Welfare Reform Bill

Baroness Grey-Thompson Excerpts

Monday 14th November 2011 Grand Committee

[Baroness Wilkins]

My Lords, I could not agree more strongly with these amendments. As ever, my noble friend Lady Campbell has nailed the issue and then hit it firmly on the head. The title of the Government’s proposed replacement benefit to disability living allowance is vague, confusing and misleading. As my noble friend Lady Campbell points out, it does not even mention disability. No doubt this is intentional, and sadly this Government have taught us to be fully justified in our cynicism. By removing any indication of PIP being a disability costs allowance the Government can manipulate entitlement to the benefit to their heart’s content.

I should declare my interest as someone who has received DLA and its predecessor benefits since the mid-1960s. Should I now expect screaming Daily Mail headlines spelling out the shocking amount this must total over the years? Of course, they will completely fail to mention that it was only this benefit that enabled me to be mobile, educated and employed, and so become a contributing taxpayer for the whole of my career. Now more than ever this week’s shocking press headlines vilifying disabled people as scroungers could not teach us more clearly that it is essential that the press and public know what this benefit is for; that they are given no excuse for the misinformation; and that the name spells out clearly what is in the tin. It is a disability living costs allowance.

The Minister has emphasised throughout this Committee stage that the Government’s whole purpose with this Bill is to change the country’s culture in people’s attitude to work. It remains to be seen whether they will succeed. I hope that they do. But sadly, what this Government have succeeded in doing is changing the public’s attitude to disabled people. It has become totally acceptable to depict disabled people as scroungers defrauding the benefits system. The Secretary of State, Iain Duncan Smith, was quoted as saying on 11 November in the Daily Mail:

“At the moment hundreds of millions of pounds are paid out in disability benefits to people who have simply filled out a form. The vast majority are getting the benefit for life without regular checks to see if they are still eligible”.

He finished that sentence by saying,

“or if their condition has worsened and they need increased support”.

Of course, concern for those who are missing out was not the lead story.

Will the Minister say when we are going to see the Government move to rebut any of these wildly inaccurate press reports which are helping to stoke disability hate crime? The Government’s acceptance of this group of amendments would be a welcome indication of their intent and I feel sure that my noble friend Lady Campbell has made the Minister very aware of the importance of this issue.

[Baroness Grey-Thompson]

My Lords, my noble friend Lady Campbell of Surbiton has very ably described the purpose of this amendment. I, too, declare an interest in that I am in receipt of DLA. Like my noble friend Lady Wilkins, it has helped me in terms of education and working throughout my life.

When I was doing my own research on what the title PIP meant, the most common response was, “Isn’t that something linked to pensions—a personal investment plan?”. The title should more accurately reflect what the benefit is and why support is required. Obviously, a name change on its own will not solve the issue but anything that clarifies why the benefit is necessary can only be helpful. Many disabled people are very frightened, partly by what will happen to their benefit but also about the change in the way in which they are viewed by society. It is not just in the recent media coverage over the weekend.

There has been a worrying change in how disability is reported in the media. The Strathclyde Centre for Disability Research in the media unit at Glasgow University has recently published a report, Bad News for Disabled People. It compared the coverage of five papers in 2005-06 and 2010-11 and found that there had been a decrease in stories presenting disabled people in a positive way and an increase in stories concentrating on benefit fraud. The focus groups in the same study all claimed that levels of fraud were much higher than they are in reality with some suggesting that up to 70 per cent of claimants were fraudulent. Participants justified these claims by reference to articles that they had read in newspapers. One of my concerns with the current name is that it possibly suggests that disabled people are getting a lot more money than they will actually receive. I also believe that there is an ongoing misconception over the purpose of DLA that we need to correct.

The DWP has highlighted in a press release the length of time many disabled people have received DLA as if people somehow do not need the benefit after a certain time. Again, this leads people to misunderstand the purpose of the benefit. Many people with congenital conditions, like myself, will continue to have higher costs of living throughout their lives. Of course, there need to be reviews as circumstances can change, but the fact that some people continue to qualify for these benefits in the long term is not on its own a signal that the system has gone wrong. A colleague frequently says to me that language is the dress of thought. Disability cost allowance is the right name to use.

