Social Security (Special Rules for End of Life) Bill [Lords]

Chloe Smith Excerpts

2nd reading
Thursday 8th September 2022 Commons Chamber

[The Secretary of State for Work and Pensions (Chloe Smith)]

I beg to move, That the Bill be now read a Second time.

It is a pleasure to move the Second Reading of the Bill in this role, and I welcome the new member of my ministerial team, the Minister of State, my hon. Friend the Member for Banbury (Victoria Prentis), who will be at the Dispatch Box for the later stages of this Bill.

For a person to find out that their illness cannot be cured can be a frightening experience. As a Government, we are committed to do all that we can to alleviate the pressures facing those who are nearing the end of their lives and their families. To provide some financial security to those who find themselves in this difficult position, the Department for Work and Pensions has, since the 1990s, provided access to key benefits via what are often referred to as the “special rules”. These are benefit rules that enable people who are nearing the end of their lives to get fast-track access to certain benefits. Historically, people eligible under those rules have not had to wait as long as others to start getting benefit payments. They have not been required to go through medical assessments, and, in most cases, have qualified for higher rates of benefit. In order to access this fast-track route, people had to be assessed by their healthcare professional as having six months or less to live, and this became known as the six-month rule.

For more than 30 years, these special rules have ensured that, at this most difficult time, people have got the financial support to which they are entitled quickly and easily. None the less, since those rules were first introduced there have been significant advances in how the NHS treats and cares for people nearing the end of their lives, meaning that many terminally ill people are now living longer. Given these advances, in July 2019 the Department launched an in-depth evaluation of how the benefit system supports people nearing the end of their lives. As part of that consultation, the Department worked with those people, those who support them and clinicians.

The evaluation’s findings showed that there was consensus across all groups that the Government should extend the current six-month rule. It showed support for the DWP to adopt a 12-month end-of-life approach that would allow people in the final year of their life to claim under the special rules. An added benefit of the 12-month approach was that it would also bring greater consistency with the definition of “end of life” used within the NHS and across Government.

[Sir Stephen Timms (East Ham) (Lab)]

May I be the first to congratulate the right hon. Lady on her appointment and say on behalf of the Work and Pensions Committee how much we are looking forward to working with her and her colleagues in the months ahead?

The Select Committee had previously suggested getting rid of the time period altogether and referring simply to people having a terminal illness, and that approach has now been taken in Scotland. Did the Department consider that in looking at this change, and, if so, what was the reason for rejecting it?

[Chloe Smith]

The Chair of the Select Committee makes, as ever, a thoughtful point. I very much look forward to working with him and the Committee. Yes, our evaluation did look at exactly that point. As I was just coming on to argue, our approach brings a greater consistency with the NHS, which considers people to be

“approaching the end of their lives when they are likely to die within the next 12 months.”

That consistency is an important objective. At that 12-month point, clinicians are encouraged to think about the support that their patients need, including any financial support.

A point that I am sure my hon. Friend the Minister of State will draw out at Committee stage is that we also think it is important that clinicians can be supported to make the most consistent and straightforward decisions. Of course, in many cases that is not straightforward, but we want to enable clinicians to have the best chance of making a clear decision in support of their patient. That was the evidence that our evaluation found in favour of the 12-month definition. Indeed, that has been borne out by a great deal of support for what we have since been able to announce, which the right hon. Gentleman will be aware of from the various groups that support those in their last stage of life.

[Michael Fabricant (Lichfield) (Con)]

I am very grateful to my right hon. Friend for presenting this Bill, as will be my constituents in Lichfield. We are blessed with a particularly wonderful hospice, St Giles Hospice in Whittington village. Has the Department spoken to clinicians and organisers at hospices such as our one in Lichfield?

[Chloe Smith]

Yes, that is absolutely the case. There have been extensive conversations with clinicians and those in the hospice movement more broadly. I join my hon. Friend in paying tribute to all those who work in hospices such as the one he mentions in Lichfield and the many more across the country. They do such an important job in giving people comfort and support and the right care at the end of their life.

