Welfare Reform Bill

Baroness Browning Excerpts

Tuesday 17th January 2012 Lords Chamber

Of course I understand the noble Baroness’s concerns, but these amendments would not restore the DLA status quo and they fail to address the more fundamental questions of how, and for whom, support is prioritised. I repeat that we are trying to make sure that the scarce resources that we have go to the people who need them most. We know that under these changes there will be shifts in provision. Some people will receive less support—

[Baroness Browning]

I am sorry to interrupt my noble friend. On the point about scarce resources, I think we all understand the financial situation and the imperative to reduce the deficit. However, if people who are currently on the lower rate of DLA lose it—a point made earlier in the debate—they will not just carry on with life as it is. If we accept that these people do not claim DLA without a need for it, then we accept that they have a genuine disability and that the lower rate of DLA is factored into their weekly budget. If it is then decided that their case is not as important as someone else’s and that that person might need the DLA, that is going to have an impact. Earlier, the point was made that if you take away the lower rate of DLA from a lot of people with a wide range of disabilities, there will be consequences for their health and well-being, which will translate into a financial cost on the public sector. Will my noble friend consider undertaking a cost-benefit analysis of that consequence?

[Lord Freud]

My Lords, I have two answers to that question. The first is that people who need the support because of a disability may happen to be on the lower rate of DLA today but that does not mean that they will not be entitled to the standard rate in the future. My noble friend gave an example of people who are really dependent on that funding. I would expect in those circumstances that it would continue. Indeed, I would regard PIP to be a failure if it did not do that. Secondly, we will be monitoring that really closely. As I have discussed, later this evening I will present an amendment to make sure that we properly monitor what happens in this area and make sure that PIP does what it should be doing, which is to stop people ending up in the situation that my noble friend is so concerned about.

I must point out that if we move to a three-tier system on the daily living component, the implications are that the caseload would be larger—possibly larger than that under DLA—and spending would increase rather than decrease against the original and revised forecast under the personal independence payment. We cannot possibly quantify such expenditure implications, mainly because we have not yet set the rates at which benefit is paid, but the implications are there. I want the House to be under no illusions that they would be anything but significant.

Before I ask the noble Baroness to withdraw her amendments, I would like to confirm that the Government see Amendments 50ZGH and 50ZJA as directly consequential upon Amendment 50ZGB. On that note, I beg the noble Baroness to withdraw the amendment.

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[Baroness Grey-Thompson]

My Lords, the issue of the social model of disability was discussed at some great length in Committee and the noble Baroness, Lady Campbell, spoke very eloquently on it. Despite the Government’s commitment to the social model of disability, their other commitment on this issue—to provide an objective assessment—works in opposition to this aim.

The idea of an objective assessment is to ensure that people with the same functionality receive the same level of PIP. This looks only at the person’s functionality, and not at the barriers faced by that person within society. A benefit which was based on the social model of disability would look at the barriers that individuals face, not just at their functionality. Despite their stated intention to bring in a more active and enabling benefit that supports disabled people to overcome the barriers they face to lead full and independent lives, it actually takes less account of the individual barriers people face—because different people face different barriers.

The DLA has been criticised and no one would argue that it could not be improved on. However, DLA takes into account to some extent an individual's circumstances and uses—again to some extent—the social model of disability. It is claimed that, by making the criteria simpler, PIP will use the social model. However, it seems to rely much more on the medical model and appears to be going backwards in terms of taking into account someone's costs in surmounting their barriers. The charity Scope has made it clear that it considers that the Government are introducing a tick-box style medical assessment that will not help them achieve the aims they have set out to achieve.

The stated aim is to provide a more active and enabling benefit that supports disabled people to overcome the barriers they face to leading a full and independent life, yet nowhere in the assessment process is there any space for looking at the barriers that an individual faces. Disabled people face a multitude of barriers to participation and independence, many of which come as a direct result of social, practical and environmental factors. Making the test more objective and simpler will inevitably lead to a greater focus on the medical model, which will work against the stated aims and purpose.

