Social Care and Military Compensation

Debate between Jim Shannon and Gordon Marsden

Wednesday 25th March 2015 Commons Chamber

[Mr Gordon Marsden (Blackpool South) (Lab)]

As has now been confirmed several times, this is the last occasion to raise such issues in this Session, and I wish to speak about the unfair treatment of some veterans owing to the disparity in the way that different armed forces compensation schemes are treated when social care costs are calculated. I pay tribute to Poppyscotland and the Royal British Legion, which highlighted that issue with their Insult to Injury campaign. In the past, I have been pleased to work closely with the Royal British Legion, both nationally and locally in Blackpool, and together we delivered a petition with 3,000 signatures calling for stronger punishment for those who vandalise war memorials. I was also pleased to support the Blackpool armed forces covenant and veterans charter in 2011. I wish to touch on that veterans charter and covenant, praying in aid the arguments I will present tonight.

As chair of the all-party group on veterans, which deals with a number of issues, including welfare, I was fortunate to initiate a meeting in Parliament with the Forces in Mind Trust. Its latest report is about support for veterans’ families, and we will hear tonight about veterans who are losing the means to support their families when compensation payments are removed. Fundraising year-on-year by the Royal British Legion and other ex-service organisations, including Poppyscotland, provides extra support for veterans. Locally and nationally, our veterans should not be left by the state in financial circumstances that are unfair. The state must do its bit, particularly when there are unequal Government regulations.

Tonight I will focus on the disparity between the way that the two different compensation schemes operate. Those injured before April 2005 received compensation for particular injuries through the war pension scheme, which provides regular payments based on the severity of injury. Those injured from April 2005 onwards receive support for any disablement through the armed forces compensation scheme—AFCS. That comes in two parts: a lump sum and, in a similar fashion to the war pension, a regular payment for the most severely disabled veterans and ex-servicemen. Those two schemes seek to compensate for the pain and challenge of particular injuries that some veterans receive when serving bravely in our armed forces, but when it comes to how they are processed through the social care system, they are treated very differently.

As of 2012, any veteran supported by the newer AFCS scheme has all that income disregarded while they are means-tested for social care. Although their other forms of income are rightly considered so that they make the same contribution as any civilian to their social care, they will still have left over the income they receive to compensate for the injuries they received in the military. Those on the older war pension scheme, which could cover awards from the second world war up to 2005, receive far less support. Only £10 of their war pension is automatically disregarded, and the rest can be clawed back by local authorities into paying for their standard social care. The full value of the war pension—which of course reflects the level of disablement suffered by that veteran—is on average £80 a week and can be as much as several hundred pounds a week for the most severely injured.

Does the Minister agree that it does not show enormous respect to veterans on the war pension scheme, who have fought in conflicts from the second world war to Korea, the Falklands and in some cases as recently as Afghanistan, if we suggest that the pain of those disabling injuries is worth only £10 a week? What compounds that regrettable diminishment of the veterans’ sacrifice is the apparent injustice and inconsistency in the way the two schemes are treated in social care and the way different arms of Government look at the problem.

Almost all local authorities use their discretion fully to exempt the income from both compensation schemes when council tax or housing benefit is calculated, and central Government have recognised that both types of compensation should be left untouched when the new universal credit is calculated for recipients who have served in the forces. Yet protecting that income for council tax and housing benefit will be in vain if the great majority of it is then lost to pay for social care. As I have said, Government guidelines only disregard £10 of the war pension, and in present circumstances local authorities have not been able to go much further, with only 12% of councils using discretionary funding fully to exempt those on the older scheme. That is completely inconsistent with the way that civilian personal injury compensation is treated in social care means-testing. When saved in a trust fund, that income is fully disregarded by local authorities as they calculate care costs. What is left appears to be a social care system that, however worthy its objectives, fails to meet two criteria of the armed forces covenant that Members from both sides of the House were proud to support.

