Department for Work and Pensions

Justin Madders Excerpts

Tuesday 2nd July 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I welcome this opportunity to scrutinise the DWP’s spending, because when I sit in my surgery, week after week, listening to the stories of people living in poverty and struggling to survive while facing a continual battle with the benefits system, I find myself wondering just where nearly a quarter of all Government spending is going. It is certainly not reaching the people who need it most in my constituency. People have had overpayments, underpayments, long initial waiting periods, inaccessible and complex online forms that lead to uncompleted claims, a lack of support with claims, and cruel disability benefits tests, with fines consistently being overturned at appeal.

We have had plenty of debates about universal credit, and it is not working. The five-week wait for initial payment is driving people into poverty, debt and rent arrears, forcing them to turn to food banks to survive. We have already heard about the number of people using food banks. In my constituency, like everywhere else in the country, the numbers are going up year on year at an alarming rate. Despite the Government’s claim that nobody will be worse off under universal credit, we now know, thanks to the Institute for Fiscal Studies, that 1.9 million adults will be at least £1,000 worse off.

While the Office for Budget Responsibility’s report at the start the year upheld the Government claim that 1 million ESA households will, on average, receive an extra £110 a month, it also showed that exactly the same number of ESA households will lose, on average, £217 a month. It is no wonder, therefore, that the UN special rapporteur, Professor Philip Alston, accused Ministers of window dressing to minimise the political fallout. That is both damning and shaming.

I have spoken on many occasions about the cruel, unfair disability benefits tests that my constituents have to go through, and for what? Record numbers of people are winning appeals against the Department, and it just looks like the whole process is a stick to beat people with. As we have heard, more than 70% of personal independence payment and employment and support allowance appeals will find in favour of the claimant. One of my constituents was assessed five times in eight years of being on ESA, and despite being found fit for work each time, they won every time on appeal. How flawed must the assessment process be to be so consistently wrong? How can the cost of defending five separate appeals be justified when the decision is the same each time?

More than 16,000 appeals have overturned a PIP decision in the first three months of this year, and nearly three quarters of the 22,000 that went through a tribunal also ruled against the DWP. Waiting times for a PIP appeal are coming up to a year in my constituency—nearly a year in which some of the most vulnerable people in our society are denied the financial support that they need. Things can get worse, because if they have a Motability vehicle, they can lose that as well. I met someone last week who clearly could not get to her job on public transport, but she now faces losing her car due to a PIP assessment. I have little doubt that she will win her appeal, but what consolation will that be if she loses her job in the meantime?

[Alison McGovern]

Does my hon. Friend agree that this poor decision making fatally undermines the relationship between the citizen and the state, and that it must make his constituents wonder what kind of country we live in?

[Justin Madders]

I thank my hon. Friend and constituency neighbour for her intervention. I do sometimes wonder what kind of country we live in when vulnerable people feel the cards are so stacked against them that it is not even worth their while to appeal. Those are the people who come to see me. I do not know what happens to the people who are so beaten down by the system that they just give up, which I feel is the unintended consequence—or possibly the intended consequence—of this policy time after time.

We know that the cost of successful PIP appeals was £27 million last year. ESA is not included in that figure, but 74% of those claims were successful, too. Let us not forget the figures I uncovered towards the end of last year, which show that the Department is not even turning up to four in five appeal hearings. We know what would happen if my constituents did not turn up to four in five appointments with the DWP: they would be sanctioned straightaway.

I also hear from parents whose children are not eligible for free school meals because their household income is just a little too high, and they are struggling to provide their children with a school lunch because they cannot afford it. Many of these families are struggling to make ends meet.

We now come across parents who are eligible for help but who are not getting it due to the complicated application process and the long waiting times. I have constituents who, in the period before the first universal credit payment is made, are desperate for support but are told that they are not eligible for free school meals. Surely we can do this better and provide eligibility for free school meals when the universal credit application is made, rather than waiting until the first payment comes through.

Briefly, on access to benefits for people at the end of life, the current special rules for terminal illness—SRTI—exclude many people with terminal illnesses. I am meeting the Minister next week to discuss this, and I hope we have a constructive conversation, but I raise it now so that people are aware of some of the difficulties and of the money and time being wasted on inappropriate and unnecessary assessments.

Only 45% of people with motor neurone disease are claiming personal independence payment under SRTI. The majority of people in that situation are still using the standard claims route, which is inappropriate for their situation. They are required to fill in a long form, attend a face-to-face assessment and then wait weeks before the benefits are received.

[Neil Gray (Airdrie and Shotts) (SNP)]

I commend the hon. Gentleman for his speech. Is he aware of Social Security Scotland’s plans to ensure that all medical evidence is available to decision makers at the application stage, so that a correct decision can be taken without the need for often demeaning, demoralising and horrible assessment processes such as the one he describes? Will he support my call for the UK Government to follow Scotland’s lead?

[Justin Madders]

The hon. Gentleman makes a helpful suggestion. Certainly those who have, by definition, a very short time to get these matters sorted due to terminal illness should have as much of the process done at an early stage to avoid such difficulties.

It is highly insensitive that people who have been diagnosed with what can be a devastating condition that will end their life, possibly within 12 months, have to face this extra hoop-jumping when they should be focusing on spending what time they have left with their loved ones.

The majority of people with motor neurone disease are awarded the enhanced rate of PIP anyway, so we need to make it easier for them to claim through SRTI instead of the standard route, which many are currently going down. There are a number of helpful suggestions that we can discuss with the Minister next week.

My hon. Friend the Member for Wirral South (Alison McGovern) spoke passionately and eloquently about the Women Against State Pension Inequality Campaign. She rightly drew attention to the scandal, which will not go away. The WASPI women are there, and they are growing in number. She is right that, while the Tory leadership candidates continue to spaff cash up the wall with spending promises on tax cuts for the most well off in society, for big corporations and for whatever else they decide when they wake up in the morning, it is damning that not one penny has been committed in the leadership hustings to the WASPI women.

Ultimately, it comes down to priorities, and it is clear that WASPI women are not a priority for this Government and will not be a priority for the new Prime Minister, either. The hardship, the injustice and the erosion of the contributory principle that underpins the welfare state are clearly not a priority for this Government, and it is to their shame that they continue to ignore this campaign in the face of overwhelming evidence that a real injustice is being done.

Inequality and Social Mobility

Justin Madders Excerpts

Wednesday 12th June 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I refer the hon. Member for Glasgow East (David Linden) to the report on access to the professions by the all-party parliamentary group on social mobility, which talks about politics and the scourge of unpaid internships.

As chair of the APPG, I was pleased when, on taking office, the Prime Minister talked about tackling the burning injustices. She seemed to sum up many of the frustrations and factors that led to the Brexit vote. Ironically, the fact that the Government have been tied up with that is part of the explanation for the stagnation on social mobility right now.

