Welfare Reform Bill

Lord Low of Dalston Excerpts

Wednesday 16th November 2011 Grand Committee

[Lord Wigley]

My Lords, as I was saying before I was interrupted a couple of days ago, these amendments touch on a critical consideration—namely, the need to ensure that those making assessments can identify factors that may make it difficult to engage meaningfully, fairly and objectively with the applicants: disabled people, whose condition of course fluctuates, as has been mentioned already, and for whom communication itself is often a challenge.

Nowhere is this more evident than among those whose difficulties arise from the autistic spectrum of disorders. As was pointed out by the noble Lord, Lord Touhig, on Monday, on the autistic spectrum not only are no two people the same, but the same person may exhibit different characteristics over a period of time.

The Minister will, I am sure, have noted from Monday’s debate that many of those who contributed—the noble Lords, Lord German, Lord Addington and Lord Touhig, and the noble Baronesses, Lady Howe and Lady Healy—highlighted the challenge of proper assessment in the context of autism. The noble Baroness, Lady Healy, emphasised the need for assessors to have specific training in autism, and access to expert champions. The noble Baroness, Lady Grey-Thompson, who moved the amendment, warned of the dangers of incorrect decisions where assessors base their conclusions on face-to-face interviews without professional knowledge and without experts’ evidence. Given the extent to which autism factors have run through this debate, may I urge the Minister to address the points raised in that autism context?

In particular, I urge the Minister to ensure that in dealing with problems of face-to-face assessments, safeguards be written into the Bill, so that wherever there is ample expert written evidence available, applicants do not have to go through unnecessary face-to-face assessments. The Bill should stipulate that all assessment will take into account expert reports and evidence as a first tier in that assessment process.

Secondly, there should be a requirement that those undertaking assessment have appropriate training, including in autism. This is something about which Autism Cymru, the organisation in Wales, feels particularly strongly. Also, in every assessment centre there should be available to assessors appropriate experts or champions in mental, intellectual or cognitive disabilities, including autism.

The third point I want to underline—and these have all been raised in different ways by noble Lords who have contributed to this debate—is that the Bill and regulations must specify that parents and carers are categorically allowed to support disabled individuals at every stage in the assessment process. Those without such support should be told of their rights to an independent advocate.

Finally, I turn to the position of lifelong awards in the context of Amendments 86F and 86G, to which I have added my name. The Government have said that they want all awards to be for fixed terms apart from in exceptional circumstances, and that there will be some sort of built-in review process. Surely the Minister must realise and accept that there will be people who are sadly not exceptional, whose condition is a lifelong one and for whom the worry and uncertainty of regular reviews are an unnecessary imposition, the cost of which is a waste of public money. Does not all common sense say that those with a degenerative disease, for example, should not have to face repeated assessments? In this group there are more than 300,000 adults, as I understand it, with autism, whose core condition will not change; there are some 70,000 with MS and 20,000 with Parkinson’s disease, whose condition is incurable. Retesting these people is no more than pandering to the tabloid agenda we heard about in the last sitting.

I urge the Minister to take on board these amendments and to facilitate lifelong awards where appropriate.

[Lord Low of Dalston]

My Lords, I have put my name to Amendment 86ZB in this group. These amendments, which would dispense with a face-to-face assessment where there is appropriate written evidence, have considerable overlap with Amendment 86ZZZV in the name of the noble Baroness, Lady Campbell, in the next group. So, if I may, I will say what I have to say on the matter now and spare the Committee the repetition when it comes up later especially since, with apologies to the Committee, I have to leave for the airport at 3.15 and may not be around when we come to the later discussion.

[Baroness Hollis of Heigham]

Lucky man.

[Lord Low of Dalston]

I particularly support the idea of a trial period before incurring huge public expenditure in reassessing 2 million disabled people, many of whom really do not need it, for example, if their circumstances are unlikely to change. Where there is written evidence of severe impairments, it is simply common sense to accept that evidence and avoid putting people through costly and potentially distressing face-to-face interviews. Setting out criteria that would signal eligibility for PIP without an interview is an administratively simple way to indentify those who have severe impairments that have already been assessed through written evidence as giving rise to a higher level care or mobility need.

The Government have said that they do not think it is right that we should judge people purely on the type of health condition or impairment they have, making blanket decisions about benefit entitlement. One can understand their desire to personalise the assessment process when the impact of an impairment may not be clear. However, it is obvious that in some cases the impact is clear from written evidence and beyond dispute in terms of its implications for the rate of PIP that should be awarded. For some groups of people it is perfectly clear from the severity of their impairment that they should be eligible for enhanced rates of PIP without further assessment. For example, if someone is deafblind, a face-to-face interview to establish that they have mobility needs of the highest level is barmy. If someone has no sight at all or no legs, no further assessment is needed to confirm that they have a high level of mobility need. In cases such as these, a face-to-face interview is simply a waste of money. In addition to avoiding unnecessary stress for severely disabled people, this amendment would save money for the taxpayer. It feels pretty much like a no-brainer to me.

[Baroness Thomas of Winchester]

My Lords, I strongly support this amendment and perhaps I might read it out, because it is a long time since we first started talking about it. It would insert:

“including a requirement for the decision maker to collect evidence from the claimant’s own health care professionals as a part of the decision making process”.

There is a strong suspicion that this is not always done. The only thing that I would quibble with in that amendment is that not only does the decision-maker have to collect evidence, it has to be taken into account when the decision-making process is gone into.

My question for my noble friend is about a sentence that I found in one of the documents we were given—I cannot now remember which one it is. It says:

“Decision Makers will change erroneous decisions rather than send them to a Tribunal”.

The next sentence says:

“If a claimant’s points at issue are not resolved, they can still appeal to the HM Courts & Tribunals Service”.

I had to go to a tribunal having had my papers re-examined, presumably by a decision- maker. What will change about the process now with PIP? I am not quite sure, reading between the lines, what the two sentences that I have read out mean. Are things going to change from now, or not?

--- Later in debate ---

[Lord Wigley]

Before the Minister sits down, he mentioned the possibility of developing in conjunction with the National Autistic Society an initiative to augment training. Is he aware of the scheme that has been running in Wales, under the autism plan that was adopted by the Government of Wales, with training work undertaken by Autism Cymru with Careers Wales and to some extent with Jobcentre Plus itself? Last February, an online booklet was published for Careers Wales and Jobcentre Plus, and there were similar publications on autistic conditions relating to the advocacy service and GP practices. Are these the sort of initiatives that the Minister sees being developed in conjunction with the National Autistic Society?

[Lord Low of Dalston]

Before the Minister concludes, I am sorry if I was not paying attention, but I did not hear him respond to the points made about our amendment about cases where the written evidence was clear and unambiguous, where there were very high levels of need which, the nature of the impairment made clear, were unlikely to change. I heard the Minister say that the assessment process would be implemented with flexibility, but my impression was that the avoidance of a reassessment would be a pretty exceptional situation. Those of us who support Amendment 86ZB believe that cases where people's circumstances are unlikely to change and their high levels of need have been unambiguously and unequivocally evidenced are not isolated exceptions. That is a widespread and general circumstance. Can the Minister respond a bit more positively on that?

[Baroness Thomas of Winchester]

Will the Minister also respond to my question, when I asked whether the sentence:

“Decision Makers will change erroneous decisions rather than send them to a Tribunal”

is a change from the present system?