ESA and Personal Independence Payments

Justin Tomlinson Excerpts

Wednesday 30th November 2016 Westminster Hall

[Justin Tomlinson (North Swindon) (Con)]

It is a pleasure to serve under your chairmanship, which seems almost a daily occurrence this week, Ms Dorries, given the Bill Committee I am also serving on. I pay tribute to the hon. Member for Lanark and Hamilton East (Angela Crawley). This is an important debate and a topic that regularly comes up, particularly in this room, which shows the importance of Westminster Hall. We are fortunate that we have a Minister who is very engaged and proactive when it comes to listening—particularly when the system is not quite working as it is intended to—and when it comes to acting and working with experienced charities, policymakers and all sorts to bring us all together. What we all want, regardless of which side of the House we sit on, is a fair system that supports the most vulnerable in society. It is a pleasure to follow the hon. Member for Strangford (Jim Shannon), who, during my time as a Minister, was really proactive and constructive on this issue. I had many good meetings with him to discuss specific issues and lessons we could learn from Northern Ireland, and to share best practice.

Two issues have been raised: PIP and ESA. I gently remind Scottish National party Members that Scotland could take responsibility, certainly for PIP. During my time as a Minister, I had a good relationship with my counterpart in the Scottish Parliament. He was aware that Scotland could take on that responsibility as and when it was ready.

Some 1.8 million people have already gone through the PIP process, which is considerably better than the old DLA system, and that is widely accepted by the vast majority of charities who represent people who have been through the system. Under DLA, only 16% of claimants got the highest rate of the benefit. Under PIP, it is 23.5%. It is far better at identifying hidden impairments and fluctuating health conditions. For example—this has been highlighted in the two previous speeches—under DLA, only 22% of those who had a mental health condition accessed the daily living component, yet under PIP, 66% did. For the higher rate of mobility, it was 9% under DLA; it is 24% under PIP.

The new system is far better and more streamlined. The assessors are there to help people to fill in the forms. The fundamental problem with DLA was that it was, in effect, self-diagnosis. People would fill in a very long, complicated form. A lot of people did themselves an injustice by not highlighting all the issues they faced, often because they took them for granted. For example, they might think, “I can’t sleep at night. That’s just the way it is”, but they did not then highlight that in their forms. The forms were complicated, so people would not necessarily know which were the right bits to put down.

Even worse, 70% of claimants on DLA had an indefinite award. It is very attractive for MPs to say, “We don’t want anybody ever to go through an assessment”, but the reality was that, under DLA, 70% did not. That sounds great, yet one in three claimants’ condition changes so significantly within 12 months that they should be on a different benefit. The vast majority of people who go through the system have a deteriorating condition, so if their condition has changed, it has probably changed for the worse and it is highly likely that they would therefore go from the lower rate to the higher rate of benefit.

That was the single difference that contributed to why, under DLA, only 16% of claimants got the highest rate, and 23.5% get it under PIP. There were people who, for 10 or 20 years or more, were on a benefit below that which they were entitled to. They were unaware that they could have had an opportunity to go up. It is right, therefore, that we assess people to ensure that they are given the correct benefit.

Now, common sense kicks in. If someone is on the highest rate of benefit, they have a deteriorating condition. Unless there is some miracle cure, they are likely only to be reassessed at the end of the 10-year period, and it would probably be very light touch. In effect, someone would phone and ask, “Has there been a miracle cure?” The answer would probably be no, and they might ask, “Can you provide the GP’s evidence that there has not been a miracle cure? That’s fine. You will go through.” It is those who are on the cusp of going from the lower benefit to the higher benefit who will have another assessment. The system is programmed to say, “This person nearly meets the highest rate of benefit. I suspect they will need it in nine months’ time.” It will automatically trigger a reminder to people that there is a reassessment, so they are not left languishing. I urge hon. Members to be careful in trying to stop people having an opportunity for an assessment.

In cash terms, in 2010, DLA delivered £12.7 billion of benefit support. The combined DLA and PIP is now at £16.6 billion. When the scheme was first launched, the time until assessment was terrible. We had lots of debates here on that. I was not the Minister then, but I was warned when I first went into the role that we would have almost weekly debates. Some people were waiting up to a year for their assessment. That was unacceptable. For nearly 18 months now, it has been in a settled state, taking about seven weeks for an assessment and 13 weeks for the whole process, end to end, which is well below the initial target of about 16 weeks. Again, charities and those with a huge amount of experience accept that the system is working well. The forms have been streamlined. They are still longer than we might like, but it is always a balancing act because, if we do not capture all the information, people could miss out on the benefit they need. I repeat that the assessors are there to help the claimant. The Government set the amount of money and the points that are required, but the assessors are there to ensure that the form is completed.

