Personal Independence Payments: Merseyside

Angela Eagle Excerpts

Tuesday 26th March 2019 Westminster Hall

[Ms Angela Eagle (Wallasey) (Lab)]

It is a pleasure to be here, although I wish we did not have to discuss this extremely difficult issue. I pay tribute to my sister and hon. Friend the Member for Garston and Halewood (Maria Eagle) and other colleagues who are here to talk about this important issue. I want to spend a bit of time relating what is happening with personal independence payments on the other side of the River Mersey, on the Wirral. For the Minister’s interest, I will mention five cases. I will give him a letter with the more important details, and I hope that he will help me to deal with the three that are outstanding.

Wallasey is 25th in the table of PIP cases and our authority, Wirral Council, is 22nd out of 380 local authorities for volume of such cases. Within Wallasey, what are known as psychiatric disorders were the most common reason for claiming PIP, which is why I associate myself with all the points made so far by my hon. Friends on how cruel and disruptive the stress people are put through when making claims is. Psychiatric disorders include anxiety and depression, learning disabilities and autism, and 36% of people who make claims for PIP in Wallasey belong to that group. The system should take much more account of the effects that the process is likely to have on those who are already suffering from mental illness or depression, or who have learning disabilities that mean they cannot—even with the best will in the world—operate effectively in the kind of system that the Government’s PIP reforms have placed them in.

The second most common reason for awards was musculoskeletal disease in general, which includes osteoarthritis, inflammatory arthritis and chronic pain syndrome. In Wallasey, waits at the Birkenhead tribunal were 33 weeks, but as of two weeks ago that had risen to 38 weeks—that is nearly 10 months, on average, to get a re-assessment and an appeal. Some 73% of appeals found in favour of the claimant by the end of last year. That is what the statistics say. Once more, we see the same pattern of extremely and unacceptably high, and increasing, waits for access to tribunals. It is close to a three-quarters success rate for people who appeal. I join my hon. Friends the Members for Garston and Halewood and for Liverpool, West Derby (Stephen Twigg) in saying that we worry about those who do not make claims, do not come to see us at our advice surgeries, and are suffering an often catastrophic loss of income in silence when we can see that they might well be entitled to support from the PIP benefit.

There are some general themes about how Atos Healthcare runs the contract for PIP assessments. I will go through some cases—I will not use names—and then spend a bit of time pointing out the themes that worry me the most. Constituent one has a benign brain tumour, epilepsy, short-term memory loss, anxiety, mild depression and an adjustment disorder. He has had brain surgery and will need to have it again in the future. He has regular seizures, which cause loss of awareness, perception and consciousness.

On 10 January he had a reassessment, which was carried out at his house, although, funnily enough, it was not requested that it should be. He has received DLA, carer’s allowance and mobility for the past 15 years, but in this assessment he scored only six points, despite medical evidence stating that he needs help at home. There were also discrepancies between the points scored and the information in the report. Medical evidence states that he cannot prepare food or clean himself without supervision, but his PIP assessment report states that he can do both unaided. He was recorded as being able to carry out complex budgeting calculations because he recognised a £5 note. The assessor recorded him as having good eye contact and focus, despite the fact that he was crying and shaking throughout the interview. There is no mention in the report of this man hurting himself and other people in the middle of the seizures that he has regularly. It was emphasised that he is not safe alone either inside or outside the home because he is a risk to himself and others. Despite my constituent showing the assessor some of his injury marks from seizures, which were not mentioned in the report, and his doctor’s letter that references them, he had reductions in his benefit that leave him and his wife £578.20 a month worse off.

