Welfare Reform Bill

Baroness Hollins Excerpts

Monday 24th October 2011 Grand Committee

Moved by

[Baroness Hollins]

51CD: Clause 14, page 6, line 33, at end insert “, and
“(d) if the claimant has a long term health condition or impairment, the claimant commitment must specifically address any reasonable adjustments which need to be made.”

[Baroness Hollins]

What I am going to talk about is very relevant to the discussion that has just taken place. I shall speak about Amendment 51CD first, whose purpose is to require Jobcentre Plus staff who are drawing up an individual claimant commitment to specifically address whether the claimant has a long-term health condition or impairment. There is growing evidence that the current system often fails to take adequate account of specific health needs of some individual claimants. This is relevant when considering compliance with the conditions that the claimant has agreed to as part of the assessment in the claimant commitment. It is a concern both when looking at a person’s performance during the work capability assessment and with respect to their ability to attend and fully explain their condition at the assessment.

The policy intention is for staff to make reasonable and appropriate adjustments as required by the Disability Discrimination Act. I was going to give noble Lords a different example, but last night I had a phone call from an acquaintance who is autistic—a middle-aged woman, who rang up to ask my advice about something. She does this quite regularly on a Sunday evening. I thought last night, “I really don’t want to have this conversation”—but in fact it was very useful, because halfway through the conversation she said, “I’ve just had this work capability assessment, and they have said that I have to join the work-related activity group”. She does not know what I do, apart from being a psychiatrist. So I said, “That’s really interesting. What conditions have been suggested and what is happening? Did they ask your doctor for advice?”. She is autistic, she has epilepsy and at the moment she has a neurological condition which is leading her to be quite unable to move very far or fast. She does not have very much insight and she has a recurrent depression, which is really not good at the moment. I find it quite difficult to imagine what conditions one would be able to put in place. I would love to see her back in work but, knowing her as I have done for 20 years, I really wonder. She said that as far as she knew, her doctor and her psychiatrist had not been asked for their opinion, so I thought, “I need to tell the Committee about her”.

The claimant commitment really should include specific reference to a health problem and to the agreed adjustments which should be made to enable a person to meet the conditions which are set. Another example was given: if somebody had agoraphobia and was perhaps unable to travel by bus or outside their own familiar neighbourhood, that would restrict where they could reasonably be expected to seek work. Yet there is some evidence that many quite ill people are being sanctioned because they have not been able to comply with conditionality, when such needs have not been taken into account.

Understanding that particular candidates have particular needs is the first step to ensuring that the claimant commitment is workable, which is of course what we are looking for. That awareness could be built on through training Jobcentre Plus staff. Good training is clearly vital but it is not enough to rely on, so that is the reason for this amendment. Many of these people will be covered by the Disability Discrimination Act and there is a requirement for the DWP to make reasonable adjustments, but I want to make sure that the question is specifically addressed in the claimant commitment so that it cannot be overlooked. I hope that the Minister will agree that staff training is not enough but that through this amendment, the requirement to make reasonable adjustments as part of the claimant commitment would make it more likely that appropriate action would be taken locally. I suggest that addressing the responsibility to make reasonable adjustments would in fact result in improvements in treatment for a lot of claimants and should be put into law.

The purpose of Amendment 51CE is to ensure that the work-focused health-related assessment process takes into account:

“Evidence from the claimant's own”,

doctors, who will of course have much fuller knowledge than the independent assessor. The purpose of these assessments is to highlight what they can do and what useful steps they can take to get back to work. It is important that they give as accurate a picture as possible of the impact of the claimant's condition on their daily life but the assessments carried out by an independent assessor, without access to the person's medical history, often fail to pick up vital information. If the healthcare professionals do not know somebody, a 40-minute assessment really is not long enough to fully appreciate the nature of a claimant's condition, particularly if it is complex. I propose that medical evidence from the claimant’s own doctors should become a key part of any work-focused health-related assessment.

Mind has written about a client who attended a work-capability assessment and failed to score any points, but what was not taken into consideration was that the client had a serious mental health problem and had been in hospital under Section 3 for six months prior to the assessment. She knew very little about her own condition and had a long history of hospitalisation.

[Baroness Hollis of Heigham]

And she was found fit for work?

[Baroness Hollins]

Yes—she did not score any points. I would like to mention a small, recent study done by Citizens Advice and presented to the Select Committee looking into the personal independence payment proposals last week. It reviewed 37 reports. The claimants went through the report with the CAB adviser, looking mainly at the section where the healthcare professional is meant to record the claimant’s account of the impact of their impairment or health condition on their life. Sixteen of the 37 were reported to have a very substantial level of inaccuracy. The suggestion is that if information from the claimant's own healthcare professionals had been involved, the accuracy of those assessment reports would surely have been better. In another recent report commissioned by DWP, healthcare professionals working for Atos were interviewed and agreed that the provision of medical information from a claimant's own doctor is rather helpful in completing their own assessment.

--- Later in debate ---

[Lord Freud]

The noble Baroness, Lady Wilkins, makes a point, which we have actually discussed in the Chamber in the past. She knows my concern about this. I think that the Atos and WCA process is genuinely improving now, with the changes that have been made. A lot of the stories that we have are of the system as it was, unreformed. It is gradually improving. That is not to say that it is now perfect—that is not my claim. We are committed to getting the process right, and we inherited that process. I know the concerns that there are, seeing them at first hand in many cases. It is a terrible balance between abandoning people and saying, “You’re out of the economic life of this country” and then trying to pull them in in a coherent way. Getting that balance right, as all noble Lords here today understand, is complicated and a path that we are moving down. But I am determined that we will get to a position where we are doing it with the right balance.

[Baroness Hollins]

My Lords, I am grateful to the Minister for his response, particularly for saying that he is going to consider these amendments deeply as we move towards implementation. There were three things that the amendments were trying to do. One was to try to ensure that evidence from claimants’ own health professionals would be properly taken into account at an early enough stage to prevent some of the distress that is currently affecting some claimants. The second one was about reasonable adjustments, which are a requirement under the law but are perhaps not fully understood. It is about an individualised approach, is it not? The third one was ensuring that the impact of a health condition on a candidate’s ability to comply was properly assessed and understood. It is not about asking for a rigid list of things in the claimant commitment. What it is really about is asking for joined-up work between different departments with different responsibilities and joined-up care for people with health conditions with the NHS and the DWP. There is no reason why Jobcentre Plus staff and existing specialist NHS staff could not share some information for the benefit of the claimant, both at the assessment stage and during their progression into work, which is what we would all like to see.

Although decision makers are required to take information into account, there is evidence that they are not always doing that. Yes, of course people can appeal, but appeals are very distressing, not just for the individual but also for their families. These amendments were intended to make the system work better both for claimants, so that they are more likely to succeed, but also because it is much more satisfying for staff to work in a system that they know is working fairly. So I am hoping that the Minister will find a way to ensure that the spirit of the amendment is taken on board. I beg leave to withdraw the amendment.

Amendment 51CD withdrawn.