Disability Benefits: End-of-life Support
Justin Tomlinson Excerpts(2 years, 9 months ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Government are committed to supporting people nearing the end of their lives. The current Special Rules for Terminal Illness (SRTI) have been in place, unchanged since 1990 and the support they provide to people who find themselves in this terrible situation is crucial.
In response to requests for a review of the special rules the Department for Work and Pensions undertook a wide-ranging evaluation into how the benefits system in Great Britain supports those nearing the end of their lives. I can now provide honourable Members with an update on the outcome of the evaluation.
We have listened to the views of people nearing the end of their lives, their families and friends, the organisations supporting them and the healthcare professionals involved in their care, and I would like to thank all who contributed their views on this important subject.
I am today setting out the Department’s intention to replace the current 6 month rule with a 12 month, end of life approach. This will mirror the current definition of end of life used across the NHS and ensure that people receive vital support through the special rules six months earlier than they do now. Supporting people nearing the end of their lives is a priority for my Department and I am pleased to be taking this step forward. The evaluation report will be published alongside the upcoming health & disability green paper.
[HCWS166]
Draft Scotland Act 2016 (Social Security) (Consequential provision) (Miscellaneous amendment) regulations 2021
Justin Tomlinson Excerpts(2 years, 10 months ago)
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The Chair
Before we begin, I remind Members to observe social distancing, and to sit in the places that are clearly marked as available. I would also like to remind Members that Mr Speaker has stated that face coverings should be worn in Committee unless Members are exempt or are speaking. Hansard colleagues would be most grateful if Members could send their speaking notes to hansardnotes@parliament.uk.
The Minister for Disabled People, Health and Work (Justin Tomlinson)
I beg to move,
That the Committee has considered the draft Scotland Act 2016 (Social Security) (Consequential Provision) (Miscellaneous Amendment) Regulations 2021.
The regulations will make some necessary legislative changes to prevent overlapping entitlements of the soon to be introduced Scottish child disability payment with UK disability benefits. They will also permit the Department for Work and Pensions to accept the Scottish Government’s appointee arrangements for UK Government benefit purposes, thereby reducing the administrative burden for claimants and appointees in dealing with both Governments.
As many hon. Members will know, the UK Government are committed to making devolution work and to ensure the safe and secure transition of powers to the Scottish Government under the Scotland Act 2016. As a result of the devolution of social security powers to the Scottish Parliament under the Act, the DWP will need to update its legislation from time to time to reflect the introduction of the Scottish Government’s replacement benefits. Section 71 of the 2016 Act allows for the necessary legislative amendments, in this case as result of benefits introduced under the Social Security (Scotland) Act 2018.
The regulations are technical in nature. They will prevent payment of the Scottish child disability payment overlapping with UK disability benefits such as the disability living allowance for children, the personal independence payment and the armed forces independence payment. They also include some time-limited provisions for Northern Ireland. In addition, the regulations enable the DWP to accept appointees aged 18 or over if they have already been granted appointee status by the Scottish Government. That is a positive change for claimants and staff.
Hon. Members will be aware that the Social Security (Scotland) Act 2018 established the legislative framework for the Scottish Government to introduce new forms of assistance using the social security powers devolved under section 22 of the Scotland Act 2016. Specifically, section 31 of the 2018 Act allows the Scottish Government to introduce legislation to provide financial support through their disability assistance for people in Scotland with long-term additional health needs.
The Scottish Government have legislated for disability assistance for children and young people, which will be introduced from July 2021. They are calling the assistance child disability payment and I will refer to it as CDP from now on. I understand that CDP will have residency conditions attached, and primarily will only be paid to claimants who live in Scotland. However, as part of their offer, the Scottish Government will continue to pay CDP for a period of 13 weeks after a claimant has left Scotland and moved to another part of the UK. That will allow claimants to sort out new benefit arrangements should they wish to.
If the regulations are passed today, they will ensure that there are clear boundaries between entitlement to CDP and UK Government benefits to ensure that there is no overlapping provision. They will do that by making it clear that entitlement to a relevant UK Government benefit will not start until the day after payment of CDP has ended. That will reflect the Scottish CDP legislation, which also prevents overlap with UK Government benefits. That will not only protect the public purse by avoiding double payment but will also help to prevent the need for complicated overpayment calculations and recovery. Furthermore, it is also in the best interest of the claimant, who will have clearer expectations of which Government are responsible for paying their benefits at which point in their claim or award.
The statutory instrument also includes provision on behalf of the Ministry of Defence to ensure that the armed forces independence payment will similarly not overlap with CDP. Provisions have also been included to prevent overlapping entitlement when a claimant moves to Northern Ireland and is in receipt of the 13-week run-on payment from the Scottish Government. Finally, we also recognise that many DWP claimants will also be claimants of the Scottish Government’s devolved provisions. The instrument will make changes to UK Government legislation to allow the DWP to accept that a person over the age of 18 has appointee status, if they have already been granted it by the Scottish Government. That removes unnecessary burdens on the claimant, appointee and the Department through effective and proportional collaboration on information being shared and used by respective Governments.
The UK Government are working collaboratively with the Scottish Government to ensure that the two systems of social security will operate effectively alongside each other, and that the required legislation that underpins them is delivered successfully for the people of Scotland and, where relevant, claimants in England, Wales and Northern Ireland.
I commend the regulations, which highlight the importance that the UK Government place on the effective functioning of devolution, and ask the Committee’s approval to implement them.
Justin Tomlinson
I thank the hon. Lady for her helpful contribution and indication of Opposition support for the measure. The broader points raised go beyond the debate, so I will try not to be too tempted, but our forthcoming health and disability Green Paper will consider how we support people through benefits and disability employment. A cross-Government exercise will also address the national disability strategy, which will consider how we all collectively create a more inclusive society and remove barriers. That is for another day.
The Government are committed to the safe and secure transfer of powers to the Scottish Government, and recognise the importance of making timely and necessary changes to our legislation to ensure that the two benefit systems work together effectively. I commend the regulations to the Committee and ask for its approval to implement them.
Question put and agreed.
Oral Answers to Questions
Justin Tomlinson Excerpts(2 years, 10 months ago)
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Jessica Morden (Newport East) (Lab)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Department is committed to publishing the outcome of the evaluation, and it will be announced in due course. I understand that the delay has been frustrating, and I remain absolutely committed to delivering an improved benefit system for claimants who are nearing the end of their lives.
Jessica Morden [V]
As the Minister knows, it is nearly two years since the DWP announced its review of the special rules for terminal illness and we are still waiting for it to be published. Last July, the Minister said it would be published shortly; today, he says, “in due course”. In the meantime, many have died while waiting for benefits decisions. How long do we have to wait until the Government scrap the six-month rule?
Justin Tomlinson
I pay tribute to the hon. Member, who has been brilliant at championing the need to make changes, with which the Department agrees as part of its review to raise awareness of support, improve consistency with other services and, crucially, change that six-month rule. We will be able to make changes very, very soon.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Like the review of the special rules for terminal illness, the Government’s disability strategy has been much delayed. After two long years, we are told to expect it “soon”. Disabled people are hoping for radical policies that will improve their lives. However, many fear it will contain warm words and platitudes but no real action. Can the Minister convince us that his strategy will be published with a fanfare and not just a whimper?
Justin Tomlinson
Absolutely. I am grateful to all the stakeholders and those with real-lived experience, including disabled people themselves, who have been working with the Department on: the proposed changes to SRTI; our forthcoming health and disability Green Paper, which will look at both disability benefits and support and disability employment, of which we have delivered record amounts; and our national strategy for disabled people, which has the Prime Minister’s personal support and will, for the first time, bring genuine cross-Government focus to create more inclusivity and remove barriers. All of those are due very soon, and I am confident that they will be well received.
Sarah Olney (Richmond Park) (LD)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
On 18 March 2003, the UK Government formally recognised that British Sign Language is a language in its own right. Provision for accessing services by users of BSL are already covered by the Equality Act 2010 and the public sector equality duty.