[Lord Low of Dalston]

My Lords, I give my support to this amendment—the first in a long series that we are due to consider on this part of the Bill which deals with the personal independence payment. Like the noble Baronesses who have already spoken, I declare my interest as a recipient of disability living allowance since its inception in 1992. I hope that that can be taken as read throughout the rest of the amendments as we speak to them.

The noble Baroness, Lady Campbell, has made a very full case. What has emerged is the iconic significance of DLA to disabled people. It was an enlightened measure introduced by a previous Conservative Government, when, as the noble Baroness, Lady Campbell, told us, the noble Lord, Lord Newton, was Secretary of State—and, if I am not mistaken, Sir Nicholas Scott was Minister for Disabled People. It corrected many anomalies, as the quotation of Sir Bert Massie by the noble Baroness, Lady Campbell, reminded us.

Blind people were particularly grateful for the introduction of DLA. They had campaigned for many years for recognition of the extra costs attributable to blindness, but they were never officially acknowledged until the introduction of DLA. There were still anomalies; blind people were only eligible to apply for the mobility component at the lower rate—an anomaly that was only removed with the passage of the Welfare Reform Act 2009. That reform was supported by the Conservative Party at the time. I very much hope that blind people will not find that that hard-fought gain is snatched from their grasp—just as it has been won—with the implementation of personal independence payments. That would surely leave a legacy of bitterness that the Government would find hard to overcome.

This brings us back to the iconic significance of DLA. For many people it is not only the means but the symbol of their independence. As we have heard, much apprehension has been caused among disabled people by the changes the Government are making to the benefit system. People are fearful that their independence will be undermined with the change from DLA to PIP, or personal independence payment.

As Ministers probably recognise, the Government have a gap in confidence to overcome as regards the reforms where disabled people are concerned. They may well feel, on reflection, that retaining the name, which has such significance for disabled people, would be a small price to pay for the changes that they wish to make to the benefit. As the noble Baroness has said, names are important, and many disabled people obviously feel that we would lose this one at our peril. I hope, after due consideration, the Minister will take the same view.

--- Later in debate ---

Moved by

[Baroness Grey-Thompson]

86ZZZJ: Clause 76, page 55, line 15, at end insert—
“(A1) A person is entitled to the daily living component at the basic rate if—
(a) the person’s ability to carry out daily living activities is limited by the person’s physical or mental condition; and(b) the person meets the required period condition.”

[Baroness Grey-Thompson]

My Lords, I will speak to the amendments tabled in my name in this grouping. These amendments identify what I believe to be a significant weakness in the current approach. When DLA was introduced it was to help with disabled people’s high living costs and to ensure that those who could not access alternative help were supported, as well as to maximise disabled people’s independence. However, since DLA was introduced, most councils have restricted access to care services. Around 80 per cent of local authorities in England now provide support only to people with needs assessed as being “critical” or “substantial”. People with low or moderate needs have been prevented from receiving support through care rationing. But the Government’s plans to end DLA and introduce PIP would abolish entirely the low-rate care DLA and deny help to many disabled people and their families least able to receive any kind of alternative support. The amendments have been proposed to ensure that some disabled people who need basic, but not a great deal of, support are still able to access help under the new benefit. I declare an interest in the level of support being targeted for total abolition.

We need to be aware of those who are at the greatest risk of losing help if the proposals progress as drafted. The amendments would secure some basic support for disabled people and would make a substantial difference between being cut off from support and receiving a little help towards high living costs. It would also ensure that some disabled people were able to manage health conditions and thus prevent the overuse of more expensive NHS treatments or inpatient care. I wonder if the Minister could say whether the Department of Health has provided costs for how it expects to see increases in NHS usage rise for this group of people.

The current support helps people manage health conditions and helps towards some of the costs of, for example, higher heating bills for people with conditions that require consistent home temperatures. To lose DLA would undermine the ability to manage and therefore enforce use of the NHS or reliance on formal care services.

--- Later in debate ---

[Lord Newton of Braintree]

My Lords, I picked up two points in the course of this debate. First, I think the noble Baroness, Lady Grey-Thompson, indicated that she thought there were 655,000 potential losers from this. Is that right?

[Baroness Grey-Thompson]

It is 652,000.

