People with Disabilities: Cost of Living

David Linden Excerpts

Tuesday 16th May 2023 Westminster Hall

[Marion Fellows]

I wish that the hon. Member would take that back. In Scotland, we treat people with dignity, fairness and respect. We help them to fill in their adult disability payment applications, and we make it much easier for them—[Interruption.] The hon. Member is shaking his head, but he is wrong. We make it easier for people with long-term illnesses from which they will not recover. They do not have to go through continuous reassessments.

[David Linden (Glasgow East) (SNP)]

Will my hon. Friend point out to the hon. Member for North Swindon (Justin Tomlinson) that unlike the UK Government and their pernicious welfare system, the Scottish Government have actually worked with people with experience of the benefits system and those who have disabilities in designing that system? It is rather rich that he lectures us from a Tory Government who have been found to have treated people rather inhumanely.

[Marion Fellows]

I thank my hon. Friend for that. I am appalled at the remarks being made. I shall move forward and I will not take any further interventions in the meantime; I need to make progress.

The insufficient cost of living support, combined with an inadequate system of social security and an economic crisis created by this Government and their predecessors, have created an unwelcome perfect storm for those with disabilities, plunging millions into poverty. Disabled people often face higher costs for their energy, and they are saying that they need more heating—most disabled people need more heating to stay warm. Others say that they must use more electricity simply to plug in their assistive technologies. Those extra costs mean that disabled people have less money in their pockets and, in many cases, go without. The result is that disabled people are more likely to have a lower standard of living, even when they earn the same as a non-disabled person.

According to the British Association of Social Workers, 7 million people—almost half of those living in poverty in the UK—are either disabled or live with someone who has a disability. Families with a disabled loved one are seriously struggling as they have to make difficult decisions and cutbacks. Guide Dogs UK has highlighted how families with a child with visual impairment are being hit incredibly hard, and the mental health of parents is suffering.

The disabled poverty figures are unsurprisingly reflected in food bank usage, with the Trussell Trust advising the Work and Pensions Committee that disabled people are hugely overrepresented in food poverty. More than half of food bank users in the UK are disabled.

The covid pandemic deepened pre-existing inequalities in society for disabled people, and the rise in inflation has disproportionately hurt the most vulnerable in society. Disabled people and their households have, on average, lower incomes than their non-disabled counterparts in spite of incurring higher costs. Poverty and disability are often mutually reinforcing, particularly for working-age adults.

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[Justin Tomlinson (North Swindon) (Con)]

Thank you, Dr Huq—a double thank you for your late substitution this morning, for which we are all very grateful. It is a pleasure to follow the hon. Member for Motherwell and Wishaw (Marion Fellows), who clearly demonstrated a real passion for this important subject. I think her constituents would recognise that she is a real champion for those who need a voice in this area, and I pay genuine tribute to her.

I also pay tribute to the Minister, who I know will respond in full. He has immersed himself in the details of his role and has always shown himself willing to engage with stakeholders. I think we would all agree that there is a wealth of knowledge and expertise in local and national organisations, and the Minister is passionate to utilise that wherever possible. That has come through very clearly in his time as a Minister.

I pay tribute to local and national organisations up and down the country that provide people with advice and support in accessing the often complex and daunting layers of support that are potentially available. For example Tim Saint, of the Swindon Carers Centre, does a huge amount of work in our community to help people access support. During my time as a Minister, I was surprised to see how many people miss out on the various forms of support that we have all voted to give them, often because they are faced with a complex and daunting system.

We have made progress. Under PIP, including the legacy benefits of DLA, and attendance allowance, we are now spending £12.5 billion more in real terms on help for those with disabilities or long-term health conditions. Under the old legacy system of DLA, only 16% of claimants would access the highest rate of support. A few years ago, that figure had reached 33%, and for some health conditions, in particular mental health conditions, people are now six times more likely to access the higher rates of benefits. So we are very much heading in the right direction, and there are further opportunities to turbo-speed improvements with the forthcoming White Paper.

There are two key lessons the Government can focus on: speed and specialisation. First, on speed, there are lessons that can be learned from the welcome changes to the special rules for terminal illness. We were able to apply a policy change that was co-designed by stakeholders, their policy teams and end users—people with real-life experience. Using the same principles, we can widen the severe conditions criteria in the PIP system, removing up to 300,000 unnecessary assessments or reassessments each year.

The principle behind that is that we would look at specific conditions. We could then be fairly confident about the trajectory of that condition and set in place a timetable of support. For those people whose condition has perhaps changed more quickly than expected, there would still always be the option to have a light-touch assessment to speed up their access to the increased rate of support.

