Ten Years of the Work Capability Assessment

Karen Lee Excerpts

Wednesday 24th April 2019 Westminster Hall

[Karen Lee (Lincoln) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing the debate, and on her excellent speech.

My office was involved in a work capability tribunal case last Wednesday and I have obtained permission from the person involved to discuss publicly what she has gone through because of such assessments. Sophie is the daughter of a friend of mine. Her mum and I trained 20 years ago as nurses and we worked all those years together on a ward at Lincoln County Hospital, so I know her really well. I provided Sophie with a letter for her tribunal, as her MP, as a qualified nurse and as someone who has known her for 20 years, before and after her diagnosis of multiple sclerosis.

Sophie tries hard to live as normal a life as she can, but I have seen how her illness affects her ability to do that day to day. She is just 30 years old and she was diagnosed with relapsing remitting multiple sclerosis at the age of 16 when she first developed balance difficulties. Over the following years she has developed problems with weakness, particularly on the right side of her body, as well as urinary difficulties, pain, fatigue and visual problems. She uses a wheelchair and struggles with mobility.

We went on a hen weekend in February; Sophie is my friend’s best friend, and we were in Boston. Everywhere we went she was in a wheelchair, and she simply cannot get out and about on her own. Whereas some patients with relapsing MS are unaffected between attacks, Sophie has chronic symptoms and is affected by her MS every day. The symptoms fluctuate markedly, and even mild infections and changes in temperature can make things much worse. There were complications during a trial treatment—I remember Alison and I and a few of us looked really hard to try to get her on trials to control what she had. There was a drug called alemtuzumab. Sophie now has an overactive thyroid and has to have regular blood tests to monitor her blood levels of thyroxine.

Sophie left school at 18 and trained as a nursery nurse. She worked at a nursery. She loved that job; it was one of her bits of normal. Eventually, though, she had to give up her job because of her MS, and after being forced by her disability to do that she applied for employment and support allowance benefits.

Recently, after a medical review, Sophie was deemed fit to work. The reasons given were that she has no problem with balance, uses public transport on her own and takes herself places independently. The truth is that she wears a support on one of her legs at all times, as I saw when we stayed for the weekend in February, because she drags the leg as she walks. She has to use a wheelchair every time she goes out of the house. She cannot walk any but short distances indoors, so how she is supposed to use public transport is totally beyond me.

The person who completed the assessment was allegedly competent to do it. Yet at the tribunal last week, those hearing the evidence seemed surprised that the case ever got as far as a tribunal and dismissed it in less than 10 minutes. They said something about a level 2 out of 3; I do not understand the terminology—but that is how ill Sophie is, although she had been deemed fit to work.

When someone is deemed fit to work, the process is that they have to appeal the decision if they feel it is wrong. Sophie appealed, but her appeal was dismissed because, I am told, the only evidence that the DWP will consider is the examination on the day, which came to such worryingly inaccurate conclusions. Sophie was therefore forced to take her case to a tribunal. That was eventually successful, but she should never have been put through such an anxiety-inducing ordeal. She is pregnant—she has a little boy of two and is about eight months pregnant, and the assessment came on top of all those other things in her life. I am sorry—it gets really upsetting, because I know her and what has happened to her is disgusting.

For people like Sophie it feels as if the DUP—[Interruption.]—I am sorry. That was a Freudian slip, and I meant no offence. It feels as if the DWP is working backwards from the conclusion that they are fit to work, regardless of the severity of their disability. That practice must end. Support must be given to the most vulnerable in society.

It has become popular in recent years to demonise those who are forced to claim benefits—to label them as somehow being scroungers or as faking their disability. Just after Christmas, I watched “I, Daniel Blake” on TV, and a prominent Conservative MP said on Twitter that it is only a film, but actually it mirrors real life, and people need to realise that. It is high time that the Government woke up to the fact that the vulnerable in society are suffering because of what they have done to our welfare system. It is meant to be the safety net for those who need it. People say that the mark of a decent society is how it looks after its vulnerable people. I am sorry, Sir Henry, but at present the reality is that the system is broken.