Richard Hawkes, chief executive of the disability charity Scope, said:

“We recognise that Disability Living Allowance needs reforming and we fully support the government's ambitions to create a more active and enabling benefit. However, we are concerned that the new assessment the government is planning to use is flawed because it doesn't take into consideration all the barriers that disabled people face in daily life. Without understanding the extent of barriers people face, the government has no hope to overcome them and genuinely enable people to take part in daily life”.

At a time of limited resources, it is crucial to ensure that support is targeted as effectively and accurately as possible. This will not happen using the proposed assessment. To ensure effective targeting, the assessment process for PIP claimants must accurately measure the extra costs that individuals incur, based on an understanding of the variables that affect those costs. I beg to move.

[Baroness Browning]

My Lords, this is the first time I have contributed on Report. I declare my interest as vice-president of the National Autistic Society, patron of Research Autism and as the named carer of an autistic adult man in receipt of DLA. I am concerned about this part of the Bill and support the amendment and the detail with which it outlines what I believe are shortcomings, despite my noble friend's best efforts to identify how the assessment will affect people on the autistic spectrum.

In 1990, the House of Commons sent to this Chamber the Autism Bill, which became an Act of Parliament. It was passed as a result of a Private Member's Bill introduced by the right honourable Cheryl Gillan MP. It was supported by all parties in both Houses and was enacted in 2010 by the coalition Government. I tabled a Question for Written Answer just before Christmas asking whether the Welfare Reform Bill that is before us was compliant with the Autism Act. It is worth remembering that no other Act of Parliament has been passed that is specific to a condition. Certain medical conditions are mentioned in other Acts, but the reason for both Houses agreeing to pass the Autism Act, which is now on the statute book, was that autism is different. I make no apology—I know I bang on about it quite a lot—for drawing the attention of the House to the fact that an Act of Parliament was needed because autism is so different.

There are many aspects to the Bill, including the amendment we are now debating, which have a specific read-across to the autistic spectrum. Some years ago in another place I introduced the first debate in Parliament on Asperger's syndrome. It was not well understood then. It is far better understood now, which is a great relief to me and many others. Even so, parents and people with Asperger’s syndrome still struggle to get access to services, benefits and independent living, and to take their place in society as they would wish. The Autism Act was passed in recognition of that. I have to say to my noble friend that I was very disappointed when the reply to my Question for Written Answer in relation to this piece of legislation said that this was a matter for the relevant services by local authorities and NHS bodies and was not the subject matter of the Welfare Reform Bill.

Under the Autism Act, there is now a statutory responsibility on health and social services to implement the autism strategy which will require them to work with partners; for example, local authority housing departments. The Health Minister will be in a strong position to call to account local authorities and health authorities that do not implement this strategy. I know it is not the subject of this clause but if you are going to say that people under 35 will have restrictions placed on them as to where and with whom they live, that is a total contravention of what local authorities are being asked to do to implement the Autism Act. Equally, in the assessments for people on the autism spectrum, Asperger’s syndrome is not “autism-lite”.

Some years ago the National Autistic Society produced a report on autism called Ignored or Ineligible?. It is a 10 year-old report but sadly a lot of it is still relevant today, especially for those trying to get support for people on the autism spectrum, particularly those at the end of the spectrum who are more able—people with higher than average IQs. The anomaly about this condition is that you can have people with Masters degrees who cannot cope with some of the day-to-day detail of looking after themselves. The House has put on the statute book the Autism Act because autism is so different. The amendment before us picks up on some of those defects in the assessment.