When the board of the Social Mobility Commission took the unprecedented step of resigning wholesale 18 months ago, it was not a decision taken hastily or lightly; it was an act of desperation, following months of frustration at the Government’s failure to engage meaningfully on the issue. We have a new chair now, Dame Martina Milburn, who attended the all-party group last month, when we asked for her view on what she considered to be the top three asks of the Government. She said that they were: extending the eligibility of the 30 hours’ free childcare to those working eight hours a week; introducing a student premium for those aged 16 to 19; and making the Government a living wage employer. A recent study by Pearson found that there had been a 60% drop in funding for 16 to 19-year-olds in the past few years—how on earth is that investing in young people? As for the Government being a living wage employer, as a result of what she said I have been asking written questions to Departments and it seems that most do not even hold the data on who receives it already, which hardly suggests great enthusiasm for the idea.

I was encouraged by similarities between some of the recommendations the all-party group made in its recent report on the regional attainment gap and those put forward by the commission, such as looking at the way Ofsted operates; thinking differently about how the pupil premium can be used; and the importance of children’s centres in getting a good early start in life. The question we both have is: are the Government listening? What happens if the commission’s recommendations are not acted on? How much longer will things be left to stagnate? For how much longer will the most likely experience in the job market for our young people be casual work, low pay and chronic insecurity?

The commission’s report provides us with a wholesale national analysis of the issues, which demands cross-government action. Yes, its focus is on education—addressing inequalities in access to early years provision; primary and secondary schools; and technical, further and higher education—but it goes far wider and includes access to work, tax, welfare, housing, transport and health, to name but a few. There is plenty to build on, but we need a focused, consistent approach across many Departments, one that transcends the day-to-day whirl of politics. That is where I hope the commission can really add value.

Taking just two of the headlines from the latest state of the nation report, we can see the scale of the challenge we face. The first is that social mobility in this country is virtually stagnant and has barely moved in the past five years. The second is that a staggering half a million more children are in poverty now than there were seven years ago. Those two facts alone tell us we need to do so much more, and it is even more damning that this is coming off the years of consecutive economic growth. Could there be a clearer example of how growth is not evenly spread?

I believe there is much merit in the Select Committee’s recommendation that a Minister be given specific responsibility for leading cross-government work on social mobility, with a dedicated unit to tackle social injustice. Indeed, I am pleased that my own party has pledged to create a Minister for social justice, who would also work cross-departmentally to help drive the social justice agenda across all parts of the Government, so that whom someone was born to and where they were born are no longer the biggest influences on their prospects. The analysis that the commission’s powers need to be expanded and become much more proactive is one I support; the limited role it has at the moment is evident from the previous chair’s frustrations and resignation. There does need to be much greater accountability and transparency about what the Government do in this area. It seems incredible that no automatic impact assessment is carried out on every piece of legislation. Perhaps if it were, we would not have much legislation coming forward.

I wholeheartedly agree that social justice should be central for any Labour Government, but I also believe that social mobility can play a part in levelling the playing field as we work towards creating a society where everyone has the same opportunities in life, regardless of their background. We have a long way to go, and as long as three quarters of the senior judges, more than half the top 100 news journalists and more than two thirds of British Oscar winners are privately educated, we will not have a fairer society and the kids from the council estates will still get the message that those jobs are not for them. So “aspiration” should not be a dirty word, but “inequality” and “injustice” should be. The evidence shows that countries that have greater social mobility tend to have less inequality, thus demonstrating the two go together. It is a scandal that in 2019 where someone is born and whom they are born to are still the biggest influences on their prospects. If we are ever going to move forward as a nation, everyone should be given the same opportunity to achieve their potential.

Invisible Disabilities and Accessibility Challenges

Justin Madders Excerpts

Wednesday 5th June 2019 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I congratulate my hon. Friend the Member for East Lothian (Martin Whitfield) on securing this debate. It is an important issue. It is a shame that the Chamber is so empty again because every Member of this place will have constituents who have hidden disabilities. I also congratulate my hon. Friend the Member for Newport West (Ruth Jones) on her speech. She clearly has some relevant experience that she is bringing to this place.

I am pleased to be able to take part in the debate because I believe that the issue of hidden disabilities can have an immense impact on individuals’ lives. It is something we do not speak about enough in the Chamber. As some hon. Members may know from my contribution in a Westminster Hall debate earlier this year, my wife has an invisible condition—fibromyalgia—so I am well aware of how some of these conditions can be very hard to deal with. She can look perfectly okay on the outside, but she is really suffering on the inside. Fatigue can wipe out fibromyalgia sufferers for days at a time, and the pain experienced can vary from aching muscles and painful joints to extreme tenderness all over. There are cognitive challenges too, such as brain fog, insomnia and disturbed sleep. In fact, there are so many symptoms, it is not possible to list them all here. Just as with many of the conditions we have heard about today, the outside world cannot see that there is any issue at all.

My wife, like many others, has tried to find ways to manage her condition. She has to pace herself, plan ahead and make adjustments to keep her symptoms under control. That is the only way in which she can manage her condition. She does not always succeed—it still catches her out. It is incredibly frustrating and tough to know how best to help and improve things, which is why I, along with others, have called for greater awareness of the condition by the medical profession and employers so that fibromyalgia sufferers are not disadvantaged by more than their symptoms, and so that they have support out there in the world.

In common with many people with invisible, long-term and fluctuating conditions, what matters most to people with fibromyalgia is how their condition is treated and supported. Much more research is needed on the condition and how it begins. We need consistent treatment pathways and better training for medical professionals to recognise those symptoms and recommend treatment. There is a huge need for services to be put in place to support and enable people with invisible conditions to live their lives as fully as possible.

I should like to discuss the barriers that people with invisible conditions face in their everyday life, beginning with getting back to work. I recently spoke in a Westminster Hall debate on another invisible condition, arthritis. An estimated 16,000 people in my constituency live with back pain. Another 4,000 and 8,000 people respectively are estimated to live with hip and knee conditions. Those are just some of the estimated 17.8 million people who live with arthritis or related conditions across the country. About half of them live with pain every day. That is a staggering number of people coping in their everyday lives, while people around them are blissfully unaware of their suffering. Just because we cannot see their pain does not mean that it should be ignored or written off as just how it is.

As with fibromyalgia, the problems that people with arthritic conditions face are exacerbated by the fact that they can fluctuate in severity, leaving them unsure how well they will be able to cope from day to day. That can make it difficult to hold down a regular job, but that should not be used as cover for discrimination. Many people with arthritis want to work and can do so if the right support is in place. Such help is available through the Access to Work scheme, but that is not working as well as it should, as various arthritis charities have said. They are also calling for the Government to commission research on the meaning of “reasonable adjustments”, and for support to be put in place to help people who challenge employers who do not act on Access to Work recommendations. Employers, as we know, are obliged to make reasonable adjustments but, if someone is in work and not a member of a trade union, who will argue the case for them?

There was a Westminster Hall debate yesterday on trade union access to workplaces My hon. Friend the Member for Warrington South (Faisal Rashid) has introduced a private Member’s Bill on the issue, as some well-known employers have actively sought to prevent trade unions from accessing workplaces by banning visits or by manipulating shift patterns to prevent opportunities for engagement. It is important that we do as much as we can to ensure that people have access to trade unions at work so that they can be adequately represented. Rights are only as good as our ability to enforce them.

To return to employment opportunities for people with invisible conditions, on a practical level, how easy is it for them to raise issues associated with their condition at a job interview, or when they begin work? It is a difficult conversation to have because, although discrimination is unlawful, that does not mean that it does not happen or that it is not a difficult subject to raise at the beginning of an employment relationship. If an employer refuses to make adjustments, how realistic is it to expect people to take them to tribunal, especially without support, and what reassurance can we give them that if they raise those issues and put their head above the parapet it will not rebound negatively on them?