[Jim Shannon (Strangford) (DUP)]

It is appropriate that the last Adjournment debate of this Parliament concerns our veterans and our soldiers, and I congratulate the hon. Gentleman on securing it. Many Members have a particular interest in the armed forces. In the years that I have been a Member of Parliament, we have had the chance to speak on behalf of our veterans. I know many veterans who suffer from post-traumatic stress disorder and their number, after Iraq and Afghanistan, has increased significantly in the past few years. Does the hon. Gentleman agree that the onus is on the Ministry of Defence, the Department of Health and local government to work together to address this issue? The Minister represents the Department of Health. Other Departments, which are not represented here tonight, need to work alongside her.

[Mr Marsden]

I agree with the hon. Gentleman, who is assiduous in covering veterans’ issues in this House. I pay tribute to the military from Northern Ireland for the sacrifices they have suffered over the years. He is absolutely right. We are pleased that the Minister is here tonight, but the issue can only be solved out of Government silos.

The covenant enshrines the principles of no disadvantage and special treatment. These, in turn, dictate that a person should experience no disadvantage as a result of military service and that it is appropriate in some cases for special treatment to be applied to those who are serving or have served. We have already seen that as a result of failing to disregard the war pension, Ministers are not providing any special treatment for veterans. More fundamentally, however, they end up failing the rule of no disadvantage, too, as the injuries incurred purely as a result of action in the armed forces receive little compensation when income such as the war pension is diverted into providing standard civilian social care.

I am pleased, therefore, that my colleagues in the Labour Front Bench team have pledged, under a future Labour Government, to review the compensation schemes to see where they might be improved. In particular, the focus should be to take a laser-like focus to existing and new rules that affect veterans through the prism of the armed forces covenant. We want to ensure that the principles of no disadvantage and special treatment are met by all arms of government.

All Members have, at one time or another, drawn attention to the strong feelings of many veterans and others about insufficient engagement with the concerns raised in relation to social care and military compensation. I welcome the reports from the Government, the Royal British Legion and Poppyscotland that talks are ongoing about how the two schemes might be aligned, but we need to see results. After all, every year, as more elderly veterans pass away, the group of people who could benefit from a change in the rules diminishes by 5%. Half that group are aged 70 or over. We are running out of time to offer these people the chance to navigate social care in far greater comfort, with access to the full deserts of their military compensation. With a change in the rules, we can put this right, but it needs real Government commitment. I have to say, however, that when we look at the Government’s stated objections so far, they seem to give the impression of delaying progress rather than accelerating it.

Ministers have claimed that some of those on the old war pension scheme also receive top-ups to their pension, which are designed to help to pay for care costs. Only 6% of war pensioners actually receive such care top-ups. More to the point, it is surely not beyond the wit of the Government to devise guidelines that will include those care top-ups in the payment for social care, but not include that part of their income that relates to the pain suffered through injuries received in the field of conflict. This is a position that the Royal British Legion accepts would be perfectly reasonable.

Ministers have also suggested that military compensation could be placed in a trust fund to protect it from social care means-testing. However, given how war pension works, only a small amount is provided as a lump sum. For the most severely injured veterans, most compensation is provided through regular payments that cannot be placed in a trust. It has also been suggested that the war pensions scheme was established before the modern understanding of personal injury compensation, yet it is clearly understood that way, as is evident, as much as anywhere, from the words of the veterans Minister, who said:

“The War Pensions Scheme provides no fault compensation to Service personnel disabled as a result of their service in HM Forces.”

In the discussion of all these disregards, different schemes and allowances, the human effects of these rules and their perceived injustices can too often be forgotten. In my area, the Royal British Legion estimates that 600 veterans in the pre-2005 group could see their war pension eaten up by care costs, and Members across the country will have service constituents who have told emotive tales of the effects of losing their compensation.

