Welfare Reform Bill

Baroness Wilkins Excerpts

Wednesday 16th November 2011 Grand Committee

In summing up, this amendment would represent greater value for money and would drive costs down in a tough economic climate and at a time when disabled people are being told that their support is being cut back due to lack of government resources. It would also enable the Government to demonstrate their commitment to working in partnership with disabled people and their organisations. Action speaks much louder than words for disabled people. They would like a bit of the action; why not put it in the Bill? I beg to move.

[Baroness Wilkins]

My Lords, at the risk of replaying the record, this is an important amendment because it would go a long way to protect the Government from facing the same sort of vilification that they have received from their introduction of the work capacity assessment for employment and support allowance. Much more importantly, it would protect disabled people from facing the anxiety, illness and ill health they have experienced while undergoing the headlong rush to reassess the 1.5 million claimants for incapacity benefit. That reassessment has gone ahead despite the fact that the Government know that the assessment criteria are seriously flawed.

As the Minister of State at the DWP, Mr Chris Grayling, said in the other place on 24 October:

“We have received suggested descriptors for mental, cognitive and intellectual function from Professor Harrington’s working group. Given that they represent a substantial departure from how the current assessment works, we are considering what impact they will have and will come forward with proposals soon”.

That is fine. He went on:

“The challenge facing us is that the recommendations will involve a complete change of the work capability assessment, not simply for mental health issues, but for physical issues, and is therefore a multi-year project”.—[Official Report, Commons, 24/10/11; col. 8]

Let us not make the same mistake again. Or rather, please let the Government not make the same mistake again.

I was going to quote from the lady I mentioned in an earlier debate, a GP who attended a recruitment evening for Atos assessments, and who wrote in the BMJ this year. The figures that she was quoted about what a doctor could earn from the assessment process were, I found, quite shocking.

Sessional doctors work a minimum four sessions a week, and are paid per item: £51.37 for non-domiciliary disability living allowance examinations, for example. The application forms for sessional doctors state :

“10 DLA domiciliary visits cases per week would earn £40, 211.60 per annum”.

I ask the Minister—and I apologise if he has already given this answer to the noble Lord, Lord McKenzie—what is the Government’s estimate of the cost of re-examining the thousands of people whose conditions will not change, or will only worsen? And can he remind us how often he is expecting them to be reassessed ?

[Lord Touhig]

My Lords, like many noble Lords I am a great fan of pre-legislative scrutiny, because I think it improves the quality of the legislation we pass. I also have great faith in this Committee system, because we go through a Bill line by line in order to improve it, amend it, and make good law as a result. I certainly support this amendment, because a trial period does make sense.

I look across at my good colleague the noble Baroness, Lady Browning. She and I sat on the Public Accounts Committee in the other place. Time and again we considered reports from the National Audit Office which showed that some great government scheme, some great initiative, had gone billions of pounds over budget, or gone over time. Inevitably we found that these things had not been trialled beforehand, to see if key elements of the proposals would work effectively.

Some unfortunate Permanent Secretary would be brought before the Public Accounts Committee, and like modern-day Draculas, we drew a lot of blood in our interrogations. Inevitably, this Permanent Secretary was not responsible for what the department had got wrong, anyway; it was the previous incumbent, but that is by the by. We were seeking to learn lessons, but inevitably it was like closing the door after the horse had bolted. If only more care had been taken, or things had been trialled and piloted beforehand, then things would not have gone wrong in the way that they did.

If the Government take this amendment on board, it has the potential to save millions of pounds. If the Bill does not take account of this, then somewhere down the track the NAO will come in, in two or three years, and find that there has been some great failure, or some great cost. The Public Accounts Committee will have to investigate, and the Department for Work and Pensions will be held up again as having failed to pilot or introduce a scheme in a good or effective way, as it promised it would. The amendment makes a lot of sense, and I hope the Minister will see that.

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[Lord Freud]

Let me take each of the noble Baroness’s amendments in turn. On the trialling of the assessment, I am sure that noble Lords are aware that it is possible to test out and evaluate the assessment process without trialling it. There is, indeed, an advantage to testing over trialling, because the former can be done without affecting an individual’s entitlement to benefit.

The noble Baroness will be aware of the testing we undertook throughout the summer with more than 900 disabled volunteers, and the informal consultation that took place alongside it. Both were very effective, and allowed us to review, revise and improve the draft assessment criteria from the draft published in May to the draft with which noble Lords have recently been provided. We are now seeking further views on that.

For our testing, using independent experts has demonstrated that our proposed approach to assessment is both reliable and valid. This testing included individuals on the autistic spectrum. This is not the end of the matter, though, as we believe the development of the benefit processes, including the assessment, should be and will be an iterative process. Therefore, in addition to testing of the assessment, we have created a specific development group to engage with a broad spectrum of disability organisations, to understand their views on a range of issues related to the delivery of the benefit. We have also created a number of customer research panels made up of groups of disabled people who share similar characteristics. We will seek to test our processes in a model office environment, allowing us to see how they work without affecting individuals. These processes will be vital in helping us gather insight first-hand from individuals on whom the process may impact.

Turning to the independent review of the trial referred to in the amendment, I first state that I do appreciate the importance of such reviews, and will talk about that in more detail later. However, undertaking this after only one year of operation would not provide adequate time for the assessment process to bed in. It would not allow enough time for sufficient data to be captured, as it requires people to go through the full claims process in this time, and there are inevitable lags in the production of statistics. Any subsequent analysis would therefore provide an unrealistic impression of how the benefit was operating.

There are, of course, other means by which we seek to evaluate and improve the operation of the new assessment. The assessment and its associated process will remain living tools, and we will continually carry out internal evaluation work to monitor their performance. We will therefore not have to wait for the outcome of the independent review to learn from and take action based on operational and individual experiences.

