Work Capability Assessments

Justin Tomlinson Excerpts

Wednesday 13th December 2017 Westminster Hall

[Justin Tomlinson (North Swindon) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh, and to follow the hon. Member for Wolverhampton South West (Eleanor Smith)—I have many happy childhood memories of visiting Wolverhampton. I pay tribute to the hon. Member for Glasgow East (David Linden), who demonstrated his passion for this very important subject. He is clearly representing his constituents in a very strong way.

The importance of this debate is shown by how well-attended it is, particularly with other things going on in the main Chamber. That is because there is an opportunity to influence what the Government are doing. Following the Green Paper, they have demonstrated that they are willing to listen, engage, consult and make changes. We have a new Minister—the Minister for Disabled People, Health and Work—who is widely respected and who is determined to be accessible, to listen and learn, and to improve the situation.

The work capability assessment is not a new thing—it was introduced in 2008. There have been five independent reviews, more than 100 recommendations to improve it have been made and more than 100 recommendations have been enacted. Almost weekly, the Government are considering ways to make further changes. Each and every hon. Member, through our experiences of casework and of sitting through work capability assessments, can feed into the process and suggest changes.

I am a former disabilities Minister. The work capability assessment was not in my remit, but I made representations on behalf of many of the groups that have already been mentioned—Parkinson’s UK, Multiple Sclerosis Therapy Groups, Mind and others—and found that the policy makers and experts are willing to listen and change the scripts, including on how questions are asked and how things are identified, particularly when people have fluctuating health conditions and when health conditions are less common, such that an assessor does not regularly come across them. We have come along in leaps and bounds.

It is clear to me that the examples given today by Members—I presume other examples will be given by the Members who follow me—show that the system is still not right. That is why it is so important to have a Minister who is keen to engage.

I will make a couple of broad points, and then I have some asks. Many people ask why we have assessments. I wondered that myself when I arrived as a Minister. I thought, “I could save the Government a fortune. We could do away with assessments. They are expensive. The Treasury—George Osborne—is very keen for us to find savings, and this is a bit of an easy win.” The reality—we saw this as we transferred from disability living allowance to PIP—is that the assessments, ignoring the cases where they have gone wrong, are there to help build the case.

Under DLA it was purely a paper form. In that written document, most of us here would have articulated the challenges we face in our everyday lives pretty well, and we almost certainly would have got the benefits to which we were entitled, but many people navigating the system were not able to do that for a variety of reasons. Only 16% of claimants under DLA accessed the highest rate of benefit. Under PIP, that figure is 26%. That is because in some parts, the assessment has helped build people’s cases, particularly those with deteriorating health conditions at the beginning of that journey. The assessors are able to say, “At the moment, your day-to-day life is not too affected, but it is likely to be before too long.” The system triggers the ability to reassess and, in the majority of cases, that benefit and support is increased. The principle of the assessments is good. That is why the then Labour Government introduced them in 2008. The assessments are not Conservative ideology, but are done to assist people. Where the assessments go wrong, there is a problem, and that is why it is absolutely right to have this debate to engage and help shape the future.

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

When the hon. Gentleman was a Minister, we had a very constructive relationship on the points we are debating. Does he accept that one problem with the assessments is that they assess people on their best days and make an assumption on what their best days look like, not their worst days? If there was a change in assumption, that might help.

[Justin Tomlinson]

I thank the hon. Gentleman for his intervention, and in particular for his very kind words. It was always a pleasure working with him. He is certainly one of my favourite Members on the Opposition Benches in the way he engages and shapes things, although my comment might not help him in Scotland. The theory is that, if the assessments are done correctly, they are a judgment over a period of time. They should not be a judgment just of the isolated moment someone is in the assessment. It is meant to make a judgment on the typical challenges someone has to overcome over a period of time. That is an important point to make, and the system should be recognising it.

The first concern people raise is why the appeal rates are so high. They say, “If the rates are so high, there must be a fundamental problem.” Actually, if we drill down, the vast majority of successful appeals are where additional evidence is provided late, whether orally or in writing. The solution is that we must do more to access people’s health records in advance. Before data protection people come down on me like a tonne of bricks, that can be voluntary, but it should be a given.

