Social Security (Personal Independence Payment) Regulations 2013

Debate between Lord Touhig and Baroness Browning

Wednesday 13th February 2013 Lords Chamber

[Lord Touhig]

I refer noble Lords to my entry in the register of interests. As the Minister will recall, in Committee and at Third Reading of the Welfare Reform Bill, a number of colleagues, notably the noble Baroness, Lady Browning, and the noble Countess, Lady Mar—who is no longer in her place—and I all raised issues about face-to-face assessments.

I urged the Government to take a “tiered approach” to the PIP assessment. This would mean that instead of people with conditions such as autism having to undergo a stressful and often inaccurate face-to-face consultation, assessors would first consider existing medical and other evidence about their needs. On the basis of this, a decision would be made as to whether a face-to-face consultation would be necessary. We are all keen to learn the lessons of the work capability assessment for employment and support allowance, which, as the Public Accounts Committee in the other place confirmed recently, continues to be problematic at best. A tiered approach to PIP would help make it fairer and more accurate for people with autism and other complex conditions.

The guidance that has been published by the Department for Work and Pensions for the assessment providers Atos and Capita reflects this tiered approach, which is certainly most welcome. However, the guidance also makes it clear that the end-to-end assessment process should be completed within 30 days. I understand that contracts between the DWP and the providers make it clear that there is a financial incentive to work towards this timescale; indeed, if fewer than 85% are completed within 30 days the providers are at risk of losing their contract.

I share the view of the National Autistic Society, which has serious concerns about whether evidence can and will be collected within this very tight timeframe and whether as a result people with complex conditions such as autism will undergo a stressful face-to-face consultation, and a decision will be made about their needs by an assessor who may not be in possession of all the relevant evidence. A one-hour face-to-face assessment will not enable the assessor to gain a full picture of the impact of autism on the claimant. It is an inherent part of the condition that people with autism will present differently according to the environment in which they find themselves.

Does the Minister think that 30 days is a realistic timeframe in which to get a response to a request for further evidence from busy health and social care professionals? Is he prepared to consider extending that, in particular with regard to people with autism and other very complex conditions?

[Baroness Browning]

My Lords, I refer to my interests in the register and also declare an interest in that I have close relatives who are in receipt of DLA. I want to use this opportunity to put on the record again my ongoing concerns, which are very much reflected in the amendment that the noble Lord has spoken to. I continue to have these concerns about the Government’s change from DLA to PIP for three principal reasons.

First, although I recognise, as others have, that my noble friend has worked very hard and made concessions that have very much improved these regulations, in successive debates about PIP he has repeatedly reassured us that “the most vulnerable” will still be in receipt of the benefit. To me, saying “the most vulnerable” is like saying “the most pregnant”—people are vulnerable or pregnant but the degree starts to give me cause for concern.

The second area that gives me concern, which has already been mentioned, is this figure that has been attached to how many people will lose their DLA. It seems to be an arbitrary figure and nobody seems able to identify quite how that figure came about or how it will be implemented.

Thirdly, in recent years the Government have had to take account of the demographic changes relating to the cost of the care of the elderly—something on which we have had an announcement in the past week. But equally, in looking at these changes, they have ignored another demographic change: the number of people with a disability who now live independently, who 20 or 30 years ago would not have done so.

When I had the privilege of representing Tiverton in Devon, in the 1980s we had three mental institutions in that constituency. The policy to take people out of mental institutions and integrate them into the community was not without its problems, but when you saw those people eventually living in the community it was only too evident that they had become institutionalised because they had basically been locked up for decades, and that the vast majority of them should never have been there in the first place. We do not do that any more. We do not lock people away. Equally, a changing trend that I am very pleased to see is that particular groups of disabled adults no longer live into their middle or old age with even more elderly parents. There are many who still do that, but the trend has been to move them into independent living.