Constituent two has 95% hearing loss, agoraphobia and anxiety and has been on DLA for 17 years. Because of her severe anxiety she asked for a home assessment, having previously had severe panic attacks when she attended the jobcentre. It was initially refused, but I intervened and a home assessment was granted. At the assessment in September last year, a sign language interpreter was not provided. Her father sat in the interview and asked if he could write the questions down for my constituent so that she would know what was going on, because she has 95% hearing loss. The assessor refused to allow that, claiming my constituent was making it up and could hear the questions. The assessor terminated the interview early, and the DWP claimed it had no knowledge of my constituent being deaf, despite the fact that she had been claiming DLA for her disability for 17 years. The Department must surely have known that. In February this year my constituent received a letter stating that her PIP claim was terminated because the interview ended early. It was the assessor who terminated the interview and the DWP did not think the fact that she could not hear was a good enough reason. She has now been without benefits for almost a year.

Constituent three received a wheelchair from the local NHS service because her mobility and health was declining. She was advised to apply for PIP as the wheelchair she was fitted with does not fit in her car and she is unable to get around independently as a result. In the assessment she stated that she could walk for only 10 to 15 metres, but the assessor recorded her as having the ability to walk for 50 metres. The assessor also failed to record other issues with mobility and health that my constituent mentioned. The incorrect information meant she did not score highly in the assessment and as a result was not awarded PIP. The case has gone for mandatory reconsideration and she is waiting to hear back.

A couple of issues have been resolved now. Constituent four has had multiple sclerosis for 30 years. He was diagnosed with secondary progressive MS in 2003. He received DLA and qualified for higher rate mobility. Yet at his most recent assessment for PIP in November last year he lost the higher rate mobility component and was worried that he would lose his Motability car, which has been specifically adjusted to allow him to drive to work. He has an electrical stimulator in his leg to help him move, and he uses crutches, which means he has tennis elbow and carpal tunnel syndrome, and he has lost fine motor skills in his right hand. Despite that, the assessor said that he could use crutches and so his hands were fine.

Despite not seeing my constituent walk more than 15 metres at his assessment, the assessor claimed he could walk between 20 and 50 metres with aids. My constituent provided 13 letters of support from medical professionals, including neurologists and consultants, but despite all that and despite having multiple sclerosis, which is a deteriorating condition, it was decided he needed less support, not more. After I wrote to the DWP and raised his case with the jobcentre, his mobility component was reinstated last month, but it took four months. Just think of all the anxiety that my constituent suffered as a result, none of which helped his condition.

Constituent five was on PIP enhanced daily living from 2005 and received the mobility element because he has epilepsy. He has depression, anxiety, attention deficit hyperactivity disorder and cancer in the pituitary gland. He asked in advance of the assessment if it could be recorded because he has problems with his concentration and memory. He was told by the DWP that it would not provide a recorder and it would accept only a double tape machine, such as the police use. At interview the assessor wrote that he was relaxed and coped well when he was actually anxious and upset, and he was crying because he had to attend the assessment on his own as his family live in Northern Ireland. The assessor listed medicines that my constituent does not take and omitted medicines that he does take. He was also not warned that as a result of his claim being reduced he would lose the enhanced daily living component and the ESA enhanced disability premium. Consequently, he struggled to manage to live and feed himself. A reconsideration took place relatively quickly, thanks to my intervention, and the benefit was reinstated. Having heard about such cases, the Minister must surely see what is going on.

Assessors are not adequately prepared for the assessments that they must do. For example, sign language interpreters are not provided, but the assessor carries on with the interview regardless. The DWP claims it is not aware of someone’s major hearing loss when it has been paying DLA for hearing loss for 17 years. It takes no extra care to ensure that the constituent involved can have a fair assessment.

Over and again, the process is demeaning and dehumanising. It is a grossly unfair system. It is flawed and uncaring and puts people through the mill. Recently the Disability News Service put in a freedom of information request and although the DWP said it would be too expensive to produce figures for all the claims, it did produce figures for a sample of 100 cases. In 97 cases decisions were made without the DWP making any attempt to seek further advice or clarification from Atos, despite ongoing complaints about assessors’ inaccuracy and omissions since PIP was introduced in 2013. That must be why so many appeals are successful. All the relevant evidence is considered a second time around, and it is hard not to come to the conclusion that claimants are assumed to be lying if assessors do not record things accurately. Are targets set by the DWP or by the organisations that have the contracts for knocking people off disability benefits such as PIP?

