Welfare Reform and Work Bill

Lord Patel Excerpts

Wednesday 9th December 2015 Lords Chamber

Moved by

[Lord Patel]

50: Clause 13, page 14, line 24, at end insert—
“( ) Subsections (2) and (3) shall not come into force until the Secretary of State has laid before both Houses of Parliament a report giving his or her estimate of the impact of the provisions in those subsections on the—
(a) physical and mental health,(b) financial situation, and(c) ability to return to work,of persons who would otherwise be entitled to start claiming the work-related activity component of employment and support allowance.( ) Regulations bringing subsections (2) and (3) into force shall not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.”

[Lord Patel (CB)]

My Lords, my turn has come—rather sooner than I thought it would. In moving Amendment 50, I will speak to Amendment 53 in my name. I am very grateful to all the noble Lords who have put their names down supporting my amendments.

These amendments would prevent Clauses 13 and 14 coming into place unless the Government can demonstrate to Parliament’s satisfaction that they will achieve what they state—namely, supporting people into work—without having a detrimental impact on people’s financial situation or health. At Second Reading I raised significant concerns about the proposals that I know were shared by many in this House and by Members in the other place, too, including Members in the Minister’s own party. They tabled amendments that were not moved.

What do I see as the problem? Many organisations, including Macmillan Cancer Support, Rethink Mental Illness and Parkinson’s UK, oppose these clauses because of the detrimental impact the changes will have on people who are ill or debilitated by their condition. The changes will mean that from 2017 new claimants will receive the same amount as those on jobseeker’s allowance, meaning they will be £30 a week worse off than under the current system. Those claimants, such as people recovering from cancer, will no longer be entitled to additional financial support in recognition of their illness or disability.

In his response at Second Reading, the Minister pointed out that many people with cancer are, at least initially, placed in the support group and suggested that they will not be affected. I agree; those in the support group will not be affected. However, my concern is not that people will not be supported while they undergo treatment for illness. My concern is for those people who either have moved into the WRAG from the support group once their treatment has finished or do not meet the stricter criteria of the support group and are placed straight into the WRAG. The suggestion that the number of such people is small is not true; the Government’s own estimates suggest that it could be above 5,000. Given the transient nature of the benefit, with people moving in and out of the WRAG, the number of people who will be affected is likely to be much higher. My amendments seek more accurate figures as part of the evidence.

What is also not clear, and which is particularly important for people with cancer, is whether those who are in the support group before April 2017 but then move into the WRAG after April 2017 would be classified as new claimants or whether they would be subject to the cut and be put on to the lower rate of £73.10. I hope the Minister will be able to clarify that. I am sure that he will.

The impact of having cancer does not necessarily end once someone finishes treatment and recovers from its immediate side-effects. Common consequences of treatment include: chronic fatigue; extreme pain; mental health problems, including moderate to severe anxiety or depression and post-traumatic stress disorder; urinary and gastrointestinal problems; speech difficulties; and much more. Many of these problems may emerge some time after treatment and last for months or years. I give the true example of Jim, who was successfully treated for prostate cancer. He said, “I suffer lots of problems with my bladder and colon. Being caught short is a constant worry so I have to live my life aware of this constantly”.

It cannot be right to suggest that people like Jim should be treated in the same way as jobseekers who are fit and able to work. If the proposals go ahead, people such as those with cancer who may initially go into the support group, but then move into the WRAG when their treatment finishes, will drop from £109 to £73.10 when they move from one group to the other. For many, this is a huge drop, leaving them in a particularly vulnerable situation, and could compromise the progress of their recovery. I urge the Minister to look carefully at this group of people and the impact that the change will have on them before making any changes to the legislation.

Ahead of the election, the Government made a very welcome commitment that their welfare reform programme would be underpinned by a commitment to protect the most vulnerable and the disabled. People recovering from cancers are vulnerable. Some face side-effects, live with the knowledge that their cancer may return and are in need of support. They are not fit to work. The reason that people receive ESA WRAG or the limited capability for work element of universal credit is because they have been judged as having limited capability to work—in other words, they are too ill to work. Cutting someone’s money will do nothing to address this. It will not improve their health. Indeed, if anything, it is likely to make it worse by causing additional stress and anxiety, with added worries about making ends meet financially.

The Minister made a particular effort at Second Reading to highlight the fact that having limited capability to work is not the same as being unable to work. It is my understanding that someone is placed in the WRAG because their capability for work is deemed to be so limited that they cannot reasonably be expected to look for, or engage in, work. That is why they have been deemed eligible for ESA rather than JSA. People on ESA WRAG are simply too ill to work at this point in time. These people need time to recover and a degree of financial support to help their recovery. Cutting people’s benefit levels will not help to support them back to work.

At Second Reading, the Minister referred to an OECD report as evidence for the change. The report stated:

“Financial incentives to work can be improved by either cutting welfare benefit levels, or introducing in-work benefits while leaving benefit levels unchanged”.