I want to say a few words about the challenges of employment for people with autism. In a recent survey of over 2,000 autistic adults, just over half of respondents said that they had told their current or most recent employer that they were autistic, but just under a third had not. For people with autism, busy workplaces can be socially overwhelming, or they can overload them with too much information from noisy conversation, bright lights or other sensory stimuli. Many of these barriers can be overcome quickly, easily and cheaply through increased understand. We recently had some training here in Parliament on autism awareness—I certainly found it valuable. We can also make simple adaptations to the environment. Sadly, at the moment the National Autistic Society reports that about a third of its respondents said that support or adjustments made by their current or most recent employer, both in relation to sensory needs and to autism generally, were poor or very poor. We need to ensure that Access to Work is working effectively for autistic people and that specialist support is available throughout the country.

What about those with invisible conditions who are not well enough to work? We have talked about this issue many times, but my constituents’ experience of work capability assessments has not been good. Many decisions are overturned at tribunal and it seems to me that the system does not learn from its mistakes. A constituent of mine with two conditions I have already mentioned, arthritis and fibromyalgia, was assessed five times in eight years. At each assessment she was found fit to work. On each occasion she appealed and on each occasion she won the appeal. How can the process be wrong so many times? How can that waste of public money on five separate occasions be justified when the final decision has been the same every time? What does that say about the Government’s approach to people with long-term conditions? How many times does someone actually have to prove that they are not fit to work before it is accepted?

[Debbie Abrahams]

My hon. Friend is making a very powerful speech, particularly in relation to the work capability assessment. Is he aware that sanctions are more likely for people with invisible health conditions? This is a real issue that needs to be addressed.

[Justin Madders]

I thank my hon. Friend for her intervention. From my experience in the constituency, those with mental health issues in particular sometimes have real difficulty engaging in the process. That does, very unfairly, lead to sanctions.

Some constituents have raised concerns about the speed at which assessments are carried out and the fact that assessors do not listen to the answers given. Others have had their request for a home assessment refused, despite medical evidence being provided that they are necessary. I am thinking, in particular, of one of my constituents who has an invisible condition but was refused a home assessment. That condition was agoraphobia. Surely the need for a home assessment in those circumstances was obvious? People who enter the system deserve compassion, respect and support. They should not be made to feel that they are on trial because they are ill. I am afraid that that is the experience of so many people who come to see me about the assessments.

I want to say a few words on accessible toilets. I recently met a constituent who has a stoma, which, as I am sure Members are aware, is where the bowel is diverted through the abdomen so that bodily waste can be collected in a stoma bag. Stoma surgery is often used to treat a number of invisible illnesses, including cancer, Crohn’s disease, colitis and diverticulitis. People of all ages are affected and have additional needs—for example, when using a toilet. But, as their condition is hidden, they often, as we have heard, face prejudice. There are no accurate figures on the number of people with stomas in the UK, but estimates range from 120,000 to 150,000. A lifestyle survey by Colostomy UK in 2016 of over 1,300 people with stomas found that 19% had experienced discrimination, either in the workplace, in public or elsewhere, and 30% of respondents had been challenged or criticised for using an accessible toilet. A constituent I met last week is actively campaigning in my local area, raising awareness of the needs of people with stomas. This has included encouraging local businesses and organisations to change the signage, so that accessible toilets are able to reflect the hidden nature of conditions. We have accessible toilets here in Parliament, which have signs to remind us that not every disability is visible. I see no reason every disabled toilet could not have accessible toilet signage along the same lines.

People with a stoma have additional needs when using the toilet, which can make even a simple day trip to the shops or the supermarket extremely stressful. A few easy-to-implement changes to accessible toilets would make a huge difference to people living with a stoma: ensuring that every toilet has a hook on the door to hang clothing, handbags and luggage while changing stoma bags; a shelf to spread out the items they need; a mirror to allow users to see their stoma while changing; and a disposal bin in every cubicle to avoid embarrassment for men and women having to dispose of their stoma bag in public view. I do not see why those changes cannot be implemented across the whole country.

Many people have conditions or disabilities that affect their everyday lives and they are disadvantaged by barriers in society and in the workplace. It is incumbent on all of us to do what we can to remove barriers that restrict opportunities and choices for people with disabilities, invisible or otherwise. We need to ensure that no one is held back because of these conditions, not just because we know that fairer societies are better for us all, but because everyone deserves to be treated with dignity and respect.

Arthritis and Employment

Justin Madders Excerpts

Tuesday 21st May 2019 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate the hon. Member for Ayr, Carrick and Cumnock (Bill Grant) on securing the debate, which is of great interest to me, both in a professional capacity as a former employment lawyer, and in a personal capacity as the husband of a fibromyalgia sufferer. I have seen at first hand the impact that invisible conditions such as arthritis and related conditions can have on an individual’s daily life. We do not talk about it enough, because the hardest symptoms for any of us to understand are those that we cannot see. Symptoms such as fatigue and pain, which are common in arthritis and related conditions, can be invisible to the outside world but no less debilitating for that.

[Ruth Jones (Newport West) (Lab)]

As a former physiotherapist, I share my hon. Friend’s interest in this important subject. Anna Lockey, a young woman in my constituency, has psoriatic arthritis. She is planning on going back to work following her maternity leave in September. She is one of many who want to work and contribute to the wider economy. Does my hon. Friend agree that utilising the Access to Work scheme and the aids and adaptations, which are often inexpensive, can be really helpful?

[Justin Madders]

I thank my hon. Friend for her intervention, and welcome her to this place. She will clearly have a great deal of professional expertise to bring to bear. I will talk a little about some of the barriers that people with such conditions face in getting back to work. It is an important point, and central to the debate.

In my constituency, it is estimated that more than 16,000 people live with back pain, and that more than 4,000 and 8,000 people live with osteoarthritis of the hip and knee respectively. Versus Arthritis tells us that 17.8 million people live with arthritis or a related condition across the country, about half of whom live with pain every day. That is a staggering number of people coping with that in their everyday lives. Just because we cannot see their pain, it should not be ignored or written off as part of the ageing process. That can negatively affect the support that they receive.

The problem is exacerbated by the fact that many arthritic conditions can fluctuate in severity, leaving people unsure how well they will be able to cope from day to day. That can make it difficult to hold down a regular job, but equally it should not be used as cover for discrimination. Many people with arthritis want to work if the right support is in place. As has been touched on, that help is available through the Access to Work scheme. However, there are concerns that the scheme is not working as well as it should.

Not enough people who would benefit from the scheme are aware of it. We know that 60% of people surveyed by Versus Arthritis had never heard of the Access to Work scheme or were unaware of what kind of help it could provide, and nearly 70% had never accessed support through the scheme. Clearly, there is a lot more to be done to promote it. In a debate on disabled people and economic growth last year, my hon. Friend the Member for Battersea (Marsha De Cordova) made the point that the scheme is probably one of our best kept secrets. When we hear the figures about the lack of awareness, it is hard to disagree.