There seems to be a pattern of behaviour not being caught by how the system runs, and it causes some of the most vulnerable people in our society massive amounts of distress. It deprives them of the money that is not only their entitlement, but which they rely on to live and to afford the basics. It does not give them any chance to appeal until an average of 10 months have gone by, often leaving them destitute. We ought to be able to change the system to take account of the very important and special needs that some of the most vulnerable have. I hope the Minister will accept the envelope containing the three outstanding cases that I mentioned in my speech and I very much hope we can get a resolution for them sooner rather than later.

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[The Parliamentary Under-Secretary of State for Work and Pensions (Justin Tomlinson)]

It is a real pleasure to serve under your chairmanship, Sir Edward. I understand that we are waiting for a permanent Minister for Disabled People, but in the meantime—I am sure it will not be long—it is a great honour to be here. I formerly served as the Under-Secretary with responsibility for disabled people, but the role has been significantly enhanced. It is an extra pleasure to be here in the enhanced role, albeit temporarily.

I pay tribute to the hon. Member for Garston and Halewood (Maria Eagle). We met just last week about a separate case, and we had a debate earlier this year, I think, on a similar topic. As a former Minister, she has genuine feeling and passion for supporting the most vulnerable people in her constituency, backed up by her genuine knowledge about this issue. I am happy to look at the cases that hon. Members have raised. I will take that envelope—I can see that it is ready. I also pay tribute to the hon. Members for Liverpool, West Derby (Stephen Twigg), for Wallasey (Ms Eagle), for Liverpool, Riverside (Dame Louise Ellman) and for Battersea (Marsha De Cordova). There was a common theme: it is clear that they all genuinely care about vulnerable people who rely on people like us—the decision makers—to get it right. Although I did not necessarily agree with everything they said, I understand why they made those comments.

The PIP assessment is meant to be high quality, objective, fair and accurate, and it should focus on the fundamentals of living an independent life. Today we spend somewhere in the region of £55 billion supporting people with disabilities and long-term health conditions. In real terms, that is about £10 billion higher than when we first came to office in 2010. That is about 2.5% of GDP and 6% of all Government spending. It is an incredibly important area of Government expenditure. There are just over 2 million claimants on PIP, and many more are coming into the system or are due to do so.

Currently, 31% of PIP claimants access the highest rate of support. That contrasts with just 15% under DLA. I do not wish to diminish any of the points that hon. Members made—I will cover many issues about which we still need to do more—but we must remember that the system has come a long way from the old legacy benefit. One thing that is consistent among all stakeholders and charities that I speak to in my current role, and that I spoke to formerly when I was the Minister with responsibility for disabled people, is that nobody advocates going back to the old DLA system.

Under PIP, 45% of people with autism spectrum disorder will have the highest rate of support. For motor neurone disease, the figure is 85%. For multiple sclerosis, it is 53%, and for Parkinson’s, it is 55%. Many hon. Members rightly spoke about mental health. Under PIP, 31% will get the highest rate of support. Under DLA, only 6% did, so under PIP five times as many claimants with a mental health condition will access the higher rate. That does not mean that we are getting it right all the time, but there has clearly been a significant and much-needed improvement. In cash terms, the average claimant is getting £15.04 a week more on PIP, compared with DLA.

[Ms Angela Eagle]

Cash terms!

[Justin Tomlinson]

Yes, it is an average, and we are highlighting cases. I will come on to that.