I had time to read the case study—unfortunately it was number 13—in the information that my noble friend published yesterday, which related to a young man with autism and how his assessment had been carried out. Yes, he scored highly and one would take a lot of comfort from that. But I want to bring my noble friend back to the situation of what is sometimes regarded as quirky behaviour—sometimes threatening or challenging behaviour—but in the main non-threatening behaviour; odd behaviour, yes, with the inability to do certain things sometimes but able to do much more difficult things at other times. It is a very strange and complex condition. Therefore, in an assessment process, it is absolutely essential that people are viewed as individuals in the way in which their condition affects their day-to-day lives, whether it is their medical condition, the way they live socially or their housing conditions. It is that sort of complex condition. It is sometimes associated with other things such as learning disabilities and/or mental health issues as well, which makes it much more specialised in terms of understanding the behaviour that is presented.

I do not want to focus on my own situation but, as I am sure noble Lords can imagine, as a mum I am pretty worried. I want to take this opportunity to say on behalf of other mums—if I do not say it, who is going to say it for them?—that when you have a child who is born with a lifelong disability and you know they are going to die with that disability, as a parent your relationship with that child is very different from your relationship with other children you may have. When they are little children, you agonise about things like education. As they get older, life skills and whether they can cope for themselves become far more important to you than whether they ever got a GCSE. As they and you get older, your waking moments are haunted by how they will cope when you are no longer there to support and help them. I think that most parents of disabled children—whatever the nature of their disability —would understand that. Therefore, when you feel after many years that you have them in what I would describe as a stable situation—and how important, particularly for autism, stability is—it is so worrying when you suddenly look into the future and find that actually it is not stable at all. It is not stable for you—as you are growing older with goodness knows how many years left—and you see that it is not stable for them.

I have every respect for the amount of time my noble friend has put into autism. I am totally in favour of what he is trying to do to get more autistic people into work, because there are many who could work if they were given the right support and back-up to do it. I fully support that. But Asperger’s syndrome and those people on one end of the spectrum of autistic spectrum disorders are not “autism-lite”. I mentioned the report Ignored or Ineligible?. It showed that for people between 20 and 30 the suicide rate was 8 per cent. The reason it was 8 per cent was that the people on that spectrum try like mad to be part of society and try to be like everybody else. However, there comes a point at which, for many of them, they give up that struggle. I am very concerned that if they are not assessed as individuals, with all the quirkiness and strangeness of this very complex condition, we will go back to people on the more able end of the autistic spectrum being either ignored or ineligible, with all that that means. That is why I support the amendment tonight.

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[Lord Freud]

My Lords, let me start by referring to the moving speech made by my noble friend Lady Browning. I confess to a real concern about autism generally and I am very proud that my maiden speech was on the Autism Bill. I have undertaken a number of initiatives in the autism area because we do not look after people with autism and Asperger’s properly. I also strongly believe that it would not take a huge effort to make sure that we look after those people much better. As my noble friend knows, there is currently a major initiative to try to ramp up the number of such people who have and keep jobs. Currently only around 15 per cent have jobs, which is ludicrous, and I am determined to double that figure.

As part of that concern for this particular group, we wish to make sure that this assessment takes people with autism and with Asperger’s properly into account. I am hopeful that PIP will do a better job than DLA, and, furthermore, that we will make sure that we have the right processes in place to look after this group. As we refine processes during the next consultation period, which we are running until the end of April, one of the things that I want to make absolutely sure of is that we have the right measures in place for autism. I know that everyone in this Chamber feels similarly on this issue, and feels very strongly that we should get this right for that particular group.

I shall now turn to the more technical aspects of this issue—that is, looking at what we are doing with the PIP and its assessment. Is it a medical assessment, as the noble Baroness suggested? It absolutely is not. In fact, as I said in Committee, our approach is—and this is rather a mouthful—akin to the biopsychosocial model. I shall try to draw this out a bit—I do not mean in time: I shall try to draw the themes out. A medical assessment would be something like the industrial injuries disablement benefit, where there is a direct correlation between the injury sustained and its severity and the amount of benefit or compensation received. Nor will the PIP assessment focus on the functional limitations of the individual in the way that the work capability assessment does. Instead, it will assess how the individual’s health condition or impairment impacts on his or her everyday life by looking at their ability to carry out a series of key and holistic activities, all of which are essential for participation and independent living. In such an approach, the type of condition or impairment an individual has is of limited relevance.