If one sees the cost of what is required to move vulnerable people, even if they are only a little vulnerable, one realises that it is not a cheap option if those people are to be safe and to have the quality of life which we would all aspire to. The Government should have done their homework and looked at this change in society whereby we now integrate people into independent living in a way that a previous generation would never have countenanced. That is not just about putting a roof over their head; it is also about providing support and sometimes even having to contrive some sort of social life, which is again supported, so that they really feel that they are integrated into society.

My noble friend said at the Dispatch Box just now that the costs of DLA have gone up greatly in the past decade. I suspect that a lot of those costs are associated with the very welcome news that people are now integrated into independent living, sometimes supported but sometimes fully independent, where previously they would either have been locked up or sitting on the sofa at home with elderly parents. There would have come a point with those adults when their parents were no longer able to look after them and when, usually in an emergency, they suddenly became dependent on the state at much higher cost than those small amounts of money needed to support them in independent living. Unfortunately, despite what any Government say, Governments work in silos, so I appreciate that what my noble friend has to look at is the budget of the DWP, when a lot of people who are now moved into independent living are dependent not just on disability benefits but on health and local authority services. It is that package that helps them attain independent living.

I am seriously concerned that many of the 600,000 people, or however many it turns out to be—as my noble friend will know, I have a particular interest in this group—who are on the autistic spectrum, as my noble friend Lord Touhig described, or who have learning disabilities and mental health problems, do not always present initially as people with deep-seated problems and needs. Rather like icebergs, they very often present with a third on the surface and two-thirds under it. When they run into difficulties with independent living or taking their place in society it is not only devastating for them personally but very expensive on the public purse. It is therefore a false economy if that particular group, many of whom may be intelligent and do not present as the most needy or the most vulnerable, lose their DLA after achieving independent living. I say that on behalf of many autistic people whom I have known and on behalf of autistic young people whom I can think of who have committed suicide because they simply could not cope with day-to-day living. It may have taken a long time to get them to independent living and if you pull the rug from under them, the whole structure collapses around them like a pack of cards. It is not the case with learning-disabled or autistic people that, once they have achieved a level of independence you can walk away and say, “Okay, they’ll be all right now for the rest of their life”. They simply do not function in that way.

The Government should look at this changing trend in independent living. It is rarely mentioned by the Government but it is just as significant as some of the challenges that we face with the ever increasing dependency of old age. Much as all of us who take an interest in these matters appreciate what my noble friend has done—he has a very good understanding of autism and is doing a lot to try to help more autistic people into work—none the less, the words set out in this provision give cause for concern and it is a concern that I share.

Welfare Reform Bill

Debate between Lord Touhig and Baroness Browning

Wednesday 16th November 2011 Grand Committee

[Lord Touhig]

My Lords, like many noble Lords I am a great fan of pre-legislative scrutiny, because I think it improves the quality of the legislation we pass. I also have great faith in this Committee system, because we go through a Bill line by line in order to improve it, amend it, and make good law as a result. I certainly support this amendment, because a trial period does make sense.

I look across at my good colleague the noble Baroness, Lady Browning. She and I sat on the Public Accounts Committee in the other place. Time and again we considered reports from the National Audit Office which showed that some great government scheme, some great initiative, had gone billions of pounds over budget, or gone over time. Inevitably we found that these things had not been trialled beforehand, to see if key elements of the proposals would work effectively.

Some unfortunate Permanent Secretary would be brought before the Public Accounts Committee, and like modern-day Draculas, we drew a lot of blood in our interrogations. Inevitably, this Permanent Secretary was not responsible for what the department had got wrong, anyway; it was the previous incumbent, but that is by the by. We were seeking to learn lessons, but inevitably it was like closing the door after the horse had bolted. If only more care had been taken, or things had been trialled and piloted beforehand, then things would not have gone wrong in the way that they did.