Sarah Olney
My constituent Feras Al-Moubayed is engaged in a dispute with a high street bank but has been unsuccessful in his attempts to secure time with a BSL interpreter to sort through and categorise evidence documents for his case. As a result, he has missed several Financial Ombudsman Service deadlines, which has caused considerable stress and anxiety. If the Minister will not commit to bringing forward legislative proposals to provide BSL with a full legal status, will he commit to making more provision available to support people such as Mr Al-Moubayed in my constituency in the interim?
Justin Tomlinson
I thank the hon. Member for raising that matter; I encourage her also to raise it with our Treasury colleagues, because it sounds like additional support is needed. On the broad principle, I welcome the fact that the hon. Member for West Lancashire (Rosie Cooper), who has a great deal of personal experience in this area, is looking at a potential private Member’s Bill, for which I have offered my full support by hosting a roundtable with the Equality and Human Rights Commission, stakeholders and cross-Government officials to look at how the public sector equality duty and the Equality Act 2010 are or are not providing sufficient support for those who rely on BSL. I welcome all support in that area.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
The disability employment gap has narrowed by 0.3 percentage points in the year to March 2021 and now stands at 28.6 percentage points. The Government remain committed to seeing 1 million more disabled people in work by 2027, despite the challenges of covid.
Dr Cameron [V]
MPs, like businesses, must do everything possible to ensure inclusion in employment for people with disabilities, but there is great concern that the employment gap will increase as a result of covid-19. I would like to thank the Department and the Minister for their recent assistance; a quarter of MPs across the House have now signed up as Disability Confident employers following our recent all-party parliamentary group for disability workshop. Could the Minister encourage those MPs who are still considering signing up to do so, so that we can reach our next target of a third of cross-party MPs being Disability Confident employers and ensuring that Parliament is a role model for inclusive workplaces?
Justin Tomlinson
The hon. Member has been an absolute superstar in her role as the chair of the all-party parliamentary group for disability. She organised a brilliant event to incentivise, encourage and cajole MPs from across the House to lead by example by signing up to be Disability Confident employers, and we saw a huge increase in the number of MPs who are signed up. She is absolutely right to keep pushing, because collectively we can make a difference, and she has personally led on that.
Dr Luke Evans (Bosworth) (Con)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
Volumes of new PIP claims awarded have remained stable since the introduction of covid-19 restrictions. Official statistics show that since April 2020 some 225,000 new PIP claimants have had awards. Over this period, we have continued to assess all claims on the basis of paper evidence or telephone assessments, where necessary.
Anna McMorrin
One of my constituents who is severely disabled and vulnerable had her personal independence payments removed and lost vital care as a result—that was because medical advice was ignored by the assessors. Another lost his mobility car at the height of the pandemic, leaving him trapped, isolated and suicidal, unable to access vital services. Another had to turn to food banks to survive. They all had rejected applications overturned many months later at tribunal. Four out of five disabled and vulnerable applicants have faced unnecessary barriers to PIP support during covid. I am proud of my team in Cardiff North, who have been there to support my constituents through this traumatic time, but many are not so fortunate. So what is the Minister doing to make sure that assessments are right first time, to avoid this trauma and delay?
Justin Tomlinson
Although the vast majority of assessments—we have had over 4 million PIP assessments —are right first time, there are serious implications for those involved where they are not. As part of the forthcoming health and disability Green Paper we will be looking at claimants’ ability to get good-quality supportive evidence; the role of advocacy; the role of the assessment itself; and further changes on mandatory reconsideration and appeals, building on the holistic changes we brought in that allowed us to nearly the double the successful changes at the mandatory reconsideration stage, rather than have claimants having to go through the long appeal process. The key bit here is that the vast majority of successful appeals are because of additional written or oral evidence at that stage, and we need to make it is easy as possible to get such evidence into the beginning of the application.
Cherilyn Mackrory (Truro and Falmouth) (Con)
Oral Answers to Questions
Justin Tomlinson Excerpts(2 years, 11 months ago)
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Matt Vickers (Stockton South) (Con)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
We are currently reviewing the application process for all personal independence payment claimants. Building on our covid response PIP 2 online service, whereby claimants can receive and submit their PIP 2 online, we are in the early stages of developing a new end-to-end application process and plan to test it later this year.
Matt Vickers
As we return to normality, what steps are being taken to ensure that PIP claimants are assessed promptly, so that those in need of support can access it as quickly as possible?
Justin Tomlinson
I am conscious that my hon. Friend has raised some specific cases directly with me. As we return to normality, we have received more claims than normal. We are working hard to get through those as quickly as possible, with average clearance times slightly up from 16 to 19 weeks. As face-to-face assessments start to return, those unable to be assessed through paper-based reviews, telephone or video assessments will be prioritised.
Nigel Mills (Amber Valley) (Con)
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Department is committed to delivering an improved benefits system for claimants who are nearing the end of their lives, and is working across Government to bring forward proposals following the evaluation. I remain committed to implementing the key areas identified as soon as possible.
Emma Hardy
I have a constituent with incurable mantle cell lymphoma who does not meet the definition of terminal illness. She has been refused the personal independence payment, she is one year off her state pension, and because she owns a property that her disabled son lives in, she cannot claim means-tested benefits. She is in a dire financial situation. How much longer will she have to wait for the rules on terminal illness to be changed?
Justin Tomlinson
I thank the hon. Member for highlighting this. I do not know all the details, but if she is willing to share them, I would be very happy to look into that specific case. It highlights why we have carried out this vital evaluation, supported by stakeholders. The key three principles of improving awareness, consistency and scrapping the six-month rule remain a priority for our Department.
Mr Steve Baker (Wycombe) (Con)
Peter Aldous (Waveney) (Con) [V]
The Minister for Disabled People, Health and Work (Justin Tomlinson)
As part of the Green Paper, we will be going further than the special rules for terminal illness evaluation to look at the principles of extending the severe health condition criteria to remove unnecessary assessments and reviews.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab) [V]
Jacob Young (Redcar) (Con)
Justin Tomlinson
My hon. Friend highlights a vital issue, which is why we have developed a disability confident toolkit with stakeholders to provide comprehensive information and guidance for employers on autism and hidden impairments. I hope that his constituent’s undoubted talents will be unlocked shortly.
Duncan Baker (North Norfolk) (Con) [V]
Justin Tomlinson
My hon. Friend is absolutely right. The SRTI—special rules for terminal illness—evaluation has been completed and will not need to be rerun through the forthcoming Green Paper.
Steve McCabe (Birmingham, Selly Oak) (Lab) [V]
Justin Tomlinson
The Government are rightly proud of providing record amounts of support for people with disabilities and long-term health conditions. Through our forthcoming health and disability Green Paper, we will work with stakeholders and those with real lived experience to make sure that we improve the services and support we provide.
Robert Largan (High Peak) (Con)
Justin Tomlinson
I thank my hon. Friend for being so proactive, along with about 50 other MPs who have already agreed to host health and disability Green Paper events to look at the key themes of advocacy, getting supportive evidence, the assessment process and the appeals process. It is the Government’s absolute priority to support those with disabilities and long-term health conditions.
Daniel Zeichner (Cambridge) (Lab)
Justin Tomlinson
I thank the hon. Member for raising that point. We have been improving guidance and sharing best practice with employers. We have also made changes to statutory sick pay for those who are either self-isolating or sick to remove the four-day wait. It is disappointing to hear how that specific employer has treated their hard-working employee.
Henry Smith (Crawley) (Con) [V]
Covronavirus, Disability and Access to Services
Justin Tomlinson Excerpts(3 years ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
It is a pleasure to serve under your chairmanship, Sir Graham. I, too, want to put on record my personal tribute to Cheryl Gillan—a sad loss. No parliamentarian did more to champion the rights and opportunities of those with autism, and it was a great pleasure for me as the Minister for Disabled People to meet and work with her, and respond to her comprehensive, proactive and constructive letters, asks and challenges. With my ministerial hat on, I would say that her greatest legacy is how much she achieved for those who were reliant on having that strong voice in Parliament.
