Personal Independence Payments: Merseyside

Maria Eagle Excerpts

Tuesday 26th March 2019 Westminster Hall

[Maria Eagle (Garston and Halewood) (Lab)]

I beg to move,

That this House has considered the administration of personal independence payments on Merseyside.

It is a pleasure to serve under your chairmanship, Sir Edward. I welcome the Minister, who has been, though is not at present, the Minister for Disabled People. As a former Minister for Disabled People myself—I served for an entire Parliament, in fact—I am grateful for this opportunity to highlight a worrying deterioration that I have noticed in the administration of disability benefits in my constituency.

Personal independence payment is meant to help people with the extra costs of disability, and is payable regardless of income. None the less, many sick and disabled people who apply for it and receive it are often unable to work, tend to be poor and find it difficult to make ends meet. Many have chronic fluctuating conditions, and are very ill or very disabled. PIP is therefore usually, in my experience, an essential component of enabling people in such situations to live a decent and dignified life. It is a crucial benefit, which is all the more reason to get it swiftly and correctly to those who are entitled to it.

According to the House of Commons Library, since 2010 some £4.8 billion has been cut from disability benefit. Indeed, the introduction of PIP and the replacement of disability living allowance, its predecessor benefit, was intended from the start to cut entitlement to make it less generous, and to create monetary savings in the escalating cost of DLA. The expected savings of £3 billion a year have not materialised, but the Tory Minister in the Lib Dem-Tory coalition who introduced the benefit in 2013 said that PIP would be

“easier to understand and administer, financially sustainable and more objective.”—[Official Report, 13 December 2012; Vol. 555, c. 463.]

“Financially sustainable” means, in this context, cheaper in terms of the overall spend. That means cutting entitlement and awards when we get down to the circumstances of individuals.

Since PIP’s inception, administrative problems have been to the fore. In its first seven months, only 16% of the targets for resolving claims were met. The National Audit Office was critical, suggesting that the Department for Work and Pensions should

“set out a clear plan for informing claimants about the likely delays they will experience”.

I wish it had, because my constituents are increasingly experiencing delays, and I do not see any plan to stop them. Ever since PIP was introduced, constituents have complained to me about the way in which they have been treated when being assessed, the delays in the process of administering it, and subsequent reconsiderations and appeals. Whatever the outcome of the original assessment, it is hard to find people who are satisfied with the administration of the benefit.

Recently I have noticed that things are worsening. For the previous two years, until last December, I had a stable, steady number of cases coming through, spread over the months. I have been able to help with some cases and not others, but the flow has been pretty steady. However, during the first three months of this year my office has faced a threefold increase in complaints about PIP, and some of the circumstances my constituents relate to me are simply horrendous.

There are a set of different problems. For example, I hear about inappropriate questions at assessment, so that when people are disqualified from the benefit they consider the process completely unfair. Asking somebody who is debilitated by mental illness whether they can pick something up off the floor just does not seem relevant to that individual. In my experience, home assessments are rarely allowed, and when people cannot attend, usually for genuine reasons, they are simply disallowed the benefit.

I have one constituent who has been trying since December 2017 to be assessed. He has been refused, despite many debilitating conditions, including severe schizophrenia, bipolar disorder and chronic obstructive pulmonary disease. There are physical and mental reasons why he cannot attend an assessment centre, but PIP administrators simply will not attend him at home. He has been unable to get to the 11 face-to-face interview assessments he has been set. Consequently, his last DLA payment, which was received in the middle of last year, has long since expired.

My constituent has lost employment and support allowance as a consequence. He has now lost almost £5,000 of income, and is financially reliant on his extremely elderly and disabled mother for the basics—all because he cannot get to an assessment. Why on earth can they not assess him at home? It is ridiculous that he has been asked to attend 11 times when he clearly has problems doing so. Why can we not have some common sense?

In addition, there are poor assessments and a poor attitude from assessors. My constituents report that they are often simply not believed. Some feel sneered at, and some are right to feel that way, from the accounts that I have heard. Inaccuracies in medical assessments mean that sometimes the reports that are produced end up bearing no resemblance whatever to what has been said at the face-to-face interview, and my constituents tell me that they feel as if a completely different case and person has been reported on.

