Parkinson’s Disease (Employment and Support Allowance)

Lord Grayling Excerpts

Tuesday 19th June 2012 Westminster Hall

[The Minister of State, Department for Work and Pensions (Chris Grayling)]

It is a pleasure to serve under your chairmanship, Mr Leigh. I congratulate the hon. Member for Halifax (Mrs Riordan) on securing the debate.

I am glad to have the opportunity to set the record straight on many of the things the hon. Lady said. However, let me start by saying that we understand and are hugely sympathetic; we care very much about people with Parkinson’s. It is about providing the right mix of support for those people who can still remain in the workplace. It is clearly better that they should be able to do so. When they reach a point where that is no longer a possibility, it is entirely appropriate for the state to provide them with unconditional support. However, I am afraid that the picture painted by the hon. Lady was rather one-sided. I hope to set out why I think she has got it wrong.

The hon. Lady talked about cold-hearted and disgraceful reforms, and about a tick-box system. I gently remind her that that system was introduced by her party when it was in government. In the past two years, we have tried to improve and humanise it. When Professor Harrington first reported on this, he said that one of the great failings of the system we inherited was that there was not enough of a human dimension. He also said that we were not making enough effort—by “we”, he meant the system set up by the previous Government—to secure a proper mix of evidence about an individual. I will briefly walk the hon. Lady through the changes that we have already made. I will also explain to her what is happening about the gold standard review—the work on that has already started. I want to say a little bit about the support we provide to help those people who can still work to do so. On all those matters, she is wrong in the conclusions that she has reached.

Let me be clear and say that there is no such thing as the perfect system. We will never get this entirely right. I would love to say that we could, but these are difficult judgments to make. Often, we are encouraging people to take a step that they may be reluctant to take. If one loses belief in one’s ability to work, it may take some time to be persuaded that there is a way of getting back into the workplace. There is no doubt that this is a difficult process for all those who go through the work capability assessment and the reassessment process. We want to do the right thing. That is why we have introduced changes that increased the size of the support group, and why we have taken steps to ensure that we broaden the unconditional support available to people who are some of the sickest and most challenged in our society. However, we have to try to find the right balance.

I certainly believe—we certainly believe, and I thought it was the view of the hon. Lady’s party—that, where it is humanly possible, it is better either to get people back into the workplace or to help sustain them in the workplace before they eventually reach a point where that is no longer possible. Parkinson’s disease is a deeply distressing and difficult condition. As she said, it is a continuously degenerative condition—it fluctuates, but there is no cure. Of course, it is difficult and stressful for the families of those who suffer from it and for the sufferers themselves. However, it is certainly better—I am sure that all those who work with Parkinson’s sufferers agree—to provide support to keep those people in the workplace in some form of work for as long as possible. It is better for them in terms of quality of life and their overall morale, and it is likely to enable them to lead a longer and more fulfilling life with the condition.

Let me start with the process itself. As I said, I do not pretend that it is perfect, but I think that we have made significant improvements in the past two years. We have implemented all the recommendations in Professor Harrington’s first report. We took steps that humanised the process so that, instead of getting the classic computer-generated letter from Jobcentre Plus saying, “You will attend an assessment”, at each stage of the process, people get phone calls that explain in detail what will happen to them. We ask and encourage them to bring forward additional evidence.

We have rebalanced the process so that the work capability assessment plays a smaller role in the decision than was originally the case. We have done that because we want to take into account additional medical evidence about a person’s condition so that it is not just a computer-generated exercise. We must bear it in mind that the decision is not taken by the assessor who carries out the assessment, but by a decision maker in Jobcentre Plus, who looks at the assessment and the ESA50 form that the claimant has submitted setting out the nature of their condition, as well as any medical evidence that they wish to submit to Jobcentre Plus. We have introduced a process of automatic reconsideration—a second opinion in Jobcentre Plus—so that if we have got it wrong the first time, there is a quick, simple process for looking at that decision again. The process does not require the claimant to go immediately to appeal; they get a second opinion before they reach that stage, so I think we have a better process.

[Jessica Morden]

What percentage of people are now successful on appeal?

[Chris Grayling]

I cannot give the hon. Lady the updated numbers, because they are national statistics and will be published shortly. However, they are still too high. We are in dialogue with judges who preside over tribunals to look at the reasons for that. The reality is that a large number of people go to appeal because they have the opportunity to do so. Sometimes they fall into the fit for work group, which, typically, does not apply to people with Parkinson’s. Of course, they are losing money, as was set out in the process that the previous Government set up, so they have a particular reason to appeal. However, we are working as hard as we can to ensure that the decisions are right first time so that we minimise the number of tribunal successes for claimants. We want to get it right; I do not want people to have to go to tribunals to overturn decisions.

[Jessica Morden]

Is it not true that the last time we saw those figures, between 40% and 70% of people were successful on appeal, depending on whether they were represented or not?

[Chris Grayling]

The average figure was about 40% in the last figures that were published. That represents only about 6% of overall claimant numbers. In the case of decision making for Parkinson’s, people are much more likely to end up in a support group. On the average numbers for new claims going through a work capability assessment, 40% are entitled to ESA; 13% are put in the support group; 26% are put in the work-related activity group, and 60% are fit for work. That is the whole gamut of applications.

For Parkinson’s, 71% are entitled to ESA; 33% are in the support group; 38% are in the work-related activity group, and 29% are fit for work at that stage. We expect those who are fit for work—as they reapply and are reassessed as their condition develops—to enter the work-related activity group and then the support group. Of course, when people are not able to work again, they will receive support in the support group.

