Welfare Reform and Work Bill

Baroness Meacher Excerpts

Monday 25th January 2016 Lords Chamber

[Lord Lansley (Con)]

My Lords, perhaps I may intervene briefly to say a word about Amendment 42 in the name of the noble Baroness, Lady Howe, and Amendment 43 in the name of the noble Lord, Lord Layard. In Committee, we discussed this briefly. While I have previously made it clear that I would seek to minimise those occasions on which we seek in statute to specify the circumstances in which people should access NHS treatment, that principally should be determined on a clinical basis. Past experience has demonstrated the value of the Improving Access to Psychological Therapies programme in providing assistance to people with mental health and behavioural disorders, especially anxiety and depression. Your Lordships will know that the numbers who are in receipt of benefit and who are out of work by reason of those conditions has significantly increased over the last two decades. We need to respond to that.

The IAPT programme, which begun under the Labour Government before 2010, was continued and rolled out during the coalition Government after 2010. I stress that the importance of this will, I hope, give the Minister the opportunity to say that, while not accepting the letter of Amendment 43, the Government are sympathetic to the spirit of it. After 2012-14, there has been a 25% increase in the number of therapists providing psychological therapies through the National Health Service. That rollout is continuing. Health Education England anticipates that the increasing supply resulting from its commissions for training places for psychological therapists should arrive at the point whereby at 2017-18 the demand for such therapy is able to be matched by the supply of trained therapists. We have an opportunity, in the timeframe anticipated for the measures in the Bill, to make it more certain that somebody with anxiety and depression requiring access to therapies while signing on for benefits should be able to access that therapy. I hope that the Minister can give that positive response to these amendments.

[Baroness Meacher (CB)]

My Lords, I really was not expecting to speak today on this. We had asked that Amendment 43, on IAPT, be shifted and taken separately on Wednesday. The IAPT programme has now been going for 10 years: we had the first pilot in the mental health trust in east London 10 years ago. The point of that pilot, and of the whole programme, was to help the large numbers of people with mental health problems back into work. I remember talking to jobcentre staff and having great difficulty persuading them to refer people to the programme. Ten years on, we have so much evidence that if people with depression or anxiety receive good therapy quickly, they achieve remarkable results—far better results than any other that I am aware of in the psychological therapies. I stand here completely unprepared, save only to say to the Minister: please make use of what is an excellent programme on the whole—nothing is perfect everywhere, of course not—to help the 50% or so of unemployed people who desperately need precisely such help so that they can quickly get back to work. I make that big appeal to the Minister.

[Lord Kirkwood of Kirkhope (LD)]

My Lords, I add my support to the opening remarks of the noble Baroness, Lady Campbell. She said that she was somewhat disappointed by the Minister’s response to these amendments in Committee. She is right. He founded his response on a defence that these statistics are already available if you know where to find them and that they will continue to be published. That is only half the story. There is a case to be made for looking at more qualitatively based, specific disability-related data that are not available. It would not cost a great deal of money. The DWP has a capable resource department. Over a period of years, a lot of small but very important disability employment issues could be explored and the trends chased down and studied.

I give the example of the change as we move to universal credit, using work coaches rather than disability advisers. I understand that and I am very supportive of that new environment, but the work coaches are not dedicated specialists. They will have access to people, but I would love to watch how that works—if it does—as universal credit is rolled out. If it does not, we will need to change the setup, as I am sure the Minister will agree. I would like to see that kind of thing in gremio of the other suggestions for the reporting requirement from the noble Baroness, Lady Campbell. I support her in observing the need for what does not currently exist. With a bit of good will, working with the disability communities, we could have better sight of some of these problems.

My second point is that a contract of employment takes two people: you need an employer as well. We must not forget the employers. They try to do the best they can. As was said, physical disability is in some ways easier to address because the solutions are more obvious. Potential employees who suffer from any kind of intermittent condition—it is mainly, but not just, mental illness—are in a different category altogether. I remember feeling sympathy for the Minister when he got into trouble for saying that people with disabilities were not worth the money, or something—I am sure he never said it and that he did not mean it even if he did. However, he is right, in that the one risk that a potential employer fears—if I can put it that way—with regard to a very good candidate with intermittent conditions is that they cannot control their ability to turn up at key moments. Therefore, we need flexible working and to compensate for or take account of that, to reassure employers. You could do it by mitigating NI contributions, for example. We are not yet engaging in sufficient outreach with employers who might otherwise be willing to address this gap.

--- Later in debate ---

The amendments cover a lot of ground and touch on some very important issues. I hope that I have been able to assure noble Lords of the Government’s commitment and determination in this area and that the noble Baroness will feel able, on the back of those commitments, to withdraw the amendment.

[Baroness Meacher]

My Lords, before the Minister sits down, perhaps he would help us by explaining what the technical problems are in a simple referral to NHS by IAPT of people who have a diagnosis of a mental health problem.

[Lord Freud]

Yes. The Secretary of State for the DWP has no power to make referrals into the health system. That is just the way that these things are kept separate, and there is enormous sensitivity in the medical area about data and information flowing around the systems. In practical terms, that makes it impossible to join them up; it must be done in a much more subtle and clever way.