It is not, however, a full social model assessment. I accept that. That is something that many noble Lords and disability organisations would like, but I have to point out that it was not our intention to develop it in this way. As a department, we do support the social model. As the noble Baroness, Lady Wilkins, said, we are on record as supporting it. While we want to ensure that the PIP assessment better reflects it than previous assessments, that does not mean that the full social model is relevant for assessment, although it is relevant for some things. I sent round a rather interesting piece of analysis to many noble Lords in the Committee, called Models of Sickness and Disability, which showed the differences between the models, explaining the medical model, the reaction of the social model against the pure medical model and the synthesis of the biopsychosocial model. The summary of the biopsychosocial model in the analysis is that:

“Sickness and disability are best overcome by an appropriate combination of healthcare, rehabilitation, personal effort and social/work adjustments”.

There is a coherent theory behind this assessment.

[Baroness Browning]

Will my noble friend confirm whether, when people on the autistic spectrum are assessed, there will be somebody present as part of that assessment who is expert in cognitive specialisms?

[Lord Freud]

People will be able to bring anyone with them to the assessment, whether it is a parent, adviser or anyone else. For the WCA, the person doing the assessment can call in that support where they need it. We are now entering the consultation phase on the PIP assessment. Wrapping in that support will be one of the elements that we will look at. I accept that the assessor needs to understand how those factors reduce the ability of the person in front of them to run their lives.

[Baroness Browning]

It has been suggested—I hope that this is an opportunity for my noble friend to put this straight—that the assessor will be able to call somebody on the telephone in making the cognitive assessment. I hope that he is able to assure me tonight that that is not the case.

[Lord Freud]

Clearly, the system will be elaborated and developed, and we are at an early stage. Although the WCA is a very different test from the PIP assessment, one of the useful lessons that we have drawn from Professor Harrington’s recommendations for it is that mental health champions are available on site for assessors. That is the way in which that test has developed, and there are some valuable lessons there for when we look at how we elaborate the PIP assessment.

If we were to go with the full social model assessment along the lines suggested by Scope, looking at the full range of factors that potentially cause barriers and cost, it would require a very long, intrusive and costly assessment, putting significant cost burdens on the state and, more importantly, very large burdens on the individuals involved. They would also inevitably require much more regular assessment, as the social factors that would be taken into consideration would change more regularly than the impact of a health condition or impairment. You might, for instance, get to the ludicrous position where every time a local bus service changed, you would have to do a reassessment on that model. In meeting after meeting with noble Lords, I have been left under no illusion that having too many reassessments is one of the things that they dislike the most. We will try to provide later on some reassurance that there will be decent gaps wherever possible between reassessments.

The situation could go very dramatically the other way and lead inevitably to inconsistency, with factors considered varying from person to person and affected by local factors or service provision. With PIP, we are looking at something that is universal and where entitlement is based on the same criteria wherever individuals are and whatever their circumstances. This discussion carries echoes of our ring-fencing debate earlier today in relation to the Social Fund. If we move to a kind of local needs-testing, which is what the amendment implies, it would be at odds with how we deliver a national benefit. Clearly, we could do something else. We could localise it as a benefit, but then it would be a very different benefit. I suspect that many noble Lords would be very concerned about moving in that direction.

Most importantly, we think that a social-model approach would be more subjective. Benefit entitlement needs to be based on clearly defined and transparent criteria which we need to be able to set down in legislation and apply to individuals consistently, whatever their circumstances and wherever they are in the country. If you cannot do that there would be a level of unfairness and uncertainty, high levels of appeals and a system in disrepute. Under the type of assessment proposed, it would be harder to define the criteria that individuals would be assessed against and less clear whether they had met the thresholds for entitlement.