I thank my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) who not only spoke passionately in the debate but has, through her excellent chairmanship of the Women and Equalities Committee, held the Government and the whole of Parliament to account on a number of serious issues. She is a formidable parliamentarian, and is held in the highest regard among colleagues. Frankly, it is staggering that she is not in the Cabinet helping to lead the challenges that are often raised, and on which we must keep a laser focus.
The unprecedented challenges of covid have impacted all, including disabled people, as has been highlighted by the important report by the Women and Equalities Committee. In my role as the Minister for Disabled People I welcome the opportunity to talk through the measures that the Government have put in place for disabled people throughout the pandemic, and how we are responding to those serious recommendations. My involvement in my cross-Government capacity, and that of the Disability Unit for which I am responsible, is to influence and shape Government policies, sharing our subject matter expertise, data, and knowledge of lived experiences and connecting relevant stakeholders with colleagues across Government to reach the best outcomes for disabled people.
Before I turn to the specific points raised by my right hon. Friend and the report, I would like to say how proud I am of the roll-out of the vaccination programme, which was an absolutely key issue and ask of the disability stakeholders that I regularly meet with. The Government are now offering vaccines to all those aged over 45, those on the learning disability register or clinically extremely vulnerable people, and health and social care staff. I am very pleased that my own Department has linked with NHS services in England to share data on over 600,000 carers, allowing the NHS to invite those carers to book an appointment for a vaccine. This is a huge achievement, and makes a significant impact on the lives of disabled people as they navigate this pandemic. This is a good example of cross-Government work.
Turning to the specific points raised, from the very start of the pandemic, we have ensured that the views of disabled people and their families and carers have been taken into account when considering how best to support disabled people and link through to the relevant Ministers, Departments and agencies. Casting our minds back to the beginning of the pandemic, there was real concern about access to food and medicine, as a number of the people who have spoken in this debate have highlighted. In normal circumstances, Governments would typically take 12 to 18 months to develop policies, engaging, consulting and piloting before implementing new legislation. However, with the challenges of covid, that time was simply not available.
Therefore, by connecting key stakeholders with real lived experience, we were able to help relevant Ministers and Departments develop responses quickly. For example, we linked stakeholders including Disability Rights UK, Scope, Sense, Leonard Cheshire and the RNIB with the Minister for farming, fishing and food, my hon. Friend the Member for Banbury (Victoria Prentis), and her officials to engage through the food vulnerability stakeholder group. Within days, they were able to resolve this potentially serious issue, as the Committee report highlights. This is an example of best practice. Several speakers raised the challenge faced by those who did not get included in the clinically extremely vulnerable list, but an additional scheme was organised through 305 local authorities, Age UK, Mind, Scope and RNIB, which were able to then make referrals for priority online shopping slots. Again, these important changes were vital.
More widely, to identify potential issues and areas of real lived experiences, we have an extensive programme of engagement. I regularly meet with the Disability Charities Consortium, which includes Scope, Leonard Cheshire, Disability Rights UK, the National Autistic Society, Mind, Mencap, Sense, RNIB, RNID and the Business Disability Forum. That includes being joined by relevant ministerial colleagues to discuss aspects of the pandemic’s impact on disabled people. During covid-19, this forum’s work has included meetings with the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi); the Minister for Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately); and the Minister for Civil Society. It has been a real opportunity to share their expertise and help shape the urgent new policies that are needed to support those who are most vulnerable in society.
Furthermore, the Cabinet Office covid-19 taskforce considers disproportionately impacted groups, including disabled people, through policy development to tackle the pandemic. They do this through close working with the Equalities Hub and, within it, the Disability Unit, co-ordinating with other Government Departments and wider stakeholders to ensure a holistic approach to policy implications and delivery. In addition, we have regular stakeholder engagement through our regional network, which includes disabled people, carers, and crucially those with real lived experiences.
Turning to accessibility, I reaffirm that it is vital that public information on covid-19 is accessible to all, and we have made key strides in this area. These are things I was challenged on during my stakeholder engagement, and I happily raise these across Government. The Government are committed to providing both key covid-related guidance and communications in alternative formats, including large print, easy read, British Sign Language and audio. Most recently, this has covered ensuring that national restrictions, vaccination testing and the Government’s road map are accessible. We have now established BSL interpretation at the No. 10 press conference via the BBC News channel and iPlayer, available on all TV packages as part of Freeview. Accessible information is also available on the Government’s social media channels.
A significant further improvement, following the Committee’s report, is that the Cabinet Office now has a senior lead for accessible communications as part of the national resilience communications hub, who meets with a group of disability charities on a monthly basis. The group is briefed on the latest covid-19 guidance, including accessible versions, and works to ensure that communications to disabled people continue to be accessible and timely. Most recently, we held bespoke briefing sessions with the disability communications working group on 25 March, explaining the road map and communications activity, enabling charities to brief their audiences, prepare and share accessible communications through their network. I have personally pushed hard for that and I thank the Women and Equalities Committee for its support on the need for this vital additional layer of support.
Turning to health and social care, as we have seen, the covid-19 pandemic has had an unprecedented impact on the NHS and social care systems. Recognising the challenges in care settings, the Department of Health and Social Care made £546 million available in its adult social care winter plan, including money for vital infection control measures to ensure that disabled people getting social care and support are kept as safe as possible. The Government has also made £4.6 billion available to local authorities to address pressures on local services, including adult social care. Furthermore, the Minister for Mental Health and Suicide Prevention announced £500 million for mental health recovery, of which £31 million will be used to support learning disability and autism services, alongside an additional £3.6 million announced by the Minister for Care for disability voluntary sector organisations to provide practical support to disabled people to mitigate the impacts of covid-19.
I know many disabled people and their families have raised concerns about easements to the Care Act, which were introduced as a temporary measure to help local authorities continue to meet the most urgent and acute needs in the face of covid-19, when local authorities were experiencing extraordinary pressures. The measure was used sparingly and has now ended. In response to concerns about the use of “do not resuscitate” decisions and the clinical frailty scale, the Government recognised the issues and guidance was changed strongly and quickly.
It is important to recognise the particular challenges the covid-19 outbreak has had on families of children with disabilities or serious illnesses. Supporting vulnerable children is a priority for this Government and has been central to our response throughout the pandemic. Turning to the work done by the Minister for Children and Families, the Government provided £40.8 million for the family fund in 2020-21, which supported more than 90,000 low-income families who are raising children who are disabled or seriously ill.
I know there are concerns about the legal duties to provide support to children and young people with education, health and care plans. The Secretary of State for Education has not used this power since July last year and has made it clear that he would need a compelling reason before doing so again.
Caroline Nokes
I thank the Minister for giving way on the point about the Secretary of State for Education’s powers. My right hon. Friend the Secretary of State has made it clear that he would require a compelling reason to use them, but he has not used them, he does not plan to use them and there is much less need to use them. Will my hon. Friend indicate whether there might be a timescale for when they are going to go?
Justin Tomlinson
That is a fair challenge. I do not have the answer, but I will certainly make sure that the Secretary of State for Education gives a clear response to that question.
While the covid-19 pandemic has unavoidably delayed the completion of the special educational needs and disabilities review, the Secretary of State for Education is clear that it remains a key priority for this Government. It is vital that we deliver on our promises to children and young people and the DFE intends to publish proposals for consultation in the coming months.
Several speakers talked about the importance of disability employment. I am incredibly proud, as the Minister for Disabled People, to have presided over record disability employment. In normal times, when I have the pleasure of travelling around the country on visits, when I talk to young disabled people and say, “If you were the Minister, what would be the single thing that you would want to see?” the answer is nearly always, “I just want to have the same opportunities that my friends have for work and career progression.” I have never lost sight of that. I speak as somebody who has employed and benefited from employing disabled people, both prior to being an MP and as an MP. We have faced unprecedented challenges, but we have not lessened our ambition to have a million more disabled people in work by 2027. I want to reiterate that that has not changed.
