Welfare Reform Bill

Baroness Howe of Idlicote Excerpts

Tuesday 17th January 2012 Lords Chamber

[Lord Wigley]

My Lords, before the Minister gets up—I am sorry I did not get in before the noble Lord on the Opposition Front Bench, who beat me to it—I want to say a few words in support of Amendment 50ZGB moved by the noble Baroness, Lady Grey-Thompson. It provides a basic rate of daily-living payment to minimise the number of disabled people who might otherwise be totally deprived of such focused help. Listening to Radio 4 this morning and hearing the Minister from the House of Commons acknowledging that 500,000 people could be hit by these changes really brought home to everyone the significance of what we are talking about. The ending of lower-rate DLA will leave people with needs arising from their disability but without the means to pay for them.

The point was made earlier by the Minister—and I understand his point—that the day-to-day costs of living are covered separately from the additional costs of disability. The implication is that people who would be in the lower group do not have additional costs of disability, but we all know from experience that they do and they are going to be losing out as a direct result. If the Government’s intention is that so many people who have previously been recognised and acknowledged as having needs will no longer be helped to meet those needs, let them say so. I think it is a very retrograde step.

[Baroness Howe of Idlicote]

My Lords, I had also meant to rise to speak a bit earlier. I, too, very much support what has been said about those amendments. We have all been absolutely flooded with e-mails about the situation of many of the people with disabilities we are talking about, who are fearful about their future and about how they are going to be affected. What has really impressed me is the details they give of their own lives and just what they need the extra money for—things that you and I would not even think about. It is not just support to get out of the house and to get to the shops or extra money for a car because there is no other way of getting about, but support for very basic extra things to make it possible to use saucepans and things like that.

I appreciate the actions that have already been taken, but I hope that serious thought will be given to those half a million people who will still suffer as a result. I am sure that the Minister will do everything he can to ensure that those in real need are approached with a flexible mind, but, nevertheless, some will fall between the new systems that are being devised, so I support the amendment and hope that serious consideration will be given to it.

--- Later in debate ---

[The Countess of Mar]

My Lords, I, too, support the noble Baroness, Lady Grey-Thompson, in her amendment. I read the whole of the information sent to us yesterday and I was pleased to see that ME/CFS, in which I am interested, was raised in two examples, and that the difference between the two conditions was shown. I am concerned not just for people with ME but for those who can almost function normally and will not meet the criteria for getting DLA. For example, there are those who, because they have an endocrine problem, cannot cope with the cold. They need extra heating and clothes. If they are working, they are probably on a minimum salary because they are not very well. Therefore, they need extra money. They might also need extra clothing.

If they are incontinent, they may need to be able to change their clothing regularly. They may need incontinence pads, which—as everyone knows from questions in the House—are extremely difficult to get from the National Health Service. My mother-in-law, who died a few years ago, could not go out of the house because she was worried about wetting herself in public. If she could have afforded incontinence pads, she would have been fine. She was not going to tell her children or her daughter-in-law about her problem and we had to extricate the information from her to find out why she was not going out. Such people get confined to their homes and become desocialised, and it is very difficult to get them back into society. We must take all these things into consideration—not just whether they can cook or wash themselves—when we think about what they need to keep functioning on a relatively normal basis.

[Baroness Howe of Idlicote]

My Lords, I shall speak briefly on this amendment. The comments of the noble Baroness, Lady Browning, about her personal experience of the whole range of autism reminded me just how this range has developed over the years. When I first got involved with the autistic movement many years ago, it really was just one thing; but since then, many different branches and forms of behaviour have been identified. The fact that all these extra aspects have to be borne in mind re-emphasises the whole question of whether the clause is fit for purpose. In particular, the Asperger’s syndrome comment was very apt. I hope the Minister will be able to persuade us that there will be a thorough method of assessment by people who understand the range of problems that we are talking about as well as—as my noble friend Lady Mar said—the detailed and different ways in which extra help is used and needed for such people to have a basic ability to lead a normal life.

[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.