Welfare Reform Bill

Lord Touhig Excerpts

Wednesday 16th November 2011 Grand Committee

[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?

[Lord Touhig]

My Lords, I have already spoken in this debate but I ask the Committee’s indulgence to make one other brief comment. The noble Baroness, Lady Gardner of Parkes, has tabled Amendment 86ZAA in this group. Yesterday, she was mortified when she realised that she has a commitment today which it is impossible to break and she cannot be here. I know that she has apologised to the Minister. She has asked me to extend that apology to the whole Committee and asked that I make one brief comment on her behalf. If she had been here, she would have said that if a person has a clearly diagnosed and irreversible condition, they should not be required to have continuing assessments as it causes them concern and adds unnecessary cost to the system. I think that point has been made by other noble Lords in the debate, but the noble Baroness was really keen to get that point on the record and, again, she apologises for not being here today.

[The Lord Bishop of Blackburn]

My Lords, I speak broadly in favour of this group of amendments, which address the fact that the assessment of individuals for eligibility for PIP is a complex and very stressful process both for those being assessed and for assessors, unless the assessors are appropriately trained and supported. That is a vital point that we must take on board: that the assessors must be well trained and well supported.

I remain concerned about the tests that the assessed are being put through, the activities and the scoring. I am not one of those bishops who have not come up through the ranks, as it were; I have spent most of my ministry in parishes. From a long ministry in parishes—I still visit the elderly regularly—I have seen parishioners able one day to prepare and cook a meal, and to be able to do virtually everything for themselves. Then I have gone in the next day or the next week and they can do very little unaided. These tests can be no more than a snapshot and we must again take that on board.

All along I have believed that there will be a real need for the most careful monitoring: the assessment cannot be made on a tick-box basis. That, I am afraid, is how it looks to many of us at the moment. It is essential that the tests and assessments are made by those who are adequately trained and qualified and have the perception to see that someone’s performance the next day will perhaps produce a different score.

--- Later in debate ---

[Baroness Wilkins]

My Lords, at the risk of replaying the record, this is an important amendment because it would go a long way to protect the Government from facing the same sort of vilification that they have received from their introduction of the work capacity assessment for employment and support allowance. Much more importantly, it would protect disabled people from facing the anxiety, illness and ill health they have experienced while undergoing the headlong rush to reassess the 1.5 million claimants for incapacity benefit. That reassessment has gone ahead despite the fact that the Government know that the assessment criteria are seriously flawed.

As the Minister of State at the DWP, Mr Chris Grayling, said in the other place on 24 October:

“We have received suggested descriptors for mental, cognitive and intellectual function from Professor Harrington’s working group. Given that they represent a substantial departure from how the current assessment works, we are considering what impact they will have and will come forward with proposals soon”.

That is fine. He went on:

“The challenge facing us is that the recommendations will involve a complete change of the work capability assessment, not simply for mental health issues, but for physical issues, and is therefore a multi-year project”.—[Official Report, Commons, 24/10/11; col. 8]

Let us not make the same mistake again. Or rather, please let the Government not make the same mistake again.

I was going to quote from the lady I mentioned in an earlier debate, a GP who attended a recruitment evening for Atos assessments, and who wrote in the BMJ this year. The figures that she was quoted about what a doctor could earn from the assessment process were, I found, quite shocking.

Sessional doctors work a minimum four sessions a week, and are paid per item: £51.37 for non-domiciliary disability living allowance examinations, for example. The application forms for sessional doctors state :

“10 DLA domiciliary visits cases per week would earn £40, 211.60 per annum”.

I ask the Minister—and I apologise if he has already given this answer to the noble Lord, Lord McKenzie—what is the Government’s estimate of the cost of re-examining the thousands of people whose conditions will not change, or will only worsen? And can he remind us how often he is expecting them to be reassessed ?

[Lord Touhig]

My Lords, like many noble Lords I am a great fan of pre-legislative scrutiny, because I think it improves the quality of the legislation we pass. I also have great faith in this Committee system, because we go through a Bill line by line in order to improve it, amend it, and make good law as a result. I certainly support this amendment, because a trial period does make sense.

I look across at my good colleague the noble Baroness, Lady Browning. She and I sat on the Public Accounts Committee in the other place. Time and again we considered reports from the National Audit Office which showed that some great government scheme, some great initiative, had gone billions of pounds over budget, or gone over time. Inevitably we found that these things had not been trialled beforehand, to see if key elements of the proposals would work effectively.

Some unfortunate Permanent Secretary would be brought before the Public Accounts Committee, and like modern-day Draculas, we drew a lot of blood in our interrogations. Inevitably, this Permanent Secretary was not responsible for what the department had got wrong, anyway; it was the previous incumbent, but that is by the by. We were seeking to learn lessons, but inevitably it was like closing the door after the horse had bolted. If only more care had been taken, or things had been trialled and piloted beforehand, then things would not have gone wrong in the way that they did.

If the Government take this amendment on board, it has the potential to save millions of pounds. If the Bill does not take account of this, then somewhere down the track the NAO will come in, in two or three years, and find that there has been some great failure, or some great cost. The Public Accounts Committee will have to investigate, and the Department for Work and Pensions will be held up again as having failed to pilot or introduce a scheme in a good or effective way, as it promised it would. The amendment makes a lot of sense, and I hope the Minister will see that.

[Baroness Browning]

My Lords, this is the first opportunity I have had to contribute to the Committee. I declare my interest both as the named carer of an adult with autism and as, I believe, somebody who will need to attend the assessment meeting with him. I am that other person, so I am more than personally interested in this legislation.

My friend the noble Lord, Lord Touhig, made a good point about getting good value for money and making sure a system works. However, there is another point about trialling it with new applicants. I remain cautious about the ability of a lot of people newly recruited for the purpose to carry out what will be really quite difficult balances of judgment across a wide section of people, particularly those with learning disabilities, mental health conditions and autistic spectrum disorders, some of whom will have two or all three of the conditions.

I refer the Minister to my personal experience over many years: I am very proud to have raised the very first debate on Asperger’s syndrome in the House of Commons many years ago. When it came to getting contracts signed for people to get people into paid employment, one of the contract requirements was that the various agencies and commercial companies had a full understanding of this range of really quite difficult disabilities. All too often that training and preparation was based on reading up and taking a bit of advice. It never, ever, made the mark.

To give an example, in the case of people on the autistic spectrum it is well known—if I am to generalise and as has been said quite rightly they are individuals who will all display individual characteristics—that their lack of imagination and inability to express and understand non-factual things, as opposed to in some cases a quite high level of ability in understanding factual information, very often leads one to read in manuals and books about autism that if you converse with somebody on the spectrum it is best not to deal in generalities but to deal with specific questions that require specific answers. Some of the contracts that have been issued in the past to get people with autism into work have led the people assessing their aptitude for employment to carry out conversations that frankly beggar belief. I have had some personal experience of this. The questioning would be very much along the line not of, “How are you?”—that is a difficult question to answer—but “Do you live in your own home?”, “How many chairs do you have in your sitting room?” and “What size is your television screen?”. There was a mistaken belief that this was a normal conversation that somebody on the autistic spectrum would feel comfortable with. In one example the person being questioned was actually very intelligent and felt straightaway that they were being patronised, as any of us in this Room would have done.

Therefore, a lead-in period is needed to assess not just the value for money and the way in which this new system is working but also to allow for time, which is really needed, to make sure that the people carrying out these assessments have a working knowledge of some of the more complex conditions and a much better understanding to be able to make their judgment.

I hope the Minister will listen carefully to the points that are being made to allow a lead-in time for new applicants so that we can get this right.