With the Government’s own figures showing that Access to Work was approved for only 25,000 people in 2016-17, it is clear just how much room we have to make up. The scheme can provide invaluable practical and financial support to meet the needs of disabled people, but only if it is actually accessed. If the Government are serious about meeting their aim of getting 1 million more disabled people into work by 2027, the scheme must be better publicised and actually work for its users.

A quarter of those who have applied for support from the scheme did not receive all the support that was asked for or that was recommended by their assessor. A tenth of respondents reported that they did not receive any support at all after applying to the scheme. Has the Minister looked at those alarming figures, and has there been any kind of research on why that is the case?

As we know, the major arthritis charities are calling for the Government to commission research on the meaning of “reasonable adjustments”, and for support to be put in place to help people who challenge employers who do not act on Access to Work recommendations. Employers are obliged to make reasonable adjustments, but if someone is in work and not in a trade union, who will help to argue for them? If someone is applying for a job, just how easy is it to introduce that issue at a job interview? If an employer still refuses to make adjustments, just how realistic is it to expect people to take their employer to tribunal, especially without support, and what comfort do they have that putting their head above the parapet will not rebound on them?

Do not forget that the coalition Government introduced employment tribunal fees, putting another hurdle in the way of those who seek justice. I make that point because having rights is one thing, but being able to enforce them is another, whether through support in the workplace or through access to the tribunal system. Too little protection is given to workplace rights in this country. If we are to change the hire and fire culture, those with disabilities need extra support, and we need to understand the real barriers that they face not only to accessing support but to enforcing their rights. Without doing that, we will not do them the service that they deserve.

Ten Years of the Work Capability Assessment

Justin Madders Excerpts

Wednesday 24th April 2019 Westminster Hall

[Laura Pidcock (North West Durham) (Lab)]

I beg to move,

That this House has considered 10 years of the work capability assessment in relation to employment and support allowance and universal credit.

This feels like such an inadequate environment to describe the work capability assessment and its brutal consequences. I wish that every single person affected by the system could be here with us in the Chamber and look in the eyes of those who defend the system. I hope that when they have heard what I am about to describe, Conservative Members—there are not many of them—will feel shame, and that in this debate we can do justice to the experiences of those subject to the work capability assessment.

The work capability assessment for the employment and support allowance and universal credit should be a simple concept: people who have a physical or mental health problem or a disability that means that they cannot work or have a limited ability to work will receive a replacement income from the state. I will talk about the face-to-face application process and the assessment, which are draconian, elicit fear, deny justice and have, in some circumstances, ended up contributing to the end of life. As Frances Ryan wrote recently in The Guardian, suicide is becoming a feature of the system.

Everyone in the Chamber will know someone who is unable to work for whatever reason. Those with personal wealth are often able to avoid having to prove that they are worthy of income replacement. Because they have that personal wealth, they are safe from having to share every single detail of a condition or illness, and do not have to wonder if they will be believed. People without savings, on the other hand, are only one step away—one accident or one conversation with the doctor—from being subject to that system.

Let me set out some of the elements that we believe are wrong with the system; this is based on evidence gathered from my constituents when they come to surgeries, on submissions by professionals, and on the vast number of submissions I have received from people currently applying for this social security payment. In both the application form and the face-to-face assessment, the descriptors that enable a score to be given to assess a person’s ability to carry out tasks are essentially a functionality test. They cannot capture the fluctuating nature of physical and mental unwellness or disability and how that could prevent or limit the ability to work. People often describe feeling punished for telling the truth. Yes, perhaps they could go out unescorted on a journey somewhere, but the test is not interested in, for example, the panic attack before leaving the house, or the emotional recovery afterwards. Perhaps venturing to the supermarket will have been their only trip out that month, but making that journey could lose them their entitlement.

In reality, one day someone may be in the depths of despair, and the pain from their condition may be unbearable; the next day, they may be able to have a laugh over a cup of tea with a loved one. The question is, should they lie about that laughter or feel shame about it because they might get points deducted? Does that laughter render meaningless the pain felt the day before? Fundamentally, does that have any bearing on someone’s ability to work? I think not. The test ignores the complex reality of living with long-term or fluctuating conditions.

Many people have told us that they do not feel accurately represented by the reports written about them. Advisers have openly claimed that they see copy-and-paste jobs. A constituent read that they were apparently happy and confident during the assessment, when in fact they were crying and shaking. No wonder as many as 74% of ESA decisions are overturned at appeal, according to Citizens Advice. That, of course, is one of the consequences of using a private company to assess the medical conditions of people who need support. Not having people qualified in the condition or illness with which assessors are presented is also a huge issue.

It is claimed that Maximus incentivises health professionals through the number of reports they complete. Logic says that that could directly lead to a proliferation of inaccuracies. Ultimately, profit should not be made from ill health; it leads to corner cutting and misplaced priorities. To defend the marketisation of the process is obscene.

I am not sure whether the Government or Conservative Members realise just how truly terrified some people are of the brown envelope from the Department for Work and Pensions. They know that they will be forced through a long and extremely difficult process. They will have to attend an assessment, and the decision notice they receive about the outcome of their work capability assessments is often inaccurate and misleading, leading to a long and stressful appeal process of up to 18 months; that is 18 months without the entitlement that those people deserve and need.

The process exacerbates poor health, and the Government make things worse. When people, because of their physical or mental health condition, ask that their assessment be carried out at their home, the answer given is almost always no. My caseworkers and agencies have sent substantial evidence to private contractors to show that my constituents would have severe difficulty attending the assessment centre. The stock response is, “If the claimant can get to their GP or to the hospital, they can attend the assessment centre.” How cold-hearted is that?

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Does my hon. Friend not agree that there is a difference between someone going to a location quite close to their home, which they are familiar with, and an assessment centre that may be many miles away and difficult to get to unless they have their own transport?

[Laura Pidcock]

That is right, and in a place like North West Durham, where we have an inadequate and expensive transport system, it is unjustifiable not to have assessments carried out at home if someone is feeling unwell and faces stress in having to go to that assessment.

If the person does manage to get to the assessment centre, the assessor uses that as evidence of their ability to travel, walk, sit comfortably and cope with social interactions. One person got in touch with me to say that they had to sit in the assessment centre waiting room in soaking wet clothes due to their incontinence issues. Is this a system anyone can really defend? Is anyone really comfortable with a private provider forcing people to attend assessments in pain and with worry, to be degraded by the DWP?

If a person is found fit for work when they are not, that can have a huge impact on their mental and financial wellbeing. It can have a direct impact on their entitlement to housing benefit and council tax benefit, plunging them into destitution, and resulting in increasing debt, risk of eviction and untold stress. People wrongly found fit for work are then expected to do job searches and training, and are even sanctioned. It came as no surprise to any of us Opposition Members that in 2016 the UN concluded that the Government had committed “grave and systematic violations” of the rights of people with disabilities. That report should have seen an end to the Government, but they limp on.

For people who do go on to win at appeal, reassessment is too frequent. No sooner have they won than they are being reassessed—even people with terminal illnesses have to endure that. Imagine the retriggering of mental health difficulties when people have to describe, in assessment after assessment, historical sexual abuse to which they were subject.