Keith Clarke, who is 43 years old, was left paraplegic while attempting to put out a fire on his submarine. He receives a large war pension for the most severe injuries, but £100 is lost every week to meet the cost of his care worker, who visits daily to help him dress and look after his two children, one of whom is also disabled. His only other benefit comes from statutory benefits. He told The Daily Telegraph:

“I feel angry and frustrated. It’s…an injustice to be treated as a second-class citizen.”

Fred Cannon, who fought on the Gold beach at Normandy on D-day when he was 19 years old, was the only survivor of the company to come home, but a severe bullet wound left him with one leg shorter than the other. Now in his 90s, like too many others, he is left with only £10 a week compensation. Then there is the 50-year-old Lancashire veteran who was diagnosed with osteoporosis from his time in the Army. He said:

“Unless the system changes, I’m concerned that I will lose a lot of my pension, which isn’t fair. People who receive AFCS don’t pay for their social care—and rightly so—but why should we pay just because we were injured before April 2005? It doesn’t make sense.”

Of the two principles of the armed forces covenant, it is ultimately not special treatment that veterans want; all they want is not to be put at a disadvantage: to have the injuries they suffered in the armed forces compensated for in their own right and then to make a contribution from their other income towards social care, just as any civilian would rightly do. They want fair treatment for all and a system that does not discriminate on the basis of an arbitrary date; they want to be treated the same in the different means tests that central and local government operate; and they want to be treated in the same way as civilians who receive compensation for personal injury.

Whatever the historical context of the creation of the war pension scheme or the complexities of its operation today, it is surely possible to design a system that will meet the requirements of the proper 21st century fairness that the veterans are asking for. The time has come to go beyond discussions and look for concrete solutions to the disparity between the two different military compensation schemes, rather than focusing on the obstacles to a more just system. I am pleased to note that Labour would review the fairness of military compensation in the light of the armed forces covenant, and I call on Ministers to show a similar political will and commitment.

Many Members will have the date of 7 May on their minds tonight, but many other people will have a possibly more important date—the next day—on their minds. That will be the 70th anniversary of VE-day. I feel honoured that both my late parents served in that conflict, and I am mindful of the debt we owe to those of that generation who remain with us. At this time, we must surely refocus our energies to ensure that we provide all the support that the brave men and women who have served in conflicts spanning the last 70 years deserve, particularly as they make their way through challenging periods of their lives in the social care system.

Employment and Support Allowance (Blackpool South)

Debate between Jim Shannon and Gordon Marsden

Wednesday 5th September 2012 Westminster Hall

[Mr Marsden]

I thank my constituency neighbour for that question. I do not think that the two questions are separate. The inadequacy with which some of these issues are treated inevitably casts light on the strength or otherwise of the process. If the hon. Gentleman is asking whether I am in favour of disabled people being given every opportunity to expand their capabilities and to work if that is proportionately possible, the answer is an unqualified yes—and that would be the case for most hon. Members—but that issue is not under discussion today.

The Minister also needs to think about the effects on the families and carers of people who are knocked back. One of my constituents, a lone parent of two sons in their teens, one of whom has Asperger’s, was knocked back last month. My constituent says, “Two days before being admitted after a series of operations on my shoulder, I received a letter to inform me of the results of the medical I had to attend with Atos, saying that I was fit for work and that my claim for ESA had ended from yesterday. Both my sons live with me, but my housing benefit will stop because my ESA claim has ended. I don’t want to be claiming benefits. I would rather be back working, but with the pain I am in, I am unable to do that.” I have already mentioned what happens to the income of the carers of partners judged fit for work.

Another claimant who was knocked back, who had had long-term depression, wrote to say, “Is there any way you could possibly have the appeal process speeded up? I have been told it could take up to eight months. I feel so lost and powerless.”

The stress falls not just on the person with a disability, but on the partner, particularly when, as a number of my constituents have told me, they were discouraged from going to the assessment because of the restrictions of the venue. That is a denial of human rights, as well as, practically, a very silly thing to do.