During covid, we have made changes to the support provided. We have recently announced over 300 more disability employment advisers, taking the figure to over 1,000. We continue to review our Work and Health programme. All of the plan for jobs is fully inclusive, and we have made changes to schemes such as Access to Work, where we now provide support within the workplace. We will keep that beyond covid-19, which will perhaps open up opportunities for more people who have not been able to access work opportunities up to now. I am proud that we have reached 20,000 employers signed up to Disability Confident. The equivalent of 11.2 million employees are now represented by businesses in the Disability Confident scheme, sharing best practice about helping disabled people into work, to progress in work and be retained in work. That is very much a priority for me and the Department.
While there will undoubtedly be opportunities to learn from our covid-19 response in the longer term, the overall picture is that the Government have moved fast and flexibly to provide support for disabled people in these unprecedented times. The importance of cross-Government work linked to and supported by those with real lived experiences is absolutely clear, as it allows us to move faster and more flexibly to provide support to those most in need, including those with disabilities.
To ensure that that notion is embedded at the heart of the Government, we now have ministerial disability champions in every Department, with whom I meet regularly, with the full authority of the Prime Minister. They are genuinely enthused, engaged and determined to play their part on behalf of their respective Departments. In our forthcoming ambitious national strategy for disabled people, we will demonstrate the very real and vital focus on cross-Government work to remove barriers and create a fully inclusive society as we return to normality.
In conclusion, I thank all the staff and volunteers across the country working on the frontline, and in particular those supporting people with disabilities, as we navigate these challenges. I thank again my right hon. Friend and her Committee for their fantastic ongoing work, the Committee’s important report and the recommendations it made. The Government and I personally take them very seriously, and we are acting on them.
Oral Answers to Questions
Justin Tomlinson Excerpts(3 years, 1 month ago)
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Cat Smith (Lancaster and Fleetwood) (Lab)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
We have made a series of improvements to the personal independence payment claimant experience following research and two independent reviews. Building on that, the forthcoming Green Paper on health and disability support is being influenced by the views of disabled people and representatives from disability organisations.
Cat Smith
I wrote to the Minister last week telling him about the work of the Morecambe Bay Poverty Truth Commission, which has empowered people who have experienced the social security system to speak truth to power and try to improve the system. Will he meet the PIP claimants in my constituency who want to tell him about their experiences?
Justin Tomlinson
I thank the hon. Member for that question, and I would be delighted to do that. I know that she has been very proactive on a number of issues in my area over the years, and I would be delighted to have a meeting with her and her organisation to listen to their experiences.
Vicky Foxcroft (Lewisham, Deptford) (Lab) [V]
Following the coroner’s damning prevention of future deaths report in the case of Philippa Day, who took an overdose and, sadly, passed away because of DWP and Capita failings, have the Government implemented the recommendations, and if not, when will they? As well as responding to the coroner, will the Minister keep this House updated, and do the Government not accept that, when so many people have to go through an inhumane assessment process, the system is flawed and it is time for a radical change?
Justin Tomlinson
While I cannot comment on individual cases, when we tackle any of these serious issues, we put a great amount of thought and care into doing so. That is why the Department set up the serious case panel, personally led by the Secretary of State, to look at the themes and to make sure, if there are any lessons that need to be learned, they are shared with the key decision makers quickly, and that we improve our support and our services for some of the most vulnerable people in society. It is a real priority for our Department.
Karl MᶜCartney (Lincoln) (Con)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
We stopped regular assessments for people with severe conditions for work capability assessment and personal independence payment claimants with the highest level of needs which will not improve. We are continuing to remove pensioners on PIP on to ongoing awards at their award review, and the upcoming health and disability Green Paper will consult on further improvements to the assessment process.
Karl MᶜCartney
As we move towards the end of this difficult period, what lessons can be taken forward regarding the simplification of the benefit process for those in my constituency and across the nation with confirmed severe conditions?
Justin Tomlinson
My hon. Friend raises an important point. One lesson we can take from these unprecedented times is to look to extend the principle of the severe conditions criteria and, where possible, use clear evidence to remove unnecessary assessments. We will explore that further, working with disabled people and health and disability charities, in the upcoming health and disability Green Paper.
Christina Rees (Neath) (Lab/Co-op)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Department is committed to delivering an improved benefit system for claimants nearing the end of their lives, and we are working across government to bring forward changes.
Christina Rees [V]
Will the Minister urgently correct the anomaly whereby someone with a severe condition eligible for an ongoing award under the normal rules has a light-touch review after 10 years, but someone with a terminal illness such as motor neurone disease has to reapply after three years under the special rules or risk having their benefits stopped?
Justin Tomlinson
I thank the hon. Member for raising that important point, referring to someone who qualifies under special rules for terminal illness normally having an award for three years. The point was raised during the review of changing the rules around special rules; we are considering it and I welcome its having been raised.
Catherine West (Hornsey and Wood Green) (Lab)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Government have delivered an unprecedented package of support during the pandemic. Where eligible, financial support for those self-isolating in line with Government guidance includes access to employment and support allowance, universal credit, statutory sick pay and the test and trace support payments scheme, depending on individual circumstances.
Catherine West
The scientists on the Scientific Advisory Group for Emergencies have said that many people are still not self-isolating for financial reasons. What assessment has the Department made of the means-testing involved in the £500 payment? Does the Minister not agree that this should go, and that everybody should be eligible for that £500 payment, because we cannot allow a stop-start recovery as we come out of lockdown? Secondly, does he agree that statutory sick pay is pathetically low for those jobs that are eligible for it, and that there are far too many jobs where people do not even get basic statutory sick pay?
Justin Tomlinson
While the £500 test and trace scheme payment is rightly targeted at those most in need, we have also provided local authorities with £35 million for discretionary payments, and we will continue to provide local authorities with a further £20 million per month while this scheme carries on. The rate of statutory sick pay should not be looked at in isolation because, depending on eligibility, people may also be able to claim universal credit or new-style employment and support allowance, and the majority of employers pay more than the statutory minimum.
Zarah Sultana (Coventry South) (Lab)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
Throughout the pandemic we have ensured that disability benefits remain open and we are committed to ensuring that claimants receive a high-quality, consistent and efficient service. We continue to complete paper-based assessments where possible and are now carrying out telephone assessments alongside a trial for video assessments.
Zarah Sultana [V]
The outsourcing of assessments for employment and support allowance and personal independence payments to companies such as Capita has been a travesty. Constituents tell me how they have been signed off work by their GP, only for non-specialist Capita assessors to refuse their claims. When they appeal, they are forced to wait absurd lengths of time for the decision, which causes severe financial hardship. Coventry Law Centre, which deals with the majority of appeals in the city, has found that a staggering 90% of appeals are successful. This pandemic has shown that things can be done differently, so will the Minister take this opportunity to scrap these cruel assessments, kick out outsourcing companies such as Capita and bring in a framework that treats disabled people with dignity and respect.
Justin Tomlinson
We have increased, in real terms, by £3 billion the support provided to those with disabilities and health conditions, through disability benefits. All of our assessors have at least two years’ experience and extensive training. The Department monitors closely the quality—this is carried out independently—and 92% of claimants have found their experience either satisfactory or better.
Kate Osamor (Edmonton) (Lab/Co-op)
Florence Eshalomi (Vauxhall) (Lab/Co-op)
The Minister for Disabled People, Health and Work (Justin Tomlinson)
Disabled people and their carers have access to the full range of social security benefits according to their circumstances. DWP Ministers and officials regularly discuss support for disabled people and carers with their counterparts across government, and recognise and value the vital contribution made by carers in supporting some of the most vulnerable in society.