There is a sort of principle around this, which already exists with universal credit and the industrial injuries disablement benefit. An independent panel could look at these conditions, and one example would be motor neurone disease—I cannot understand what the point would be of putting somebody with MND through an assessment. Where we can be fairly confident of the deterioration of health conditions, we could put in place an automatic right to support, with the backstop that, if somebody’s condition, sadly, deteriorates more quickly, a light-touch assessment could then move them to the higher level of support much more quickly. Removing 300,000 people a year would mean we have more resources available to speed up the process for those who would go through the more standard, traditional route.

During covid, we made sure we kept the gateway open for new entrants, and it is a tribute to staff up and down the country that disability benefits continued. We used video and telephone assessment, a further benefit of which is that it allows for greater specialisation in terms of the assessors. Rather than relying on a fixed number of staff in each geographical location, we can assign someone with a particular health condition via telephone or video to other locations in the country. That also helps with the point about making sure that the assessments are right first time, so that people do not have to go through an appeals process further down the line.

I know that these broad themes are being considered as part of the White Paper, but they are a real win-win and they are probably things that people could rally around, regardless of which political background they are from. I certainly know from my time working with our very knowledgeable stakeholders and policymakers that there would be huge support for them.

A broader point is that not everything is black and white. As much as I admire the passion and drive of the speech by the hon. Member for Motherwell and Wishaw, there was a presumption that everything the Government do is terrible and that everything the Scottish Government do is good. I say that because I have a brother who is a proud Labour party supporter, another brother who is an SNP supporter, a sister who is a sort of Lib Dem/ Conservative and a cousin who is a Green, so we cover all the bases, and I was very much brought in the belief that things are not black and white.

To their credit, the Scottish Government identified that we could and should have made changes to the special rules for terminal illness and to PIP, which is the main disability benefit. The Scottish Government have had challenges; they had hoped to complete both those tasks many years ago, but that has proved a lot more complex, particularly when we start to unravel the complicated machinery behind those benefits.

In my former life, I attended inter-ministerial meetings with Scottish officials and Scottish Ministers, who were always a great pleasure to work with, and I absolutely admired their end goal. However, they also had that presumption that the system was completely broken and had to be completely changed. Therefore, they sometimes would not listen to stakeholders and policy experts in disability and health charities who wanted changes but not necessarily the changes the Scottish Government had settled on.

For example, there is a principle that the Scottish Government do not like assessors. I understand that, given a lot of the media coverage of the earlier years of PIP, in particular. However, there is a reason why, under DLA, only 16% of claimants got the highest rate of support, compared with 33% under PIP. Many of the people who navigate the system are the least well equipped to do so. Therefore, we are relying on a system where, in effect, their evidence—self-supplied—is the only basis for them to get DLA. However, assessors tease out additional things and fill in the gaps, which is why we have gone from 16% to 33%.

[David Linden]

The hon. Gentleman is giving an incredibly thoughtful speech, but I have a fundamental objection to assessments. However, even if I was to follow the former Minister down the assessment route, we would find ourselves in a ridiculous situation where the people carrying out the assessments have no professional qualifications to enable them to adjudicate on the condition. For example, in one recent constituency case, someone was actually asked, “Does your son still have autism?”. That is the level of expertise we are dealing with and that, I am afraid, shows that the system is broken.

[Justin Tomlinson]

That shows the slight misunderstanding here—and I say that in a good spirit. All the health practitioners who carry out assessments have at least two years’ experience and come from health professional backgrounds. However, the point where the hon. Gentleman is right is that they are not necessarily specialists in certain areas. If someone goes to a GP, the fact that they are the initial gatekeeper to the NHS does not mean they are an expert in everything—they refer people on to specialists. There would generally be five or six assessors in each location, so we cannot expect the collective knowledge of those assessors to cover every single health issue. Through the introduction of telephone and video assessments, however, we can refer people, and that is what I am pushing for. The point is: the role of the assessors was not broken, but it needed improving. That is what both the UK and Scottish Governments were looking to do.

I am urging the Scottish Government to be cautious about relying too much on the claimant, because not all claimants are in a position to argue their case and understand the conditions. It is not even just a case of that; it is also about people being unaware of additional health conditions. I made a point earlier about those with mental health conditions now being six times more likely to get access to the highest rate of PIP. Many people do not realise that their mental wellbeing is being impacted by their physical health condition. They would enter the PIP system thinking, “My physical health condition is impacting on me. I’ll fill in all the bits on that and answer the questions.” However, the assessor’s questions on how that impacts mental wellbeing then begin to identify additional challenges that the claimant was either unaware of or had got used to and took for granted. That then gives them the additional points that allow them to enter the higher rate.