The hon. Member for Halifax mentioned the case of the constituent affected by the time-limiting proposal. She is right to highlight that. It applies only to people in the work-related activity group and only to people who have money in the bank or who have another form of household income. It establishes the same principle to contributory ESA as has always applied to contributory jobseeker’s allowance. In the way our welfare state works, if someone is a JSA claimant with another form of income or with money in the bank, we have always allowed them to get a contribution back in recognition that they themselves have paid contributions. They get six months of contributory JSA if they have other financial means. We have simply applied that same principle to contributory ESA. We have done that for reasons that the hon. Lady well knows. We face enormous financial challenges, and we have had to take back that part of our welfare state into the safety net that it was originally intended to be, and we have had to accept that we cannot afford to pay benefits to people who have got another form of household income. We debated that extensively in the welfare reform debates. I would rather that we had not had to make that decision, but financial necessity meant that was inevitable.

We are not talking about people who have no other means of support. They are not people whose condition has developed so that they can no longer realistically work again. They are people in the work-related activity group who may be able to return to work with help and support, but possibly not in the profession that they worked in previously. It may be that their condition has made that impossible, but that does not mean that it is impossible for them to work.

[Sheila Gilmore]

The Minister has given us figures for the proportion of people in the work-related activity group, but he has not really addressed the issue of Parkinson’s. The figures that the Parkinson’s Society presented suggest that 45% of claimants are being placed in the work-related activity group. Such people will have lost their previous jobs and are often in their 50s and early 60s. With the loss of the contributory benefit, they have to use up their retirement savings. Will the Minister address the specific issues around Parkinson’s?

[Chris Grayling]

Nobody has to spend their pension funds while they are of working age. Realistically, if people put aside money for a rainy day, and they become ill and lose their job, but have money in the bank, what else constitutes a rainy day? There will always be limitations on the amount and breadth of support that the state can provide through the welfare state. There were limitations under the hon. Lady’s Government; there are under our Government. The constraints on us are greater than on hers, because the money is not there any more. The reality is that the state has never provided unconditional support for everyone. There are limits inevitably created by an individual’s financial means.

We have only five minutes remaining, so let me touch on a couple of the other points that the hon. Member for Halifax raised. Let me give the context for the gold standard review. We invited the mental health charities and the fluctuating condition charities to bring forward their thoughts on how we could adapt the work capability assessment to reflect more closely what they believed to be the best approach. I am open about this. I want continually to improve this process and I want it to be as good and effective as possible.

What the charities came back with was extremely ambitious, not just in changing the current descriptors. It would involve rewriting and recasting the whole work capability assessment for not only fluctuating conditions or mental health problems, but physical conditions as well. It would involve re-engineering all the software and the assessment. It would probably be a two-year process and extremely expensive. Before we embark on that process—I am open to looking seriously at that—we need to understand the impact of the changes.

More than a year ago, I was told by the charities that if I implemented the internal review that I had inherited from the previous Government, with recommended changes to the work capability assessment, it would disadvantage particularly people with mental health problems. The advice that I had internally was that we had done a similar review to the gold standard review on the work capability assessment, as it was then structured, and it showed that more people with mental health problems would end up in the support group—the opposite of what the charities had said. History has shown that the internal advice was right and the charities were wrong, so I really want to get this right. I do not want to embark on a grand project to reorganise this without getting it right.

Work has started on the gold standard review. The terms of the project have been agreed. There are meetings between the Department and the charities virtually on a weekly basis at the moment. The work is being carried out over the next few months. We will judge the outcome of that work and ascertain whether there is a need to make changes or whether the charities have got it wrong. We have to do that. The hon. Lady would expect us to do that. In the meantime, we are looking to embed some of the recommendations that they have made into the way the ESA50 form is structured. If that enables us to tease out more information that is of value to the decision maker, informing the decision about a person’s condition, that is clearly the right thing to do.

The other point that the hon. Lady made was about the support not being there for people in the work-related activity group. That is not correct, either. Every single person in the work-related activity group on ESA has access to the Work programme tomorrow. They will receive specialist back-to-work support from one of the providers operating up and down the country—a mix of public, private and voluntary sector organisations, some with specialisms in fluctuating conditions. There is a specialism within each supply chain for those who are on ESA. One of the challenges that we have at the moment is trying to encourage more people to come forward and take advantage of that support. It is absolutely not the case that people cannot access help and support. Everyone has access to support, and it works.

We had a case a few months ago—not a Parkinson’s sufferer, but a gentleman from the north-east who was partially sighted and in a wheelchair. He had applied for thousands of jobs and got absolutely nowhere. He did not believe he could get back into work in a part of the country where the labour market is weak. He joined the Work programme and within a small number of weeks was in employment with a job and his life turned round. That, fundamentally, is what this is all about. I know it is difficult and sometimes challenging. I know that it takes many people through a process that they do not want to go through, because they do not actually believe that they can make a return to the workplace. Is it not better if we can help them get there? Even if they happen to have had to give up the profession that they have had for years, because their condition makes that no longer possible, surely it is better to get them back into doing something that they can do with their condition, that can keep them in the workplace for a few more years and give them a chance to live a more fulfilling life. That is what we are trying to achieve. We will not always get it right. The system is not perfect. It never can be perfect. I wish that it could be, but it cannot.

In conclusion, I can tell the hon. Lady that this is absolutely about saving lives, not saving money. I genuinely want to see more people given a chance to live a more fulfilling life. We will do everything that we can to help them, but those who cannot work again will get ongoing unconditional support.