Let me mention some of the contributions from people who got in touch. One person said:

“The process feels like psychological rape, expressly designed to make you feel that you are the absolute property of the state, that you are not a human being and that your continued survival is basically an affront to society.”

Another said:

“When you are disabled, you are defined by the able-bodied by what you cannot do, rather than what you can do. No disabled person wants to be a burden on society. They want to be an active contributor but are denied this by society”,

and that

“The whole thing should be abolished as it’s a cruel and pointless exercise in ideology.”

It is about ideology, isn’t it? This system, with its complexities, its high thresholds and the way in which employment and support allowance and higher rates of universal credit have been denied to so many, cannot be seen outside the context of almost 10 years of austerity and budget cuts, which have literally taken money from people who are disabled, unwell or dying.

What are the worst consequences, the ultimate results, of this brutality? Jodey Whiting, who lived in Thornaby, not too far from my constituency, took her life 15 days after her benefits were stopped for missing a work capability assessment when seriously ill. The independent case examiner found multiple failings on the part of the DWP, including it simply not following its safeguarding procedures. Her mum, Joy Dove, is campaigning for an independent inquiry into benefit death and I am sure everyone on this side would say “All power to her” in that campaign.

Stephen Smith, aged 64, who had chronic obstructive pulmonary disease, osteoarthritis and an enlarged prostate that left him in chronic pain, failed a work capability assessment in 2017, which meant that his employment and support allowance payments were stopped. Anybody who saw Stephen’s emaciated body on social media will have been horrified. Stephen died last Monday. Jeff Hayward, who won his appeal seven months after his death, had a debilitating skin condition and spent his last 18 months fighting a “fit for work” decision. Michael O’Sullivan, aged 60, from north London had long-term mental health problems, and the coroner found that the benefit process was a key trigger for his death.

These are the real-life tragedies of a broken system. I do not think I can bear to hear the Minister say, yet again and as his predecessor did, that we should come to him with our individual problems with the system. They are not individual problems; they are systemic failings, and a consequence of privatising social security and making £37 billion in welfare cuts.

Let us be honest: this is institutionalised bullying and harassment of sick and disabled people. I have no doubt that administrative ineptitude is part of it, but when the issue is on this scale, there can be no other conclusion. By deliberately stripping people of their rights, in order to disrupt the welfare state and the very concept of legal entitlement, the Government have trodden all over the expectation of citizens that they will be looked after in their hour of need. And what for? To replace the state with private and family provision, to boost the coffers of private insurers, and to replace legal rights with charity, subject to moral judgments of deservingness.

It does not have to be like this. How can our social security system be about security and not about punishment? The Labour party has rightly committed to scrap the work capability assessment. That will be a big step forward and will no doubt be welcomed by disability rights groups and welfare rights agencies alike. In the meantime, why do the Government not start rectifying injustices in the system by taking the vast amount of evidence from medical professionals, including GPs, consultants and nurses, into account? Testimony should be fundamentally believed. The culture permeating the DWP is one of disbelief that looks cynically on those who request help. Stressful, face-to-face assessments should be used only if there is an absolute necessity, such as a lack of evidence on which to decide on entitlement. Assessments should be a last resort.

The system should be designed by people who are experts through experience. Experts who understand how conditions affect the ability to work should be employed. Any social security system that replaces the work capability assessment as it exists today should not be a functionality test with arbitrary rules that do not account for the fluctuating nature of a person’s condition, disability or illness. There needs to be a revision of the assessment criteria, so that they are linked much more closely to the real world of work, or the work that the person was doing. Knowing whether someone can move a carton of milk with one hand cannot allow us to understand a person’s comfort or ability to work in a specific environment. Any process should include an assessment of the additional support that person would need to ease them back into the workplace. Recording of assessments should be standard, unless a person asks not to be recorded. The Government are dragging their heels on that recommendation.

Private outsourcing of the assessments has to be scrapped. The market has failed all aspects of the social security system, placing company profit before the needs of the people interacting with the system. When will the Government understand that private enterprise and illness are incompatible, and inevitably lead to the injustices that we see today?

When people are dealing with the stresses of not being in full health and of needing support for their disability or mental health condition, they should fundamentally not be subject to further stress, degradation and even abuse by the state. The system should be designed on the presumption that people are telling the truth when they come to see the assessors. They should not be forced though a humiliating and exhausting process that often results in them winning appeals at tribunal, with the help of the excellent but underfunded advice agencies and many of our caseworkers. For many people, their last fight on this earth is not with their illness, but with the state, and that fact alone should lead us to scrap this dreadful system.

--- Later in debate ---

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing the debate and on the excellent way in which she introduced it, covering a range of issues. I felt compelled to speak because many of my experiences with constituents are similar to those we have heard. I have received the clear message—I hope the Minister receives it as well—that improvements to the assessments process are very much needed.

Some constituents who have attended assessments have raised concerns with me about the fact that assessors carry out the assessments very quickly and do not listen to their answers. We have touched on the refusal to conduct home assessments, sometimes despite medical evidence that they are necessary. On one occasion, a constituent suffering from agoraphobia was refused a home assessment. Surely the need for one in that situation was obvious.

I note from an overview of the work capability assessment mandatory reconsideration and appeals process that, from October 2013 to June 2018, 33% of assessments were closed by the claimant. That is 1.3 million people—not a trifling number. The Government line may be that all those people pulled out of the process because they were fit to work, but I doubt it is as simple as that. My worry is that there are people within that 1.3 million who would be entitled to ESA but did not go through with the process because they were too anxious or worried about the assessment or because they simply could not cope with the idea of having to discuss their intimate medical issues with a stranger. I would like to know from the Minister whether any research has been done into those 1.3 million people, the reasons why they withdrew and whether people in genuine need have been failed.

The study goes on to say that 15% of all applicants go on to register a mandatory reconsideration, which is 370,000 people within that five-year period. Some 85% of those reconsiderations stick with the original decision, and 21% of those people then go on to submit a formal appeal. There is sometimes a misconception that the mandatory consideration is the appeal stage, and that there are no further opportunities to challenge. However, those who carry on to launch an appeal have a success rate, according to these figures, of 63%, although we heard from my hon. Friend that, according to the CAB, it is more like 74% or 75%.

[Danielle Rowley (Midlothian) (Lab)]

My office team has experience of constituents challenging assessments and getting nowhere until they come to our office and we get a reconsideration straightaway, which gives the impression that they are not taken seriously. It is the exact same evidence, but they are not listened to until we get involved. Does my hon. Friend agree that that is a sad state of affairs?

[Justin Madders]

I find that disappointing, but not surprising. The fact that the appeals success rate is so high suggests that not only the initial assessment is flawed, but the mandatory reconsideration stage is not a proper appraisal of the full merits. Perhaps that takes place only when Members of Parliament get involved. A cynical view would be that the mandatory reconsideration stage is just a hurdle put in front of people to make life a little more difficult for them. I am shocked that recent figures for the appeal stage show that the DWP does not even bother to turn up to about 80% of the appeal hearings.

I want to pay tribute to my fantastic local CAB, which represents people at the appeal hearings. However, it cannot help everyone, and it is the people who are not able to get representation I worry about.