The old DLA system relied solely on self-assessment. For many claimants, the very complex DLA forms were a barrier too far, and people who were in genuine need of support were missing out. Although the lifetime awards were seemingly attractive, they missed the point that many people enter the benefit on a lower rate of support, because conditions can get progressively worse. People on a lifetime award were often told, “If things deteriorate, please contact us for reassessment.” People often did not, either because they did not want to risk losing their benefit or because they did not appreciate that getting a reassessment could work to their advantage financially. Bear in mind that one in three claimants’ conditions changed so significantly within a year that they could be due a change in those circumstances, and the majority would be higher.

[Ms Angela Eagle]

The Minister is making a case for the benefit, but nobody is arguing that it is fatally flawed. We are asking for the assessments to be more accurate, because they are causing problems. He is making a case about conditions that deteriorate, but I have brought to his notice cases of people with deteriorating conditions whose awards have been lowered.

[Sir Edward Leigh (in the Chair)]

Order. May I just make one point? This debate is about the administration of personal independence payments on Merseyside, so we want from the Minister talk about administration and Merseyside.

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[Justin Tomlinson]

I will come to that. Fear not; I have woven in as many of the answers as I could.

The average length of time for assessments is now 15 weeks, and it has actually fallen. Initially, in July 2014, when it was at its worst, it stood at 42 weeks, so it has fallen by two thirds to 15 weeks. We got it down to about 13 weeks, but feedback from stakeholders and charities suggested that it was better for assessments to take a bit longer, to help people—particularly the most vulnerable claimants—to gather evidence.

The assessors must be health professionals—occupational therapists, nurses, physiotherapists, paramedics or doctors—who have had at least two years’ experience since they became fully registered. Although there has been understandable criticism of some important cases, the vast majority of the staff on our frontline are well-trained and exceptionally hardworking, and they have claimants’ interests at heart. I think that we all recognise that. In the skills that assessors must have there is an emphasis on assessing people with conditions affecting mental health, intellectual or cognitive functions. There is comprehensive training on how health conditions and impairments affect claimants’ day-to-day lives.

[Ms Angela Eagle]

rose—

[Justin Tomlinson]

Hang on; I will address the previous intervention. What are we doing to ensure that cases such as those that hon. Members have mentioned do not happen? First, there is the independent audit for quality assurance, which is separate from the Department. It is important that we look at that. Our own DWP clinicians will also observe cases, and we get a considerable amount of helpful feedback from stakeholders.

Such examples are part of the reason behind the call for video recording. We agreed to pilot that in the autumn of last year, and it has progressed encouragingly. If there is no backlash from stakeholders, we will look at making that a given by the end of the summer. Video recording would make a huge difference, particularly in cases where something clearly is not going right. We would be able to look back at recordings, which would hasten our addressing of problems, and recordings could be used for appeals.

Satisfaction in 2015-16 was at 76%, and it is now at 82%. It still has some way to go, but the direction of travel is improving.

[Ms Angela Eagle]

I raised a case of someone who was 95% deaf. Her father was not allowed to write the questions out so that she could see them. The interview was terminated early, and the assessor was of the opinion that my constituent could hear but was pretending that she could not. How on earth is that allowed to happen if the system is as good as the Minister claims?

[Justin Tomlinson]

It is difficult to comment without having seen the details. I am not saying that what the hon. Lady says is not true, but if that case is exactly as she describes, that should not be happening and needs to be looked at, which is why I have committed to doing so. In general—as in the case about which I met the hon. Member for Garston and Halewood last week—common sense is not being applied. We must make sure that the rules and guidance that are in place are consistent across the board.

A number of hon. Members highlighted that in Liverpool and Merseyside, home visits are not offered. Between 15% and 20% of claimants in Liverpool and Merseyside have actually been offered home visits, as they should be. If, for a variety of medical reasons, travelling to the assessment is a barrier to accessing the benefit, that should be taken into account. Certainly, when I was the Minister with responsibility for disabled people, we improved the communication by making it more proactive to encourage that. We want the assessment process to work for the claimant.

I also welcome our introduction of the video relay service for those who are deaf and use British Sign Language. That is important not just for PIP, but across all frontline services.