People with Disabilities: Cost of Living

Justin Tomlinson Excerpts

Tuesday 16th May 2023 Westminster Hall

[Marion Fellows]

I could not agree with the hon. Lady more. This is a scandal, and it is a huge waste of public money with the number and cost of appeals and tribunals.

[Justin Tomlinson (North Swindon) (Con)]

To follow on from that point, why would the Scottish Government seek to make it harder for people to access support through the PIP system for when it is fully devolved to the Scottish Government?

[Marion Fellows]

I wish that the hon. Member would take that back. In Scotland, we treat people with dignity, fairness and respect. We help them to fill in their adult disability payment applications, and we make it much easier for them—[Interruption.] The hon. Member is shaking his head, but he is wrong. We make it easier for people with long-term illnesses from which they will not recover. They do not have to go through continuous reassessments.

--- Later in debate ---

[Justin Tomlinson (North Swindon) (Con)]

Thank you, Dr Huq—a double thank you for your late substitution this morning, for which we are all very grateful. It is a pleasure to follow the hon. Member for Motherwell and Wishaw (Marion Fellows), who clearly demonstrated a real passion for this important subject. I think her constituents would recognise that she is a real champion for those who need a voice in this area, and I pay genuine tribute to her.

I also pay tribute to the Minister, who I know will respond in full. He has immersed himself in the details of his role and has always shown himself willing to engage with stakeholders. I think we would all agree that there is a wealth of knowledge and expertise in local and national organisations, and the Minister is passionate to utilise that wherever possible. That has come through very clearly in his time as a Minister.

I pay tribute to local and national organisations up and down the country that provide people with advice and support in accessing the often complex and daunting layers of support that are potentially available. For example Tim Saint, of the Swindon Carers Centre, does a huge amount of work in our community to help people access support. During my time as a Minister, I was surprised to see how many people miss out on the various forms of support that we have all voted to give them, often because they are faced with a complex and daunting system.

We have made progress. Under PIP, including the legacy benefits of DLA, and attendance allowance, we are now spending £12.5 billion more in real terms on help for those with disabilities or long-term health conditions. Under the old legacy system of DLA, only 16% of claimants would access the highest rate of support. A few years ago, that figure had reached 33%, and for some health conditions, in particular mental health conditions, people are now six times more likely to access the higher rates of benefits. So we are very much heading in the right direction, and there are further opportunities to turbo-speed improvements with the forthcoming White Paper.

There are two key lessons the Government can focus on: speed and specialisation. First, on speed, there are lessons that can be learned from the welcome changes to the special rules for terminal illness. We were able to apply a policy change that was co-designed by stakeholders, their policy teams and end users—people with real-life experience. Using the same principles, we can widen the severe conditions criteria in the PIP system, removing up to 300,000 unnecessary assessments or reassessments each year.

The principle behind that is that we would look at specific conditions. We could then be fairly confident about the trajectory of that condition and set in place a timetable of support. For those people whose condition has perhaps changed more quickly than expected, there would still always be the option to have a light-touch assessment to speed up their access to the increased rate of support.

There is a sort of principle around this, which already exists with universal credit and the industrial injuries disablement benefit. An independent panel could look at these conditions, and one example would be motor neurone disease—I cannot understand what the point would be of putting somebody with MND through an assessment. Where we can be fairly confident of the deterioration of health conditions, we could put in place an automatic right to support, with the backstop that, if somebody’s condition, sadly, deteriorates more quickly, a light-touch assessment could then move them to the higher level of support much more quickly. Removing 300,000 people a year would mean we have more resources available to speed up the process for those who would go through the more standard, traditional route.

During covid, we made sure we kept the gateway open for new entrants, and it is a tribute to staff up and down the country that disability benefits continued. We used video and telephone assessment, a further benefit of which is that it allows for greater specialisation in terms of the assessors. Rather than relying on a fixed number of staff in each geographical location, we can assign someone with a particular health condition via telephone or video to other locations in the country. That also helps with the point about making sure that the assessments are right first time, so that people do not have to go through an appeals process further down the line.

I know that these broad themes are being considered as part of the White Paper, but they are a real win-win and they are probably things that people could rally around, regardless of which political background they are from. I certainly know from my time working with our very knowledgeable stakeholders and policymakers that there would be huge support for them.

A broader point is that not everything is black and white. As much as I admire the passion and drive of the speech by the hon. Member for Motherwell and Wishaw, there was a presumption that everything the Government do is terrible and that everything the Scottish Government do is good. I say that because I have a brother who is a proud Labour party supporter, another brother who is an SNP supporter, a sister who is a sort of Lib Dem/ Conservative and a cousin who is a Green, so we cover all the bases, and I was very much brought in the belief that things are not black and white.