Given my constituents’ experiences, there is no doubt that the original assessments are flawed. Many decisions are overturned at tribunal, and it seems the system does not learn from its mistakes. For example, one constituent was assessed five times in eight years of being on ESA. At each assessment she was found fit for work. On each occasion she appealed and on each occasion she won that appeal. In the process she paid £150 to get medical evidence to support her appeals. How can the assessment process get it wrong five times? How can the absolute waste of public money that five separate appeals must have cost be justified when the final decision was the same every time? What does it say about the Government’s approach to people with long-term conditions? How many times does someone have to prove that they are ill and unable to work?

Last-minute cancellations have also been an issue. I have heard from constituents whose assessments have been cancelled on the day the assessment is due to take place, and in some cases the constituents were actually at the assessment centre when their appointment was cancelled. That seems to be particularly the case when the assessment is scheduled for a time after half past three. The most recent example involved a lady who was struggling when entering the assessment centre. Obviously, it is a very stressful experience. She was shaking, crying and not engaging, and then she was told that her assessment would be delayed by another 45 minutes, at which point she became so distressed that she had to leave the centre and cancel the appointment. That is a callous and uncaring way to treat someone. When one of my constituents rang up two days before her assessment to give notice that she would not be well enough to attend, she was told that it was too late for the assessment to be rescheduled and she would be recorded as a no show. It is double standards of the highest order.

In conclusion, people with long-term conditions deserve compassion, respect and support. They should not be made to feel they are on trial because they are ill.

Disability Assessment Services

Justin Madders Excerpts

Wednesday 13th March 2019 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

We have all seen that the appeal rates are unusually high. What, in the hon. Lady’s experience, is the time it takes to get to an appeal? In my part of the world, it is 40-plus weeks, which for some of these people is a ridiculous amount of time to wait.

[Gillian Keegan]

Yes, it can be quite a long time. We have heard that people can wait for three or four months. That uncertainty means that it is very difficult for a person to plan, as they do not know how much support they will receive.

--- Later in debate ---

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Chichester (Gillian Keegan) on securing the debate. Like many other Members, I am sure, I felt compelled to speak because of the number of constituents who have come to me with harrowing stories of their experiences, and with a clear message that improvements to disability assessment services are very much needed.

In my constituency, we have seen a variety of issues recently, including cases of incorrect information being recorded; there have been statements saying that physical assessments were carried out when they were not, and that a constituent could go out alone when the assessor was actually told in the interview that they could not. In one case, the information was so incorrect that it was assumed that the assessment report had been mixed up with that for another case. My constituent Amy was recorded as walking despite being wheelchair-bound, which must surely have been apparent at the assessment. When a complaint was raised, the DWP noted that that could be a “misleading statement”, but worryingly, Capita, which has consistently failed to meet its target for an acceptable standard of assessment, responded that there was no evidence that the statement made by the assessor had been misreported. I find that unbelievable.

Last-minute cancellations are a problem. We have heard from constituents whose assessments were cancelled on the day that they were due to take place. Even worse, in some cases, the constituents were actually at the assessment centre when their appointment was cancelled. Yet perversely, if a constituent is unable to attend their assessment, they are penalised. When one of my constituents rang up two days before her assessment to give notice that she would not be well enough to attend, she was told that it was too late for the assessment to be rescheduled, and that she would be recorded as a no-show. Those are double standards of the highest order.

Constituents who have attended assessments have raised with me the concern that their assessor carried out the assessment very quickly, and did not listen to their answers. Others were concerned that the assessment was not carried out safely. For example, a constituent with a slipped disk was asked to complete the physical part of the assessment without anything to support her, despite informing the assessor that she would need to hold on to something. Why are my constituents being put at risk in that way?

Another major concern is the refusal to conduct home assessments, despite medical evidence that they are necessary. That is a concern shared by organisations such as Macmillan Cancer Support, which has found that home visits can often be difficult to obtain, and that the option of a home visit is not widely communicated.

[Jamie Stone]

The hon. Gentleman makes an excellent point about home visits. Does he agree that the problem is compounded by the fact that some people have to travel very large distances for those assessments? That is an issue facing some of my constituents. It would be so much easier if they could be done at home.

[Justin Madders]

Absolutely. The hon. Gentleman’s constituency must be rather more rural than mine, but for anyone who has a disability, travelling distances of any order is challenge. Home assessments need to be much more widely promoted.

[Andrea Jenkyns]

I was recently contacted by a constituent who won her battle against cancer. That should have been a moment of celebration, but she is worried about her impending disability assessment. Does the hon. Gentleman agree that the parity of esteem between mental and physical health should be reflected in disability assessments?

[Justin Madders]

I agree; I will address that shortly. I will not take any more interventions, because a number of hon. Members wish to speak.

My constituents feel let down by the complaints process. They do not feel that it is fit for purpose. Many of their legitimate complaints are just passed back to the DWP, so those undertaking the assessments face little accountability. Does the Minister monitor the number of complaints against particular providers, and if so, can she tell us who the worst offenders are and what will be done about them?

As the hon. Member for Morley and Outwood (Andrea Jenkyns) mentioned, another common issue is that assessments do not take into account the effect of mental health conditions, or acknowledge that many physical conditions can fluctuate daily. Certainly, the assessments that I have seen have focused on what people say about their good days—or moments—as the baseline for a typical day. There appears to be an almost institutional incapability of appreciating that just because people with fluctuating conditions have times when they are doing better, that does not mean that that is their condition all the time. There are occasions when they do need real assistance.

I am sorry to say that some private providers show no prospect of making any real improvements to disability assessment services, which are inaccurate, ineffective and unfair, and need to be brought back in house. It is a damning indictment of the system’s failings that the DWP does not even bother to turn up to about 80% of the appeal hearings against the assessments.

The message that I bring from my constituents to those who undertake the assessments—perhaps the Minister can consider this—is that they should be carried out with the idea that we should treat others as we wish to be treated. Show respect, show empathy and show compassion. That is what our constituents deserve.

Oral Answers to Questions

Justin Madders Excerpts

Monday 11th February 2019 Commons Chamber

[Guy Opperman]

This year, we continue to spend more than £120 billion on benefits for pensioners, including £97 billion on the state pension, which goes up. Mixed-aged couples already claiming pension credit or housing benefit for pensioners will continue to receive those benefits and will not be affected while they remain entitled to either.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

On 2 November, my constituent won his ESA appeal—the DWP did not even bother to attend—but three months on, it is still arguing about whether he should get the full back pay. At what point did the Department become above the law?

[Sarah Newton]

Something has clearly gone amiss, and I should be happy to meet the hon. Gentleman and see what we can do to sort it out as soon as possible.

Recognition of Fibromyalgia as a Disability

Justin Madders Excerpts

Tuesday 15th January 2019 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for Chesterfield (Toby Perkins) on securing this debate.

I have an interest to declare: my wife is a fibromyalgia sufferer. I want to talk primarily about her experience of the condition. Perhaps the hardest symptoms to understand are the ones that we cannot see. The fatigue literally wipes her out for days at a time. There is also the pain: to the outside world she looks okay, but underneath she is suffering. In her own words, she said:

“I do experience various aches and pains. These can differ from aching muscles to painful joints, especially knees and ankles; tenderness all over my skin like I’m covered in a thousand small but painful bruises; and sometimes it feels as if every bone in my body is burning.”