[Lord Newton of Braintree]

I got it nearly right, but it is still quite a lot of people. In that case, my question to the Minister is: what steps does he expect to take—it may be that this is already clear and I just do not know—to protect people who are already receiving DLA at the point of transition? We are talking about sums of money that, although not large to many of those in this Room, can be very large indeed to some of the people who are receiving them. One of the things that I always had in mind—I think at one stage my then Cabinet colleagues occasionally referred to it as “Newton’s law”—is that not giving somebody something is quite different from taking away from somebody something they already have. I would like to hear my noble friend’s comments on that.

The other thing is also, in a sense, a question directed to the Minister, although it may also have occurred to the noble Baronesses and others who are interested in this. It is the reference in the Bill and in this amendment, which follows the Bill, to a person’s ability to,

“carry out daily living activities”,

being limited by,

“the person’s physical or mental condition”.

I would like to say a word or two about how that is to be done. In my day, which some in the Room will remember, we had a benefit called the housewives non-contributory invalidity pension, which entailed a lot of tests, that were regarded as demeaning and humiliating in the extreme, about whether somebody could boil a kettle or take a tin off a shelf. I think there were others, to judge from the reaction of the noble Baroness, Lady Wilkins, who will remember them. I would not want to get back into that. Indeed, I got rid of it. I hope that we may have a word that there will be a more civilised way of assessing the ability to carry out daily living activities than is revealed on the surface of the Bill.

--- Later in debate ---

[Lord Freud]

My Lords, I will pick up the point of the noble Baroness, Lady Hayter. I have no figures on how many people may or may not lose, mainly because we have not yet locked down the thresholds. However, I assure her that this is a bottom-up exercise based on assessing people's real needs. We are working at it that way round rather than working to a budget. That is what some of the testing we did over the summer was about.

The noble Baroness, Lady Morgan, asked about the work we have done on some passported benefits. We had detailed discussions with colleagues in the Department for Transport about passporting disabled people to the blue badge scheme. We will include key outcomes from the discussions in the updated impact assessment that we will publish in time for Report.

[Baroness Grey-Thompson]

My Lords, I thank all noble Lords for their contributions this afternoon. I took over the amendment from the noble Baroness, Lady Campbell of Surbiton, and I am responding as such. I absolutely understand the need to prioritise the money that is available, and the fact that choices have to be made. I understand that the Government want to support those most in need. I, too, want that. However, the people currently seen to be not in greatest need will become those in need because they will not be able to carry out the daily tasks that DLA enables them to do. We may be storing up trouble for later. I look forward to seeing the more detailed information that is required to understand what the new landscape may be; and I look forward to having many more weekends taken up with reading.

I agree wholeheartedly with the comments of the noble Baroness, Lady Hollins, on the difficulty of assessments, and with those of the noble Lord, Lord Newton, on transition. The barriers are still significant to those who may not be considered so disabled in the wider context of disability.

I think of this in terms of sport—and specifically athletics, which I know well. If life as a disabled person is a race and the finish line is full integration into society where DLA is not required, disabled people are not at the start of the 100 metres but spread out at different points along the marathon course. Many disabled people are still in the warm-up area and a few were left on the bus. Of course, this should not stop our attempts to remove barriers, but we should be very careful about the choices that we make. I have concerns that we are simply pushing this issue into other areas and I look forward to continuing the discussion with the Minister, especially around the projection figures of the Department for Work and Pensions, of which I take a slightly different view. I will come back to this at a later stage. At the moment, I beg leave to withdraw the amendment.

Amendment 86ZZZJ withdrawn.

--- Later in debate ---

[Baroness Hollis of Heigham]

My Lords, I was rather surprised to see that the amendment was felt to be needed. I had thought that the past 30 years would have made such an amendment redundant. Some time back, for just a few months and for reasons that I am ashamed to admit, I was in a wheelchair. Looking back, it is hard to say whether the difficulties I had were due to social or medical factors. What I am sure about is that an impairment easily becomes a disability if the environment is not supportive of that individual. That seems to make the difference.

