Errol Graham: DWP and Safeguarding Adults Board Inquiry

Debbie Abrahams Excerpts

Tuesday 6th June 2023 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I start by thanking Mr Speaker and his office for granting me this very important Adjournment debate in relation to Errol Graham, and in particular the safeguarding review by Nottingham City safeguarding adults board that was published a couple of weeks ago.

It was June 2018 when bailiffs came to Errol Graham’s flat to evict him and discovered that he was dead. Errol was penniless—he had no gas, no electricity and no water. His only food was two out-of-date cans of fish. At his 2019 inquest, the coroner confirmed that Errol had weighed four and a half stone when he died, and that the cause of death was starvation. He was 57 years old.

Errol suffered from severe mental ill health. He had been in receipt of employment and support allowance and housing benefit since 2014, until he missed a fitness for work assessment in 2017. He did not respond to the Department for Work and Pensions when it tried to contact him by phone and in person, and eight months later his ESA and housing benefit payments were halted, in accordance with DWP policy.

The coroner’s report fell short of issuing a section 28 prevention of future deaths notice to the DWP over Errol’s death, as the DWP witness at the time stated that a safeguarding policy review was underway by the Department. However, in July 2020 the coroner had to write to the DWP again, as it had failed to supply her with the new safeguarding policy. It is a bit moot whether there has actually been a revised safeguarding policy. Certainly, information from the House of Commons Library suggests that there have just been tweaks around the edges. There has been no new safeguarding policy, and as we will see as I proceed, the impacts have been felt elsewhere.

Just before recess, Nottingham City safeguarding adults board published an independent review of what it described as the “shocking and disturbing” events that led to Mr Graham’s tragic and lonely death. In that report, the board concluded that multiple failings by the DWP, Mr Graham’s GP practice and his social landlord meant that chances to save him were missed. Moreover, the Department for Work and Pensions also failed to share the severity of Mr Graham’s illness with other agencies, including his landlord at Nottingham City Homes. Knowing Mr Graham’s illness, the DWP failed to contact his GP for potential reasons as to why he was not engaging with the Department. Significantly, it has now emerged that the Department failed to disclose information from Errol’s 2014 work capability assessment to that independent safeguarding review. A communiqué from Nottingham City Council on 17 May stated that the independent chair of Nottingham City safeguarding adults board, Lesley Hutchinson, had said:

“We can confirm that the 2014 documents were not provided”

by the DWP

“for consideration by the review author.”

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward this debate. She has compassion and a heart for people who are in trouble, and we commend her for that. She often brings forward things that we all add our support to. Each day in our offices we witness people who have fallen foul of the DWP: those with extreme health difficulties, people who are desperate, people at their lowest—that is just the way they have had it. Does she feel that the DWP needs to be aware of those who need help, and that DWP staff need to be trained accordingly so that they can spot those who are in trouble? It is sometimes a knack, but I believe that is important.

[Debbie Abrahams]

The hon. Gentleman is absolutely right. In fact, he was in the Chamber back in February 2020 when we had the previous debate and described some of these events. Three years on, nothing has changed. He is absolutely right: not only would it be nice, but it is a requirement. The DWP has a safeguarding requirement and a responsibility to ensure that the claimants who come to its attention are adequately protected.

[Lilian Greenwood (Nottingham South) (Lab)]

I congratulate my hon. Friend on securing today’s debate, which obviously highlights the sad death of my constituent Errol Graham. The purpose of a safeguarding adults review is not to hold an individual or organisation to account, but it is about agencies learning lessons to improve future practice. If tragedies such as Errol’s death are to be prevented in future, which I am sure is what we all want, surely all agencies must share the relevant information with the board. Does she share my concern—I know she does—that in failing to share that 2014 assessment, the DWP did not assist the local authority in its really important duty in that respect?

[Debbie Abrahams]

My hon. Friend is absolutely right. That is the purpose of this Adjournment debate. The situation has gone on for too long, with information not shared and information lost—I will come to that later on. There have been concerns about how the Department has acted to safeguard not just individual claimants but the information it has on claimants, so that it can learn those lessons and improve its practices.