[Jim Shannon (Strangford) (DUP)]

May I reflect on the hon. Lady’s opinions regarding PIP? I am very involved in this matter in my constituency back home, with the changes that there have been. Does the hon. Lady feel, as I always have, that it is important that the assessor or officer who comes out to visit the person in their home, or takes them to an office for interview, has knowledge of the medical circumstances of that person? Also, when it comes to mental and emotional issues, does she agree that it is important to have someone there to support the person being assessed—perhaps as a witness as much as anything?

[Maria Eagle]

I agree with both those points. A lack of understanding and basic common decency sometimes seems to creep into these assessments.

I also have vulnerable constituents who are being prevented from getting help in explaining their situation to assessors. For example, I have a constituent who has a brain stem tumour, among other physical conditions. Perhaps not surprisingly, her mother was with her at the assessment. However, she was told that her mother could not answer any questions for her, despite the fact that my constituent has significant difficulty in processing information because of her condition. That goes completely against the PIP assessment guidance, which says that

“companions may play an active role in helping claimants answer questions”.

I have constituents who were prevented from having that kind of help and, perhaps not surprisingly, thereafter had their PIP stopped because it was felt that they had not answered the questions appropriately.

There are extremely long delays in assessments, reconsiderations and particularly tribunal dates for appeals. It is hard to justify the fact that the average waiting time for PIP is now 15 weeks. That is almost four months. It is completely unacceptable to make disabled people, who rely on that money to make their lives a little easier, wait so long for a first payment.

Reconsiderations are a necessary step to be gone through, but they almost never overturn the original decision. In my recent experience, I have not come across a single case in which that has happened, even when it is blindingly obvious that that is the point at which what has gone wrong can be put right with the least possible damage. Surely the purpose of the reconsideration stage is to apply a little common sense, but these days it just seems to be a way of wasting another two or three months, during which the individual does not get their benefit.

The wait for a tribunal is the killer. On Merseyside, the average wait is more than nine months, but I know of people who have waited for 12. It is an absolute scandal. How can the Government or the Minister possibly justify treating vulnerable, sick and disabled people in such a callous and horrendous manner?

I have also come across many reports of compassion fatigue among bureaucratic and indifferent contractors who are paid to assess vulnerable and desperate people. Compassion fatigue is not a new phenomenon, but it seems to be rife these days. It was reported in the newspapers recently that a DWP official had submitted papers to an appeal tribunal in which they referred to the appellant, a disabled person, as a “lying bitch”. How revealing of their attitude is that? Yet there is not much evidence of fraud in claims for these benefits: according to DWP figures, it represents only 1.5% of the total expenditure. That figure is put into context by the heftier 4.2% of total expenditure on making up underpayments to people who have not claimed their full entitlement—one can hardly argue that there is a huge problem of fraud that we need to crack down on.

Let me give a few examples of cases in my constituency that illustrate my concerns. Some people’s benefits have been stopped, quite unfairly, when they have fallen foul of overly bureaucratic practices that take no notice of plain common sense and that apparently cannot be put right without the lengthiest process imaginable, causing extreme hardship and pain. I have a constituent with kidney disease who attends hospital weekly for dialysis. She was diagnosed with a very painful and severe complication of her condition and was treated for it as an in-patient. When she got home after being discharged last July, she was exhausted, disoriented and in severe pain. She was expecting a district nurse to attend her at home to change a dressing, but her carer was confronted at the door by someone who claimed to be a health professional, but who—sure enough—seems in hindsight to have been sent by the DWP.

The “medical professional”, who was turned away by the carer because my constituent was in no fit state to be seen, appears to have had a compassion bypass. Instead of being given another appointment at a more convenient and sensible time, my constituent had her benefit stopped last August because she was said to have refused to be interviewed. Not only was she in no fit state to be interviewed, but she had received no letter. Even if such a letter had been sent, she had been in hospital for weeks and was very poorly, so she certainly would not have seen it. Why on earth was another appointment not made as a matter of plain common sense? Her request for a reconsideration last October was refused. What is the point of having reconsiderations if we cannot reconsider a case like that?