Another constituent with chronic pain has been through this revolving door and says, “I am now mentally preparing myself for the fact I will have to take my case to a tribunal. I have been without any payment from DWP since April and although my partner has taken on extra duties during the lunch hour, we still cannot meet our outgoings—full-time hours where she works will not be available.” That is the reality of these people’s lives in Blackpool; it is the reality of the work process there.

Ministers and officials needs to address some fundamental questions. Leaving aside the individual inadequacies of the Atos process, what are the jobs for which these people are alleged to be fit? How much will it cost the Government and the taxpayer to support them properly in those jobs and, in particular, given some of the new Government restrictions on working tax credit, will they ever be able to earn from them a living wage? I have already said that I fully support proportionate and fully rounded initiatives to enable such people to use their abilities, and I feel strongly about that, having had a mother disabled by osteoporosis for 25 years. However, there is a balance to be struck.

Yesterday, in my local newspaper, The Blackpool Gazette, in a piece written by the feature writer Jacqui Morley, the wife of one of the constituents who had come to me, who is a gentleman with a severe degenerative condition akin to motor neurone disease, said that her husband’s former bosses had moved heaven and earth to keep him until he had realised that he was taking more than he was giving. She said that unless the Government were prepared to give disabled people all the support they need—in her husband’s case, certain facilities, personal assistants, and aids and equipment that cost a fortune—this is just a tick-box exercise about integration, not real inclusion. The system also dictates that the man will have to go through the process again in three years’ time to be reassessed on that progressive degenerative condition.

Alan Reid, who manages Disability First, our Blackpool disability information service, has commented that many people in the town who are genuinely in need are being dumped by these assessments. He says, “They come to us desperate and, in some cases, suicidal.”

Some of these concerns were raised during pilots of the process—indeed, disability group representatives in the Blackpool area took part in those pilots—so it is not entirely surprising that some of the problems have come to pass. I strongly stress that there is a sense of waste and people saying, “Working for what?”

The same constituent’s wife who was quoted in the Gazette put her finger on the problem in the letter that she wrote to the decision maker at Jobcentre Plus. When talking about the test, she said that the question should be about to what end people could press a button and use a keyboard and mouse, and whether they could do so at a speed—and without the need for continued support—that would facilitate meaningful input and a financially viable outcome such that their employment could be sustained by an employer. Surely that should be one of the elements considered in the process.

I have cited all those examples in the context of Blackpool, but the truth, of course, is that this is a country-wide issue. That is why various disability groups, such as the disability benefits consortium, the Royal National Institute of Blind People, Parkinson’s UK and Scope, have all raised serious doubts. The DBC has said that the work-capability assessment is poor at identifying disabled people’s needs.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on illustrating very clearly the position in Blackpool South. He is right to say that the situation is replicated across the whole country. Does he feel that when it comes to ESA appeals and the medical evidence that is used, there should be direct contact with the GP and consultant as a matter of course? That is not always the case, but if it happened, there would be better knowledge of the person’s medical condition for the tribunal and the appeal.

[Mr Marsden]

I thank the hon. Gentleman for his intervention. He leads me to the series of recommendations that the disability benefits consortium makes in that area. They include the fact that evidence is not routinely gathered from the health-care professionals who know the claimant best, such as consultants and nurses; that evidence is often ignored. I accept that that cannot be the sole deciding factor, but it certainly seems ludicrous that it should be excluded entirely. The other side of the coin, as I have mentioned in relation to an individual we had concerns about in Blackpool, is that some of the health-care professionals who carry out the process that we are discussing have limited knowledge of complex or uncommon conditions.

The DBC also discussed the issue of people with long-term degenerative conditions, especially progressive forms of multiple sclerosis, being reassessed far too frequently. Even people in the support group are being reassessed very regularly. Of course, there has been the revelation—this was subject to freedom of information—that more than 1,000 people died shortly after their work capability assessment. That does not take into account the others who died shortly before.

