Employment and Support Allowance Application

Debate between Jim Shannon and Eilidh Whiteford

Wednesday 7th May 2014 Westminster Hall

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

It is a pleasure to serve under your chairmanship in this short debate on the employment and support allowance application process for those with mental health problems, Mrs Main. We may be a small, select company this afternoon, but I am sure that I am not the only MP to have seen over the past couple of years a steady and increasing stream of people with quite serious mental illnesses falling through our social safety net, which is now very frayed because of welfare reforms. Despite modifications, the work capability assessment is still failing too many people.

It goes without saying that most people with a mental illness will never need to depend on the benefits system, but some of those with more severe or persistent illnesses do require support, and some of them are extremely vulnerable. In the time we have for this debate, I want to focus on the shortcomings of work capability assessments with regard to mental health conditions and make some concrete suggestions about how the process might be improved.

The issue is by no means new. Ever since the introduction of the work capability assessment, mental health care professionals and representative organisations have expressed concerns that it does not capture the impact of more serious mental illnesses on a person’s capacity to function in a working environment and consequently leads to poor decision making. A core problem is that too often assessors and decision makers have little or no relevant background information about claimants’ complex medical histories and too rarely seek input or opinions from claimants’ clinicians.

The problems were clearly acknowledged at the time of the first Harrington review, when Professor Harrington said that decision makers should be

“able to seek appropriate chosen healthcare professional advice”.

In his third review, he recommended that they

“should actively consider the need to seek further documentary evidence in every claimant’s case”.

The fourth review, led by Paul Litchfield, devoted significant attention to the assessment of mental function and made a number of recommendations, some of which the Government have accepted. However, the Royal College of Psychiatrists said this week that

“there is little evidence of any significant increase in the collection of evidence by either ATOS HCPs or DWP Decision Makers.”

The issue is not going away; indeed, it is being compounded by the new Department for Work and Pensions sanctions regime, which is having an acute effect on people with mental health conditions. According to a freedom of information request, in 2013, 58%—almost six out of 10—ESA claimants sanctioned were people with a mental health condition or learning difficulty. That is an increase from 35% of sanctioned claimants in 2009, and it suggests that people with mental health problems are being inappropriately sanctioned.

There is a growing body of evidence from a range of sources that, in spite of the changes that have been implemented along the way, the work capability assessment is still failing people with serious mental health problems. However, I want to highlight the report published recently by the Scottish Association for Mental Health, or SAMH, which details findings on how experiences of living in poverty affect peoples’ mental health, and how SAMH service users have been affected by welfare reforms.

SAMH has been a leading mental health charity in Scotland for many decades and works directly with thousands of people across the country, helping them to recover from mental illness and offering support and training. It also works to improve policy and practice in relation to mental health, reduce stigma, raise awareness and promote well-being. SAMH undertook a major survey of its service users in 2013. The truly shocking finding was that 98% of respondents said that welfare reforms were negatively affecting their mental health, including increasing stress and anxiety, while 79% were also facing financial problems. Of SAMH staff, 85% said that they were having to provide additional support to service users as a direct result of the welfare reforms, and, in six cases, SAMH staff had to carry out suicide interventions directly related to welfare reforms.

I know that the Minister will be well aware of the tragic case of a woman known as Ms DE, whose suicide in 2011 was the subject of an investigation by the Mental Welfare Commission for Scotland. Ms DE took her own life after scoring zero points in a work capability assessment made in the absence of an ESA50 form and without any additional information from her clinicians. The only information her assessor had about her condition was the single word “depression”, a word that in her case masked a long and difficult psychiatric history. Both her general practitioner and consultant psychiatrist considered Ms DE unfit for work at the time of her death, even though she had worked for most of her adult life. Indeed, the significant event review after her death noted that

“Ms DE was hoping to return to employment at some point.”

However, it also noted the distress caused by her benefits assessment and the role that it may have played in her suicide, concluding that there was “no other known trigger”.

[Jim Shannon (Strangford) (DUP)]

I am grateful to the hon. Lady for giving way, and for her permission to make an intervention. Just this week my office has dealt with two ESA appeals and four inquiries on the subject. Each one of those six cases relates to addiction or mental health problems. I am very aware of the far-reaching impact that the process has on people, which the hon. Lady outlined. Does she agree—she probably will—that if there is no compassion and understanding in the system, as there seems not to be, many other people will come to the same point as the lady whose case she is describing?

[Dr Whiteford]

I think that is right. On reading the evidence produced by organisations that support people with mental health problems, it is very clear that the increased anxiety and stress can contribute to ill health and make people more ill than they were to start with.