Florence Eshalomi [V]
I thank the Minister for his answer. A recent survey of disabled people conducted by Inclusion London, a disability organisation based in my constituency, found that more than one in three disabled people had experienced a worsening financial situation during the lockdown, and recent research by Citizens Advice found that one in four disabled employees has faced redundancy since the pandemic started. We know that even before this pandemic, disabled people faced an employment gap of nearly 30% when compared with non-disabled workers. Will the Government commit to using the upcoming national disability strategy to bring forward comprehensive proposals to address the chronic employment insecurity that disabled people face in the wake of covid-19?
Justin Tomlinson
I thank the hon. Lady for raising a very important point about disability employment. The Government are very proud that we delivered record disability employment—it is up 1.4 million since 2014 alone. Even during these unprecedented challenging times, over the past 12 months 25,000 more disabled people are in work. But we recognise that there will be challenges going forward, which is why we have made changes to Access to Work so that people can get support working at home; we have increased our support through Disability Confident, sharing best practice and providing resources to employers to be able to make changes, often small ones, to take advantage of the huge talent pool available. This is a key area, and in both the forthcoming national strategy for disabled people and the health and disability Green Paper we will continue to look at ways in which we can support employers to offer more opportunities for disabled people of all ages.
Rushanara Ali (Bethnal Green and Bow) (Lab)
Christine Jardine (Edinburgh West) (LD) [V]
The Minister for Disabled People, Health and Work (Justin Tomlinson)
I thank the hon. Member for this question. While there were delays to the review because of covid, we are committed to the three themes that have come out of the review: raising awareness, improving consistency and changing the six-month rule. I thank all the health and disability organisations and charities that have helped to support that review. I am committed to going further to explore extending the principle of the severe conditions criteria to remove unnecessary assessments as well as changing the six-month rule.
Christian Wakeford (Bury South) (Con)
Kerry McCarthy (Bristol East) (Lab) [V]
Justin Tomlinson
I thank the over 15,000 individuals and organisations who have already responded to the national strategy pre-consultation. However, this is only part of our extensive stakeholder engagement ahead of the forthcoming national strategy for disabled people. I have also written to all MPs of all parties to say that I am keen for them to host events either with me or with senior officials, depending on parliamentary business, to get more real lived experience, whether from individual disabled people, organisations or charities. I would be very happy if the hon. Member would agree to do one of those on behalf of her constituency.
Andy Carter (Warrington South) (Con) [V]
Ian Lavery (Wansbeck) (Lab) [V]
Justin Tomlinson
Yes, I would be happy to host such a meeting. I know that the hon. Member has a long-standing track record of raising very important issues in this area.
Chris Green (Bolton West) (Con)
Christian Matheson (City of Chester) (Lab) [V]
Justin Tomlinson
Although the vast majority of people who access their benefits get the outcome they were hoping for, we recognise the need for continuous improvements, which we make working hand in hand with health and disability charities, organisation users and frontline staff. In the forthcoming health and disability Green Paper, we will look at the specific themes of evidence, advocacy, assessment and the appeals system to ensure we continue to deliver those improvements.
Mr Speaker
I am suspending the House for a few minutes to enable the necessary arrangements to be made for the next business.
Covid-19: Statutory Sick Pay
Justin Tomlinson Excerpts(3 years, 2 months ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
I thank the hon. Member for Leeds East (Richard Burgon) for securing this debate.
We have been facing the most serious public health emergency in a generation since the beginning of the pandemic, and the whole of the UK has joined together in a great national effort to face this challenge. Throughout the pandemic, the Government have done, and will continue to do, whatever it takes to fight the virus and get our nation through these difficult times. This Government have a strong safety net in place, and we took action to strengthen it for those who need it most. As part of that action, we introduced the coronavirus job retention scheme and the self-employment income support scheme, increased the universal credit standard allowance by up to £1,040 this financial year, and extended statutory sick pay to those who are self-isolating or shielding in line with the latest Government health guidance. We also went further and made SSP payable from day one instead day four for anybody who is sick, self-isolating or shielding due to coronavirus.
Taken together, these measures help to ensure that employees do not attend work when they should be staying at home, helping to keep themselves and others safe. Where clinically extremely vulnerable individuals are not able to work from home and shielding advice is in place, they should not attend work. Statutory sick pay is available to those who are unable to work, and is intended to be a safety net in cases where their employer chooses not to furlough them under the coronavirus job retention scheme and does not have other suitable policies in place.
Jim Shannon (Strangford) (DUP)
In my constituency, quite a number of employers did not buy into the furlough scheme, and sick pay simply does not cover costs. I understand that the Minister is always very responsive to the issues; he always has been in any debates that I have been in, and I hope that he will be to this one. Will he and the Government consider grants or a help scheme for those who have got into debt just to feed and heat themselves at this particularly difficult time?
Justin Tomlinson
I thank the hon. Member, who I know from several debates to which he has contributed cares passionately about those in most need in his constituency. I am meeting the First Minister of the Northern Ireland Assembly next week to discuss a number of issues, including this, and I will set out in my speech the wider support that I know he will be looking to champion, and rightly so.
Clinically extremely vulnerable individuals are currently being advised to shield until 31 March. We expect employers to do the right thing and help their employees in following public health guidance. That is underpinned by the clear guidance issued by the Department for Business, Energy and Industrial Strategy, ACAS and the Health and Safety Executive to help employers make workplaces covid-secure. Where individuals have concerns about their health and safety at work, they should raise them directly with their employers or with staff representatives, HSE or their local authority.
The Government have also provided a comprehensive economic response that is one of the most generous globally, taking unprecedented steps to protect people’s income and support businesses, most notably through the coronavirus job retention scheme. We know that this has been a difficult time for businesses too, with many experiencing increased levels of absence due to employees needing to self-isolate. Any increase in the rate of SSP during the pandemic would have placed an immediate, direct financial burden on employers at a time when we know that many of them are struggling. That could have put more jobs at risk.
Many of those earning below the lower earnings limit who are not eligible for SSP are already in receipt of benefits, meaning that the welfare safety net is the most efficient way of providing targeted further financial support. Statutory sick pay should not be looked at in isolation. It is the minimum level of income replacement that employers must provide to eligible employees, and the majority of employees receive above the statutory minimum. Those who require further financial support while unable to work have been and will continue to be supported by the Government. For example, where someone’s income is reduced while on SSP, they may be able to claim universal credit. Where they are not eligible for SSP, they may be able to claim UC and new-style employment and support allowance. For ESA, we have removed the seven waiting days for claimants affected by coronavirus, so it is payable from day one of the claim.
For the millions of hard-working people who are self-employed, we continue to provide generous support through the self-employment income support scheme. The minimum income floor in universal credit has been relaxed for the duration of the crisis, which means that where self-employed claimants’ earnings have fallen significantly, their UC award will have increased to reflect their lower earnings.
Beyond the welfare safety net, we have also introduced a number of unprecedented packages of support to put money directly into the pockets of those who are in most need. We are providing financial support to self-isolate to those on low incomes through the £500 test and trace support scheme, alongside £35 million being made available to local authorities for discretionary payments to support those on low incomes who cannot work from home if they are required to self-isolate because they have tested positive for coronavirus or have been identified as a contact of someone who has.
We have worked closely with local authorities to monitor the effectiveness of the scheme since it launched in September 2020 and have listened to feedback from charities and support groups on the frontline. I welcome the changes to the eligibility criteria to include a parent or guardian who is staying off work to look after a child who is self-isolating. We will also be making an additional £20 million available for discretionary payments every month from March until the end of the scheme, which has been extended until the summer. Employers can also furlough employees who are on long-term sickness absence or have been advised to shield.
At tomorrow’s Budget, the Chancellor will set out the next phase of our economic support package, reflecting the Prime Minister’s road map to ease restrictions published last month and tailoring support for individuals and businesses to reflect the changing public health restrictions. The actions that this Government have taken were the right ones to respond to the immediate short-term pressures that the pandemic presented, but it is right that we also think about the longer term.