This information from the 2014 work capability assessment—do not forget, Errol died in 2018—expressed in the clearest language that he would not be fit to work “indefinitely”. That was the language of the assessor. It was not him saying that he was not fit to work; it was the language on that 2014 work capability assessment, which was not presented either to the safeguarding review or to the High Court judge. It also was not presented at the coroner’s inquest. The presenting of that report to the organisations that should have had it when making assessments of the circumstances of Errol’s death has been carefully avoided. This is serious stuff. I know that the Minister is relatively new in the role, but I want to know why that 2014 work capability assessment was not provided specifically to the recent safeguarding review board. I will go back to the other instances in a moment.

My hon. Friend is absolutely right about to Errol. Errol was her constituent, and I have had long-standing contact with Mr Graham’s daughter-in-law, Alison Burton. She has said that the Department’s behaviour raises “serious questions” about its honesty and transparency, given the Department’s knowledge of Errol’s significant mental distress and its failure to disclose it to the safeguarding review. That can be taken in conjunction with the Department’s failure to provide peer review reports into the deaths of claimants to the independent reviewers of the work capability assessment, Professor Harrington and Dr Litchfield. Members will be aware that there was a statutory requirement to undertake independent reviews of the work capability assessment. There were two separate assessors; one was Professor Harrington, and the other was Professor Litchfield. None of the peer reviews—there have been a number of different names for what happens when the Department investigates the deaths of claimants—or serious case reviews and so on were provided to the independent reviewers.

The response I got when I asked various urgent questions on this issue a few years ago was, “Well, they did not ask for them.” Then—this is all on the record; I was going over it last night when I was writing this speech— in response to the urgent question that I secured on this issue, the answer was, “Well, they were lost. We no longer have these reports, so we cannot provide them.” It is clear to see why there is a crisis in confidence in the Department and why there is a lack of trust from not just families, but claimants themselves.

This issue needs to be seen in the context of the recent action by the Equality and Human Rights Commission, which 14 months ago issued a section 23 notice to the Department over its concerns about the evidence that the Department is discriminating against disabled claimants. For 14 months, there has been nothing—nothing—from the Department, and there has been nothing from this Government. Surely as a Government they would see that the equality laws that have been set for everyone should also apply to them, but, no, 14 months on, there has been nothing. I will let people draw their own conclusion on what drives that, but if we say that the first duty of any Government is to keep their citizens safe, I think we would all agree that the DWP is clearly failing as far as disabled claimants are concerned.

In a 21st-century civilised society, the circumstances that led to Errol’s death should shock us all, but Errol’s death, unfortunately, is just one of many, and there is a pattern here. In addition to the lack of safeguarding provisions that led to Errol’s death—even though, as I say, there was an awareness from 2014 of his severe condition—many social security claimants have been found fit to work and have then died. For example, a freedom of information application in 2019 showed that 274 claimants a month—a month—who had been found fit for work subsequently died within six months, which is a much higher mortality rate than for the population as a whole.

The true scale and causes of these deaths are simply unknown. In an answer to a written question I submitted last year, it was revealed that between 2019—so since the inquest into Errol’s death—and June 2022, 140 more claimants and 39 serious harms were being investigated by the DWP, but that is only what the Department says it is investigating. The National Audit Office, in its review in 2020, said that it is probably a much, much higher figure.

Errol’s story is an example of the Department’s failure to safeguard claimants, and subsequently to avoid any form of scrutiny or accountability. Any Government who were confident in their policies would be open to scrutiny, but there is a pattern of avoidance by the Department, including the refusal to provide various reports and data to the Work and Pensions Committee, on which I sit. I have asked this in the past, but I am going to give the Minister and the Government one more opportunity: will the Government convene an independent inquiry into the scale and causes of the deaths of social security claimants? The Minister is welcome to intervene on me, but if he wants to include that in his response to the debate, that would be absolutely fine.

The seven Nolan principles of public life apply to us all—Ministers and MPs. Two of them are openness and transparency, but unfortunately, those principles are absent from the Minister’s Department. In an area such as social security, this could not be more important. We need a paradigm shift in our social security system from one that demonises to one that is supportive and enabling. Disappointingly, I see a re-emergence of the vile shirker-scrounger narrative from 10 years ago, and a focus on working-age sick and disabled people and social security claimants.

I do not know whether there is anybody from The Daily Telegraph in the Gallery, but I have to point out that I saw its shameful editorial last week. Not only was it ignorant in some of the assertions made, but it has what I see as absolutely disgraceful rhetoric in trying to vilify social security claimants. Just like our NHS, our social security system should be there for any one of us in our time of need, providing dignity and security for all.

