Welfare Reform Bill

Baroness Howe of Idlicote Excerpts

Monday 14th November 2011 Grand Committee

One worry put to me was, if it is called the personal independence payment, will it be easier for the benefit to be scrapped in the future than something with the word “disability” in it? Does that lie behind this? There is a lot of concern and suspicion about motivation for such a name. I support the amendment.

[Baroness Howe of Idlicote]

My Lords, we have all been very moved by the speeches made by our disabled colleagues, particularly that made by my noble friend Lady Campbell, who put it so beautifully clearly. Perhaps one of the reasons is that quite a number of our colleagues in your Lordships’ House are getting older and are beginning to have some form of disability, which makes one a little more aware of the needs. I do not know whether this form of words is necessary but the more that I have listened to the fact that the word “disability” is missing from the description, the more worried I am, not least when you hear how the press is reacting and the effect that that may have.

On listening to noble Lords, I clearly recognised the detailed areas of their special needs. That was useful knowledge on which to play the rest of our approach to this Bill. I hope that the Minister will take back to his colleagues the sort of reasoning that has taken place during this debate. His colleagues are probably engaged in goodness only knows how many other debates around Parliament, but if they had been able to be here I hope that they would have been at least as moved as I was and would have changed their approach. I hope that he will be persuasive in getting them to do just that.

[The Countess of Mar]

My Lords, I, too, support these amendments. I think particularly of people with fluctuating conditions which eventually become so bad that they are housebound, bedridden and almost unable to get out, and of the 25 per cent of people suffering from ME who are in this state. I should say that I am the chairman of Forward-ME. Every day I get letters from people who are terrified of what is going to happen when the PIP is brought in. However, I am grateful to the Minister and to the Deputy Chief Medical Officer at the Department for Work and Pensions for specifically asking for people with ME to be part of the pilot programme for the PIP. But the feedback I am getting is that the people who are examining them have no understanding at all of their illness. We are talking about a personal independence payment, which is the idea the examiners have in their mind, against a disability payment. However, these are severely disabled people—we have heard some very moving speeches from my noble friends and from the noble Baroness, Lady Wilkins—who cannot even get out of their houses. They must have help with their laundry, cleaning and shopping—with everything. To call it a personal independence payment does not help them, I fear, so I strongly support this amendment.

--- Later in debate ---

Amendments 86ZA and 86ZB seek to do just that. They would secure two key objectives that I feel the Minister would be willing to embrace. They would put safeguards in the Bill so that those who have sufficient written evidence to demonstrate their needs do not have to go through a face-to-face assessment unnecessarily. As a result, the Bill would provide that all assessments will take into account expert reports and evidence as a first-tier assessment. This is our chance to ensure a fairer and more reasonable application of the new proposal that the Government are bringing forward. I hope that the Minister will take it on board.

[Baroness Howe of Idlicote]

My Lords, I will be brief as I have not put my name to any amendments in the group, but there is a definite case for someone who has listened intently to what was said to back the arguments. The noble Lord, Lord Touhig, recalled to my mind a time in the early 1980s when—I usually get this phrase wrong—my noble kinsman held parties at No. 11 Downing Street. I was very involved with the National Autistic Society. The Christmas party, with him as Father Christmas, was held for the benefit of autistic children. In those days, autism covered just one group. Now there is differentiation between different forms of autism, as there is with many other forms of illness.

My noble friend Lady Grey-Thompson moved her amendment sensibly and practically. The requirement that the health implications of what the patient was suffering from should be known before any decisions are taken is obvious and essential, quite apart from all the other good reasons why various aspects should be taken into account. The communications skills that are so important in everything have yet again been re-emphasised.

I will say no more, but I hope that the Minister—if he is listening—will say something very positive. I hope that he has listened to and has been as impressed as I have been by the arguments that were made for something rather more positive in the Bill.