As the Minister for Disabled People, I welcome the opportunity to highlight the “Health is everyone’s business” consultation, in which we sought views on the rate of statutory sick pay and the role that employers can and should play in supporting employees who are disabled or have long-term health conditions to stay in and thrive in work. We have explored how long-term reform of SSP could support the Government’s ambition to reduce ill health-related job loss and drive transformational change, so that those managing long-term health conditions can live and work well. I cannot stress enough the importance of that work. One in five people in this country have a disability or health condition, and the vast majority of them will get that while they are of working age. It is therefore absolutely right that we review and look at the ways we support both employees with changing health conditions and employers to do the right thing.
Jim Shannon
I thank the Minister for giving way again. One thing that is very much an issue in my constituency—it probably is in the constituency of the hon. Member for Leeds East (Richard Burgon) as well—is mental health. When it comes to accessing all those benefits, there is absolutely no doubt that mental health and anxiety issues are one of the greatest crises we have had for a long time. Can the Minister and his Department offer help to those people with anxiety or depression or wellbeing issues?
Justin Tomlinson
The hon. Member, with laser-like precision, has identified one of the key issues. For those employees who have a fluctuating health condition—for example, mental health—one of the inbuilt challenges of the system is that someone is presumed to be either 100% fit for work or 100% sick, which stops them dipping in and out or having phased returns to work. Also, while society’s awareness of issues around mental health and mental wellbeing is significantly improving, there is not an easy guidebook that any employer—particularly small and medium-sized employers—can simply take off the shelf and then know exactly what to do. Therefore, we must look to address the issue of 100% fit or 100% sick to allow for that phased return as well as significantly improve the guidance and support for employers to ensure that people do not drop out of work. We recognise that work is good for people’s health, and it is significantly harder to help somebody back into work, dealing not only with their health condition but with the loss of confidence from losing their job, than it is to provide that support earlier on.
SSP maintains an important link between the employee and their employer during sickness absence while providing a level of income replacement for such a period. That is why the consultation set out that we are minded to extend SSP to those earning below the lower earnings limit, who are not currently eligible for financial support from their employer during a period of sickness absence. I think this is an area where the Government and the hon. Member for Leeds East would agree: it is important that there is a link, regardless of the number of hours that an employee works with their employer, because it is a partnership to deal with short-term, medium-term or long-term health conditions for the benefit ultimately of the employee but also the employer. We know that good work is good for one’s health and that work can play an important role in a recovery.
The consultation also proposed changes to SSP rules to allow for fully flexible phased returns to work, as I have set out, with SSP being paid alongside an employee’s wage. That can be beneficial for both the employer and the employee. We know that many employers are already taking positive action to support their employees to remain in work, but many businesses—particularly small and medium-sized organisations—need access to improved information and advice on how to better manage health in the workplace. We want to ensure that employers are supported and equipped so that they can do the right thing by their employees, and many of them wish to do so. We will publish the findings shortly.
Crucially, as we begin to build back better, employers will have a vital role to play in creating workplaces in which all employees can thrive. It is by working together that we can truly transform the lives of disabled people and those with health conditions. The benefit of that will be felt by all, so we must each play our part. I welcome the points made by the hon. Member for Leeds East. This is something that we will all continue to focus on.
Question put and agreed to.
Social Security
Justin Tomlinson Excerpts(3 years, 2 months ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
I beg to move,
That the draft Pneumoconiosis etc. (Workers’ Compensation) (Payment of Claims) (Amendment) Regulations 2021, which were laid before this House on 14 January, be approved.
Madam Deputy Speaker
With this we shall consider the following motion:
That the draft Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2021, which were laid before this House on 14 January, be approved.
Justin Tomlinson
These statutory instruments will increase the value of lump sum awards payable under the Pneumoconiosis etc. (Workers’ Compensation) Act 1979 and the diffuse mesothelioma scheme established by the Child Maintenance and Other Payments Act 2008. As many hon. Members will know, these two schemes stand apart from the main social security benefits uprating procedure. While there is no statutory requirement to increase rates, I am happy to maintain the position and increase the amounts payable by the September 2020 consumer price index of 0.5%. This is the same rate that is being applied to industrial injuries, disablement benefits and other disability benefits under the main social security uprating provisions. These new amounts will be paid to those who satisfy all the conditions of entitlement for the first time on or after 1 April 2021.
The Government recognise the great suffering of individuals and their families caused by the serious and often fatal diseases resulting from exposure to asbestos or other listed agents. The individuals affected and their families may be unable to bring a successful claim for civil damages in relation to their disease. This is mainly due to the long latency period of their condition, but they can still claim compensation through these schemes. These schemes also aim, where possible, to ensure that sufferers receive compensation in their lifetime, without first having to await the outcome of civil litigation. While improvements in health and safety procedures have restricted the use of asbestos and provided a safe environment for its handling, the legacy of its use is still with us. That is why we are ensuring that financial compensation from these schemes is available to those affected.
I will briefly summarise the specific purpose of the two compensation schemes. The Pneumoconiosis etc. (Workers’ Compensation) Act 1979, which for simplicity I will refer to as the 1979 Act scheme, provides a lump sum compensation payment to individuals who have one of five dust-related respiratory diseases covered by the scheme who are unable to claim damages from employers and who have not brought any action against another party for damages. The five diseases covered by the 1979 Act scheme are: diffuse mesothelioma; bilateral diffuse pleural thickening; pneumoconiosis; byssinosis; and primary carcinoma of the lung if accompanied by asbestosis or bilateral diffuse pleural thickening.
The 2008 mesothelioma lump sum payment scheme, which I will refer to as the 2008 scheme, was introduced to provide compensation to people who contracted diffuse mesothelioma but were unable to claim compensation under the 1979 Act because, for example, they were self-employed or their exposure to asbestos was not due to their work. The 2008 scheme allows payments to be made quickly to people with diffuse mesothelioma at their time of greatest need. Under each scheme, a claim can be made by a dependant if the person with the disease has died before being able to make a claim.
The rates payable under the 1979 Act scheme are based on the level of disablement assessment and the age of the sufferer at the time the disease is diagnosed. The highest amounts are made to those diagnosed at an early age and with the highest level of disablement. All payments for diffuse mesothelioma under the 1979 Act scheme are automatically made at the 100% disablement rate, the highest rate of payment, reflecting the serious nature of the disease. Similarly, all payments for this condition under the 2008 scheme are made at the 100% disablement rate and based on age, with the highest payments going to the youngest people with the disease. In the last full year for which data is available, April 2019 to March 2020, 3,220 awards were paid under the 1979 Act, totalling £42.7 million, and 450 people received payments under the 2008 scheme, totalling £9.7 million. Overall, 3,670 awards were made across both schemes in 2019-20 and expenditure was £52.4 million.
I am keen to address the impacts of the covid-19 pandemic on sufferers of pneumoconiosis and mesothelioma. While this uprating debate is an annual event, this has been far from a normal year. We took the difficult decision at the outset of the pandemic to temporarily suspend all face-to-face health and disability assessments, including for the industrial injuries disablement benefit to protect the health of claimants and staff. We have continued, where possible, to process and qualify under SRTI rules—special rules for terminal illness—where a claim can be processed through paper-based review, and have recently explored telephone and video options in line with wider disability benefits to start to clear the backlog.
We are committed to working with our agencies and arms-length bodies to improve the lives of those people with respiratory diseases. People suffering from occupational lung diseases are likely to face a higher risk of complications resulting from covid-19 and it continues to be a distressing time for sufferers of the diseases we discuss today. As of Sunday 14 February, all those identified as clinically extremely vulnerable have been offered a vaccine.
