Welfare Reform Bill

Lord Wigley Excerpts

Monday 21st November 2011 Grand Committee

[Lord Touhig]

My Lords, Amendments 86F and 86G in my name, that of my noble friend Lady Healy of Primrose Hill and those of my good colleagues, the noble Lord, Lord Wigley, and the noble Baroness, Lady Gardner of Parkes, are intended to make it clear that indefinite awards could and should be made for people with lifelong conditions or disabilities of a degenerative nature. Such awards should be based on evidence from healthcare professionals showing that the needs of the person receiving the award will remain the same or increase over time, and that they will therefore continue to meet the eligibility criteria for the benefit indefinitely.

The Government have stated an intention to make the personal independence payment awards for a fixed term, except in exceptional circumstances. In addition, the Government’s proposal is that there will be an in-built review process for all awards to ensure that they remain accurate. This proposal is based on the assumption that most individuals will show some improvement or will be able to adapt to their condition over time to the extent that their needs will lessen. However, this is simply not the case for those with long-term conditions. There are around 300,000 adults in England with autism, which is a lifelong condition. While some people with autism may develop the ability to manage aspects of their disability, such as improving verbal communication or overcoming an inability to travel by learning a specific route, such positive change happens only as a result of support, including the present disability living allowance. If that is taken away, progress risks being reversed.

I am not arguing that people should be granted indefinite awards solely on the basis of their diagnosis. However, if medical and social care assessment evidence for the individual claimant indicates that theirs is a lifelong condition that is unlikely to improve, this should be taken into account to indicate that an indefinite award may be appropriate. It is important that this is prescribed in regulation. Reassessing all claimants with long-term and degenerative conditions not only wastes taxpayers’ money but can cause significant stress for claimants, especially those with autism, who often have additional mental health problems. The increased anxiety can lead to deterioration in the claimant’s health, thereby undermining the Government’s purpose and the rationale of enhancing the independence of disabled people—to which we all subscribe.

Our amendments before your Lordships this afternoon would allow for lifelong awards where there is evidence to show that the individual’s condition is unlikely to change over time. In our debate last Monday I said that, so far as understanding autism is required, the condition can be summed up in four words: autism is for life. Where it is established that a person with autism should receive the personal independence payment, it, too, should be for life. I beg to move.

[Lord Wigley]

My Lords, I rise to speak very briefly in support of these amendments so ably moved by the noble Lord, Lord Touhig. Many of the arguments that underpin these amendments have already been rehearsed in the previous debate, so I will not take too much time.

It seems sensible to have an equal-handed approach to these circumstances. If someone has a condition that is palpably for life, the guidance should be that the benefit should run for life. Equally, in those circumstances where there may be doubt, there needs to be flexibility. What is needed, perhaps on the face of the Bill as these amendments propose, is that there are guidelines that take those two sets of circumstances properly into account. The system itself must be willing to respond to the individual circumstances rather than just follow a dogma about restricting benefits even where benefits are probably much needed.

[Lord Skelmersdale]

My Lords, I am not sure whether I ought to declare an interest, but I will do so nevertheless. My daughter is a research biochemist at the University of Sheffield where she works in a cancer laboratory. Her objective, as it currently stands, is to starve cancer cells of blood—something that other researchers around the country, and indeed around the world, are currently working on without yet having achieved a satisfactory result.

Although I readily understand why the noble Lord, Lord Touhig, has moved his amendment, I find the amendment, although this might be unfair, perhaps—to make up a word—a little closed mind-ish. There is no doubt that, over recent years, the medical fraternity has made leaps and bounds in research. There is even, as I understand it, a possibility that stem cells could be used to repair the nerve system up the back. Now, such developments may come up in five, 20 or 50 years— I do not know, and nobody knows—but an amendment like this is so restrictive that it rather ignores the possibilities of medical science.