The report makes upsetting reading, and we should all express condolences to the unnamed woman’s family. Her death is a sobering reminder to all of us of the very real impact that Government decisions and state bureaucracies have on people’s lives. However, I was also struck by the very robust terms in which the Mental Welfare Commission, a statutory body, questioned the effectiveness and appropriateness of the work capability assessment and how it was working. As part of its investigation, the Mental Welfare Commission conducted a survey of responsible medical officers working in health boards across Scotland, most of whom are consultant psychiatrists, and 80% of respondents had patients who had undergone work capability assessments. Of those 80%, most had been asked to provide medical evidence, either before or after the assessments. However, three quarters had never been asked for their opinion at any point in the Atos or DWP process. Only 25% had had a request—some before the assessment, some after—and 96% said that their patients had been distressed by the assessment process; 93% reported patients distressed at the outcome of an assessment; and 80% reported patients who had successfully appealed decisions.

What also gave me great cause for concern was the impact on clinical care provision: 85% of the RMOs reported an increased frequency of appointments; 65% had had at least one patient who required an increased dose of medication; 35% had at least one patient who had been admitted to hospital as a consequence of a work capability assessment; 40% had at least one patient who had self-harmed after the assessment; 13% reported that a patient had attempted suicide; and two psychiatrists reported patients actually taking their own lives. In the light of the anecdotal evidence from the hon. Member for Strangford (Jim Shannon), I can say that various sources show that this is not just hearsay; evidence is coming from reliable and credible people who are involved in the process, and who understand that the systems are having real and difficult consequences for people.

It is critical that greater use of expertise is drawn into the assessment process for claimants with mental health conditions. I acknowledge the conclusions of the Litchfield review on this point, which were that it may not be necessary in every case, but there seems to be an enormous gulf between a universal approach and current practice. It is a chasm into which large numbers of very ill and vulnerable people seem to be falling. SAMH found that 56% of its service users did not receive any supporting information from a health care professional in their ESA application, which, in the wake of the tragedies we have heard about, should shake us out of any sense of complacency that we are doing enough.

The DWP’s most recent quarterly statistical bulletin, published in March, outlined the total caseload to date. With regard to completed claims, 52% of people who made new applications for ESA on the grounds of mental or behavioural disorders were found fit for work, so the high numbers of people awarded ESA on grounds of mental ill health represent less than half of applications made because of these conditions. Too many people are falling through cracks in the assessment process. I have alluded to the increased pressure that this creates in the NHS, but it also brings attendant costs in social care, policing and homelessness, which outstrip the cost savings that the DWP might be making.

Throughout the work of the Harrington and Litchfield reviews, there is an implicit acknowledgment that the work capability assessment is not working as it should and not working well enough for people with mental health problems. My request to the Minister today is simple: will he meet me and representatives of SAMH to discuss some of the ways in which the recommended improvements might be integrated into the work capability assessment?

I know some changes have been instigated since 2010, and I note Professor Harrington’s evidence-based review of December 2013, which considered whether a more specialised test developed with disability organisations might be more effective. Although that test was found to be less effective than the work capability assessment in determining fitness for work, it proved more effective in determining limited capability for work. Lessons could be learned from the scoring approach used in each assessment, so I want to ask the Minister whether he can provide an update on how the Government are using those insights to improve the work capability assessment.

It was announced in March that Atos Healthcare will leave its contract early, with new contractors commencing in 2015. The renegotiation of the contract presents an ideal opportunity for the DWP to reconsider how the right information and expert opinions can be brought into the assessment and decision-making processes. SAMH is of the view that claimants should be asked at the beginning of their application to nominate relevant health care professionals to provide supporting statements. That would significantly reduce the stress on individuals, improve input from professionals, and, we have to conclude, lead to better decisions the first time round, reducing the need for costly and stressful appeals. With the DWP in the process of reviewing and updating its contract, surely this is a prime opportunity—the ideal moment—to introduce a process by which the statements could be secured. What practical steps might the Minister take to move this forward?

Lastly, the SAMH report highlights the increased stress and anxiety for claimants who face lengthy waits for assessments, often have to live on a reduced income, and fear that they will not get a fair assessment. That has come out in the past few years as people see what happens to those in their support groups and social networks, who have come through the system and feel that the assessment concentrated on their physical health, not their mental health. Sometimes their physical symptoms can be connected to their mental health problems, but they are often more easy to cope with in day-to-day life than the debilitating effects of mental illness.