In 2020, I read from a list of people who we knew had died. At the time, I said:

“The death of any person as a result of Government policy is nothing less than a scandal… For too long, the Department has failed to address the effects of its policies. It must now act. Enough is enough.”—[Official Report, 24 February 2020; Vol. 672, c. 155.]

Three years later, 140 more families are grieving. When will the Government sort this out?

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[The Minister for Disabled People, Health and Work (Tom Pursglove)]

I congratulate the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) on securing this important debate. It is, of course, always tragic when a person dies having been in receipt of benefits, and my sincere condolences remain with Mr Graham’s family. I assure you, Madam Deputy Speaker, that where there is an allegation that the DWP’s actions may have in any way contributed to this outcome, we take it very seriously.

To begin with, I want to set in context the nature of the recommendations made by Nottingham City safeguarding adults board. Five recommendations were made, with three specific to Nottingham City Homes, one applying to all agencies—with an emphasis placed on Nottingham City Homes—and one specifically aimed at the DWP, working jointly with Nottingham City safeguarding adults board. I confirm to the House that the Department for Work and Pensions has accepted that recommendation, and my officials will work constructively and collaboratively with the safeguarding board on that. We will approach taking that recommendation forward in good faith and with proper dialogue.

I also want to give some background on the case in question. Mr Graham was a claimant in receipt of employment and support allowance until his claim was closed in October 2017 following non-attendance at a work capability assessment. In the interim, he had not responded to calls, text messages or two home visits by the Department. Mr Graham had ceased to engage with his family, healthcare and other statutory agencies over a number of years, and was found deceased in his flat in or around June 2018. An inquest into Mr Graham’s death was held in June 2019.

Since July 2020, my Department has co-operated fully and openly with Nottingham City safeguarding adults board on this very sad case. I am pleased to see that its report notes the “significant changes” that the DWP has made in its support of vulnerable claimants since 2019.

The board wrote to the Department in July 2021 confirming that it would be carrying out a safeguarding adults review into the death of Errol Graham. For the avoidance of doubt, it might be helpful to quote exactly how the board explained the scope of the review from its own terms of reference. It said:

“The scope period for the review is from June 2017—the date EG’s benefit review process began—until 20.06.2018, the date EG unfortunately died. However, if agencies have information of relevance to the ToR before that date…it would be helpful if they briefly summarised that as well”.

The Department complied with the board’s request, providing it with detailed information in scope of the review as well as briefly summarising information from before 2017, as we were asked to do.

[Debbie Abrahams]

The Minister may be coming on to this—I hope he is. Will he ensure that he responds to my point about why the details of the 2014 work capability assessment were not made available to the review?

[Tom Pursglove]

If I may, I will make a little progress on this point. I am aware that a journalist has claimed that officials hid information from the board, but that is simply not true. They had no reason to do so. As explained, the board had the information that it requested. The board’s published report includes a wording change stating that agencies were asked to “provide additional information” and not “briefly summarise” as in previous versions. That slight wording change could have led to the wrong impression that the DWP was asked to provide every single form and document relating to Mr Graham’s benefit claim—even those outside the scope of the review. I believe that may have contributed to claims that information was hidden.

It is important to note that we know that the board extensively reviewed the findings of the 2021 judicial review proceedings in which a former Secretary of State for Work and Pensions successfully defended a claim in the High Court, challenging some of the decisions made in this case. That judgment referred to the content of a previous work capability assessment of Mr Graham’s. The safeguarding board clearly understood from that, and the other information provided, what officials had discovered about Mr Graham’s state of mind. It is difficult to see what the DWP would have gained by hiding it when the board had stated its review of the findings. Officials continue to engage with the Nottingham City safeguarding adults board and we welcome having further conversations with it if needed.

It is important to understand the role of safeguarding adult boards in the context of Mr Graham’s case. National guidance on safeguarding adults boards states:

“The purpose of a SAR is not to hold any individual or organisation to account, because there are other processes and regulatory bodies available for that purpose; they are about learning lessons for the future”.

Those other processes include the coronial process, where coroners investigate unnatural deaths and where the cause of death is unknown. Nottingham City safeguarding adults board’s role was to look at how agencies worked together to support Mr Graham and what lessons it could learn from his tragic death, not to re-examine the court’s previous judgment or the coroner’s conclusions. My Department’s key obligation is to ensure that claimants receive the correct benefit entitlement at the right time. While we do not have a statutory duty of care or safeguarding duty, that does not mean that we do not care. We often need to consider a customer’s particular circumstances to provide the right service or ensure appropriate support. We can help direct our claimants to the most appropriate body to meet their needs.