Those mistakes—they are mistakes—must not be replicated when personal independence payments are introduced in 2013. It is no surprise that disability organisations have expressed concern about that. I want to quote just a couple. Mr Ford, chief executive of Parkinson’s UK, has said:

“It is hugely concerning to see that Atos have been given the green light for the Personal Independence Payment contract.”

He says that its assessments

“have led to many people being forced to appeal against decisions that are plainly wrong. How can someone with Parkinson’s—a progressive neurological condition—have an assessment report that implies they will be ready for work again in six, 12 or 18 months?”

Others have written in the same vein.

The concerns in this area have been emphasised by the sheer complacency and smugness—I use the words advisedly—with which Atos has responded in relation to these processes. I received, as no doubt have other hon. Members in the north-west, a very bland letter from its general manager that told me that it had been awarded the contract for the north-west of England. It said:

“Engagement with MPs and the wider stakeholder community was an important element of our successful bid”.

As far as engagement with MPs is concerned, I am not aware that it ever engaged with me in any way, shape or form whatever. As far as the wider stakeholder community is concerned, it may well have engaged with them. That stakeholder community expressed concerns and reservations, most of which it completely ignored. The British Medical Association has also expressed serious concerns in this area.

Blackpool offers a sample what is going on nationally. It may be a particularly strong sample, for the demographic reasons that I have described, but it is a sample. The comments made in yesterday’s debate by my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) and others showed the depth of concern in the House about the process. My hon. Friend the Member for Birmingham, Northfield (Richard Burden) put his finger on it when he talked about “a weird revolving door”: people get assessments, question them and wait ages for an appeal. He said that they

“may or may not win the appeal, but by the time the appeal comes up, they have had another assessment and…they go through”

another

“revolving door”.—[Official Report, 4 September 2012; Vol. 549, c. 19WH.]

My hon. Friend the Member for Aberdeen South (Dame Anne Begg) who, as most Members will know, knows a great deal about such things, not least through her chairmanship of the Select Committee on Work and Pensions, said that she did not think that this

“Government have grasped how disastrous the ESA assessment system is…In too many cases, genuine claimants are not scoring any points in their initial assessment. There is something fundamentally wrong with the system and the contract that Atos is delivering.” —[Official Report, 4 September 2012; Vol. 549, c. 27-28WH.]

The Minister and his officials could and should take notice of the proposals on the table, not least those from the DBC. They should think about proactively gathering relevant written evidence, about reassessing it only when changes in circumstances are likely and ensure that there is an appropriate assessment venue for the full range of disabled people. Atos decision-makers should be trained in a wide range of conditions and share their reports and observational evidence with claimants. The supreme irony in all of this is that the storm is gathering during the Paralympics. Atos is one of the sponsors of the Paralympics. I will leave others to judge the appropriateness of that, but as Prime Minister’s questions demonstrated today, it is a major issue.

I have already welcomed the Minister to his position. He has come from the Treasury, and is, I am afraid, inheriting this mess. I do not envy him. I urge him to reflect not only on what I have told him about the situation in Blackpool and the individual miseries of the affected constituents who have come to me, but on what so many organisations are telling him. It is rare that Ministers are given the opportunity to have an open mind and open the books—normally, it is only at the beginning of their tenure. I ask him to look at what the RNIB and the DBC have said. I urge him to consider whether the Select Committee on Health and others should not look at the quality of some of the doctors; at empowering decision-markers; and at seriously re-examining the target-based approach, considering a qualitative, not only a quantitative, approach.

The Minister should be in no doubt that if he does not address the problems, that will be on his head, and on his reputation—the fiasco will indelibly imprint itself on his record. Seventy years ago, the great parliamentarian, Nye Bevan, laid down the principle that Ministers should not allow outsourced officialdom to play with or ruin people’s lives without a source of redress. The buck very much rests with the Minister.