The reduction in support services as a result of austerity cuts has left some very unwell people unsupported. The DWP could minimise such distress by providing clear, accessible information to applicants at the outset of the process, signposting them to organisations that can provide advice on welfare rights, finances and well-being, and setting out the process by which health care professionals can be contacted regarding supporting statements.

[Jim Shannon]

Problems have come to my attention relating to correspondence with those who have mental health issues. Often, correspondence is mislaid or inappropriately addressed, which means that people with mental health issues are not aware of the process and how they should respond to it. The Minister always responds positively to the issues, but does the hon. Lady feel that one of the things that could be done better, when dealing with people with addiction and mental health issues, is ensuring a follow-up whenever responses are not made directly to the Department?

[Dr Whiteford]

The hon. Gentleman makes a very important point. Indeed, that was one of the key recommendations of the report by the Mental Welfare Commission for Scotland in the case of Ms DE. Attempts had been made to contact her, but there were no repeat attempts and no one managed to get hold of her. It is easy to envisage somebody who is suffering from severe depression not answering the phone and not opening the mail in the way that someone in a healthier situation was more able and minded to. Those points have been well made, and I am sure that the Minister is already cognisant of them, but I will be interested in his response on the process, particularly in the DWP, going forward.

Relatively small steps could have a marked impact on people’s lives, and could help ensure that the process does not actively contribute to people’s mental health problems, but helps set them on the road to recovery. Will the Minister consider what he can do in terms of signposting, explaining to people their rights in the process, and making sure that we are not making things worse for people who are already very ill? It is in everyone’s interests to achieve a work capability assessment that is fit for purpose. I hope that the Minister will take the time to read the SAMH report and hear the perspectives of those with most at stake in the process and who badly need our support, and I hope he will meet us in the not-too-distant future.

Transparency of Lobbying, Non-Party Campaigning and Trade Union Administration Bill

Debate between Jim Shannon and Eilidh Whiteford

Wednesday 22nd January 2014 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I congratulate the shadow Minister on raising important issues. I do not say for one second that the Minister is ignoring them, but the fact is that charities are not convinced by the arguments put forward. The hon. Member for Stevenage (Stephen McPartland) said that the charities in his area have not contacted him with concerns. I can tell him that the charities in my constituency, and across the whole of Northern Ireland, have stated clearly that they do have concerns, and I want to present them now.

I support Lords amendment 45, which was tabled by Lord Harries of Pentregarth. He outlined some of the issues relating to seeking to narrow the requirement for third-party campaigners to account for staff costs, which has come up again and again. Charities in my area are deeply concerned by the original proposals, and we must address this. It is beneficial for staff costs to continue to be included in controlled expenditure in relation to election material, marketing and canvassing, and when they directly relate to communicating with the electorate. The simplification of the requirements will make them much more understandable and workable for charities. I agree with commentators who say that that will make it easier to comply with the proposed legislation. One need only ask any farmer about being bound in red tape by European legislation that stifles everything to understand why it would be prohibitive for charities to undertake the original provisions.

[Dr Whiteford]

Might that not also deter small charities from campaigning in the first place, as well as placing those that do under a regulatory burden?

Persecution of Christians

Debate between Jim Shannon and Eilidh Whiteford

Tuesday 3rd December 2013 Commons Chamber

[Jim Shannon]

I thank the right hon. Gentleman for that very valuable contribution. I will mention Baroness Warsi later in my speech. She has outlined the issue from the Government’s point of view and explained some of the ideas she is thinking of. I will return to them shortly as I believe they show the direction we should be going in, and hopefully that will address some of the points Members have raised.

In Indonesia and the Philippines Christians have had their churches burned to the ground and church members attacked and killed because they dared to tell others about the love of God, and that God is a God of love who loves them and wants them to be saved and in heaven. Now, in the 21st century, nearly 65 years since the universal declaration of human rights was adopted by the UN—we can now think about the UN’s role and the role it can play—and with great improvements in technology and medicine, we might also expect to see an improvement in how humans treat each other. However, sadly, we still see severe violations of human rights around the world. Indeed one human right that is particularly violated is that outlined in article 18: the right to freedom of religion or belief. It is enshrined in the motion before us today, too; that is the thrust of where we are coming from. This right is one of the only rights defined as non-derogable in the international covenant on civil and political rights. That means that it must be protected at all times and cannot be suspended or reduced in times of emergency.

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

I congratulate the hon. Gentleman on bringing this subject before the House. What role does he think human rights legislation and constitutional protections might play in helping prevent the kinds of human rights abuses we are seeing at the moment?