--- Later in debate ---

[The Minister for Disabled People, Health and Work (Justin Tomlinson)]

It is a pleasure to serve under your chairmanship, Sir Henry; you have expertly managed the timekeeping. I pay tribute to the hon. Member for North West Durham (Laura Pidcock). I know this is an area that she has campaigned on since she was first elected, and she does so with real passion and a determination to see improvements right across the system. That was echoed by all speakers. I might not have agreed with absolutely every point—hon. Members would not expect me to—but it is clear that there is a real desire to see continued improvement and an emphasis on how important that improvement is to people who are going through the process.

The hon. Member for Lincoln (Karen Lee) highlighted a particular story, which I was very touched by. I would like to meet her to discuss it further, as I think there are lessons to be learned from that case. I am certainly sorry for the experience that person has gone through.

This area is a real priority for me. I have been the Minister for Disabled People before, when I was a Parliamentary Under-Secretary. I have been an elected representative for 19 years, so I recognise the comments—we see first-hand through our casework instances where things have not gone right. I have spent my parliamentary career being proactive, working with MPs across the House, and stakeholders, charities and experts in this area. I listen to what is said, I try to do my best to make improvements and I certainly hope that that was reflected in my record as Minister for Disabled People last time. I will continue in the same vein.

The Government are focused on this area, and we have rightly increased funding for those with disabilities and long-term health conditions. This year, we are expected to spend £55 billion, which is a £10 billion increase in real terms since we came to office. It is a record high and it is 2.5% of GDP, which is higher than the spend of any other G7 country. It is 6% of total Government spending, and I think every penny is rightly supported by the wider public.

The debate today is focused on the 10-year anniversary of the work capability assessment, which I note a few speakers did acknowledge was introduced by the last Labour Government. Clearly, it was not perfect and there has been much-needed improvement since its introduction. We are all committed to playing our part in improving the process and to taking account of the developments in healthcare, modern workplaces and flexible working arrangements.

Backing up those improvements were the five independent reviews. The first three were carried out by Professor Harrington and the final two were carried out by Dr Litchfield. More than 100 recommendations were made that we have accepted and delivered. As the Secretary of State set out in her recent speech, we need to do more, and that is a real priority.

Many people have highlighted concerns with the frontline staff and process. Since 2015, the Centre for Health and Disability Assessments has taken over the delivery of the work capability assessment, and the focus has been on improving the operational process. It has increased the number of healthcare professionals by 82% and 1,300 staff are now directly involved in supporting assessments. It has increased the number of assessment rooms and significantly improved the training programme—many speakers highlighted these issues, in particular in relation to individual conditions. There is broad training on disability analysis and on specific conditions, including multiple and complex conditions, which covers three distinct areas—principles and professional standards; the assessment process; and scrutiny and file work, with an emphasis on quality. Training is predominantly modular, with competency testing at every stage. The healthcare professional must then undergo the continuing medical education programme and is subject to regular case reviews and audits. For complex cases, we expect the healthcare professional to refresh knowledge prior to the assessment.

One very important and welcome addition that has begun to be rolled out is the introduction of customer champions. I absolutely recognise just how anxious and nervous people can be when going for assessment. I absolutely get that. The customer champion can assist those claimants, before and after assessments, to ensure that they receive the best service. We have had good feedback on that, and the intention is that there will be one in every single assessment centre.

I also recognise the comments about communication—the brown envelopes coming through. There is a commitment from me to work further with stakeholders to improve the letters that come out. I have seen this as a constituency MP; I have taken a deep breath at the poor quality of some communications. We need to improve that.

[Karen Lee]

Does the Minister agree that subjecting people who have either a chronic illness, such as multiple sclerosis, or a terminal illness to these kinds of work capability assessments is totally unacceptable?

[Justin Tomlinson]

I cannot give a broad-brush answer. I know what the hon. Lady is saying and I am coming on to the use of evidence and how we can do more earlier and, potentially, then with paper-based assessments. I will come on to that. I understand, but I cannot give a definitive answer, because every claimant has their own unique challenges that have to be addressed.

In addition, SMS text message reminders about appointments have been welcomed, and there has been a lot of work on the website, which includes mock assessment videos so that people can get an idea of the sort of things to expect. Those things are all looking to remove some of the anxiety and worry about assessments. There is more to be done in that area, but we recognise that.