In announcing that the Government intend to move from that six-month criteria to the 12-month end-of-life approach, we have engaged very widely and endeavoured to communicate as clearly as possible so that people know what support is available.

[Alex Cunningham (Stockton North) (Lab)]

I, too, welcome the Secretary of State to her new position. I welcome the changes that the Government are introducing in this Bill, but as long as one in four terminally ill people of working age spends the last year of their life in poverty, I think that we need to go further. To that end, will the Minister meet me to discuss my Terminal Illness (Support and Rights) Bill, which will require utility companies to provide financial support to customers with a terminal illness and make the employment rights of people with a terminal illness more robust at no cost to the Exchequer. In fact, it may save the Exchequer a few pounds.

--- Later in debate ---

[Chloe Smith]

I am very pleased that the hon. Gentleman is engaging seriously with this very important matter. I have seen his private Member’s Bill and I know that my colleagues in the Department for Business, Energy and Industrial Strategy will be looking at it very closely in terms of the formal response from the Government. I can say that today’s Bill is all about how to get the best type of financial support to people. I really hope that that means that he will join us in support of the principles and practice of this Bill in addition to his own campaigning work.

In April of this year, changes were made in secondary legislation to the eligibility criteria for the special rules in respect of universal credit and employment and support allowance. These changes have been well received by the key charities that are active in the area as well as by parliamentarians and the public.

The special rules definition, however, for personal independence payments, disability living allowance and attendance allowance is set in primary legislation and therefore we need to be here today dealing with this primary legislation to change the eligibility criteria in those benefits from six to 12 months. This Bill, therefore, is a single issue, two clause Bill that makes those eligibility changes for these three benefits. As I have already explained, the changes put forward in the Bill will mean that, together with that secondary legislation, those expected to live for 12 months or less will be able to access that vital support via the fast-track process rather than waiting until they might meet the current six-month rule.

[Wendy Chamberlain (North East Fife) (LD)]

As the Minister mentioned in her response to the Chair of the Select Committee, in Scotland there have been changes to the process. It has been highlighted to me by Motor Neurone Disease Scotland that part of the challenge now is that the benefits assessment for special rules in Scotland—BASRiS—form and the DS15000 form are required to be completed by clinicians. Can she advise us on what discussions she is having, because it would be very good if we could minimise that complexity?

[Chloe Smith]

The hon. Lady is absolutely right. We want to get the greatest amount of support as simply as possible to those who need it the most. To that end, my officials and I have been having extensive conversations with the Scottish Government. We would very much have preferred them to agree to a simpler way to ensure that we get the relevant details and the relevant paperwork. But, of course, this is not fundamentally about paperwork: we need to work together to get that support across both the reserved and the devolved benefits to those who need it most.

We are talking about thousands more people at the end of their lives who will be able to access the three benefits in the Bill and others in secondary legislation. We want a consistent end of life definition across health and welfare services that can be more easily understood by clinicians, end of life charities and patients. The alignment of the definition will allow clinicians in particular to include discussion of welfare benefits in wider conversations about what matters most to their patients, which will, in turn, be more responsive to their needs. We have already touched on how we hope that means that clinicians will be better supported by a more straightforward and simple definition.

Once the Bill is fully rolled out, between 30,000 and 60,000 more people may benefit from the special rules process each year. My Department recognises that it is essential that people are aware of and understand the changes. That is why there has been that extensive engagement that I referred to in response to my hon. Friend the Member for Lichfield (Michael Fabricant) with key end of life charities, hospices, medical organisations and clinical groups such as the royal colleges.

I pay tribute to the many people who have supported this work since the launch of the evaluation of how the benefits system can better support people nearing the end of their lives. Their expertise and personal experience has been crucial in better informing and enabling the important changes in the Bill. I pay tribute to all those who support patients at the end of their lives, and I am sure we would all agree that it is crucial when someone reaches the final stage of their life that they have that support. By passing the Bill today, we will provide thousands more people with vital financial support so that they can worry a little less about their finances and focus more on sharing the valuable time they have left with the people who matter most to them.