I have sat through assessments, and I have seen two different extremes. I saw the assessment of a practising nurse, and the assessment was super-quick. They used lots of very long words of which I had no understanding, and they were able to breeze through. At the other extreme, I saw an individual for whom English was not his first language. He had a mental health condition and was socially isolated. If he had self-diagnosed under DLA, he would not have qualified, but the assessor spent one hour and 10 minutes teasing out and piecing together the jigsaw to make sure that all the challenges he faced in his everyday life were accurately reflected. He would have ended up getting a higher benefit than he would have received under DLA.

I urge those who criticise the assessments to go and view one, which can be arranged. They will have their eyes opened, because too many people claim knowledge based on a film that is there to make money, rather than based on the real world. Frankly, that is an insult to the huge amount of hard work that these trained professionals do to help some of the most vulnerable people. The facts are there to compare DLA with PIP.

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

Rather than commenting on the film, which is a dramatic portrayal, will the hon. Gentleman comment on the “Dispatches” programme? That was not fictional; it was an actual portrayal of the assessment process that people go through.

[Nadine Dorries (in the Chair)]

Mr Tomlinson, the same applies to you as applied to Mr Shannon.

[Justin Tomlinson]

I will not be long. I am glad that the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) intervened. I have a feeling that she will not let me intervene on her later, so I can link this in nicely. The “Dispatches” programme showed an isolated incident that was totally unacceptable. The individual was moved, and rightly so. That is why we have external inspectors. Remember that we are talking about 1.8 million people, and I urge her to take up my invitation to go and view an assessment. Hearsay is not the right way to hold Governments to account. This is so important that people in positions of responsibility need to invest some time in going to see what is actually happening.

[Debbie Abrahams]

That is patronising.

[Justin Tomlinson]

It is not patronising. This is an important subject.

There have been further improvements, including the removal of the 28-day rule for terminally ill people. That cross-party campaign has made a huge difference to those who are terminally ill, and it is a welcome measure. There is ongoing training, and I would like to see automatic recordings of all assessments, which would help the appeals process. That requires a change in the contract, which I understand is the intention.

It is also right that assessors now encourage people to bring somebody with them into the assessment, which is particularly helpful for people who are not necessarily articulate, for whom English is not their first language or who would not have the confidence to display all their challenges.

As the hon. Member for Lanark and Hamilton East said, the ESA and PIP assessments are not a million miles apart. I have too often heard of cases where someone has done one assessment one month and the other assessment the next month. In respect of the Green Paper, many organisations will lobby for some serious data sharing.

In conclusion, because I have focused on PIP, I will briefly address ESA. The Green Paper is a wonderful opportunity, as the charity Scope said, because disabled people need “expert, tailored employment support”. We need to focus on what individuals can do, rather than on what they cannot do. It is important to provide tailored support, to recognise that people have fluctuating health conditions and to utilise the best parts of the universal credit system to allow for flexibility and common sense, particularly in relation to voluntary work that builds confidence to get people back into work. We need to provide ongoing support, through a specific named coach, when people go into work for the first time. I will continue to pitch, as a matter of importance, the small employer pilot, which was so successful that it should be rolled out across the rest of the country as quickly as possible. We need to unleash the opportunity for disabled apprentices. Everyone agrees it is a great thing, and we have signed it off. We now need to see it making a real difference, particularly for those with a learning disability.

--- Later in debate ---

[Justin Tomlinson]

I am sure the hon. Lady will welcome the fact that an extra £3 billion is now being spent to support those on DLA and PIP compared with DLA alone in 2010, and the fact that 23.5% are on the highest rate compared with 16% on DLA. That is good news.

[Patricia Gibson]

The hon. Gentleman would do well to remember the fact that, according to OBR figures, although more money is being spent, that is down to the fact that demand has increased, so we should treat those figures with a little more caution.

The fact that the system is flawed is demonstrated by the fact that 65% of appeal decisions found in favour of the claimants, which means that that 65% initially had their application turned down, causing untold stress and anxiety about how they would cope in future. The hon. Gentleman spoke of work capability assessments as an opportunity. Well, I am afraid that my constituents in North Ayrshire and Arran did not see this process as an opportunity. Perhaps the constituents of North Swindon found it so, but certainly in my part of the world, that was not the case.