It is same around the special rules for terminal illness. We extended that from six months to 12 months, working with hospices, the health and disability charities and GPs. The Scottish Government, with very good intentions, tried to create a system where it was automatic. They then realised that not everyone can be dealt with automatically, because we are all terminally ill in the sense that nobody lives forever. Conditions then have to be put in, but that inadvertently creates a more complex system. It would have just been easier to say, as Northern Ireland did, “Actually, on this occasion, the UK Government—having listened to the stakeholders and health and disability charities—might be on to something. In this case, we ought to do the same.”

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[David Linden (Glasgow East) (SNP)]

It is a pleasure to serve under your chairmanship, Dr Huq. I pay tribute to you for getting here in double-quick time as a late substitution. I commend my hon. Friend the Member for Motherwell and Wishaw (Marion Fellows) on securing this debate on a very important topic.

The cost of living crisis has permeated so many different aspects of our communities. The topic is brought up continually in my weekly advice surgeries, where sadly constituents have repeatedly told me that they are struggling to afford their weekly food shops and monthly energy bills. It is very much either/or. I am sure that other MPs in Westminster Hall today can relate to that—how helpless it feels to be sat across the surgery table from people who are clearly struggling and who desperately need support.

In far too many cases, people fall between the cracks and end up without the help that they not only deserve, but are entitled to. That is far too often the case for disabled people, who incur hidden costs through no fault of their own. As we have heard repeatedly this morning, disabled people and their families spend a greater share of their income on food and energy, the commodities that face the steepest rises in inflation. Again, as we have heard, people with special dietary requirements are being hit particularly hard by food inflation, with statistics from January showing that households with specific dietary requirements are paying up to 73% more for their food than those who do not need to buy “free from” products.

Disabled people face many additional costs related to the treatment and mitigation of their disability, such as equipment or therapies. In some utterly awful cases, disabled people face the impossible choice between powering essential medical equipment such as wheelchairs and ventilators and putting food on the table. All those extra costs hit harder because disabled individuals and their households have, on average, lower incomes than their non-disabled counterparts, with 27% of disabled people living in poverty compared with 21% of non-disabled people. The result is that disabled people are more likely to have a lower standard of living, even when they earn the same.

According to research from Scope, on average, disabled households need an additional £975 a month to have the same standard of living as non-disabled households, and if that figure is updated to account for inflation over 2022-23, those extra costs rise to £1,122 a month. The price tag on disability feels incredibly dystopian. What kind of Orwellian society are we living in when having a disability incurs a price tag?

We have only to reflect on the words of Nye Bevan to understand the absurdity of the situation. Bevan said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community.”

Let me make it clear: illness is not an indulgence or an offence. People should not have to pay or be penalised. If Nye Bevan could understand that in the 1940s, I am puzzled as to why the current British Government are having so much difficulty with the concept.

The Government must do more—so much more—to use all the powers at their disposal to tackle the cost of living crisis on the scale that is required. While the uprating of benefits in line with inflation was welcome, for far too many it sadly came too late. The additional payment of £150 to disabled people, while welcome, will not provide the same long-term assistance as a sustainable benefit uplift. Indeed, Disability Rights UK is on record as saying that the “lack of meaningful increases” in disability benefits over recent years means that the extra £150 “doesn’t touch the sides”, and it is right.

As my hon. Friend the Member for Motherwell and Wishaw said, the Scottish Government are taking action within their devolved powers and within their fixed budget to try to help disabled people with the combined effects of higher energy bills, the general rise in inflation and the impact of Westminster policies. Yes, there are things that we can do—for example, the winter heating payment; the Scottish Welfare Fund; spending money on discretionary housing payments, such as the £84.1 million being made available this year; the council tax reduction scheme; and the most generous concessionary bus scheme—but the reality is that devolution was not, and in my view never has been, set up to be a sticking plaster for bad welfare policies made here in London.

Yes, the Scottish Government are doing all that, but they are doing it with one hand tied behind their back. The brutal reality is that every additional pound that we spend on those measures to help with rising costs has to be funded by budgetary reductions elsewhere, given our largely fixed budget and our limited fiscal powers. Scotland has already suffered a decade of British Government-imposed austerity since the financial crisis, which has disproportionately hurt the most vulnerable people in society and has resulted in under-investment in our crucial public services. The SNP Government in Holyrood are using their limited powers and resources to do everything they can, but that has to be matched by the British Government. With every day that Westminster fails to use its reserved powers to adequately tackle the cost of living crisis, it is demonstrating that independence is the only way for people in Scotland to boost their income and build a truly fairer society.

