Welfare Reform Bill

Lord Touhig Excerpts

Tuesday 13th September 2011 Lords Chamber

[Lord Touhig]

My Lords, I will focus my remarks on Part 4 of the Bill, which will bring in a new benefit called the personal independence payment to replace disability living allowance. In particular, I will consider the impact of the changes on people with autism.

Disability living allowance is a key benefit for many people with autism, designed to meet the additional costs of their disability. The National Autistic Society has said that reform of disability living allowance could offer an opportunity to ensure that the needs of people with autism, who are some of the most vulnerable in our society, are better understood in the allocation of benefit. It has welcomed the increased focus on participation, communication and the ability to plan and make a journey, all outlined in the consultation documents on the reform as well as in the draft regulations. However, the National Autistic Society, along with other disability organisations, has serious concerns that the objective of a 20 per cent cut in projected spend on the award seems to be the main driver for change. If this is the case, a significant number of adults with a disability will lose out.

Our fear is compounded by the Government’s stated intention to focus benefit on those with greatest need, which is yet to be defined, and with the proposed introduction of a new assessment process, including face-to-face interviews. Like many noble Lords, I share the National Autistic Society’s concerns about the introduction of face-to-face assessment for the new benefit, particularly given the experience of the work capability assessment. The National Autistic Society followed a group of people with autism through the work capability assessment process and found that the medical assessment was a particular barrier to having needs fully and properly assessed. Face-to-face assessments for people with autism are problematic and can be extremely stressful.

Autism is a lifelong developmental disability that affects the way a person communicates with and relates to another person. Areas of difficulty include an inability to understand the nuances of language, facial expressions or tone of voice, and a propensity to take everything literally. In light of this, an interview with a stranger asking questions that you may not understand or be able to answer accurately due to the language barrier is hardly the best method of assessment. But the many different types of communication barrier also mean that an assessor untrained in autism may not pick up on the difficulties faced by the person with autism or Asperger’s syndrome. For example, if an individual on the autism spectrum has known about their interview for weeks, they may spend those weeks practising what to say in order to come across well in a way that will perhaps not truly reflect their actual communication struggles. They may come across as not having any noticeable communication difficulties and therefore be wrongly assessed.

People with autism also often lack insight into their condition and may not have a good understanding of what areas of their daily life they need help with. They could also fail to mention real areas of difficulty because they do not comprehend their importance or because they are eager to please. However, an assessor with no knowledge of autism is very unlikely to understand this. An effective diagnostic assessment of someone’s communication skills would often need to be carried out over a period of several hours, across different days and in different environments. A half-hour session with a stranger is far too blunt a tool to make a proper and fair assessment.

There are particular concerns, as other noble Lords have already mentioned, about who will carry out these assessments and what training their staff will have with autism. How we can be assured that the staff who will carry out the assessment will have adequate training in autism? Autism is particularly poorly understood among health professionals in this country. Indeed, research by the National Audit Office in 2009 found that 80 per cent of general practitioners did not feel that they had enough knowledge and training in autism. Can the Minister explain what the Government intend to do to ensure that adequate and specialist training for assessors is in place so that adults with autism can have their needs comprehensively and fairly assessed?

Organisations representing people with disabilities have been encouraged by government pledges in Written Answers and in response to the disability living allowance consultation that they understand that face-to-face assessments are not suitable for everyone. Indeed, the Minister stated in Lords Questions on 10 March this year that where it is not “realistic, helpful or appropriate”, the Government would not insist that applicants for personal independence payment be seen face to face. Could the Minister clarify what this means and commit to putting safeguards in the Bill to ensure that individuals for whom it is inappropriate are not put through face-to-face assessments unnecessarily?

As well as the limited timeframe, other factors make it difficult for proper scrutiny of the Bill to take place. The draft regulations provide no indications of the points that would be awarded for each of the criteria. Essentially, Parliament is being asked to scrutinise clauses for the personal independence payment on the basis of regulations that make it far from clear who will qualify for the benefit in 2013. That makes it extremely difficult to estimate what the impact on people with disabilities will be.

I therefore have two further questions for the Minister. Will he commit the Government to introducing biennial reviews of the implementation of the benefit to ensure appropriate scrutiny of the operation of the benefits in place? Will he also commit to ensuring that all regulations relating to the personal independence payment will be subject to affirmative resolutions so that this House and the other place can be given the opportunity to scrutinise the regulations?

For the sake of public finances in the medium and long term, for the sake of the integrity of the new benefit, but—most especially and in particular—for the sake of many people on the autism spectrum for whom DLA is their only lifeline, I ask the Minister to seriously and comprehensively review both the process and the assessment criteria for the new personal independence payment and ensure that, when introduced, it will be fit for purpose.