Finally, we do not think that an assessment along these lines would allow us to control expenditure and keep that benefit spend sustainable, making sure that it goes where it is needed most. I do not think that I can really reach a figure on how much it might cost, but our estimate is that it would be very substantial.

Although the social model approach is superficially attractive—and I emphasise that we support it in many ways—we have decided that it is not the right way to go with this assessment. We have not gone for the medical model; we have gone for the biopsychosocial model. That model has now garnered very significant academic support, as those noble Lords to whom I sent that very interesting piece of research will recognise. It recognises the diverse range of biological, psychological and social factors that impact upon an individual and cause variation in need. We think that approach—of looking at activities and outcomes—matches the requirement.

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[Baroness Meacher]

My Lords, I support Amendment 50ZR, tabled by the noble Baroness, Lady Grey-Thompson, and to which I have added my name. The noble Baroness has made the case comprehensively so I will be brief. She referred to the alarming error rate in benefits decisions. At the same time, I am aware that steps are being taken to improve the accuracy of those decisions.

Here I want to make sure that we do not forget the particular problems of people with learning difficulties and mental health problems, who may not adequately convey their limitations in a face-to-face assessment. These groups have to spend their lives concealing their symptoms. They are embarrassed by them, and the last thing they want to do is to spell them out. They are acutely aware of the stigma associated with those symptoms. The Government are ensuring that claimants can take someone along to their assessment. There is no doubt that that will help and in some cases lead to appropriate outcomes. However, for many having a companion simply will not be enough. The companion cannot conduct the interview and the pressure on these individuals to conceal their problems is very difficult to overcome in these one-off assessment interviews.

There are also people for whom the very idea of one of these assessments is completely unacceptable. The obvious example is of people with agoraphobia, for whom just going out of the house can present real problems, as can getting on a bus or whatever it is. It is a real problem for this particular group. These people would benefit massively from having a psychiatric assessment at the start of the process, which would eliminate the need for them to go through all the distress of having to do something that they find completely intolerable. It is very fashionable to knock medical assessments but, having worked in mental health for a quarter of a century, in my experience psychiatric assessments are bio-psycho-social assessments. I think that was the term that the Minister used. They do look at the biological, the social, the genetic and every other aspect of someone’s functioning.

Also, any self-respecting psychiatrist will not do an assessment in a single sitting. They expect to assess someone over a period of time. They will bring in the views of social workers, nurses and others who have seen someone over a period. There is no way that a one-to-one assessment by someone who may be a nurse but not a psychiatric nurse—even if they call in someone who might be a psychiatric nurse but does not know the patient—can meet the need to make sure that someone is properly assessed, gets the benefits to which they are entitled and does not get benefits to which they are not entitled. It works both ways. This is an important issue.

Other examples include people with a psychosis whose symptoms are not controlled by medication. Many people’s symptoms are controlled but some people’s, tragically, are not. Those people should be able to have a medical—a bio-psycho-social—assessment and, on the basis of that assessment showing that such a person may not be able to function at all, it should be sufficient. I would have thought that the Government would accept that view.

There are physical diagnoses to which the same sort of arguments would apply. For example, those undergoing treatment for cancer, who again have uncontrolled and uncontrollable symptoms, would fall into this category. I referred to this group in connection with an earlier set of amendments. An early medical certificate for those people would avoid enormous distress and the gross injustice of requiring them to do things that none of us would wish them to do if we saw them face-to-face.

I understand the issue of medical fees, which has been referred to. GPs will not tolerate an inundation of requests for medical assessments without a fee. One of my daughters is a GP. I discussed it with her and she was not impressed by the idea. I am also aware that the Government have introduced an important new element in that the claimant can seek a report from their favoured clinician, who could be anybody—it might not be a doctor. This is helpful but it raises the issue, which has already been raised, of a two-tier system. Some people may be able to afford such a thing; others may not. It is a great step forward and I wish to acknowledge that, but it does not detract from the importance of this amendment. I look forward to hearing the Minister’s response.