The second element of the noble Baroness’s amendment is the involvement of disabled people’s organisations in the assessment process. Let me assure the noble Baroness that we have involved disabled people’s organisations in the development of this policy from day one. We are trying to approach this work in a co-produced way, seeking the views of disabled people and their organisations at each stage. I have mentioned in earlier debates that our assessment development group comprises members of Equality 2025 and Radar. Both have provided critical support, direction and challenge throughout the process of developing the assessment criteria.

We also held a 16-week informal consultation on our initial draft of the assessment criteria, which sought the views and opinions of disabled people and their organisations. This process helped us to revise the initial draft assessment criteria and develop the second draft, which has lately been made available. Most of the changes that we have made have been as a direct result of the input of disability organisations. We are now seeking views on the second draft and, importantly, the proposed weightings, before we reach any firm views on the entitlement thresholds. We then intend to carry out a full consultation on the entire assessment criteria, including the weightings and thresholds.

Equally, we are involving disabled people and the organisations that represent them as we design the operational processes for personal independence payment. To achieve this, we have created a dedicated working group specifically for this purpose. The group’s membership has been drawn from a wide number of national and grass-roots, user-led organisations, and it is currently working with us on a range of operational issues. We also see disabled people’s organisations playing a key role in the delivery of the new benefit, helping to inform individuals and guide them through the process. This could include assisting them in making claims, providing evidence to help support their case and/or attending assessments with them to provide support and reassurance. We are undertaking work to strengthen and expand our partnership arrangements with local organisations that represent disabled people and ensure that they have all the relevant information about PIP.

Meanwhile, there is nothing in the legislation to prevent disabled people’s organisations being involved in the delivery of assessments. The key for us is ensuring that, regardless of which organisation or organisations deliver the assessment, they have the capacity to do so, and that individual assessors have the requisite skills and experience. Disability organisations have been free to participate in the procurement exercise for the assessment, which is now under way, either as prime contractors or as partners of such organisations. Whatever the outcome of this exercise, we will ask the assessment provider to work with disability organisations and seek their input, so that we can deliver the best possible service to claimants.

The final element of the noble Baroness’s amendment is intended to ensure that individuals whose condition is unlikely to change over five years should not have to undergo an assessment more often than once every five years. We will discuss this issue in more detail in a later group of amendments. However, we know that disabled people’s lives are varied and that health conditions and impairments affect people in many different ways. As I have said before, we therefore do not feel it would be appropriate to make blanket rules for particular groups of people.

Under personal independence payment, we want individuals’ treatment to be tailored to fit their personal circumstances. This includes our approach to award length and review date, which should also be personalised. Such an approach would be able to take into account the likelihood of the impact of an individual’s health condition or impairment changing. We know that for some people a shorter-term award might be appropriate. For others, a longer-term award might be appropriate, while, for those with the severest disabilities, an ongoing award might be right. We absolutely do not want unnecessary reviews of claims, both to reduce the impact on individuals and to ensure that we do not waste money.

The noble Baroness, Lady Wilkins, raised the question of the overall cost of delivering DLA reform over three years. This was included in the 2010 Budget Red Book at £675 million.

[Baroness Wilkins]

I asked about the cost of reassessing people with conditions that will not improve or where there will be no difference.

[Lord Freud]

My point is that we will try to minimise those costs by not having reassessments in those circumstances. I cannot put a precise figure on it but I can tell the noble Baroness that our ambition is to have as low a cost as possible in those circumstances. Assessors and decision-makers should be empowered to make these decisions based on the circumstances of the case and with the aid of departmental guidance. These matters should not be prescribed by the Government through legislation. Only by doing it that way will we achieve the personalised approach we desire.

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My reading of the whole aids, adaptations and appliances section is that we may be back where we started—that there will not be any change from what happens now—but I fear that having put several contradictory sentences in the various explanatory documents we have received, the Government may be spreading confusion rather than clarity and decision-makers may end up not interpreting this section as consistently as they should. The DWP must make its position clearer. The crucial question I have for my noble friend is: who will lose out in future under PIP who would now qualify for DLA as a result of using an aid or appliance? I beg to move.

[Baroness Wilkins]

My Lords, I support this amendment. The range of people who will need aids and adaptations is enormous. One of the groups who are not highlighted in the new criteria is those people who need communication aids, which can be extremely expensive and of which there is, at the moment, a very erratic supply. Whereas a child might be given a communication aid and be able to communicate with the world by using it, after the age when education finishes it becomes a very dodgy business. We are talking about a huge range of people. In the area of mobility, the cost of special shoes is £100. It is such a complicated area that the Government would be extremely wise to think again.

[Baroness Campbell of Surbiton]

My Lords, I am also extremely supportive of this amendment. It is a government misuse of the social model to withdraw support by saying that if you have a decent wheelchair-adapted house and car your disability goes away. That was quoted to me by a DWP civil servant as a social model assessment. That is exactly why I tabled an amendment on social model assessment—so that we can teach assessors what the social model really means.

The noble Baroness, Lady Thomas, is absolutely right. If I were assessed today, I would probably be taken off DLA. I have my wheelchair, my adapted house, my car and some personal assistance. However the cost of maintaining that is absolutely phenomenal. My disability has gone away; it is away today. I feel equal to all who are here but tonight it might be different. Therefore, I am absolutely in favour of placing this in the Bill. It is a perverse incentive to account for aids by means-testing. It means that people might stop using their electric wheelchairs and adapted cars to get the benefit. They might hide them in the garage or swimming pool. Apparently people put their cars there to hide them from the taxman. As noble Lords can see, I am very supportive of this amendment.