Work Capability Assessment

Gloria De Piero Excerpts

Tuesday 13th March 2012 Westminster Hall

[Sheila Gilmore]

I do share that concern, and the recommendation, which the Government indicated initially that they would accept, was that there would be such champions in all assessment centres. I appreciate that some centres are small and isolated, but two in the whole of Scotland is low, and it will be difficult for them to make a significant impression on the system.

[Gloria De Piero (Ashfield) (Lab)]

A distressing case recently at my surgery was a constituent who was in tears and crying hysterically because she believed that she had been placed in the wrong work-related activity group. She is appealing, but the appeal process in Nottingham takes an average of 56 weeks. She is really struggling in that group—she is asked to carry out role play and interviews when she believes that she is in the wrong group. I thank my hon. Friend for raising the issue, and hope that she will press the Minister to address my constituent’s case.

[Sheila Gilmore]

I thank my hon. Friend for her helpful intervention.

On the current descriptors, Michael would be unlikely to score any points. Because of the multi-dimensional nature of the proposed descriptors different aspects are looked at, including the severity of an applicant's difficulties with social engagement, the degree to which that varies between familiar and unfamiliar people, and how frequently that occurs. Those separate factors are scored, and are then multiplied together, with final points being allocated accordingly. The view in the report is that someone such as Michael would be expected to be awarded around nine points rather than none.

The purpose of the proposed descriptors is to account better for fluctuations in impairment that are commonplace in such illnesses, and the amount of support a person might need to overcome their impairment. They are structured in such a way that they could be used as the direct basis for the questions and would be better understood by the claimant.

Those were the recommendations in the report, but what about the Government’s response? As Professor Harrington made clear when he passed his report to the Government, he endorsed the proposals when writing his second review. To date, however, the Department for Work and Pensions has decided not to introduce the new descriptors, arguing either that there is insufficient evidence that the current descriptors are not working—that seems surprising given that that point was made in Professor Harrington’s first review and was accepted by the Government—or that the new ones would work better. In response, the Government said that the Department would “consider” a gold standard review that would take place in the first half of 2012.

The charities that are involved in these matters accept that more research is needed, but in the run-up to this debate they expressed their concern that no gold standard review has yet been initiated. Will the Minister confirm whether such a review will take place, and if so, when? Have DWP officials met with Professor Harrington, Mind, Mencap and the National Autistic Society regarding the establishment of such a review?

The charities have also expressed concern that a number of civil servants on the employment and support allowance team have recently moved on and have not yet been replaced. As a result, the DWP claims to have insufficient staff to initiate the review. Will the Minister ensure that staff are allocated to the ESA team to carry out the gold standard review? If the DWP is unable to provide staff to carry out that review, the charities have suggested that such work could be contracted out to an independent organisation. If that were to happen, would the Minister accept the findings of that review?

The Government accepted a suggestion about revising the ESA50 questionnaire that people fill in when making an initial application, and the idea was to reconsider and adapt, although not change substantially, the wording of the existing descriptors. Will the Minister tell us what progress has been made on that?

More broadly, my fear is that the Minister might use the cover of the gold standard review to kick the proposals into the longish grass because looking at a better way of assessing mental, intellectual and cognitive functions would shine a light on the whole work capability assessment process. That was illustrated by the Minister’s response to an oral question from my hon. Friend the Member for North Tyneside (Mrs Glindon) on 24 October 2011. She asked whether the Government would be implementing the recommendations in the report and the Minister replied:

“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. We are considering whether we can incorporate elements of the recommendations into the current approach much more quickly.”—[Official Report, 24 October 2011; Vol. 534, c. 8.]

Perhaps that is the crux of the matter. The Minister appears to be saying that a substantial change of approach is needed to the whole way that assessment is carried out for issues of physical as well as mental health. The longer the process takes, however, the more people are at risk of being wrongly assessed as fit for work, with all the stress and emotional turmoil that that causes. That is not a small matter for the DWP given the high rate of appeal and the cost and effort involved.

In conclusion, I urge the Minister to press on with the gold standard review for mental, intellectual and cognitive function. In doing so, however, he should not shy away from confronting the real issues that exist with other aspects of the work capability assessment.

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

I have a sense of déjà-vu because the hon. Member for Edinburgh East (Sheila Gilmore) and I are continuing a debate, albeit on a different subject, from an hour ago.

Let me start by saying that it is of paramount importance to get right issues of mental health in the work capability assessment process. That is the most difficult challenge, because in many respects mental health can be the most intangible of the various areas that we need to assess when we seek to understand what people can and cannot do, and there are clearly many people with mental health problems who cannot possibly be expected to work. I do not have detailed knowledge of the case highlighted by the hon. Member for Ashfield (Gloria De Piero), but people will appear in our surgeries saying that something is not fair or right, or that they are in the wrong group. Some people will genuinely believe that they cannot return to work, but that will not always be the case.

A few weeks ago, I sat with a woman in one of our Work programme centres. She had arrived having been mandated to the Work programme after 14 years off work with chronic depression, and she said that on the first day she was in tears, did not believe that she should be there and that she was protesting bitterly. I met her about eight weeks later, by which time she had started doing voluntary work in a charity shop and had begun to apply for jobs, and she said that that was the right thing to do after all. We will not always get it right, but we are taking some people down a path that can be right for them, even if they are reluctant to follow it at first.

[Gloria De Piero]

I accept what the Minister says, but does he agree that to decide whether someone is in the right group and has the right of appeal—which in itself acknowledges trial and error—56 weeks is too long?

[Chris Grayling]

I completely accept that, and we have started to reduce the backlog of cases. It is a big challenge, and we have put extra resources into the tribunal service for that. We have also tried to strengthen the reconsideration process in Jobcentre Plus, so that new medical evidence seldom appears at appeal stage. In his first report, Professor Harrington stated that one key reason why so many decisions were being overturned on appeal was that new evidence was appearing at appeal stage. We have tried hard, both at the start of the assessment process and the reconsideration stage, to ensure that such evidence is in place.

I ask the hon. Member for Edinburgh East to step back for a moment because it is tempting to take what the charities say at face value. Charities do good work and have long experience, but they do not always get it right and the internal review was the clearest example of that. I sat through meeting after meeting with the charities at which they said that we should not proceed with the internal review because it would lead to more people with mental health problems being found fit for work and that all the evidence suggested that it was the wrong thing to do.

Work had been done by the previous Government using the approach that the Department always takes to such matters, which is to take a batch of cases, put them through a new methodology and see what difference that makes. Our team of officials advised that, although there were fewer descriptors, the changes would lead to an increased number of mental health claimants in the support group. The charities protested and said, “That won’t happen; you’re wrong. That is not the case and you shouldn’t do it.” A few months later, however, that internal review led to an increased number of mental health patients in the support group. Indeed, the support group as a whole has got bigger. It is easy for groups that advocate change to existing systems to say, “We’ve got the experience; we’re right and you must do this,” but that is not always the case. It was certainly not the case for the internal review.