However, the report to which the Minister referred looked only at unemployed and inactive individuals, not people who are unable to work due to illness. Indeed, if you were to look at the research on people who have limited capability for work due to illness—as people in the WRAG do—the evidence is very different. For example, a study by researchers at Sheffield Hallam University in 2011 found that cutting benefit levels for those who are unable to work due to illness, or recovering from illness, does not result in more people returning to work. Many people with illnesses and disabilities are significantly worse off as a result. Research by Macmillan, for example, found that people with cancer were, on average, £570 a month worse off because of the financial impact of their diagnosis. Many cancer sufferers struggle to cope financially. There has been recent media coverage of Macmillan research which showed that almost 170,000 people with cancer in the UK cannot celebrate events such as Christmas or a family birthday due to lack of money.

It should be a key principle of the welfare system that those who have worked hard but who find themselves, through no fault of their own, unwell and unable to work for a period—not permanently—will be provided with an adequate safety net. We should not do anything to undermine that principle. It is important to have an assessment of the impact that the changes will have on people’s financial situation and their physical and mental health. Financial pressure will force people to return to work before they are physically and mentally fit enough. I have heard of people affected by cancer who, even on the current amount of money that the WRAG pays, have felt pressured to return to work before they were well enough. This has led to them returning to work too soon, and their health suffering as a result, to the extent that they now need to be in the support group. If this is happening on the current payment rate of £102, I can only imagine what will happen when the payment drops to £73.

Much has been said about the role that work can play in keeping people healthy. I do not doubt for one minute that that is the case. For many people who have been ill, returning to work represents a return to normality and a sign that they are reclaiming their life. Many people talk about the importance of becoming an employee again and being defined by their work status, not their cancer. However—and this is important —that only holds true if the work they return to is right and appropriate for them. It has to be “good work” for them, by which we mean work that is suitable, appropriate and meets the needs of people returning from illness.

Amendments similar to mine were tabled by Conservative Members in the other place and sought to highlight the significant impact that the changes will have. The proposed changes are neither sensible nor morally right. While my amendments seek the evidence to support Clauses 13 and 14, the important point is that people who are recovering from serious illnesses and are not considered fit to work should not be further financially penalised. There is an opportunity here for the Government to demonstrate their commitment to the vulnerable and disabled by rethinking the proposed changes.

As I said at Second Reading, when, in 2012, the Government lost several consecutive votes, the then Bill was converted into a financial privilege measure. I hope that that will not occur now but in 2012, despite the fact that the Bill was converted into a financial privilege measure, the Minister—the noble Lord, Lord Freud—came up trumps and agreed to put people who are vulnerable into the support group. I hope he is minded to do the same this time—that is, help those who are vulnerable and ill. I am sure he will do that and demonstrate that the Government support the vulnerable. I beg to move.

--- Later in debate ---

[Lord Freud]

That is a massive question. The short answer is that because universal credit is a much more efficient benefit to administer, we are able, in practice, to put more people on the front line to support those who we need to support. The department has been working very hard, with very precise ways of helping quite a lot of new people doing quite a lot of new things; work progression is one part of that and disability another.

The changes I have been talking about will be accompanied by new funding of up to £100 million per year by 2020-21, which is part of where the money is coming from, to help claimants with limited capability but some potential for work to move closer to the labour market and, when they are ready, to get back into work. We will provide more details on this kind of support next year. In the Autumn Statement, the Government announced an increase of nearly 15% to help people with health conditions return to and remain in work.

There is a great deal of interest in this House and elsewhere about how we will make this employment offer. We will set up a task force, which will include external experts, disabled people and disabled people’s organisations to make sure that we do this in the best possible way.

In this context, I will pick up one other point from the noble Lord, Lord Low, who said that the Work Programme had failed disabled claimants. More generally, the Work Programme clearly has had some astonishing outcomes. In this area, it has taken a group that is traditionally very difficult to get into work and, in the latest cohort, it has got one in 13 people into work for at least three months since joining the scheme. That figure is higher than the expected level of one in 14, and has effectively doubled since the Work Programme started. Then, when it was trying to find its way into what was working, the figure was one in 25.

The noble Baroness, Lady Howe, raised the issue of mental health, which has been of acute concern to us for a number of years and is an issue that I personally have pushed for five and a half years now. We now have a programme of £43 million over the next three years to build our evidence on what works for those who have been long-term unemployed and have mental health conditions. A range of pilot schemes is going through to test what actually works. I am enormously proud of getting that kind of money to this kind of issue, which I suspect has been but a dream for previous Ministers in my position.

Let me address the amendment tabled by the noble Lord, Lord Patel, the noble Baroness, Lady Meacher, and the noble Lord, Lord McKenzie, which seeks to do two things. First, it requires the Secretary of State to publish a report, before subsections (2) and (3) come into force, on the impact that these provisions will have on those affected by the change, particularly the impact on a person’s health, finances and ability to return to work. A similar amendment was laid and debated in the other place. We have, of course, already published our assessment of the impacts, which was made available on 20 July. I can assure noble Lords that the Government are committed to a fair tax and welfare system, and that every individual policy change is carefully considered. How the changes affect individuals will depend on their circumstances, including the nature of their illness or disability, which can vary considerably.