Returning to these important regulations, I am sure we all agree that while no amount of money can ever compensate individuals and families for the suffering and loss caused by diffuse mesothelioma and other dust-related diseases covered by the 1979 Act scheme, those who have them rightly deserve the financial compensation that these schemes can offer. I am required to confirm that the provisions are compatible with the European convention on human rights and I am happy to do so. I commend the increase of the payment scales for those schemes and ask approval to implement them.
Justin Tomlinson
I thank hon. Members for their helpful contributions to this debate, which is a rare case of cross-party support. The debate was hugely enriched by the very personal stories and experiences that were shared, which highlight the importance of these annual uprating regulations. The Government recognise that these two schemes form an important part of the support available to people with dust-related diseases, and these draft regulations will ensure that the value of that support is maintained. I wish to echo the comments about the charities and organisations that both support claimants and families to secure a diagnose and provide ongoing support. This House recognises what an invaluable role they play for people in such challenging times.
Hon. Members raised a number of points, and I will try to cover the key ones. First, on the delays, due to covid we understandably had to suspend traditional face-to-face assessments. We have now been able to start with paper-based reviews and, as we have seen with wider disability benefits, we have looked to use telephone and video technology where possible. As quickly as we are allowed safely to return to face-to-face assessments, those for whom we have not been able to do a paper-based review or a telephone or video assessment will be a priority in this area.
The Chair of the Work and Pensions Committee, the right hon. Member for East Ham (Stephen Timms), asked for an update on stats. They are published quarterly, and those he quoted are the last published ones. We will share the stats as soon as they come forward. However, we absolutely understand the importance of getting the backdates cleared. He also mentioned the issue whereby, for some claims made under the 1979 Act, due to the suspension of face-to-face assessments the amount of compensation a claimant can receive is based on their age on the date the IIDB was awarded, not the date of the claim. The Department is actively considering what we can do for those claimants who, through no fault of their own, have received a reduced amount as a result of the delays. We acknowledge that, we are looking to address it, and I very much welcome the right hon. Gentleman highlighting the issue in a proactive, constructive spirit. We do get that.
I turn to the quirk of why this debate is held annually. It was set in place in 2004, and Ministers—including me—have done it each year. A change to make this measure part of the wider statutory uprating would require primary legislation. However, aside from requiring legislation to make the change, this is an opportunity for us to focus on the scheme and the wider support, and the quality and merit of the speeches today shows why we have the debate annually. As ever, these things are kept under review, but it is one of those situations where there are gains, and it is about whether a change is needed.
A number of hon. Members raised the principle of equalising the levels of payments made to dependents. I listened carefully to the concerns raised, but the Government remain of the view that available funding should be prioritised to those people who are currently living with the disease.
A number of hon. Members spoke about the importance of research, which is crucial, particularly in our fight against cancer. I very much welcome the fact that the Department of Health and Social Care invests £1 billion a year in health research through the National Institute for Health Research. We have been working actively for several years to stimulate an increase in the level of mesothelioma research, and I thank organisations such as Cancer Research UK, the British Lung Foundation and the Medical Research Council that are proactively trying to stimulate additional crucial research in that area. We will welcome any more work that is done.
A number of hon. Members addressed the HSE, which is a wonderful organisation. I welcome the fact that it secured an additional £14 million for the financial year 2021-22 to continue to support the Government in the national response to the global covid-19 pandemic. That will fund spot checks and inspections, including those enforced by local authorities, to ensure that workplaces are covid-secure for workers and the public. That is in addition to the HSE’s regular Government funding to deliver its wide-ranging regulatory functions.
To be clear, the HSE does not only rely on direct Government funding; it also generates income. Rightly, a key part of its work is raising awareness, and its health and work strategy delivers a strategy for occupational lung disease that includes raising the profile of occupational lung diseases through activities such as facilitating the Healthy Lung Partnership to provide direction of co-ordinating stakeholder activity on occupational lung disease, in addition to targeted intervention activity. When I was responsible for the HSE as a DWP Minister—it is no longer part of my responsibilities—I was incredibly impressed with how well it engaged with businesses of all sizes to give them the best knowledge, support and guidance in all areas of health and safety, and that part of its work is crucial.
Moving on to the very important issue of cancer patients, it is imperative that people can get tested for cancer and that cancer patients continue to receive the treatment they need. While the covid-19 pandemic has presented major challenges for all healthcare systems, overall cancer treatment services have been maintained throughout the pandemic. The NHS has published a cancer service recovery plan that aims to prioritise long-term plan commitments, including respiratory disease, as a clinical priority, and that will support recovery. This includes the delivery of targeted lung health checks and the roll-out of rapid diagnostic centres. As of the end of 2020, there were 53 live rapid diagnostic centre pathways across hospitals in England, compared with just 12 in March 2020, with a further 63 pathways in development. In October 2020, NHS England, NHS Improvement and Public Health England launched the latest “Help Us, Help You” campaign to urge people with potential symptoms of cancer to see their GP. The lung cancer campaign will focus on the key symptom of a cough for three weeks or more and encourage anyone who has had this symptom to speak to their GP. I am sure we would all echo the importance of that message.
On dependents and gender imbalance, we have not conducted an impact assessment, but a valid point has been raised and I will take it away to look at it.
I commend the uprating of the payment scales for these schemes and ask for approval to implement them.
Question put and agreed to.
Resolved,
That the draft Pneumoconiosis etc. (Workers’ Compensation) (Payment of Claims) (Amendment) Regulations 2021, which were laid before this House on 14 January, be approved.
Resolved,
That the draft Mesothelioma Lump Sum Payments (Conditions and Amounts) (Amendment) Regulations 2021, which were laid before this House on 14 January, be approved.
Madam Deputy Speaker (Dame Rosie Winterton)
I will now suspend the House for three minutes to make the necessary arrangements for the next business.
Personal Independence Payment
Justin Tomlinson Excerpts(3 years, 2 months ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
The Department has published the latest update on progress on making backdated payments to personal independence payment claimants who are affected by the MH and RJ decisions of the upper tribunal. The release is published at:
https://www.gov.uk/government/collections/pip-administrative-exercise-progress-on-cases-cleared
The MH decision changed how overwhelming psychological distress is considered when assessing someone’s ability to plan and follow a journey. The RJ decision changed how we decide whether someone can carry out an activity safely and if they need supervision. We started the administrative exercise on 25 June 2018 and a frequently asked questions document is available in the Library of the House and at: http://data. parliament.uk/DepositedPapers/Files/DEP2020-0061/FAQ_-_Implementation_of_legal_decisions_MH_and_RJ.pdf
As at 17 January 2021, we have assessed 890,000 cases against the MH decision and 990,000 cases against the RJ decision. Around 6,600 arrears payments, totalling around £32 million, have been made.
It should be noted that in supporting the Government’s response to the coronavirus pandemic, the exercise was paused from April to October 2020.
We will release a further update by the end of 2021.
[HCWS796]
Terminally Ill People: Access to Benefits
Justin Tomlinson Excerpts(3 years, 2 months ago)
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The Minister for Disabled People, Health and Work (Justin Tomlinson)
I will first pay tribute to the hon. Member for Newport East (Jessica Morden). There is little in her powerful and constructive speech that I can disagree with. She demonstrated that with her private Member’s Bill, which could have had a second hearing but for the recent suspension of Friday sittings, so I very much welcome the fact that she has had an opportunity to set out her case. Her former colleague, Madeleine Moon, was formidable in our meetings, drawing from her personal experiences to help shape and focus our work as we went forward. This issue has much interest from cross-party MPs not just here in Parliament but in the devolved Assemblies across the UK; health and disability charities and stakeholder groups; public advocates such as Charlotte Hawkins, a patron of the MND Association; and individual campaigners up and down the country, including Mark Hughes, Liam Dwyer and Sandra Smith, who have brought the campaign to Westminster and spoken to the hon. Member for Newport East and me.