The improvements in the training and the extra healthcare professionals have meant that median clearance time halved from 25 weeks in March 2015 to 10 weeks in 2018, and customer satisfaction has exceeded the 92% target since that point. However, that does not mean that we are getting it right every time, and that is what I want to turn to now in focusing on MR and appeals.

All of us as Members are frustrated when what seem to be clear-cut cases come to our constituency surgeries asking for our help. There are times when we think, “How on earth can this have happened?”, and ultimately the person could have a very long appeal process to go through to get the right decision. In the majority of cases, appeals are successful because of additional oral and written evidence. That has to be addressed. We rightly are going to tackle it and will do so in two stages—first, with the MR process. We have started doing this with PIP. We are seeking to contact the claimant who is disputing a decision and talk to them directly to get the additional oral and, potentially, written evidence at that stage to see whether we can improve decisions at that point, rather than waiting for the evidence to come at the end of the appeal process.

State Pension Age: Women

Karen Lee Excerpts

Thursday 31st January 2019 Commons Chamber

[Tonia Antoniazzi]

I thank my hon. Friend for that comment. I completely agree with him.

Can the Minister provide a rationale as to why the independent case examiner has closed these 2,505 cases, and say precisely why they were closed? Knowing this, the women would be able to work out which aspect of their case they could proceed with. Otherwise, how are they going to know what to do next? How many of these complaints could have been answered before 30 November, and why does it take so long to deal with them? Now they have just been filed somewhere, and that is simply not good enough.

I would like to raise my concerns about the recent written statement on the pension credit update of 14 January. Written statements are often seen in this House as a way to bury bad news, and these further changes to the pension credit rules appear to put strain on lower-paid women. Can the Minister confirm that the effect of this change will be to debar a pensioner of either gender from claiming pension credit until their partner also attains state pension age? This measure, if brought in on 15 May, will slash the income of couples affected who can claim pension credit in future by up to £7,000 a year, in the worst cases, compared with the current rules. It is also worth noting that many of those caught by this policy change are likely to be women born in the 1950s, who will have been hit by this double whammy and rightly feel especially aggrieved. I hope that the Minister can give further clarification on this point.

I want to give a personal angle. I am very proud of my constituents. A year ago, I held a meeting on this issue in Mumbles, with over 300 women attending. As I have mentioned, approximately 5,500 women in Gower have been impacted by the pension age changes. Since then, they have held a few meetings and set up the Pension Justice for Swansea Women group, which includes all the other local constituencies. I could talk all day about the cases of women across Swansea who have had their lives turned upside down. I know women whose projected state age pension had been part of their divorce settlement. Then, when the goalposts changed, they had to go and find work and be financially worse off. These are women who have had to find low-paid and unskilled work to make ends meet—and, as I have said, they were lucky to even find that job. I know many women who have caring responsibilities, including one who looks after her grandchildren so that they do not go into care and cannot find a job to fit in with school hours.

[Karen Lee (Lincoln) (Lab)]

As my hon. Friend knows, I was a nurse, and I am of the WASPI age too. A lot of the people I worked with had worked long and hard all their lives, as care assistants and housekeepers as well as nurses. They did not earn enough money to save anything. Now the goalposts have moved and they cannot retire, but they are too old to do that really hard, physical work. It is terrible—shameful. Yet we hear a lot of warm words about looking after our NHS staff.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Let me give a little bit of advice to the hon. Lady. She turned her back on the Chair, and that means that she cannot be properly heard; and she cannot go on speaking when she has sat down again. It is not a silly, old-fashioned rule—it just works better if everybody looks the right way and stands up to speak. It is simple.

The Secretary of State’s Handling of Universal Credit

Karen Lee Excerpts

Wednesday 11th July 2018 Commons Chamber

[Karen Lee (Lincoln) (Lab)]

Lincoln saw the full roll-out of UC in March. It is about hardship; it is about poverty; it is about debt—that is the reality. This month over 600 claimants in my constituency need to apply to be transferred over to the full service. It is causing havoc and deep concern—it genuinely is. Prolonged delays have set in motion a damaging cycle of debt, rent arrears and even eviction and homelessness. In Lincoln, arrears in 264 council houses total over £80,000 of debt since UC was rolled out. My constituents who are forced to wait for UC payments are unable to cope with household budgeting—they just cannot do it on that kind of income—and their physical and mental wellbeing is affected as bills and debts pile up.