What puzzled me until the noble Lord, Lord Addington, mentioned it was that we had not referred to the DDA. The whole point of the DDA was to set the medical impairment in a context which, through social, practical, emotional and moral reasons, did not serve to bar the person from full involvement in their lives. What we asked with the DDA was that employers and providers of goods and services should be required to make “reasonable” adjustments. This seemed a perfectly intelligent balance between the costs for small businesses and the rights of individuals not to face artificially induced and constructed barriers to their full social inclusion.

I remember going around the city and looking at our historic buildings, which we had been told by various people could not be made accessible for disabled people. On the contrary, the brilliant architect John Goldsmith, who was then over at the old DoE and was himself disabled, showed how we could ensure full access to buildings from museums to 18th century chapels for disabled people in wheelchairs and the like. In the process, mothers with buggies, pensioners loaded down with bags and a whole swathe of the community found that they had added access on the back of what we were doing nominally for disabled people. We opened up some of the most beautiful buildings of the City to perhaps a third of its population who had found barriers in their way. Without needing to get into a debate about social and medical because I cannot follow down those paths, I say to the Minister that I just do not see how you can separate the one from the other, because they interlock whether they be transport, housing, public access to buildings or whatever. Unless you have both sides of that equation, an impairment will continue to remain a disability—unnecessarily so—for far too many people.

[Baroness Grey-Thompson]

My Lords, I rise very briefly to support this amendment as my name is on it. Others have explained very clearly the need for these amendments. More specifically, I rise to support the noble Lord, Lord Wigley. The social model was a lifeline to me. My parents brought me up to believe that having an impairment was not my fault. I became a wheelchair user at the age of seven—some 35 years ago. I was brought up in the social model before there was even a name for it, but I also grew up in a world where there were loads of people who almost delighted in giving me the long list of things that I never could, or even should, do, such as go to the cinema, stay in a mainstream school, go to university, go to a sports club, or even, more recently, get married and have a baby. The social model outlines very clearly how disabled people can play their part in society. We should not take this for granted because it would be too easy to forget what the social model is.

[Lord McKenzie of Luton]

My Lords, these amendments are about encompassing the social model in the Bill. We support them. I have come to this issue somewhat later than some noble Lords here such as the noble Lord, Lord Wigley, my noble friend Lady Wilkins and others. I found the Scope document, which has been referred to, particularly helpful not only because it laid out a route to a different process of assessment, but because it took the assessment and criteria in the DWP’s document and tried to point out in practical terms why they may not have encompassed these wider issues. I say to the Minister, as others have said, that this should not be a difficulty for the Government because they have on the record their commitment to the social model. It is in Hansard for 30 November 2010. I think it was the Minister, Maria Miller. It is clearly on the record and not a matter of dispute.

Indeed, the DLA consultation paper referred to the social model in the following terms:

“The social model of disability says that disability is created by barriers in society. These barriers generally fall into three categories: the environment—including inaccessible buildings and services…people’s attitudes—stereotyping, discrimination and prejudice…organisations—inflexible policies, practices and procedures”.

Of course, the model argues that these barriers can be changed or removed. We accept that dealing with these barriers is not just a matter for a DLA or PIP or whatever it is called, but the consequences of these barriers need to be taken into account in assessing entitlement. I ask the Minister how the approach to PIP is reflected in the social model of disability and how the Government would counter criticisms that their approach is still driven by the medical model which concentrated on the inability to undertake activities due to a physical, mental or cognitive impairment.

Paragraph 4.9 on page 29 of the explanatory notes to the second draft of the assessment criteria says,

“Furthermore, we remain concerned that taking greater account of issues such as housing, access to transport, informal support and utilities would make the assessment more subjective and lead to inconsistent outcomes for individuals. Many of these issues will be dependent on local circumstances and availability of services, meaning that results might differ depending on location across the country”.

Of course we understand the difficulty that taking account of a wider range of factors would involve an expanded and different process. However, any process that involves a points-based approach will have a degree of subjectivity to it.