My constituent applied for a tribunal hearing in December—given her very poor health, it took her that long to navigate the process of filling in all the required forms. For three months, she tried to make the best of things, but she came to see me last week asking how long she would have to wait for an appeal. As I have said, and as the Minister may know, the average wait on Merseyside is 38 to 42 weeks, so I had to tell my constituent that she might have to wait another six months before the matter could be resolved. I have no doubt that the decision would be overturned at a hearing, as happens in 75% of the cases that get that far.

When I asked my constituent how she was doing, she told me that she had no money for food. Her weight had reduced to just 6½ stone. On the day she came to see me, she had eaten two slices of toast—one for breakfast and one for lunch—and was planning a main meal of a bowl of soup. I would normally offer food bank vouchers to a woman in that condition, but my constituent has a special diet because of her dialysis, so she could not have eaten what a food bank would have given her. She was able to take advantage of Can Cook, a charity in my constituency that stepped in at my request to provide some fresh food commensurate with her dietary requirements—but most people do not have Can Cook in their constituency.

I happened to bump into the Secretary of State, so I asked her who I should write to about this scandalous case, given that the hon. Member for Truro and Falmouth (Sarah Newton) has resigned as Minister for Disabled People, Health and Work and has not been replaced. The Secretary of State got her officials to sort it out within two days, which is excellent, and I thank her for it. My constituent has been reassessed on higher rates of care and mobility than those from which she was disqualified, and she will receive full back payments this week. Thank goodness she came to see me, but she did not see me for 10 weeks—and what about those constituents who have not come to see me and who are suffering in silence and despair at home? What about those who are too vulnerable to get out to see me, particularly those who are debilitated by mental ill health and are struggling on with no money and no food?

[Jim Shannon]

I am quite moved by what the hon. Lady says. Many of us know of people in similar circumstances. At my constituency office, three people in 10 days came to see us who had fallen off the radar—no one knew about them. Their issues were clearly mental and emotional. Does the hon. Lady feel that someone in the benefits system should be following up on people who have been refused benefits? That would be a method of finding out what is happening to those people.

[Maria Eagle]

The hon. Gentleman is correct. One would have thought that the reconsideration would introduce an element of plain good sense, but it does not seem to be working in that way at present. There is a general issue with how the debility caused by mental ill health is not well recognised or sympathetically dealt with in the system. People who are debilitated with mental ill health often find it even harder than people who have physical disabilities to face up to filling in the forms and getting themselves organised to get some help, so they are even more vulnerable.

PIP has less generous criteria for its mobility component than DLA, because it is designed to save money: people are required to be less able to walk than under the older benefit system. Because PIP is the gateway to one of the world’s most innovative and practical disability entitlements —the world-leading Motability scheme, one of the best things that makes disabled people’s lives easier—problems in its administration hit recipients particularly hard. For many of my disabled constituents, access to a Motability car is a lifeline—it makes their lives liveable—yet in the last two years, the DWP’s own figures show that 44% of people who were getting the higher rate mobility component under DLA lost their entitlement under PIP. Of those who are being reassessed from the DLA higher rate mobility component to PIP, only 53% got the equivalent of the enhanced rate. The other half either got the lower rate, and therefore lost their car, or got no mobility component at all.

People naturally appeal when they lose so much, and they are entitled to do so. PIP appeals accounted for 52% of all social security and child support tribunal receipts, and 73% of PIP appeals succeeded. Too many people who should appeal do not; they put up with the loss of income and the hardship because they cannot cope with the process. For people who first joined the Motability scheme before 2012, the car has to go back once the benefit has been gone for 26 weeks. However, the average wait for a tribunal on Merseyside is nine months, which means that people’s cars have to go back even if they win the tribunal, as 75% of them do. What is the point of taking away a disabled person’s car only to give it back again? Is it any wonder that people feel messed around? They have been messed around. I have a number of cases where people have quite wrongly lost their Motability car. When they finally get to appeal, they get it back. Why mess them around in the first place?