[Justin Tomlinson]

To be clear, I said PIP assessments were an opportunity; not the work capability assessments for ESA, which need to be reformed.

[Patricia Gibson]

Surrounded by such a wealth of opportunity, it is hard to keep up. Nothing in the system that my constituents experience is seen as an opportunity. It is seen as extremely negative, intimidating and humiliating. When the hon. Gentleman talked about the assessments, perhaps I misunderstood him, but if I have I certainly am not alone. One might think that these assessments always resulted in somebody’s entitlement or benefit being increased, but I can assure him that in my constituency that is almost never the case.

The hon. Gentleman, perhaps in the interests of trying to be helpful to the Chamber, talked about how we should go and see an assessment taking place. Perhaps this is just me—I have not done a survey or anything—but these assessments are not a spectator sport. We are talking about people’s lives. The people who go through them very often find them humiliating and damaging. If I were to go through one of those assessments, the last thing I would want is an audience. Perhaps I might want a member of my family, or a close friend, but I certainly would not want my MP, who would in effect be a stranger, although their name might be well known to me. I certainly would not want the occasion to become a spectator sport. We must be careful about MPs filling the galleries when people are having their lives exposed and deconstructed by strangers.

This is a debate about social justice. Employment and support allowance is a form of financial support for people with life-limiting conditions whose ability to live a fully satisfying life, something we would all hope for, is effectively removed. That should be remembered during debates such as this one—and during the assessments. The hon. Member for North Swindon has informed the Chamber that the assessors are there to help, and I am sure that they think so too, but claimants feel stressed. They are confronted by assessors who are, by definition, strangers and who have little or no knowledge of their condition. We have all heard stories: for those who have not heard them, Parkinson’s UK can keep them going all day. There are stories, for example, of people with Parkinson’s being asked by the work capability assessor, “How long are you likely to have Parkinson’s for?”

We know that the criteria for work capability assessment are flawed and that people whose conditions fluctuate are always at risk of what might, strangely—as it is all relative—be called a good day. Such things are not taken into account by the work capability assessment, and nor is the impact of pain and fatigue, or the degenerative nature of conditions such as Parkinson’s. As a result, too many employment and support allowance applicants are placed in the work-related activity group, instead of the much more appropriate support group, which recognises that the claimant is simply not well enough to work. I reassure the hon. Member for North Swindon that I know that the Government have reversed the need for repeated work capability assessments for the chronically ill—that is welcome, but it simply does not go far enough. It is a matter of great concern to all fair-minded people that from April 2017 people placed in the employment support work-related activity group will receive £30 a week less than someone in the same situation today. That makes the failure of the system more alarming.

Flawed criteria are a particular difficulty for people with conditions such as Parkinson’s in receipt of disability living allowance—I could mention a range of conditions but time forbids it—when they are being assessed for PIP. Under DLA, if a person could walk no more than 50 metres they would be eligible for support. For PIP that distance has arbitrarily—randomly, it seems—been reduced to 20 metres. That is such a short distance that it is not a useful or helpful estimate of a person’s mobility. Given the fluctuating nature of some conditions and the failure of the process to register such fluctuations, many people are losing their Motability vehicles, on which they rely heavily.

The hon. Member for North Swindon will be interested to know that recent investigations found that under DLA 82% of people with Parkinson’s received the full mobility payment, whereas under PIP that has dropped to 40%. That is a massive drop, and those people lose their vehicles within 28 days of an assessment decision being made against them. I do not see how anyone can come to this Chamber and say that that is acceptable. Those people are being isolated in their own homes and effectively punished for their illness. Their dependence on family members increases.

[Patricia Gibson]

Yes, Ms Dorries.

[Justin Tomlinson]

Will the hon. Lady give way?

[Patricia Gibson]

I am being pressed by the Chair to conclude my remarks.

Everyone welcomes the Green Paper. What we do not welcome is the headlong rush to cuts before there can be proper analysis, which could be used to correct the system. We need an evidence-based and compassionate approach. Frankly, I do not see that. We should all want the same thing: we should all want to support people with disabilities into work, and to support those who cannot work. We need to make sure that we do that properly, and I urge the Minister to reflect on that and on all the suggestions made today.