In closing, I emphasise what is at stake for my constituents, whether they are in Barrowfield or Baillieston. We find ourselves in a dire situation in which it literally costs to be disabled—there is a price tag on being diagnosed with a disability. The additional monetary costs associated with being disabled are compounded by the myriad ways in which society is set up to penalise disabled people.

The social model of disability tells us that people are disabled by barriers in society, not by their impairment or by indifference. The barriers can be physical, such as in buildings that do not have accessible toilets or libraries that do not have Braille versions of books; attitudinal, such as the assumption that disabled people cannot do certain things; or systemic, as in this case, when the cost of simply living as a disabled person is higher and Government support has systemically failed. It is only by removing those barriers that we can achieve equality and offer disabled people more independence, choice and control. That is why I believe that the Government must do so much more to protect the most vulnerable in society.

[Dr Rupa Huq (in the Chair)]

I call shadow Minister Vicky Foxcroft for the official Opposition.

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[Tom Pursglove]

I will certainly and gladly take that point back to the Department. I am sure it is something I can pick up on during the many engagement sessions that I have, particularly with disability charities and disabled people’s organisations. I would be keen to hear their views on how the issue is best approached and what more we can do in the advice space.

I want to touch on the cost of living support in place for 2023-24. Members will recall the commitments that my right hon. Friend the Chancellor of the Exchequer made in the autumn statement, including a firm commitment to support the most vulnerable people in our society. That will be delivered through 8 million low-income households getting £900 cost of living payments. I am delighted to say that my Department has already delivered 99% of the first cost of living payment of £301 to the 7.3 million households in receipt of a means-tested benefit such as universal credit. That in itself represents a £2.2 billion injection of help for households.

I am also pleased to confirm that we will shortly lay in Parliament regulations that will allow us to pay the additional £150 disability cost of living payment to 6.5 million people throughout the UK who receive an extra-costs disability benefit. Those payments will land in people’s bank accounts in the summer. We will also shortly lay regulations that mean that this winter pensioner households will again get an additional £300 on top of their annual winter fuel payment, as they did last year.

[David Linden]

There has been a bit of a problem whereby some of the cost of living payments have excluded those who have previously been sanctioned by the UK Government. In essence, that means that people are doubly penalised. Will the Minister confirm that any regulations he introduces will not include any provision such that people will be doubly punished, if they have been sanctioned, by not receiving the cost of living payment?

[Tom Pursglove]

I will gladly take that point back and speak to ministerial colleagues in the Department about that aspect. The hon. Gentleman will recognise that the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Mid Sussex (Mims Davies), has generally led on the legislative efforts to put this package in place, but I would be happy to raise that with her and to get him a proper, full, considered answer to that point.

Let me deal directly with one key issue that has come up in the debate: the structure of the cost of living payment and the argument that the payment is itself too low. I stress that the rationale is different for each of the cost of living payments. The Government’s view is that it is right that the highest amount goes to those on means-tested benefits, given that those on the lowest incomes are most vulnerable to rises in the cost of living. Having said that, we estimate that nearly 60% of individuals who receive an extra-costs disability benefit will receive additional support through the means-tested benefit payment. More than 85% will receive either or both of the means-tested and pensioner payments.

I assure colleagues that we are absolutely committed to ensuring that disabled people and people with health conditions receive the support that they need, which is why in 2022-23 we spent nearly £69 billion in real terms on benefits to support disabled people and those with health conditions. We will continue that throughout 2023-24 by uprating disability benefits in line with last September’s consumer prices index inflation figures. That means we expect to spend around £78 billion in 2023-24, which is 3.1% of GDP. That is a stark statistic. I recognise that Trident is a significant issue for the Scottish National party, and the figure of £3 billion was raised, but I and the UK Government would argue that there are strong reasons why we have a nuclear deterrent, which is a debate for another day.

The scale of support that we provide—to the tune of £78 billion in 2023-24—to people with disabilities and health conditions is significant. By 2027-28, total disability benefit spending is forecast to be more than £41 billion higher in real terms compared with 2010-11. Spending on extra-costs disability benefits alone will amount to £35 billion this year, all paid tax free, and in addition to any other financial or practical support that disabled individuals may receive.

The hon. Member for Chesham and Amersham (Sarah Green) asked about the adequacy of the disability cost of living payment and its evaluation. We are committed to an evaluation of the cost of living payments later this year. The disability unit is also working to build an evidence base to better understand and evidence the full impact of cost of living challenges for disabled people, across a range of sectors. It is trying to do that collaboratively and is drawing on the expertise, views and experiences out there to help us to shape that work.