condition and

2. mental descriptors³ arises

1. 2.1 from a specific mental illness or disablement or

2. 2.2 as a direct result of treatment by a registered medical practitioner”.

In view of the fact that these regulations are running parallel with the ESA regulations—Part 4 and Part 5 —will the Minister please explain why this change has occurred? These people obviously have to have a mental or a physical condition, on a medical certificate presumably, before they can be judged to have one or other of the conditions that I have mentioned. We have a particular difficulty with ME/CFS, as the Minister knows, because many of these people will not have seen a doctor for years and cannot get a medical certificate. I would be grateful if the Minister could clear that up for me.

Also on these paragraphs, Citizen Advice states in its briefing that Regulations 39 and 40 in Part 5 of the Universal Credit Regulations 2013, to which I have referred, set out,

“who is entitled to the Limited Capability for Work element and the Limited Capability for Work Related Activity elements. Regulations 89 to 91 set out who apart from those with LCW or LCWRA will have full work related requirements. Under Universal Credit, claimants with a disability and/or a health condition can be required to undertake ‘all work-related requirements’ before the outcome of their claim for the equivalent of income-related Employment Allowance … has been decided, and whilst they are appealing that decision. ESA regulations (2013) Regulation 26 maintain current protection for those applying for contribution-based ESA … This means that claimants with an equivalent disability and/or health condition applying for ESA … (or the equivalent in UC) will face different work-related conditions through the assessment phase and any appeal, to those applying for ESA”.

Will the Minister kindly clear that one up as well, please?

[Lord Eden of Winton]

My Lords, perhaps I may make a brief comment, but first I must apologise to noble Lords. It is quite clear from all those who have spoken that there is a great deal of expertise and deep knowledge of the subject and, as will become immediately clear, I cannot live up to those standards. However, there is one matter on which I wish to make a brief point. Before doing so, I congratulate my noble friend the Minister on the clarity with which he introduced this subject and on the immense work that has clearly been done on it.

I have one worry, which is that these are enormous and complex changes that will impact on and affect many people who by definition are extremely vulnerable. While I very much support the aim and objective of what the Minister is proposing, and I hope that the pathfinder work is a success, I worry about the implementation of such complex proposals in practice. I share quite a lot of the sentiments expressed by the noble Baronesses, Lady Sherlock and Lady Hollis, and others.

It is therefore most important—perhaps this can be enshrined in guidelines—that those who will be advising the potential beneficiaries of the change are fully and adequately trained and fully understand what they will be talking about. More importantly, when it comes to actually carrying out the whole process of changeover, those who are at the decision-making end should exercise supreme patience and understanding. For me, patience is all important.

As the noble Baroness, Lady Hollis, said, many people will not have online access. I know, being of advanced years myself, how difficult it is to understand everything that is going on. I am reasonably but not fully conversant with all the complexities of new technology and new systems of communicating. I can often sense the impatience at the other end of the line in people younger than me, for whom it is second nature to handle these things. It is not so for everyone and it is most important that those who are in a commanding position assist potential beneficiaries to understand the process of changeover, and do so with extreme patience.

Health and Social Care Bill

Debate between Countess of Mar and Lord Eden of Winton

Wednesday 8th February 2012 Lords Chamber

[The Countess of Mar]

My Lords, I too support this amendment very strongly, and I think the Minister knows why.

In my dealings with people with ME/CFS, I have found that many of them have been sectioned and put into wards that I can only describe as barbaric. There was one recent case where the man had a very clear physical illness and he spent nearly nine months in a hospital in Torbay—Torbay, the hospital that has been praised left, right and centre; but its mental ward is not worthy of praise. If the funding is equal for mental and physical treatment, this will somehow redress the balance.

My mother was mentally ill for 17 years and she was treated barbarically by psychiatrists. She was hooked on barbiturates and she was given a leucotomy. I thought those days had gone but we are not far from them with the things that I have seen with ME patients.

[Lord Eden of Winton]

My Lords, we have listened to many powerful and persuasive speeches. I am tempted to go all the way with those who have advocated the inclusion of this amendment in the Bill, but I take up the words of the noble Baroness, Lady Finlay, who referred to the need for a cultural change. I think all noble Lords would agree that there is the need for a cultural change. I only question whether it is right to try to achieve that change through legislation. Surely what we are seeking to do is to change attitudes and get people to understand that there is no difference between physical and mental illness. For that reason, I think we need to hesitate before including words in legislation. What we need to do is to make people throughout the health service and everyone associated with the administration aware of the fact that there is no difference between physical and mental illness, and that those with mental illness need to be treated on an absolutely level footing with those with physical illness.