Of course, I just want to give her a hug, but doing that makes her wince. It is so frustrating knowing that I cannot help.

My wife considers the cognitive challenges—the “brain fog”, as she calls it—the most irritating symptom. She also said:

“Sleeping does not come easily. It is very difficult to get to sleep and when I fall asleep, I wake up within minutes.”

There is not enough time to go through all the symptoms, but we have heard about many of them today. The biggest thing I would like the Government to take away from today is the experience we had in getting diagnosis and treatment. My wife said:

“When I was first diagnosed with fibromyalgia, three years ago, I was actually quite relieved…I knew things were getting worse. Despite numerous tests, there seemed to be nothing wrong with me.

I recall multiple visits to my doctors where I would tell them how exhausted I felt and they told me that I was probably depressed—that being a working mum with three kids was tiring and difficult.”

Hearing that just made her despair.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

On that point, my constituent James wrote to me saying that a lot of medical professionals look at him as if the condition does not exist, and that the worst part is that nobody understands it and it is not recognised. He got zero support. He suffers from physical depression. The antidepressants do not work and he cannot get the support or the treatment that he needs from the NHS.

[Justin Madders]

That is exactly the experience that we have had and so many other hon. Members’ constituents have had. Speaking about how she felt before she got her diagnosis, my wife said:

“Sometimes, just having a bath would wear me out. I spent most weekends in bed or on the sofa…I just had no energy to move. I couldn’t do stuff with my children or even cook dinner. And I couldn’t understand why I felt like this. I knew other people got tired, but they still managed to live their lives. And so I thought I must just be lazy or completely lacking in any self-control…So when I was finally given my diagnosis, I was pleased that it wasn’t just me making it all up. It was not all in my head or character flaws leading to laziness and ill-discipline. I was and am actually ill. This is something beyond my control. And although it might be unfortunate, at least I now knew what it was.”

I was relieved as well. I knew that something was wrong, but I did not know what. On reflection, I think we both realised that she probably had the condition for years and all the time it was getting worse. We knew something was wrong, but we felt that nobody was listening.

[Tonia Antoniazzi (Gower) (Lab)]

The most shocking thing about fibromyalgia is that it mostly affects women—seven women to one man. My constituent came to visit me on Sunday at a surgery and she has just emailed me now to say that after that five-minute meeting it has taken her until today to recover. Does my hon. Friend agree that we cannot continue to ignore this?

[Justin Madders]

That is certainly something I recognise. My wife tries to live by pacing herself. That is the only way she can manage her condition. She knows it is a lot worse in winter than in summer and it will flare up if she over-exerts herself. She can save energy for specific occasions, for example a conference, work or an evening out, but no matter how much she plans, it can catch her out. She will be too exhausted or in too much pain to meet a deadline or go to a meeting. She ends up giving her apologies and feels that she is unreliable. She has practically given up trying to plan social things in advance. It is incredibly frustrating.

Unless more research can be done into this condition and more awareness raised among the medical profession and employers, fibromyalgia suffers will continue to be disadvantaged by more than just their symptoms. For us, this is not just about how fibromyalgia is classified under the Equality Act 2010, but, in common with many recurring and fluctuating conditions, about how people with these conditions are treated and supported. There needs to be much more research into the condition alongside consistent treatment pathways, with better training for medical professionals to recognise and then treat the symptoms.

Services should be in place to support fibromyalgia sufferers to enable them to live their lives as fully as possible. It has taken my wife two years, at her insistence, to be referred to a pain management clinic. A year on, she is still waiting to be seen. All the time she is suffering and her condition is deteriorating. I hate what this condition has done to my wife and our family. It is so frustrating not being able to help her make the pain go away, not being able to help her find a way for her to live her life as she should. It is so frustrating that there appears to be no hope on the horizon that things will get any better soon.

--- Later in debate ---

[The Minister for Disabled People, Health and Work (Sarah Newton)]

It is a pleasure to serve under your chairmanship today, Mr Bailey. I begin by paying tribute to Adrienne, who I believe is with us today in the Public Gallery. It is through her persistence and determination to use the mechanism of petitioning Parliament that we are here in Westminster Hall today. It is a really good example of how people all around our country can ensure that their voices are heard in this place, so I congratulate her on that.

I also pay tribute to the hon. Member for Chesterfield (Toby Perkins), because he picked up on that opportunity and worked with his constituent. I am very pleased to say, as my hon. Friend the Member for Southend West (Sir David Amess) and everybody else has done, that the hon. Member for Chesterfield is a champion. It is great that he has championed this cause, raised awareness of the issue and made sure that all of our public services are doing everything they can to help people with fibromyalgia, because we have heard today how absolutely debilitating the condition can be and how many people it affects.

Today has been a really good opportunity to build on the work that has been done with the petition and have this debate. I share the frustration that so many people have mentioned that we do not have time to address all the issues that have been raised and hear from the many people who have written to Members across the House because they want their individual voice to be heard.

Before this debate, I extended an invitation to the hon. Member for Chesterfield to bring his constituent into the Department. What we are discussing is a cross-Government issue; it affects the Equalities Office, which is the custodian of the Equality Act 2010. There has been much discussion about what more we can do about health services and research, so I will ensure that, along with me as Minister responsible for the main disability benefits, we have Ministers from the relevant Departments at a roundtable and summit, so that we can properly work with the information that has been provided today and with the great organisations that are undertaking research and standing up for those with fibromyalgia.

I pay tribute to my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns), and to the wonderful husbands who have spoken about wives who are suffering. It is brave of Members of Parliament to stand up and talk so personally about situations that have such a detrimental impact on them. It is difficult for MPs to admit to any sort of weakness; we live in fear of our constituents thinking less of us for expressing that we have a condition or disability that might be perceived as a weakness. However, it is vital that people with disabilities and health conditions are in this place, because they have an important role to play in society. I am absolutely determined to ensure that we have a society in which we focus on what people can do rather than on what they cannot, and in which they are supported to reach their full potential.

I will now draw on some of the points I have been asked to raise. On the support in the health service, we have heard that it is clearly too intermittent. I know that there are good examples; colleagues in the Department of Health and Social Care have told me that there are bespoke services for people with fibromyalgia, but we have heard from colleagues today that it is too much of a postcode lottery and that the services are not consistent. That stems from the fact, which has been recognised today, that it is a difficult condition to diagnose. Because the way in which fibromyalgia manifests is unique to each person, general practitioners want to ensure that they rule out the possibility of other conditions. We have heard so powerfully today that no two people are the same, so GPs, in the absence of a diagnostic tool, need to explore many different avenues before they can get to a diagnosis of fibromyalgia.

[Justin Madders]

It is not just about the postcode lottery. Many GPs do not really know about the condition, and we need to get more understanding out there. My wife saw a number of doctors before she got a diagnosis. Also, her experience of gaining specialist help to access the pain clinic, which hopefully she will do later this year, was that she had to be referred to a rheumatologist to get a diagnosis and then was referred back to the GP, to refer her on to the clinic. That is a pretty inefficient way of doing things.