If the Government take this amendment on board, it has the potential to save millions of pounds. If the Bill does not take account of this, then somewhere down the track the NAO will come in, in two or three years, and find that there has been some great failure, or some great cost. The Public Accounts Committee will have to investigate, and the Department for Work and Pensions will be held up again as having failed to pilot or introduce a scheme in a good or effective way, as it promised it would. The amendment makes a lot of sense, and I hope the Minister will see that.

[Baroness Browning]

My Lords, this is the first opportunity I have had to contribute to the Committee. I declare my interest both as the named carer of an adult with autism and as, I believe, somebody who will need to attend the assessment meeting with him. I am that other person, so I am more than personally interested in this legislation.

My friend the noble Lord, Lord Touhig, made a good point about getting good value for money and making sure a system works. However, there is another point about trialling it with new applicants. I remain cautious about the ability of a lot of people newly recruited for the purpose to carry out what will be really quite difficult balances of judgment across a wide section of people, particularly those with learning disabilities, mental health conditions and autistic spectrum disorders, some of whom will have two or all three of the conditions.

I refer the Minister to my personal experience over many years: I am very proud to have raised the very first debate on Asperger’s syndrome in the House of Commons many years ago. When it came to getting contracts signed for people to get people into paid employment, one of the contract requirements was that the various agencies and commercial companies had a full understanding of this range of really quite difficult disabilities. All too often that training and preparation was based on reading up and taking a bit of advice. It never, ever, made the mark.

To give an example, in the case of people on the autistic spectrum it is well known—if I am to generalise and as has been said quite rightly they are individuals who will all display individual characteristics—that their lack of imagination and inability to express and understand non-factual things, as opposed to in some cases a quite high level of ability in understanding factual information, very often leads one to read in manuals and books about autism that if you converse with somebody on the spectrum it is best not to deal in generalities but to deal with specific questions that require specific answers. Some of the contracts that have been issued in the past to get people with autism into work have led the people assessing their aptitude for employment to carry out conversations that frankly beggar belief. I have had some personal experience of this. The questioning would be very much along the line not of, “How are you?”—that is a difficult question to answer—but “Do you live in your own home?”, “How many chairs do you have in your sitting room?” and “What size is your television screen?”. There was a mistaken belief that this was a normal conversation that somebody on the autistic spectrum would feel comfortable with. In one example the person being questioned was actually very intelligent and felt straightaway that they were being patronised, as any of us in this Room would have done.

Therefore, a lead-in period is needed to assess not just the value for money and the way in which this new system is working but also to allow for time, which is really needed, to make sure that the people carrying out these assessments have a working knowledge of some of the more complex conditions and a much better understanding to be able to make their judgment.

I hope the Minister will listen carefully to the points that are being made to allow a lead-in time for new applicants so that we can get this right.

Disabled People: Disability Hate Crime

Debate between Lord Touhig and Baroness Browning

Monday 27th June 2011 Lords Chamber

[Baroness Browning]

My Lords, my noble friend hits on something very important and we should make hate crime against people who are disabled a priority. What is sometimes euphemistically referred to as anti-social behaviour or low-level crime has a cumulative effect, as we saw particularly in the tragic case of Fiona Pilkington. Also, when people commit hate actions, whether they are verbal or physical, that is criminal; it is not low level, it is not just an anti-social euphemism, it is criminal and should be treated as such.

[Lord Touhig]

My Lords, in October last year three men who tortured a young man with Asperger’s syndrome were prosecuted for actual bodily harm. Over a three-day period they kicked and stamped on his head, repeatedly beat his chest, smacked him with a tennis racquet, threw him down an embankment, pelted him with dog faeces, rubbed his limbs with sandpaper and then forced him to drink so much vodka and gin that he passed out. Their sentence was 80 hours of community service. The National Autistic Society thinks that was an extremely lenient sentence. I agree. Would the Minister therefore be prepared to facilitate a meeting between the Justice Secretary, the National Autistic Society, myself and others so we can go into this matter?