To their credit, the Scottish Government identified that we could and should have made changes to the special rules for terminal illness and to PIP, which is the main disability benefit. The Scottish Government have had challenges; they had hoped to complete both those tasks many years ago, but that has proved a lot more complex, particularly when we start to unravel the complicated machinery behind those benefits.

In my former life, I attended inter-ministerial meetings with Scottish officials and Scottish Ministers, who were always a great pleasure to work with, and I absolutely admired their end goal. However, they also had that presumption that the system was completely broken and had to be completely changed. Therefore, they sometimes would not listen to stakeholders and policy experts in disability and health charities who wanted changes but not necessarily the changes the Scottish Government had settled on.

For example, there is a principle that the Scottish Government do not like assessors. I understand that, given a lot of the media coverage of the earlier years of PIP, in particular. However, there is a reason why, under DLA, only 16% of claimants got the highest rate of support, compared with 33% under PIP. Many of the people who navigate the system are the least well equipped to do so. Therefore, we are relying on a system where, in effect, their evidence—self-supplied—is the only basis for them to get DLA. However, assessors tease out additional things and fill in the gaps, which is why we have gone from 16% to 33%.

[David Linden]

The hon. Gentleman is giving an incredibly thoughtful speech, but I have a fundamental objection to assessments. However, even if I was to follow the former Minister down the assessment route, we would find ourselves in a ridiculous situation where the people carrying out the assessments have no professional qualifications to enable them to adjudicate on the condition. For example, in one recent constituency case, someone was actually asked, “Does your son still have autism?”. That is the level of expertise we are dealing with and that, I am afraid, shows that the system is broken.

[Justin Tomlinson]

That shows the slight misunderstanding here—and I say that in a good spirit. All the health practitioners who carry out assessments have at least two years’ experience and come from health professional backgrounds. However, the point where the hon. Gentleman is right is that they are not necessarily specialists in certain areas. If someone goes to a GP, the fact that they are the initial gatekeeper to the NHS does not mean they are an expert in everything—they refer people on to specialists. There would generally be five or six assessors in each location, so we cannot expect the collective knowledge of those assessors to cover every single health issue. Through the introduction of telephone and video assessments, however, we can refer people, and that is what I am pushing for. The point is: the role of the assessors was not broken, but it needed improving. That is what both the UK and Scottish Governments were looking to do.

I am urging the Scottish Government to be cautious about relying too much on the claimant, because not all claimants are in a position to argue their case and understand the conditions. It is not even just a case of that; it is also about people being unaware of additional health conditions. I made a point earlier about those with mental health conditions now being six times more likely to get access to the highest rate of PIP. Many people do not realise that their mental wellbeing is being impacted by their physical health condition. They would enter the PIP system thinking, “My physical health condition is impacting on me. I’ll fill in all the bits on that and answer the questions.” However, the assessor’s questions on how that impacts mental wellbeing then begin to identify additional challenges that the claimant was either unaware of or had got used to and took for granted. That then gives them the additional points that allow them to enter the higher rate.

It is same around the special rules for terminal illness. We extended that from six months to 12 months, working with hospices, the health and disability charities and GPs. The Scottish Government, with very good intentions, tried to create a system where it was automatic. They then realised that not everyone can be dealt with automatically, because we are all terminally ill in the sense that nobody lives forever. Conditions then have to be put in, but that inadvertently creates a more complex system. It would have just been easier to say, as Northern Ireland did, “Actually, on this occasion, the UK Government—having listened to the stakeholders and health and disability charities—might be on to something. In this case, we ought to do the same.”

[Dr Rupa Huq (in the Chair)]

Order. I remind the former Minister that he has spoken for 10 and a half minutes, and I did want speeches to be kept within nine minutes. If he wishes to give us a concluding sentence, I will allow it, but we do have other Back Benchers.

[Justin Tomlinson]

Understood, Dr Huq. In conclusion, I urge the Minister to keep a laser-eyed focus on disability employment, ensuring that we provide support for not just the individuals seeking work but employers. The majority of people with disabilities develop them during working age, and we need to ensure that employers—particularly small and medium-sized employers—are equipped to support people with changing health conditions.

[Dr Rupa Huq (in the Chair)]

I call Wendy Chamberlain. Keep it within seven minutes, if you can, and then Marion Fellows gets time to wind up.