Welfare Reform Bill

Lord Addington Excerpts

Tuesday 17th January 2012 Lords Chamber

[Lord Addington]

The amendment on which mine is the lead name also refers to the autistic spectrum. When the noble Baroness is in the Chamber with us, I always feel as though you are definitely on the end of the passing movement, as opposed to being the play-maker. The noble Baroness knows exactly what she is talking about. At my conference, someone who was talking in a meeting about autism said, “You must understand that autism is a three-dimensional spectrum”. Does that phrase not start to explain why the diversity of people and their reactions are incredibly difficult to understand and always will be? I wish I had thought of that expression myself. The great diversity of needs and different types of behaviour mean that you must have some specific training.

When I was approached to put down this amendment, I had a conversation with the NAS. I want to use it as an example of the fact that you always need a certain degree of knowledge to make this type of assessment. I remember that, in years gone by, when the noble Baroness, Lady Hollis, spoke for the then Government, our exchanges on the subject of the initial interview process went on and on and developed almost into a ritual dance. “Can we have specific knowledge?”, we would ask the Government. “No, but we will give them lots of training”, they would reply. We have got better, because we always do, but it remains the case that unless you have someone who actually understands the condition which they are assessing and reporting on, they will make mistakes.

The noble Baroness, Lady Grey-Thompson, has already pointed out that mistakes cost “blood and gold” for everybody concerned. You burn up time; you burn up money; you cause suffering. Getting more expertise into assessment, either by taking a better history, or by making sure you have the right person there at the right time, will make life a lot easier and will probably save money in the long term or, indeed, in the medium term. The Minister has been moving forward, although he is pushing water uphill with certain concerns here. I stress that I am looking for clarification on where he is moving to and his thoughts on where this expertise is going to be dragged in. If you have a problem, empower people to say that there is a problem and that someone who understands it needs to be brought in. If you can do that, you will take huge steps forward. You will not get it right all the time but you will get it right more often.

If the Minister can give us some encouragement and some firm guidelines about what is going to happen to encourage people to get it right—not just to get the numbers through—I will be a very much happier man at the end of this.

[Lord Touhig]

My Lords, I do not intend to detain the House long, because Amendments 50B, 50C and 50D were debated at some length in Committee. I attempted to withdraw Amendment 50A yesterday, but the gremlins crept in and the only thing that has been withdrawn is my name—the amendment still appears on the Marshalled List.

With Amendment 50B, the noble Lord, Lord Addington, has once again made a very powerful case in support of the need for properly trained assessors. In particular, all assessors should have an understanding of and training in autism if they are to recognise and understand the complex cases they will have to deal with. It has been said a number of times—I make no apology for repeating it here, because it is important—that when you have seen one person with autism, you have seen one person with autism. This is why the training is so important. A knowledge of autism and possessing the right skills to assess the needs of an autistic person are essential in making any decision about the appropriate level of financial support that that person might need. I believe that the Minister accepts this point of view.

Following the Committee stage, a number of other noble Lords and I had a very useful meeting with the Minister and his colleague Maria Miller MP, and we are grateful for that opportunity to exchange views in a less formal situation. One point from that discussion, which was touched on today by the noble Baroness, Lady Browning, did concern me—the point about the qualifications of the person carrying out the initial assessment. One of the Minister’s officials told us at that meeting that the initial assessments would be carried out by an occupational therapist. Will this be the case? That seems a very narrow skill base from which to draw the expertise for any kind of wider assessment, and it leaves me, for one, with the impression that the assessment is aimed primarily at getting people into work and not at trying to understand and support them if they are not able to work. Such a situation would fly in the face of the well-argued case that assessors should have specific training in all mental, intellectual and cognitive disorders, as advocated by the amendment. I hope the Minister can allay my fears.

I turn to Amendments 50C and 50D, in my name and that of my noble friends Lady Healy of Primrose Hill and Lord Wigley. The amendments concern face-to-face assessment and would, if accepted, exempt certain categories of people from the process of continuous reassessment where sufficient medical and other expert evidence existed to demonstrate that their condition would not improve. I return again to my concerns about people with autism. Autism can be summed up in this way: autism is for life. Any reassessment must accept this fact before progress can be made. The Minister made it clear, at Second Reading and in Committee, that the Government did not believe that a face-to-face assessment would be the right course to follow in all cases.

At our meeting, both the Minister and his colleague, Maria Miller MP, gave a strong impression that the Government would support a tiered approach to assessment in such cases, as advocated by the National Autistic Society and others. In practice, this tiered approach would allow for written assessment from professionals to be considered and a decision to be made, on that basis, about whether a face-to-face assessment was appropriate or necessary. I will not test the patience of the House any longer. I look forward to the Minister’s response and hope he will have something positive to say about a tiered assessment.