[Baroness Browning]

My Lords, I am sorry to come in on Asperger’s syndrome again. I know that the Government involved people on the autistic spectrum in some trials that they carried out over the summer. I just wanted to encourage my noble friend to take the feedback from some of the people who took part in that, in a mock PIP assessment. Because the spectrum, particularly at the more able end, includes people who may be very articulate, on a good day it may be quite difficult to see that this is a communication disorder. On the other hand, you could have an assessment in which, even with the benefit of someone in support in the same room, the person on the autistic spectrum may have some difficulty in answering any question themselves as they struggle to put the words together or to make eye contact with the assessor.

On this group of amendments, I would encourage my noble friend to be aware of the variation in how people can present. However confident they may appear, it will inevitably be a very stressful situation for them to be in a room, answering questions from someone they are unfamiliar with. However they present, there will be stress behind it. I just reiterate something that I asked my noble friend a little earlier. I ask him to make absolutely sure that the people doing these assessments have not just mugged up on what autism or any other disability is from some book, but really understand and have a working knowledge of the disciplines in which they are assessing people. I will leave it at that.

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[Lord Freud]

My Lords, I could summarise my speech in about three sentences. I am in agreement with virtually everything said in the Chamber. I hope that after my three sentences I will be able to provide assurances. My only point of real disagreement is that I do not want it to be mandatory—in primary legislation. This is in regard to the point made by my noble friend Lord Kirkwood that it reduces flexibility and we are much better off setting it up in regulations and guides and in the contracts. That is our proposed approach but fundamentally we are absorbing all the valuable points made on this group. I will try now with some speed to go through those assurances. I ask noble Lords to stop me with the precise assurance they want if I am not making the assurance well enough.

Amendment 50A was semi-withdrawn by the noble Lord, Lord Touhig, but I will try to deal with it because it is a building block. People being assessed can bring in someone with them—a relation, a friend or a professional—to help them. That is really important in the group we spent a lot of time on this afternoon relating to autism and Asperger’s. When people are over-bright their relation can make the point about the reality and the over-anxiety of the person being assessed. That would be an active role in the process.

I turn now to Amendment 50B. Clearly, we need to make sure that assessors have all the appropriate training to interpret the evidence that they are provided with. I have to make the point that it is not a medical assessment PIP. It does not ask the assessor to diagnose a condition or to recommend treatment options. It is different. It looks at how the conditions or impairments affect individuals’ everyday lives. That is a different skill set from that involved in treatment. There is not quite the same level of need for specialist skills but it is our intention that assessors will have a broad training in disability analysis as well as training in mental, intellectual and cognitive impairments. That level of training will be stipulated in our contracts with any providers and we will be responsible for signing off the training syllabuses. There will be occasions when assessors need more specialist support in the course of making these assessments. We will ensure that they have access to and support from individuals who have the in-depth knowledge that the noble Baroness, Lady Meacher, mentioned with regard to mental health conditions.

[Baroness Browning]

I am sorry to interrupt again. Can my noble friend give us any hope that when an assessment is called there will be any publication of the qualifications and background of the assessors so that the people being assessed at least have some view of what their expertise actually is?

[Lord Freud]

It is a nice idea. I do not think I will make an utter commitment to it here and now but it is a cute idea and maybe we should put it in the contract. I will take it away and think about it.

We do not think that we should prescribe this in the Bill or even in regulations because it is important that assessors have an understanding of the limits of their knowledge so they know when to bring in the expert advice. I think the noble Baroness, Lady Healy, got that absolutely right.

I will now go on to Amendments 50C, 50D and 50ZR. We know that individuals can have a wealth of material, knowledge and evidence that will help in the assessment process and we need to get the right material and evidence from them at the right time and we need to encourage that evidence to come forward. We will not create a two-tier system where the poorest and the most vulnerable have less chance of receiving benefit because they cannot afford to pay for the evidence. We are going to make sure that does not happen.