I readily understand the interest of the noble Lord, Lord Touhig, in mental health, particularly autism. I confess that I do not know anything about autism, whereas clearly he does. It is not beyond the wit of man to believe that some better treatment, understanding or social environment in respect of any mental disease could well improve matters to allow people a certain amount of, for example, work. My son-in-law suffers from ME, and apparently there is tremendous argument as to whether ME is entirely a mental disease or a physical disease with mental attributes. I do not know whether he will recover enough to work; I suspect that neither he nor anyone else knows that. However, I find this particular amendment—especially the second one—somewhat restrictive.

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[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)]

My Lords, we think it is right that an individual’s benefit entitlement is based on the degree to which he or she is participating in society. This level of participation can vary as health conditions or impairments improve or deteriorate, their impact changes or individuals adapt to their circumstances. We want the benefit accurately to reflect relevant changes in circumstances to ensure that people receive the right level of support. The 2004-05 national benefit review found that about £630 million a year of DLA is overpaid as a result of unreported changes in circumstances. This cannot be right. However, it is equally about ensuring that, when people’s circumstances deteriorate, the benefit keeps track with them.

The same study estimated that around £190 million of DLA is underpaid each year—vital money that is not reaching the people for whom it was intended. There is no one-size-fits-all answer; our approach will involve a combination of awards that, in some cases, will be fixed for a short time and in others will be longer term, depending on the individual, the impact of their disability and the extent to which they are able to live independently. In many circumstances, this can change for better or indeed for worse during someone’s lifetime, and this will be different for different people. We think that an active management regime that involves planned reviews is the most appropriate way of responding to this.

However, it is important—and on this I feel we agree—that we do not undertake inappropriate or unnecessary assessments and interventions where there is unlikely to be a change in award. Key to this is ensuring that decisions on award duration and interventions are evidence based. Here I refer back to comments I made during the debate on the noble Lord’s previous amendments. In PIP assessment, we want to get the best mix of evidence from a variety of sources. This will be partly about what the claimants tell us about themselves, partly what can be gathered at face-to-face consultations and partly what we can obtain from relevant people who support them. Moreover, as I said, we want individuals to tell us who is best placed to advise us on these matters.

Therefore, I think we are fundamentally in the same place as the noble Lords and the noble Baroness. The one key difference is that we do not think that an individual’s type of health condition or impairment matters—for example, whether or not it is a lifelong condition; what matters is the likely impact of the condition going forwards and whether it is likely to affect benefit entitlement. Conditions and impairments—even ones that are usually degenerative—can affect people in very different ways. That is why we want decisions on award durations to be based on individual circumstances following consideration of all the evidence of the case.

[Lord Wigley]

The Minister said a moment ago that he was looking for the maximum degree of flexibility and not to have reviews where they were patently not necessary. Am I right in recalling that in the earlier debates he indicated that the first tier of any review might be with the professionals without impinging on the beneficiary so as not to cause unnecessary worry and that, if the professional—the GP or whoever—advised that there was no change, there would be no need at all for the beneficiary to be aware of this?

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[Lord Freud]

My Lords, perhaps I may be permitted to make an early intervention here in order to offer to take this matter away and return on Report. The Government fully agree with noble Lords on the need for robust independent evaluation of how the assessment works in practice and of the value that Professor Harrington has added through his reviews of the work capability assessment. While we had not intended legislating for multiple reviews of PIP, we are not averse to them. Given the strength of opinion that I know exists on this issue, I will take it away to see what I can do before Report. Although I cannot promise here and now that I can agree to exactly the formulation in these amendments, I will do all that I can to satisfy noble Lords on this matter.

I hope that this statement also deals with my noble friend Lord German’s concern, which I believe may lie behind his Amendments 98ZA and 98ZB. Given this assurance, I urge noble Lords to withdraw their amendments.

[Lord Wigley]

My Lords, as my fire has been taken away from me by the Minister, perhaps I may at least be allowed to say thank you. In consideration of this matter—and obviously consideration can come to a positive outcome, but not necessarily—the one initial fact that I would ask the Minister to take on board is that other circumstances can change in parallel with this—the general economy and other legislation—which may make it beneficial for reviews to take place more frequently. However, I will not press an open door.

[Lord Rix]

My Lords, I will manage to cut things short by saying that I am very grateful to the Minister. I trust that it will all come to pass and I beg leave to withdraw the amendment.