We shall take as an example what has happened to Anna, one of my constituents. Anna has been passed from pillar to post as she has tried to navigate through slow and complex bureaucracy. The delay in receiving her payment has forced her to sell everything she can, including her car. Despite help from my office and Lincoln’s Labour-led city council, Anna has fallen into arrears and has been understandably anxious regarding the lack of progress in her case; even my staff member who supported her got really upset about it—the House has to listen to this.

The chaotic roll-out of universal credit means that thousands of people like Anna are facing a nightmarish situation. We are not making it up. In my constituency, I have supported people who are either waiting for or receiving universal credit. They cannot even afford to feed themselves and their families and they have to rely on food banks to survive. I would like to take this opportunity to thank everybody who works in Lincoln’s food banks supporting those people. They are doing a tremendous job against the odds.

The Secretary of State made three inaccurate statements, but she has apologised for only one of them. I might be new here, but by my reckoning that still leaves two that have not been apologised for. There has been a lot of talk today about working together. May I appeal to the Secretary of State to pause and fix universal credit, and to listen to what we are saying before more families are plunged into debt and poverty and risk suffering the indignity of using food banks?

Universal Credit

Karen Lee Excerpts

Tuesday 13th March 2018 Commons Chamber

[Angela Rayner]

The right hon. Gentleman acknowledges the fact that under the transitional protections many more in-work families would have received free school meals than will be the case under the Government’s secondary legislation. We hope that Conservative Members will help those hard-working families by ensuring that passported benefits do apply to them. We hope that they will help out those who are just about managing, which was what the Prime Minister claimed that she was going to do in the first place.

[Karen Lee (Lincoln) (Lab)]

Some 27% of children in Lincoln live in poverty. Does my hon. Friend agree that this cliff-edge threshold might mean that some of those children might not get a hot meal one day?

[Angela Rayner]

I absolutely agree about that. [Interruption.] Conservative Members keep saying that we are scaremongering, but it is absolute fact that under the transitional arrangements that currently apply, as they do in my constituency, which was one of the first to roll out UC, free school meals do cover those applicants who receive universal credit. The regulations will remove that right for those individuals, which is scandalous.

Oral Answers to Questions

Karen Lee Excerpts

Monday 5th February 2018 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

13. If she will make an estimate of the number of children who will no longer be living in poverty as a result of the roll-out of universal credit.

[Karen Lee (Lincoln) (Lab)]

15. If she will make an estimate of the number of children who will no longer be living in poverty as a result of the roll-out of universal credit.

[The Parliamentary Under-Secretary of State for Work and Pensions (Kit Malthouse)]

Both hon. Ladies are right to recognise the role that welfare reform is playing in alleviating child poverty. Work is the best route out of poverty, and universal credit strengthens the incentives for parents to move into and progress in work. However, it cannot be considered in isolation: it is a key component of a broader strategy to move Britain to a higher wage, lower welfare and lower tax society.

[Kit Malthouse]

Undoubtedly, as my right hon. Friend the Secretary of State said earlier, children are five times more likely to be in poverty if they are in a workless household. The Government’s entire thrust is to get as many people into work as possible, and we would never contemplate anything that would get in the way of those kinds of incentives. As my hon. Friend the Minister for Employment said, nobody will lose out under the current proposals on free school meals; in fact, there might well be more recipients in the future.

[Karen Lee]

Figures published last month show that 27% of children in my constituency live in low-income households—and these are families who rely on universal credit. Does the Minister believe that it is acceptable that families living in poverty in Lincoln have to rely on food banks, particularly when due to problems with the roll-out of universal credit?

[Kit Malthouse]

I am sure that the hon. Lady, like me, welcomes the 43% fall in the claimant count in her constituency over the past few years—[Hon. Members: “That wasn’t the question.”] On her question, as she and many Members will know, the causes and drivers of people going to food banks are complex. [Interruption.] In my constituency, for example, the food bank was established in 2006—at the height of Labour’s conduct of the economy and welfare system—but the Department needs to think carefully about some of these issues, and we will be doing so in the future.