[Baroness Healy of Primrose Hill]

My Lords, I will speak to Amendments 86ZZA, 86ZA and 86ZB in my name. First I will say a few words in support of the amendment of the noble Lord, Lord German. It is vital for adults with autism spectrum conditions to have this right. It is essential that a claimant whose disability impedes communication has an advocate to help them understand the meaning of questions fully and provide accurate answers. The condition also means that many claimants with autism experience high levels of anxiety. A known advocate would be a reassuring presence in an interview.

An autistic adult may have communication problems that are not obvious to the interviewer. That their answers could dictate whether they get the support they need purely on the grounds that they did not adequately understand what was being asked would be very unfair. Judging by the Explanatory Notes to the new draft regulations, which suggest that a claimant can bring another person to a face-to-face assessment, the Government might be sympathetic to the need for such support. However, without clear rights and duties to ensure that advocates are involved, there is no guarantee that such an advocate can attend, translate at and participate in the interview. Therefore claimants must be explicitly informed of their rights, and it cannot be left to the discretion of the assessor.

Amendment 86ZZA, which was tabled by the noble Lord, Lord Addington, and has already been mentioned by my noble friend Lord Touhig, is about the need for adequate training for assessors. I strongly support it. It is important because it is a safeguard against the fear of many parents that their autistic adult children will not be understood and that the wrong decisions will be taken about their needs and their ability to work. Families from the ACT NOW campaign group are very concerned that inadequately trained assessors will not understand the complexities of autism. They also believe that the government target to reduce expenditure on DLA by £1 billion will seriously prejudice individual discretionary decisions.

Although I welcome the Government’s acceptance of Professor Harrington’s recommendation that there should be mental, intellectual and cognitive champions in each medical assessment, I hope that that will also apply to the assessment of DLA—which possibly may become PIP—and that assessors will have training in autism as well as specific understanding of the limits of their knowledge and will know when to ask for expert advice. It should also be possible for assessors to have access to an expert champion to provide that advice.

The amendment would guarantee the safeguard of properly trained assessors who will have access to the necessary range of medical and psychological expertise. It is about ensuring a standard, regularised system of excellence that will deliver a high-class public service across the country. Families that have been through so much in trying to ensure that their children will be able to live independent lives need to know that the Government acknowledge their concerns and will not leave their child’s future well-being in the hands of inadequately trained and inexperienced assessors whose judgments could result in disastrous consequences. Families are concerned that if, as a result of the proposed 20 per cent cut, the new benefit focuses only on those with the greatest needs, their adult children with autism, who perhaps are unable to access social care support, will also lose this key benefit because of misjudgments by assessors who may be expected to take decisions influenced by the pursuit of targets that have been designed to reduce costs and the number of people on benefits.

Finally, I support the amendments tabled by my noble friend Lord Touhig to allow claimants not to be put through face-to-face assessments where it is possible to determine the claimant’s entitlement to benefits on the basis of available medical or social care assessment evidence. Interviews and other similar kinds of encounters may cause people with an autism-spectrum condition severe mental anguish. It is not the nervousness or anxiety that we may experience at the approach of a difficult or unpleasant event, but dread and terror. A person with autism has autism for life, as my noble friend pointed out. It is surely unnecessary to repeat a PIP assessment every few years. For many, it will be needless cruelty. A mother of a 20 year-old man with Asperger’s said of his medical assessments, “I think the whole process is completely overwhelming for people with autism”.

The amendments seek to ensure that people who have been diagnosed by medical or social care professionals as having a condition that is unlikely to change significantly or that will deteriorate over time are released from the threat of constant assessment which in so many cases adds to their anxiety and so makes their condition more difficult for them and their carers to manage. Many, but not all, DLA claimants with autism typically undergo a number of assessments by expert professionals. Reports from these assessments will be available, as well as detailed information about them from professionals working with them. The National Autistic Society, to which I am grateful for its briefing, has argued strongly that in many cases an additional assessment by DWP is therefore unnecessary.