I want to pick up the very valuable point raised by the noble Countess, Lady Mar. If we have a mandatory process to involve the individual’s health professionals it may very well be an entirely nugatory and expensive process in the many situations where the GP is not up to date with what is happening. That is the inflexibility of having something in the Bill which adds nothing except cost. If someone who has a learning disability has not visited a health professional for many years, why go through the expense of getting evidence? It would be unnecessary; it would slow the process down; and there may be someone else whom we would not have thought of including in the Bill who is much better placed to provide information and evidence for the assessor. We need to pull out the cumbersome implications of the mandatory process—the point made so precisely by my noble friend Lord Kirkwood.

We have made it clear that face-to-face consultation should form part of the claim process for most—but absolutely not for all—claimants. Ultimately, consultation will play a key role in creating a fairer and more objective assessment. It needs to be done sensitively and proportionately, but where sufficient evidence is available, we are in absolute agreement that there does not have to be face-to-face consultation. There will be many examples where that is unnecessary.

We are talking about something very close to, if not exactly, the tiered process recommended by the National Autistic Society. That is what we are planning to adopt. We have flexibility in the Bill to do that.

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[Lord Newton of Braintree]

My Lords, for the second time today I feel that I need to say something, however brief, because of my history. Just as I engaged in badinage earlier with the noble Baroness, Lady Lister, about the Social Fund, I now have to declare to the House—possibly as a proud boast—that as a Minister I was responsible for introducing the disability living allowance in the early 1990s. I was given huge help by someone who deserves a great deal of credit, namely my former and unhappily now late colleague, Nick Scott, whom some noble Lords in the House today will remember with respect and affection.

On that occasion, we cobbled together a slightly curious construction based on the existing benefits of mobility allowance and attendance allowance, using the maximum amount of money I could extract from the Treasury at the time, to extend help to various groups who had previously been excluded, including the mentally ill. Perhaps we did a better job than I thought at the time because it has not only stood the test of 20 years but has survived with people now seeking to defend it against all comers, in much the same way as they defend the Social Fund.

What I say to the House may be uncomfortable for the noble Baroness, Lady Grey-Thompson, and the noble Lord, Lord Low, for whom I genuinely have huge respect. This is not flannel; they are immensely valuable Members of this House. However, I have been taken down a different path. If somebody had told me 20 years ago that that structure was to be seen as anything near a settled state for 20 years, I would have been surprised, because there were obvious ways in which it could have been developed and carried forward to build on what we had achieved at the time. That is what the Government now seek to do. I say to the noble Baroness that I am not sure that it is right now to try to slow down the process by yet another review after the many that we have had.

Only yesterday the Government published a revised review of the assessment process. I accept that neither I nor anybody else has had a chance to digest it. However, it makes it crystal clear—this picks up on the second half of the noble Baroness's amendment—that this will be worked through steadily and carefully, in conjunction with organisations representing disabled people. I assume that account will be taken of the results of that consultation. Of course I accept that it would be nicer in a perfect world if we had all the details now, and that there will need to be a good deal of tweaking—or perhaps more than tweaking—as the consultation proceeds. However, I also accept that we have a Minister who knows his stuff, who cares about the subject and who has shown himself to be willing to listen to those representations. We should let him get on with it.

I do not accept the tenor of the e-mails that jammed my system from yesterday through the early hours of the morning into today, which suggested that the Government had a dastardly plot to do down disabled people. It is not the case, and I would not say this if I believed that for a moment. It is clear to me, having glanced at some of the e-mails—I have not been able to read them—that a number of them came from people who will not only not lose but may well gain from the proposals that the Government made. I hope that the senders will reflect on that.