[Stephen Lloyd (Eastbourne) (LD)]

One solution could be for consultants’ records rather than doctors’ to be considered right at the beginning. I appreciate the challenges around GPs, but a consultant could say that Mr A or Mrs B was not capable of doing x, y and z because of their impairment. If that was acceptable, it would make life a lot easier, and it would deal with some of the anxiety some GPs feel about being intimidated into agreeing such and such a position.

[Justin Tomlinson]

That is an important intervention. Those records are already taken into consideration, but other things that I am about to come on to strengthen that point.

On the high appeal rates, it would help if we could get permission to automatically access those health records. Far too many people are going through the system and only realise they need those pieces of supporting evidence after they have failed and received the helpful communication saying, “This is why you have not accessed that particular level of benefits.” That is an inefficient way of doing it, and we should be more proactive. We have started to see that, but it should be emphasised.

I agree with my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) about recording sessions. That should be a given and would help deal with questions asked in appeals. There should be more videos setting out what is going on. That would help deal with the anxiety and allow people to see what is coming forward. One of the successes under the PIP assessments is that the assessors go out of their way to encourage a claimant to bring a colleague, friend or family member to support them. The same principle should apply.

Many MPs understandably get work capability assessments and PIP assessments mixed up because they are so similar. It would be a good idea if we aligned them more closely, and I know the Government are looking at that.

Getting the work capability assessment right is only part of the journey. The idea is that that assessment identifies what support people need and how we can help them move forward. Mind has said that the Government should have an emphasis on removing the real-world barriers to work. That is why I said at the beginning of my remarks that the debate is an opportunity. We have 3 million new jobs created and 776,000 vacancies available, which is a record high.

[Rosie Cooper (West Lancashire) (Lab)]

Earlier in the hon. Gentleman’s speech, he said that things should not go wrong. My problem is that one of my constituents lost more than £300 after she had to cancel an appointment because of urgent ill health. For four months, she has not been able to resolve that. It is okay saying things should not go wrong, but when they do, the system is not there. What action can be taken to ensure that the work capability system is responsive to applicants and considers their concerns, especially when it goes wrong?

[Justin Tomlinson]

None of us wants it go wrong ever—no one would argue for that. Four months is not acceptable. The hon. Lady has raised the issue. I suspect that our helpful Minister will diligently make a note and that the hon. Lady will be contacted shortly about that case.

The majority of those out of work have been away from work for a very long time. They are desperate for an opportunity. As part of the assessment, assessors look at what someone can do. More than 50% of those people will have a health condition, which will make it harder to find work than it is for the majority of people. The system needs to identify the support needed in terms of financial benefits as well as embracing the principle of offering the tailored support that is at the core of universal credit.

We have to look at matching things with what they can do. For some people, it may be an hour a week. Some people with fluctuating health conditions may be fine for months and then have to dip in and out of work. We have to ensure that support is provided to the individual person, co-ordinated by their named job coach, looking at issues to do with their health, confidence and skills. The Government have to get smarter at talking to employers, particularly the small and medium-sized employers that create 45% of jobs in this country. The big organisations and big businesses are pretty good. They have human resources departments and are good at dealing with this issue on the whole, but small and medium-sized businesses without HR or personnel departments need more support. [Interruption.] I am being reminded to be quick; I will be.

I encourage the Government not to lose sight of the need to create those opportunities for people. I am encouraged that the Government are making improvements, and each and every one of us can help to shape those.

--- Later in debate ---

[Marsha De Cordova (Battersea) (Lab)]

I congratulate the hon. Member for Glasgow East (David Linden) on securing this important debate. He made some very valuable points, particularly about inaccurate decision making leading to a very high success rate at tribunal. I also share his hope that finally the Government will actually take some action following the inquiry that the Work and Pensions Committee are currently carrying out, which has had an overwhelming response.

I also thank all other hon. Members for their powerful contributions, particularly those sharing real-life examples of people’s experiences with work capability assessments. The Government have overseen the unnecessary suffering of many of the most vulnerable in society with these assessments, which have proven to be unfair and unfit for purpose. Despite the many Chamber debates, Westminster Hall debates and Select Committee hearings, we have seen little or negligible action.

[Justin Tomlinson]

Will the hon. Lady give way?

[Marsha De Cordova]

No, I will not be taking any interventions.

There is now a broad consensus that the work capability assessment needs to be reformed. Disabled people, disabled people’s organisations, and charities have been clear that it is a blunt instrument that often gets it wrong and frequently fails to link people to the appropriate support. Labour has made it clear that we will scrap both the work capability assessment and the personal independence payment assessments, and replace them with a holistic, supportive and enabling approach. Until then, we need to mitigate the most adverse effects of the work capability assessment.