I absolutely understand the importance of this issue and the need to make changes, as does the Department. This debate is focused on special rules for terminal illness, or SRTI. For an individual and their friends and family, receiving a terminal diagnosis is devastating. Supporting people in this difficult situation is crucial, and the SRTI ensure that financial support can be provided as quickly as possible, so that the claimant can focus on what time they have remaining.
On the basis of this issue being raised by that extensive list of interested MPs, stakeholders and campaigners, we rightly agreed to do a full and comprehensive review of the support we offer that focused on four strands. The first was hearing directly from claimants and charities about their first-hand experiences. We had claimant engagement, including drop-in sessions and conversations with claimants with cancer and motor neurone disease. We also held extensive stakeholder workshops and meetings with organisations including the Motor Neurone Disease Association, Macmillan, Marie Curie, the Multiple System Atrophy Trust, Sue Ryder, the National Bereavement Alliance, Hospice UK, the National Nurse Consultant Group, the Association of Palliative Care Social Workers, the British Lung Foundation, the Queen’s Nursing Institute, the Association for Palliative Medicine, the Royal College of Physicians and the British Geriatrics Society, among others. I wish to thank them for the huge amount of time and resources they dedicated to help ensure that the changes we bring forward are the right ones that work.
Secondly, we looked at international evidence to find out what works in other nations and what support they provide. That included looking at 22 separate countries. Thirdly, we reviewed current DWP performance to better understand how our SRTI rules and severe condition processes operate and perform, including a full audit of the DS1500, in-house staff research and a clinician survey, which more than 1,000 clinicians took the time to complete to give us helpful advice and information. Finally, we had clinical engagement, where we discussed the SRTI with palliative care experts at end-of-life clinical groups, including Professor Bee Wee, the national clinical director for end of life care. As we promised, this was a comprehensive review.
It was very clear from the findings of those discussions that there is a lack of consistency. A key theme that came up was: why is this not aligned with national palliative care initiatives? That leads to duplication. I spoke to GPs, and they said to me that one of the worst roles they have to perform is explaining to a patient that they will now be entering the terminal illness phase, with the administering of palliative care. That is done at 12 months, and if someone wishes to have a DS1500—which, to be clear, is not the only way to access the SRTI, but it is probably the easiest—the GP has to have that same awful, tough conversation. That is not good for GPs, because it is a duplication—that is an obvious example of something that should be reviewed as part of the Government’s commitment to create an additional 50 million GP appointments a year—and it is not good for the claimant or their friends and family who are providing support.
We also discovered from the findings that there is mixed awareness of the support that is available. We recognise that some people are not getting the support because they simply do not know that it exists. As I have previously confirmed on the Floor of the House when asked by other MPs, we agree that there needs to be a change. The status quo is not acceptable, and the three themes will address raising awareness, improving consistency and changing the six-month rule.
I understand the frustration about the delays, and as the Minister I am very sorry that we have not been able to bring in these changes quicker—I dearly wish that I was in a position to have done that—but this is complex, and there are a number of issues. First, as the hon. Lady alluded to, covid has caused issues. We needed clinical evidence and engagement to ensure that we were making the appropriate changes, because the reality is that if we propose something that does not work for the NHS, and for GPs and health professionals, this will simply not work. That is the challenge that the Scottish Government are facing. They announced their changes long before us, and although they still hope to legislate this year, they are far further away from being able to make changes than we are. In effect, they had very laudable hopes to allow anyone with a terminal illness to be able to access this fast-track support. The problem is in relation to people who are terminally ill from the day they are born. The Scottish Government would not accept that a day-old baby should then get access to this, so they now have to apply conditions that limit access for those they were intending to give it to, which means that they are in danger of creating a far more complicated system, which would not be welcomed by health professionals and clinicians, than the current status quo that we all agree should change. I have spoken to the Scottish Government and urged them to look closely at the changes we are proposing. Hopefully we can have a united and consistent approach across the whole UK.
Covid did cause delays in completing the review. It has also caused delays because the reality is that the changes we wish to make are extensive and will require primary legislation. That has to be lined up with the Department of Health and Social Care, and I have to do that at a time when health professionals and my Front-Bench colleagues are tackling covid.
Jessica Morden
I know that the Minister is sincere about this, but could he give us some idea of a timescale? Will he also meet me and campaigners urgently to explain this in person?
Justin Tomlinson
That is absolutely a fair challenge. I do regularly meet those groups and have kept them engaged throughout the process, as I recognise how much they have invested in ensuring that we made the right proposals for change. Because of the importance and seriousness of the issue, they are understandably desperate for these measures to be brought forward, and that is an aim that my Department and I share. We hope that we are in a position in the coming months to set out the timetable to start bringing forward the changes. We have already done the bits for which we do not have to legislate; we always made it clear during the review that if there were things we did not need to legislate for, we would get on with them.
We discovered that the information on gov.uk was not good enough—we have improved that—and that not all clinicians were up to speed on the DS1500. Again, working with DHSC, we were able, before covid came, to ensure that the advice and guidance given to clinicians was increased. We are working at pace to get that legislation lined up. It is crucial that we do it in a way that works with the NHS and across Government, and that is an absolute commitment.
We are also determined to go further. From talking to stakeholders, it is clear that there are other things we can improve—for example, for those who might not quite be in the terminal illness area, but for whom the current system is not quick and simple enough. In the forthcoming health and disability Green Paper, we will be exploring a number of themes. Again, those groups will be proactively supporting our work to help to change things. First, the ability to access supportive evidence needs to be more consistent. In some cases, it is a postcode lottery. Clear supportive evidence increases the chance of a paper-based review, and a quicker, simpler and more accurate outcome. We want to look at existing evidence on the principle of “tell us once”. That is a cross-Government thing—that, ideally, those awful conversations should only ever have to happen once. That information is then populated across all the support, and that helps the claimant.
I want to look at a broader range of evidence. For example, would I need a GP to tell me that somebody has MND if they are getting support from an MND nurse? Why would the nurse be providing support unless that person had MND? That is a really simplistic example, but there are many examples from the many charities and organisations that provide palliative care. Can we not give greater strength and credence to their supportive evidence?
I also want to look at advocacy. The benefits system is complex at the best of times, and, as the hon. Member for Newport East so articulately said, in those final moments, when every moment is so precious, we do not want to be navigating something that is complicated. We want to look at the role of friends, family and advocates. Again, regarding those examples of the Macmillan nurses, the Sue Ryder nurses and the MND nurses, how can they be more involved in the application and the securing of that support?
We also need to look at the assessments themselves. During the covid pandemic, we have introduced telephone and video assessments. In the Green Paper, we want to explore this further. The key bit the stakeholders will be interested in is looking at reducing unnecessary assessments. Again, that is part of our commitment to create a quicker and easier route where the evidence is clear. That is building on a principle that we already have with UC and the severe conditions criteria. There are many positive lessons that we can learn from that and extend across the other benefits, and, as I have said, we can look at removing those unnecessary assessments.
On a broader level, through the forthcoming national strategy for disabled people, I want to look at, engage and consult on what more can be done across Government, because it is not just from the Department for Work and Pensions that people in this situation may need support, additional help and guidance. I want to see whether there are other areas where we can talk across Government to improve the situation. I would also like to look at the private sector. For example, Nationwide Building Society worked with Macmillan to improve its training, understanding and guidance to support cancer patients with its financial products. That is an exemplary example that we can look to build on and share, so that a more sympathetic, understanding and flexible approach becomes a given to people in these situations.
In conclusion, we are absolutely committed to bringing this forward as quickly as we can, and we are working across Government on this. Despite the covid challenges, despite the complexity, I am confident that we are getting close. We will look to improve and raise awareness and we will change the six-month rule. The Secretary of State and I are absolutely committed to that. I am full of admiration for the work that the hon. Lady and all of those supportive groups and campaigners have done on this vital matter. We absolutely agree that this is one of those rare issues that unites all political parties and all areas of devolved Assemblies. We are all agreed on this and we just need to find a way to deliver this complex, but crucial legislation.
Question put and agreed to.