[Jim Shannon]

As this debate develops, the Minister or his civil servants will frantically write down the answers to these questions. I have a number of questions as well. I am sure the scribes in the corner will be writing furiously throughout the debate; I hope I was not insulting them by calling them scribes.

Those who drafted our international human rights clearly saw the right to freedom of thought, conscience, religion or belief as key to the inherent dignity of the human person and that it was important to protect it at all times. We should afford it the same weight; that is where we are coming from. To this end, I am pleased that the United Kingdom Government have designated the right to freedom of religion or belief as one of the top human right priorities for their foreign policy. We understand that to be the case and hope to hear it confirmed at the end of our debate. Will the UK Government agree that this right should be protected and promoted by all Governments worldwide? That is another question.

Welfare of Laying Hens Directive

Debate between Jim Shannon and Eilidh Whiteford

Tuesday 13th December 2011 Westminster Hall

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

I congratulate the Chair of the Select Committee on Environment, Food and Rural Affairs, the hon. Member for Thirsk and Malton (Miss McIntosh), and the other members of the Committee on securing today’s debate and on raising an important issue.

I came to the issue because there are a number of small and sizeable egg producers in my constituency, which support the local rural economy and provide jobs. Over the past few years, they have invested heavily in upgrading their facilities. I am aware that, of the £400 million that has been invested across the UK, at least £7 million was invested in my constituency by small and medium-sized firms.

The comments made by the British Egg Industry Council are important to the debate. The critical issue for the producers who have contacted me is that, although they have invested heavily, they are being put at a competitive disadvantage. They are concerned about their businesses in what are already difficult economic times for all rural businesses, and they are concerned that the reward for their investments and for improving what they do is to find their profits reduced and their businesses becoming ever less viable.

[Jim Shannon]

Clearly, in the hon. Lady’s constituency, similar to my own, many people have borrowed from banks at a time when they can least afford to do so. They feel that they are comparatively disadvantaged as a result. Does she feel that banks should give some leniency at this time?

[Dr Whiteford]

The hon. Gentleman makes a valid point. Certainly, banks in the rural economy have recently tightened up their lending processes, which is regrettable when agriculture globally is ripe for investment and is a good investment. Such businesses are often asset rich, but they need credit, as farmers all over the world do. Banks can do a lot more at present to support the rural economy.

I confess that I was incredulous when the BEIC raised the issues with me. It struck me as bizarre that some EU members are still not complying with the legislation 12 years after it was passed. One of the most pertinent points today is that not just new accession EU countries are failing to comply with the legislation, but long-standing and established EU members seem to be shrugging their shoulders and letting the issue go by.

One of the most significant issues is that there has been a complete lack of foresight regarding compliance measures. I still find it quite incredible that the enforcement measures are so weak. Enforcement measures by member states may be dismissed as a business expense by the companies that are failing to comply with the law. There are big lessons to be learned about how seriously we take legislation. At the heart of the matter, it is a legal issue. It became clear back in July just how weak the legislation and compliance measures were; that is important.

I welcome the fact that the Government have looked at contingency plans. I wrote to the major supermarkets in July this year, asking them to confirm that they would ensure that their own-brand products would comply with the law and that they would not import products. To be fair to Asda, Morrisons and Tesco, they all wrote back to me to say that they could do so with their own-brand products and the eggs on their shelves, but there was no commitment on the other products that they import from suppliers. That is where the challenges lie.

In a context where the law is absolutely ineffective, I welcome the contingency measures taken by the Animal Health and Veterinary Laboratories Agency, but they are not a substitute for proper legal enforcement. We still face the issue that liquid eggs from Holland and Germany might originate from non-compliant countries. Until we deal with the legal issue, I do not think that we can move much further forward—it makes a mockery of the law.

The hon. Member for Thirsk and Malton absolutely hit the nail on the head when she posed the key question about the loophole in regulation. Does that originate from our own laws and regulations, or is it an EU-wide issue? I hope that the Minister will address that and share the legal advice that has been given. The loopholes need to be closed with some urgency.

As we consider how we move forward, I hope that we will ask how on earth we will instil any confidence in new legislation if it cannot be enforced. Farmers are already talking about the problems of complying with regulation. If there is one issue that farmers in my constituency—not just poultry farmers, but livestock and arable farmers—are concerned about, it is compliance. They feel that our compliance, regulation and inspection regimes are much more rigid than those in other parts of the EU. In some cases, they are absolutely right, and that makes it more difficult for them to earn a living and operate internationally. If we cannot even enforce the laws that we make with a 12-year lead-in period, it makes a mockery of the law. I hope that the Minister will take that on board.