We are all familiar with disabled people who wish to be in work and to have a career, but are left without the high-quality, impairment-specific employment support that they need to make that a reality. We are also familiar with disabled people who have no realistic prospect of work, but have been put in the wrong group—the work-related activity group of employment and support allowance. Some have even been found fit for work and put on jobseeker’s allowance or universal credit equivalents—forced on to lower rates of social security support for long periods.

There has always been tension regarding ESA and its predecessors on whether the main objective is to help those with the potential to move into work to find suitable employment, or just to save money by getting claimants on to the lowest rates of social security support wherever possible. Both objectives run side by side in uneasy co-existence, but the latter aim seems to have dominated recently, as poor-quality assessments and decisions have increased. A culture seems to have developed in which a good number of the Department’s contracted-out, private assessors seem to have a perception that the Government want to make a minimum award. There also seem to be parallel views among many DWP decision makers, even at the mandatory reconsideration stage, that that is indeed what their managers possibly require.

Some of the cases are truly appalling. A lady with muscular dystrophy was deemed ineligible for ESA after a WCA. The content of the questions in that WCA resulted in the entire assessment missing several key points about how her condition affects her, such as the dexterity in her hands, and her ability to lift her arms above her head or to use buttons. There was also no consideration of the pain or fatigue she experiences on a daily basis.

On Monday, the Work and Pensions Committee heard about a visually impaired woman with a medical certificate to prove her condition—the certificate of visual impairment—being asked by her assessor to read it out, and then asked to read other documents as a test. Disability organisations have raised the issue of a lack of knowledge and understanding among assessors, particularly of equality and the social model of disability. There is a lack of understanding about health conditions, and often inappropriate or unreasonable questions and treatment of those with disabilities. Assessment locations are often far away or inaccessible to people. Alternative forms and formats vary across providers. Questions that form the criteria of the WCA are often unsuitable to extract the information required to help the assessor to understand certain conditions. For some people, face-to-face assessments can also be unhelpful and counterproductive. Patients suffering from mental health conditions downplay their conditions, particularly if they have had negative experiences or fear being sectioned. Others have had their condition exacerbated by the process.

The Government have argued that as only a modest proportion of decisions are appealed, the rest must be right. That assumption is clearly unsound. More than 90% of mandatory reconsiderations are upheld, with some decisions made within 48 hours. That is not reconsideration; it is rubber-stamping. When we look at the results of those who go on to appeal, the success rate is drastically different: 60% for ESA appeals between 2013 and 2016. Clearly, many people simply accept decisions that are likely to be incorrect, and suffer as a result. We can all agree, across the parties, that the system is broken and unfit for purpose.

What assessment have the Government made of how many incorrect decisions go un-appealed? Faulty assessments and decisions not only penalise claimants, but swamp advice surgeries and services, and appeal tribunals. There are beginning to be concerns among the judiciary. Britain’s most senior tribunal judge has said that most of the benefits cases that reach court are based on bad decisions, where the Government have had no case at all.

Any work capability assessment should be rooted in the real world. In each case, the genuine employment prospects of that individual in the light of their disability or health condition, age, work history, qualifications, and so on, should be the subject of a skilled assessment. It should also not be a one-off event. Certainly, pointless reassessments of people whose disability or health condition is not going to improve should be avoided, but for those who have genuine future employment prospects, there should be positive engagement.

Since April 2017, new claimants in the employment and support allowance work-related activity group have been paid the same rate as JSA—a reduction of £29 per week. That measure removes any recognition of the barriers to work and the additional costs of undertaking work-related activity faced by many disabled people. The change also creates a cliff-edge of about £59 between the ESA support group and the WRAG.

This approach, linked to high-quality, impairment-specific, real-world assessments, points the way towards a much better system. I hope the Government listen to the judiciary, disabled people and disabled people’s organisations, and commit to scrapping the work capability assessment. They should also listen to Labour. We will replace the WCA with a personalised, holistic process. We will end the privatisation of assessments and the pointless stress of reassessments for people with severe long-term conditions. We will change the culture of the social security system, from one that demonises people not in work to one that is supportive and enabling. The Government must listen and ensure that there is “nothing about us without us”.