[Sarah Newton]

The hon. Gentleman makes a very important point, but I understand that to help GPs the Royal College of General Practitioners and Arthritis Research UK have developed an e-learning course on musculoskeletal care, which includes fibromyalgia and is free to all healthcare professionals. It aims to improve core skills in diagnosing and managing any musculoskeletal condition. A medical guide on diagnosis and treatment has also been developed by the Fibromyalgia Association UK, and a mandatory core component of all GPs’ training is an applied knowledge test. This AKT is a summative assessment of the knowledge base that underpins independent general practice in the UK, within the context of the NHS. The content guide for the Royal College of General Practitioners, which serves to prepare trainees for the test, includes specific reference to a required knowledge of fibromyalgia. Clearly, therefore, there is now a consistent attempt to ensure that GPs going through training and coming into general practice have a much better understanding of how to diagnose and treat fibromyalgia than we have seen hitherto.

State Pension: Women born in the 1950s

Justin Madders Excerpts

Thursday 22nd November 2018 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bone. I congratulate the hon. Member for North Ayrshire and Arran (Patricia Gibson) on securing this extremely important debate. The message from today could not be clearer: this issue is not going to go away. We will not allow it to be kicked into the long grass and the tenacity of the campaigners will certainly not let it be forgotten. It is not a couple of pounds that have been taken away, and this is not a request for a handout. It is about livelihoods being destroyed, homes being lost, dignity being taken away, and the social contract between the state and the citizen being broken.

Events this week have demonstrated clearly that the Government do not command a majority, even on financial matters. Given the support we have heard right across the Chamber, the parliamentary arithmetic would clearly favour a fair and just settlement for the WASPI campaigners. I say to the Minister that time is running out for the Government to bring forward a proposal on their own terms.

I understand that this is not a simple issue to resolve and that there will be financial consequences for the Government, but when we are talking about a profound injustice on this scale, there is an imperative to act. As we have seen with the vast sums of money being expended on a Brexit deal that even members of the Cabinet do not support, or the additional expenditure in Northern Ireland to pay for a confidence and supply agreement that has delivered neither of those things, the Government have shown that they can find the money when there is a political imperative.

I simply do not accept that nothing can be done. There is not just a political imperative, but a moral imperative. In this country, we do not tell people who are ill that only they should be responsible for funding their treatment. We do not tell parents that they alone should fund the education of their children. When a mistake of this magnitude has been made by a Government, whether it happened yesterday or 23 years ago, the only morally acceptable outcome is for us all to accept responsibility and find a solution. We will hear concerns about the sums involved, but what we are really trying to do is find some justice.

We have all heard harrowing stories from our constituencies of women who have worked all their lives and now, through a change of circumstance, have found themselves in a dire situation, with some having to sell their homes. Some have worked hard and progressed through their careers only to face the indignity of being told to take up an apprenticeship when they are in their early 60s. Women who were in senior positions have been forced to attend DWP courses where they are given advice on how to dress for a job interview or how to write a CV.

I fear that the most serious cases might not even be those we have heard about today, or the ones that end up in our inboxes. It is not only about the ones we hear about; it is about those who are unable to fight for their rights. One of my constituents told me:

“I am struggling daily with trying to work three days a week as I am now disabled. I suffer from anxiety and depression and every day is really hard for me. I cannot impress on you strongly enough how hard life is for me.”

Another said:

“It’s now a heat or eat situation for many. Some women are suicidal and some have had to sell their homes. Can you imagine how it feels for a woman in her 60s who has always worked, but is now frightened and in ill health, to be made to sign on? This isn’t equality it’s injustice.”

I could not agree more.

It is worth reminding ourselves that the state pension system is founded on a contributory principle; it is not a state benefit in which no prior commitment is involved. Yet that group of women, who have paid and fulfilled their end of the deal, face being short-changed retrospectively.

There is great irony in the fact that if a defined benefit pension fund became insolvent and left people possibly facing such a position in retirement, scheme members would be compensated by the Pension Protection Fund. That scheme is funded by a levy applied to all members of the scheme, so that those who have lost out through no fault of their own are not left destitute as a result.

The principle is simple: women born in the 1950s were not responsible for the failure to communicate the planned changes, so they should not be left alone to face an unfair and disproportionate burden. However difficult this might feel politically for the Government at the moment, they must now act to deliver justice.

Defined-benefit Pension Schemes

Justin Madders Excerpts

Tuesday 10th July 2018 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Crewe and Nantwich (Laura Smith) on securing the debate and the excellent way in which she introduced it. Once again, she has proved to be a formidable advocate for her constituents. I do not intend to cover the same ground but will instead raise an issue facing one of my constituents that also affects thousands of members of defined-benefit pension schemes who are not entitled to any protection against rises in the cost of living.

My constituent, Mr Thorpe, is one of a significant number of members of the Foster Wheeler defined-benefit pension plan. Members of the scheme have received no increase in their pensions since 2002. This issue is not restricted to a single scheme—those with defined-benefit pensions accrued before 1997 are not entitled to any statutory inflation protection. While many enjoy discretionary increases, about 100,000 pre-1997 pensions receive no increase, because before then any increases were based on the rules of the scheme only. That remains the position for pensions earned before that date.

If the rules provide for increases, whether fixed rate or index-linked, they must continue to be paid. However, in the same way, if a scheme does not make such provision, none will be paid. In a number of schemes, increases are paid at the discretion of either the trustees or the employer, which leaves the living standards of thousands of people in our country not protected by law but subject to the discretion of others.

To illustrate the impact, Mr Thorpe provided me with a simple calculation based on the case of a fellow Foster Wheeler pensioner. We will say that this chap is called John. He retired in 2002 at the age of 60 and his pension at the age of retirement was £10,000 per annum. In 2017, when he was aged 75, the purchasing power of that pension was down to £5,600 per annum. By 2027, when he is aged 85, the purchasing power of John’s pension is likely to be less than £3,000 per annum—a 70% fall in the value of the pension over the course of his retirement. That has an impact on only a relatively small number of pensioners who paid into their pensions during a specific period of time but, as I hope I have illustrated, it has a massive impact on those individuals.

We face a situation not unlike that of the Women Against State Pension Inequality Campaign, in which people find themselves at a disadvantage simply because they were born in a particular timeframe or had worked prior to the introduction of particular legislation. When I wrote to the Minister, his response stated that he did not think that it would be right

“to consider retrospective changes to the rules on indexation”.

Given that the analysis by the House of Commons Library found that in 2015 FTSE 100 companies paid five times as much in dividends as they did in contributions to defined-benefit pension schemes, will he look again at what seems to be a very unfair situation? Employers should have a duty to do right by their employees and pensioners before they consider rewarding shareholders.

My constituent, Mr Thorpe, states that research indicates that the cost of inflation protecting the Foster Wheeler pre-1997 pensioners would be around £1 million per 1% awarded. That is a modest and sustainable cost for a fund with a value of almost £3 billion. Thousands of pre-1997 pensioners were extremely disappointed to see that the White Paper does not propose any solutions to that issue. As my hon. Friend the Member for Crewe and Nantwich said, pensions are deferred pay. Nobody would argue that it is sustainable or equitable for someone to have no pay rises related to the cost of living for a 25-year period or possibly longer. What does that say to the next generation of pensioners about the necessity of saving for their retirement? It is hardly an encouragement to them to save for their old age. In conclusion, I ask the Minister to look again at this issue.