The Minister will be aware of proposals from Scope, which other noble Lords have mentioned, that recommend the trial of a more extensive process that has co-operation with the claimant at its heart. I will not run through the detail except perhaps to comment on the last bit of the process as it sees it, which is the production of a local support plan to capture the evidence and information brought up over the course of the assessment process in order to help highlight where in the individual’s life the barriers and the needs tend to arise. This could help the claimant to identify particular areas in which PIP might provide valuable support in meeting disability costs, but would not take the form of an outcome-based agreement binding the individual to use their PIP for specific purposes. Do the Government have any plans to test this approach, together with input from disability groups? We acknowledge that a good deal of work, thought and engagement has gone into updating the assessment criteria, and this has also been recognised by the Disability Benefits Consortium, but inevitably questions arise about the rules of engagement going forward, what further consultation will be taking place, and particularly about why the Government are confident that the current proposals will take account of the full range of barriers and costs that disabled people face. I think that that is a particular bone of contention that may have been eased by the current document, but that has certainly not been fully answered. That is why it is important to have these issues in the Bill.

--- Later in debate ---

Moved by

[Baroness Grey-Thompson]

86ZZZUA: Clause 78, Page 56, line 45, at end insert “including a requirement for the decision maker to collect evidence from the claimant’s own health care professionals as a part of the decision making process”

[Baroness Grey-Thompson]

My Lords, the purpose of the amendment is to ensure that in all cases, as part of the decision-making process to decide eligibility for PIP, evidence is collected by the DWP from the claimant's healthcare professionals. A great deal of evidence suggests that decisions are frequently inaccurate when made on the basis of reports from face-to-face assessments alone, without being informed by evidence from the claimant's healthcare professionals.

There are lessons to be learnt from the current face-to-face assessments. Evidence shows that when face-to-face assessments are carried out for the WCA, inaccurate results frequently occur. Recent figures published by the DWP demonstrate that 29 per cent of claimants who are in the work-related activity group were placed in it only after a reconsideration or appeal, after they had originally been found fit for work on the basis of the WCA. The deciding factor in tribunals overturning decisions is frequently medical evidence from the claimant's doctor or healthcare professional.

A recent small study by Citizens Advice asked claimants to check the accuracy of the report of what they had said during their assessment. It asked claimants to take part in the study before they had been to the assessment to ensure that the claimants were not just taking part because they had had a poor assessment. Thirty-seven claimants took part in the study. Sixteen of the 37 reports were judged to have a very substantial level of inaccuracy. These claimants were not angry because they have been found fit for work. In fact, nine of the 16 had been placed in the work-related group and would not have seen their report if it had not been for the study. Eleven of the 37 reports were judged to have a medium level of inaccuracy and 10 were felt to be an accurate reflection of what happened at the assessment.

The following case is one of the 16 cases judged to be inaccurate enough to affect a decision for ESA—or, if the claimant were found not fit for work, a decision for DLA. The client had a serious mental health condition as a result of a series of traumatic circumstances. He felt that there was little interest in what he said and he reported a number of factual errors. For example, the report stated that the results of an MRI scan and an ECG were normal. The ECG should have been EG and the client had explained that he had not yet had the results. There were also significant omissions and distortions in what the client is recorded as having said, and false assumptions made as a result. There are other examples in this case study.

The medical evidence sent in by the adviser when the client appealed clearly backed the client's view of the assessment, as the decision was changed on reconsideration without the need to go to a tribunal. The DWP and Atos now recognise the value of medical evidence from the claimant's doctors. The value of this evidence as part of the assessment process was acknowledged by Dr Crawford, the clinical director at Atos, in evidence to the Work and Pensions Select Committee on 18 May 2011. HCPs working for Atos also acknowledged this when a sample group were interviewed in a survey by the DWP. The DWP now encourages claimants to send in medical evidence for the WCA.

The onus should not be placed on claimants to collect this evidence. Claimants are often charged for medical reports. While advertisers are sometimes able to negotiate with a doctor to drop the charge when a claimant goes to a tribunal, doctors who charge will clearly not make this concession in the case of every claim. The charge is often £30 or £35, and sometimes more. Someone living on the basic ESA of £67 a week cannot afford this amount. It must be the responsibility of the DWP to collect the evidence that is needed for an accurate assessment. It is vital that the assessment process for PIP includes a requirement for the decision-maker to collect evidence from the claimant's healthcare professionals as a core part of the decision-making process. Without this requirement, there is a danger that there will be a two-tier system, with the poorest and most vulnerable claimants unable to afford to pay for evidence, and as a result at risk of receiving a less reliable decision. I beg to move.