[Debbie Abrahams]

Why, then, did the witness speaking on behalf of the Department at the 2019 inquest make the point that a new safeguarding policy was being developed by the Department, if the Government do not have a safeguarding policy requirement?

[Tom Pursglove]

What I will do is set out the actions the Department is taking to ensure that our safeguarding obligations are upheld and that we support claimants in an appropriate way that is responsive to their needs and circumstances. The concrete actions the Department has taken to improve matters relating to this issue in recent years reflect previous learning.

I would also like to deal specifically with the point the hon. Lady made about holding a public inquiry. I am not in a position today to be able to commit to that. Clearly, attempted suicides and suicides are very complex issues. Where there is an allegation that the Department’s actions may have contributed to that outcome, we take it very seriously. There already exists a wide, independent and transparent system for investigating such issues. Causes of death are determined by a doctor or coroner. Where a coroner identifies a risk of other deaths occurring in similar circumstances, they will issue a prevention of future deaths report to highlight that. The independent case examiner investigates serious complaints relating to the DWP. They report to the complainant and publish case studies of findings in the ICE annual report. The parliamentary and health service ombudsman also looks at serious cases and publishes reports on its website. For those reasons it is not our intention to set up an independent inquiry, but there are steps we have taken as a Department to improve matters in relation to safeguarding and I just want to set those out for the House, because they have already been implemented to support vulnerable customers. The initiatives were also highlighted, as I say, in Nottingham City safeguarding adults board report as changes the Department has implemented to improve services, and that point was acknowledged.

First, we have introduced more than 30 advanced customer support senior leaders to support colleagues when dealing with customers who may be vulnerable or at-risk. Central to the role of those senior leaders is the work they take forward with external partners and organisations, creating relationships to support citizens and providing the critical link into external agencies’ escalation routes and enabling cross-agency case collaboration. The Department also conducts internal process reviews, which form a core part of the Department’s overall approach to learning and help inform improvement activities across all DWP product lines. Internal process reviews can make recommendations to help the Department to improve its processes, policies or quality of service. We commission them in response to a range of claimant circumstances or events, which include, but are not limited to, suicides, suicide attempts and self-harm. Not all internal process reviews conducted after a death relate to suicide. Therefore, those classified as relating to a death should not automatically be read as suicide cases. Furthermore, the fact that an internal process review is being carried out does not mean that the DWP has been found culpable in the circumstances or events leading to a claimant’s death or a serious incident.

Similarly, the serious harm that prompts an internal process review investigation may relate to self-harm or a suicide attempt, or may also refer to other events that are considered to merit investigation. We have also broadened the range of circumstances where an internal process review is carried out, to increase our learning from cases where outcomes have been poor for claimants.

The Department has also set up the serious case panel, which meets quarterly to consider themes and issues that have arisen across DWP service lines, in order to agree changes and improvements. The panel has commissioned and implemented several changes since it was introduced. They include changes made to visiting vulnerable customers, where they have ceased to engage with the Department. Following two unsuccessful visits where concerns about the customer remain, the claim will no longer automatically be closed. Instead, the case will be escalated to an advanced customer support senior leader, who will liaise with relevant external agencies to assure the customer’s safety.

The Department has also made changes to guidance on administering large payments to customers who may face challenges receiving or handling such payments. The panel has also prioritised the delivery of mental health awareness training to customer-facing colleagues. The training will build colleague capability and confidence in supporting customers with mental health conditions. Going forward, I am keen to engage with stakeholders, including from mental health charities and other organisations, to continue to make improvements to our services for our customers. I recently met Rethink, a mental health charity that was representing the families of some benefit claimants who have passed away. It is my intention to organise a future meeting with a representative member of the families, in partnership with Rethink.

I want to address a specific point that the hon. Lady has raised a number of times in this House about the Equality and Human Rights Commission in relation to the ongoing section 23 agreement discussions. We continue to engage with that in good faith, but we must act in accordance with our legal obligations. The negotiations provided for under the Equality Act 2006 have been expressly confidential. Therefore, I cannot give a running update on the contents of the discussions. There are legal provisions under section 6 of the Equality Act that prevent disclosure of further details. Discussions are subject to general law principles. Parts of the discussions are also subject to legal privilege.