Oral Answers to Questions

Karen Lee Excerpts

Monday 18th December 2017 Commons Chamber

[Caroline Dinenage]

Sanctions are applied only as a very last resort and there are mitigations in place to support people when this is done. The hon. Lady is wrong to say that people in work are more likely to be in poverty; a key driver of in-work poverty is the part-time work that people were trapped in when her party was in government—people were trapped working fewer than 16 hours a week. The Labour Government were literally paying them to stay poor, whereas our reforms are about supporting people to progress in work and keep more of the extra money that they earn.

[Ms Karen Lee (Lincoln) (Lab)]

6. If he will make an assessment of the effect of the length of waiting time to receive universal credit on levels of food bank usage.

[The Secretary of State for Work and Pensions (Mr David Gauke)]

There is no reason for people to go without support while they wait for their first UC payment. New benefit claimants starting on UC today will be able to access an advance. This is normally paid within five working days, but can be delivered in a day if needed. Changes announced in the Budget will allow claimants to receive larger advances and for advances to be recovered over a longer period.

[Ms Lee]

Given the waiting period for universal credit, people face a choice: they can have no money to buy food, so either use a food bank or starve, or they can get a loan, as the Secretary of State says. Does he agree that pushing people who are already on a low income because they are on a benefit into debt in this way is totally unacceptable?

[Mr Gauke]

I do not accept the hon. Lady’s categorisation at all. The complaint that has been made about universal credit is about the cash-flow point—that people have to wait a period of time before they get their first payment. To address the cash-flow point there is a system of advances in the universal credit system so that people have the flexibility to receive the money earlier. It is an advance, they get it paid earlier—they do not get it paid twice, I accept that, but they get it paid earlier—and it is a perfectly sensible way to address a cash-flow issue.

Oral Answers to Questions

Karen Lee Excerpts

Monday 13th November 2017 Commons Chamber

[Ms Karen Lee (Lincoln) (Lab)]

5. If he will make an assessment of the effect of the length of waiting time to receive universal credit on levels of food poverty.

[The Secretary of State for Work and Pensions (Mr David Gauke)]

The availability of advances at the start of a universal credit claim ensures that those who need money immediately can access it. Our data shows that around half of claimants are receiving advances, and we have recently undertaken an exercise to improve awareness and access to this support.

[Ms Lee]

The manager of a food bank in Lincoln has said that there is evidence of a clear correlation locally between the introduction of universal credit—in Lincoln, we have only had it partially so far; we are getting full roll-out in March—and an increase in the use of food banks. I ask for your comments on that, and do Government Members, including yourself, think it is acceptable that people in Lincoln and across this country are starving but for food banks because of waiting for universal credit payments.

[Mr Speaker]

I would not presume to say what is acceptable for the people of Lincoln—that is way above my pay grade—but the Secretary of State might wish to proffer an opinion on the matter, and we look forward to it with interest and anticipation.

Universal Credit Roll-out

Karen Lee Excerpts

Wednesday 18th October 2017 Commons Chamber

[Ms Karen Lee (Lincoln) (Lab)]

My hon. Friend the Member for North West Durham (Laura Pidcock) spoke well at PMQs about the effect of universal credit in her constituency. Lincoln also has pockets of deprivation: some 13,000 people who work earn less than the living wage; one in four children live in poverty; one in 10 households are in fuel poverty; and 10 areas in Lincoln are in the top 10% of most deprived areas nationally. Universal credit was rolled out for single people in Lincoln at the end of November 2015, and the manager of the local food bank says that usage has already increased significantly as a direct result of universal credit and benefit sanctions. When universal credit is fully rolled out in March, I am concerned that people who are already suffering from the effects of the bedroom tax, benefit caps and the freezing of benefit rates will suffer even more.

Gingerbread, the CAB and Crisis—it is not just Opposition Members—all agree that simplifying benefits is a good idea, but universal credit is causing increases in poverty and homelessness. We have all received those briefings. Universal credit is this chaotic and divided Conservative Government’s initiative and it must be halted. It is a direct and deliberate attack on the poor and the vulnerable—[Interruption.] Government Members can shake their heads, but it is true. The Prime Minister must see the unnecessary suffering that her chaotic and divided Government are causing. They must stop inflicting this suffering on the people of this country and consider the needs of the many, not just the few.