I point out to the noble Lord, Lord Patel, that the proportion of people in relative poverty who live in a family where someone is disabled has actually fallen since 2010. PIP is the benefit that provides a contribution towards some of the extra costs arising from a long-term health condition, and that is protected. I know that the noble Lord is particularly concerned about the effect of this change on people with cancer. I am delighted to be able to confirm that the vast majority of people with cancer claiming ESA are in the support group. This includes anyone who is either preparing for, receiving or recovering from chemotherapy or radiotherapy that will significantly limit their ability to work. Only a small proportion of individuals whose initial diagnosis is cancer will be placed in the WRAG. Employment can obviously play a vital part in supporting an individual’s recovery. Macmillan itself recognises this and stated in a report:

“Many people who are working when they are diagnosed with cancer would prefer to remain in work, or return to their job, during or after treatment”.

I will pick up on the point made by the noble Baroness, Lady Manzoor, and my noble friend Lord Blencathra about Parkinson’s. On its website, Parkinson’s UK recognises that many people with Parkinson’s continue to work for many years after their diagnosis, although to do so they may need changes to the way in which they work. I also need to reassure the noble Baroness, Lady Meacher, that no one who has motor neurone disease is currently in the WRAG.

As other noble Lords have mentioned, we are now committed to replacing Work Choice and the Work Programme with a combined work and health programme, so the support systems should now start to ratchet up, benefiting from the considerable amount that we have learned in the last few years.

There is a large body of evidence to show that work is generally good for physical and mental well-being and that, where their health condition permits, sick and disabled people should be encouraged and supported to remain in or to re-enter work as soon as possible. That is why an important part of this change is the extra resource that we are putting into support to help bring that about.

The second part of the amendment seeks to require that any regulations made under this section of the Bill be made under the affirmative procedure. However, as these measures are being debated extensively throughout the passage of the Bill, I am not convinced that requiring further debates in both Houses on the regulations is a necessary or, indeed, appropriate use of costly parliamentary time.

I can confirm to the noble Lord, Lord Patel, that those who move from support to WRAG will be protected. It will not be regarded as a new claim, as he asked.

I turn now to the amendments tabled by the noble Lord, Lord Layard, and the noble Baronesses, Lady Hollins, Lady Tyler and Lady Howe, which seek to remove work rate requirements from claimants with a mental or behavioural disorder and refer them to IAPT. As already stated, there is a large and growing body of evidence over the last decade showing that work can keep people healthy as well as help promote recovery if someone falls ill. This includes mental health. By contrast, there is a strong link between those not in work and poor health. We also know that the majority of ESA claimants in the WRAG want to work.

At this point I would like thank the noble Lord, Lord Low, and the noble Baronesses, Lady Meacher and Lady Grey-Thompson, for the report that I received yesterday. They brought it to me, and I read it with great interest. I am particularly struck by the impact that being out of work has on people’s health—and that is, of course, the reason that we have announced our intention to have a White Paper. We will continue to monitor the impact of this change over time through regular national statistics.

Amendment 52 was spoken to by the noble Lord, Lord Layard, and my noble friend Lord Lansley. We recognise the barriers that people can face, which is why we are committing these resources to help them find what works best for them. I agree that access—and particularly early access—to treatment services can be crucial to achieving recovery. I genuinely support this part of the agenda, and the noble Lord, Lord Layard, knows that I do, but I do not believe that this particular Bill is the right mechanism to achieve these ends. The Secretary of State does not have the power to offer NHS services to claimants. Even if he did have that power, devolved Governments in Wales, Scotland and Northern Ireland have had power over the organisation and budgets of the NHS within their jurisdictions since 1999, so in practice this amendment would be constitutionally impossible.

I should like to conclude—noble Lords will be relieved to hear—by reminding the Committee that the Government committed in their manifesto to halving the disability employment gap and improving the support we provide to people with mental ill-health and long-term health conditions. The change to ESA and universal credit is an important part of that, so I urge the noble Lord to withdraw his amendment and support the proposition that Clauses 13 and 14 should stand part of the Bill.

[Lord Patel]

My Lords, we have now been talking for about two hours and seven minutes, with some 17 speakers. We cannot claim that we have not given enough time to this group. I do not want to prolong the discussion; I am tempted to take this opportunity to engage with the noble Lord, Lord Lansley—for which I have been waiting for a very long time—but I will wait a little longer. I thank all noble Lords who have taken part, whether they addressed my amendment or the other amendments. I sincerely appreciate very much—I say that on behalf of all of us—that the noble Lord, Lord Freud, does listen to us and his response at length demonstrates that. I am encouraged by some of the things he said relating to my amendment and cancer patients, but I hope that others might have felt that some of the things he said were encouraging. I have no doubt that there are others who did not. I, and, I am sure, others, will read very carefully what he said, encouraged by the White Paper. I thank the Minister and beg leave to withdraw my amendment.

Amendment 50 withdrawn.