[Debbie Abrahams]

I have two brief points. First, if we have had all the updates on safeguarding, why have 140 more people died in the intervening period? The Minister seems to be saying, “Everything is fine, we’ve done this,” but still, the Department is investigating 140 people, and we do not know the true figure. Secondly, there is nothing in the 2006 Act that says that the Department has to take 14 months to reach an agreement on how to improve the services and not discriminate against disabled people. There is nothing—I have gone through it.

[Tom Pursglove]

I do not accept the hon. Lady’s initial point. I take these matters incredibly seriously. I am engaging thoroughly with stakeholders around these issues. She will recognise my approach to meeting Rethink and bereaved family members to discuss these issues and to work out what more we can do to improve these processes and in an open, transparent and constructive way. That is how I approach my responsibilities, and that will continue to be the case. These structures have been put in place, as the safeguarding board recognises, which are considerable improvements in recent times. Of course, we must always keep under review the appropriateness of these structures. We must make sure that learning from specific cases is captured. Processes and the way in which we go about our activities as a Department must be responsive to the issues raised through those formal structures.

On the section 23 discussions that are ongoing, the hon. Lady will recognise that this is a matter not just for the DWP. The discussions are going on between two parties, and both sides need to act in good faith in reaching conclusions. It is right that we do that in response to the commission from the EHRC, and in a way that is compatible with the requirements under the Equality Act. That is what we will continue to do. As I have said before, when I have a substantive update that I am able to provide to the House, I will do that. I have made that undertaking, which I reiterate today. It would be inappropriate for the Department to discuss the contents of what may or may not be included within an agreement, or the contents of any information that may be published in future, while confidential discussions are ongoing.

My Department strives to be a learning organisation, continually seeking to better understand the experiences of our customers and any challenges that they may face in their interactions with us. We are committed to using that learning to develop our systems and processes and to make improvements to the experience of our customers. In fact, that underpins all the work we are doing through our White Paper reforms, to ensure that people have a better experience of the journey within the benefits system and that we provide benefits that are more flexible.

--- Later in debate ---

[Tom Pursglove]

It is impossible not to be incredibly moved and concerned by what happened to Errol Graham. Both Ministers and officials in the Department are absolutely determined that the learning that comes out of this case, which is reflected in the recommendation that has been made by the safeguarding adults board, must be acted upon. We must continue to consistently ensure that where issues that require improvement are highlighted, we take steps in reality, in terms of our processes, to make sure that that follows on.

It is significant that there are now checks that ensure people’s cases are not suspended or terminated when we have not heard back from them, and that we have senior customer service leaders who work on a cross-agency basis to ensure that people are properly supported. They were the right steps to take and they have been informed by cases like this. It is right that we continue to constantly monitor and understand our claimants’ circumstances and needs, and that we improve the journey through the benefits system more generally, wherever there is an opportunity to do that.

That is why I am passionate about the reforms that were announced through the White Paper, including matching expert assessors with particular conditions, monitoring fluctuating conditions more effectively and ensuring that people have the smoothest possible journey in their experience and interaction with the DWP. The hon. Lady has my commitment that we will continue to learn. We will undertake to make sure that all our processes are fit for purpose and kept under review, and to make changes when they are required.

That is the constructive spirit in which I am approaching our conversations with Rethink, for example, which has an insight into mental health conditions, so that we can understand what more we can do to ensure our processes are responsive to those with mental health conditions. I know Rethink participated in some engagement with my officials only yesterday.

[Debbie Abrahams]

My final point is that Rethink is calling for an independent public inquiry into the death. Will the Minister be supporting that campaign by Rethink?

[Tom Pursglove]

The position relating to a public inquiry is the position that I set out earlier, but within our existing processes and the transparency applying to them, I am keen to hear from Rethink and other charities what more they think we can do, or which parts of those processes they think could be improved. I approach those conversations very much in that spirit.

Ultimately, our measures will ensure that we provide benefits for, in particular, our most vulnerable customers in a more flexible and compassionate manner, and that their interactions with us constitute a positive experience. We will continue to drive forward change within the Department on the basis of what we have learnt. I appreciate the opportunity I have had this afternoon to describe some of the work that the Department is doing, “on the ground floor”, to ensure that our systems are as responsive as possible, and that all learning is captured and acted upon.

Question put and agreed to.