This is not the moment for the House to agree this amendment. If we want to agree amendments, I suggest that between now and Report both the Minister and the House might reflect on the desirability of some extra-affirmative procedure of the kind used in the Public Bodies Bill for affirmative resolutions—I hope that they will be affirmative—that will come forward as a result of all the consultation. That would be far more productive than trying to slow the whole thing down with another review.

I have other points to make but the hour is late and the House wants to get on, so I will conclude by saying that at the end of the day I speak only for myself when I say that this would certainly cause delay, and would almost certainly add to the cost of an already expensive government programme. There may be smaller issues later, including those espoused by my noble and learned friend Lord Mackay, on which I may take a different view; but this amendment is strategic, damaging and mistaken, and I hope that noble Lords in all quarters of the House will join me in opposing it if it is pressed to a Division.

[Baroness Browning]

In the context of this amendment and the ability of health and social services to carry out their statutory responsibilities under the Autism Act, will my noble friend agree to take a look the number of people who currently have DLA but are predicted to lose it? There is a read-across here, because small levels of support have been identified as having prevented people taking their place in society and gaining independent living.

As I mentioned previously, I am concerned that as regards those who will lose the allowance—some will and others who apply in the future will not get it—the measure is going to have an impact on the way in which we have required health and social services to implement the Autism Act. Does my noble friend agree that there will be some hardship for those who lose it and that we have to face up to that reality, and that the Government should have a clear and examined view of how they are going to square that with the new statutory responsibility?

[Lord McKenzie of Luton]

My Lords, we support this amendment, moved so comprehensively by the noble Baroness, Lady Grey-Thompson, and spoken to so effectively by the noble Lord, Lord Low. I would say to the noble Lord, Lord Newton, that in doing so we are not motivated by a belief that this is all some dastardly plot, but a belief that we need to be assured that the system does not just need to be tweaked but that it is fit for purpose before this major change is introduced.

This amendment is aimed at helping the Government get right the process of transfer from DLA to the personal independence payment. It calls for an added layer of safeguards within the process of reform, with an independent review of the plans for operation of the assessments before they start and a trial period when the assessment process first comes into effect. Crucially, it calls for the full involvement of disabled people and their organisations in this process, ensuring that they have confidence that the assessment process for the new benefit will be fair. The need for safeguards in this area has been all too fully revealed with the experience of the employment and support allowance. The noble Lord, Lord Newton, told us that he was responsible for introducing DLA—which in Committee the noble Lord, Lord Low, called an “iconic” benefit—and he should be proud of that achievement. I have some responsibility for having introduced the employment and support allowance so I cannot claim any such accolade.

It is clear that the assessment process has not been working and has caused not only distress to too many disabled people but considerable headaches for the Government. We all know that 39 per cent of appeals have led to a decision about ESA being overturned in favour of the claimant, and the unreliability of the assessment procedure has also made it difficult for the Government accurately to budget for the cost of these reforms. The Office for Budget Responsibility’s November economic and fiscal outlook states:

“ESA changes have resulted in an increase in expenditure of £1 billion by 2015-16”,

and the latest administrative data suggest that fewer people than previously assumed will be judged fit for work as a result of the initial ESA work capability assessment and the reassessment of incapacity benefit cases, and more will be placed in the support group. This accounts for around four-fifths of the increase. Other changes arise from a change in assumptions about the composition of the ESA caseload, which results in higher average benefit payments per person and higher inflows. The costs of getting this process wrong can therefore be high, and we know that the Government have benefited from the independent review of the ESA assessment process undertaken by Professor Harrington.

As other noble Lords have said, we received just yesterday the document providing further information about the second draft of the PIP assessment criteria, together with proposals on entitlement thresholds, impact modelling and case studies. While this technically fulfils the Minister’s commitment that we should get it before the Report day, as we have previously noted, there has hardly been time for detailed study and analysis—although it is hard to miss the startling figure that some half a million disabled people will be excluded from the new benefit in comparison to existing DLA arrangements. Before causing this to happen, the Government should be called to account for the impact that this may have on the disabled people who are missing out.