Fisheries

Debate between Jim Shannon and Eilidh Whiteford

Thursday 2nd December 2010 Westminster Hall

[Dr Whiteford]

My hon. Friend advocates well on behalf of his constituents.

I think that it is recognised that catch quotas are no panacea for the white fish fleet. They will help to mitigate the most damaging social and economic impacts of this year’s expected quota cuts and reduce discard levels further, allowing our fishermen to catch less and land more, but in order to take things to the next level, we need the opportunity to trial a mixed-species catch quota option. The North sea is really a mixed fishery, and we need to consider the ecosystem as a whole. I hope that the UK Government will pursue a full catch quota system for cod in the year ahead. I also urge the Government to secure options to trial catch quotas for other species such as haddock, whiting or plaice. If fishermen are to reap the full benefits of their conservation efforts, the Government must secure changes in the management regime.

Over the past decade, the Scottish white fish fleet has more than halved as the industry has attempted to place itself on a more commercially and ecologically viable footing. We must start rewarding our fishermen for successful conservation efforts and recognise their central role in managing and conserving our fishing resources. In my experience, it is fishermen themselves who want a whole-ecosystem approach to fisheries management. They see the dangers of displacement and know only too well that cack-handed management measures have unintended consequences for them and for the marine environment.

It is also important to remember that the quota reductions likely to affect the white fish fleet next year will have a knock-on effect on processers, some of which are already under pressure from the impact of the recession on global markets and the reduced availability of quotas. In such circumstances, the argument for extending the catch quota scheme next year is compelling, and I hope that the Government will pursue it vigorously.

The other big issue that I want to address is the so-called mackerel war between Iceland and the Faroe Islands and the rest of Europe. I have welcomed previous assurances that the Minister is not minded to acquiesce to the unreasonable demands of Iceland and the Faroe Islands for huge chunks of the global mackerel quota and is keeping pressure on the European Commission not to cave in on the issue. As he knows, about 60% of the UK pelagic fleet is based in my constituency. I have been in regular contact with pelagic fishermen and their representatives during recent months, as I know he has, and they keep saying to me that they want a negotiated settlement, but not at any price.

Mackerel is the UK’s most valuable fish stock. It is also one of the most sustainably managed. Iceland and the Faroe Islands have awarded themselves quotas amounting to 37% of the total allowable catch. Their grossly irresponsible actions are jeopardising the sustainability of the stock and threatening the Marine Stewardship Council accreditation that the pelagic fleet worked so hard to achieve. Our fishermen accept that there are mackerel in Icelandic waters and that Iceland is entitled to some quota, but they argue rightly that that quota must be proportionate and in line with the long-term management plans that exist to protect the stock. There can be no doubt that the increase in mackerel in Icelandic waters is attributable to the successful implementation of conservation measures elsewhere in the North sea. I do not want that work to be undone in order to give Iceland an expedient political payoff.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Lady agree that the acquisition of 185,000 tonnes of mackerel is akin to piracy on the high seas and should be objected to in every forum by the Minister?

[Dr Whiteford]

I agree 100%. In my view, appeasement of the unreasonable demands of Iceland and the Faroe Islands will lead only to further demands. The EU must not reward behaviour that has been utterly reckless in conservation terms.

We must remember that our fishermen have absolutely nothing to gain in the negotiations; they can only lose out from any deal struck. Nevertheless, they see that their own long-term interests depend on the long-term health of stocks, so they want us as politicians to hold our nerve and stand firm for a fair and equitable resolution of the issue.

On the subject of mackerel, one of the most frustrating aspects of European fisheries policy is that while our fishermen have made strenuous efforts to fish sustainably, they have seen other member states flouting the conservation targets. Spain overfished its mackerel quota by 296% last year, yet the Commission has taken no action against it. I am unable to explain to the fishermen in my constituency why fishermen in some parts of the EU can flout the rules and regulations with impunity while they face serious sanctions if they do so. I hope that the Minister will take up the issue of Spanish overfishing with the Commission and work with other member states towards more sustainable fisheries in all EU waters.

Sea fishing has the inherent potential to be both a sustainable and a profitable industry. Those goals are sometimes in tension, but I think that most people in fishing communities and the industry recognise that over the long term, they go hand in hand. Our fishing communities deserve better representation from UK Governments than they have had. Too often, fishing has been a bargaining chip in bigger negotiations. It has not had anything like the priority that it deserves. I hope that that will change. I wish the Minister well in the forthcoming round of talks, and in opening the debate this afternoon, I urge him to put the economic, environmental and social sustainability of our fishing industry and coastal communities at the heart of his Government’s approach.