One constituent has lost her car and is awaiting a tribunal hearing—she will have waited almost a year by the time she gets one. I tried to have her case expedited with the Courts and Tribunals Service, as I have with a number of others, as this young woman has to make three or four journeys to hospital, in different directions, to different hospitals every week. She and her parents, who are fairly low-paid workers, used the car to get her to those hospital appointments. Her journeys cost £17 per journey in a taxi, multiplied three or four times a week. When her mother came to see me, they were starting to decide which hospital appointments to go to and which not to go to. I asked the Courts and Tribunals Service to expedite the hearing, and it was put in front of the judge—that is the first time I have got that far—but he said no, so she will have to wait until this summer.

The Mayor of Liverpool has a mayoral hardship fund, with millions of pounds that were raised through the invest-to-save arrangements, which was supposed to be about improving the Merseyside economy. He now spends all of that fund supporting poor people, and the young woman now has her taxi journeys paid for. That is the only reason she is still able to attend her hospital appointments.

The Minister must recognise that there is a severe problem here, at the very least in the length of time it is taking to get appeal hearings, and in the way in which people are being messed around in the interim. The people who benefit from PIP are some of the poorest, most vulnerable and most disabled people in our society. They should not be being put through the mill to get their basic entitlement to an extra benefit. I hope the Minister will be able to show us that the situation is going to improve in future.

--- Later in debate ---

[Justin Tomlinson]

We always recognise that there is a need for improvement, and we continue to review all the processes—not just PIP, but all parts of Government activity. It is right to do that, and I am sure any party in government would make the same commitment.

Some 92% of claimants complete the forms, but that still leaves 8% who have challenges with them. We have already tried to make improvements by changing the language, tone and style, and shortening the paragraphs. We commissioned further independent research to support further changes. For those 8%, ahead of further changes, we can grant an additional two-week extension. We try to identify vulnerable claimants whom we may have to help with the initial application. With the support of charities and stakeholders, we have produced videos to explain the process. We are trying to make it clearer and remove claimants’ understandable anxiety. For claimants who have severe mental or behavioural conditions, learning disabilities, development disorder or cognitive problems and who cannot engage with the claims process, we will try to offer what support we can, beyond the excellent work of local organisations, which has been highlighted.

Many of the concerns that hon. Members raised were about the assessment process. We encourage help from carers, family friends, social workers or local support workers. I am really disappointed to hear the two examples from Liverpool and Merseyside of people who were trying to provide that support, which would have resulted in a better quality assessment. That should not be happening, and we should look into it. That is an incredibly important part of the process—not just because people are anxious or because demonstrating all their individual challenges is a complex process, but because for some people, particularly those with long-term health conditions, their issues have become a given. They no longer see those issues as a challenge and do not raise them, so they do not get the support that they should be getting. It sometimes takes having someone with them to say, “Actually, that isn’t right. We need to do something.”

[Maria Eagle]

I thank the Minister for giving way—it is a bit hard with twins. He said he was disappointed to hear the examples that my hon. Friend the Member for Wallasey (Ms Eagle) and I gave of that going wrong, but can he explain what he is going to do to stop it happening? It is a fundamental problem with administration.

[Justin Tomlinson]

I will come to that. Fear not; I have woven in as many of the answers as I could.

The average length of time for assessments is now 15 weeks, and it has actually fallen. Initially, in July 2014, when it was at its worst, it stood at 42 weeks, so it has fallen by two thirds to 15 weeks. We got it down to about 13 weeks, but feedback from stakeholders and charities suggested that it was better for assessments to take a bit longer, to help people—particularly the most vulnerable claimants—to gather evidence.

The assessors must be health professionals—occupational therapists, nurses, physiotherapists, paramedics or doctors—who have had at least two years’ experience since they became fully registered. Although there has been understandable criticism of some important cases, the vast majority of the staff on our frontline are well-trained and exceptionally hardworking, and they have claimants’ interests at heart. I think that we all recognise that. In the skills that assessors must have there is an emphasis on assessing people with conditions affecting mental health, intellectual or cognitive functions. There is comprehensive training on how health conditions and impairments affect claimants’ day-to-day lives.

--- Later in debate ---

[Justin Tomlinson]

It is difficult to comment without having seen the details. I am not saying that what the hon. Lady says is not true, but if that case is exactly as she describes, that should not be happening and needs to be looked at, which is why I have committed to doing so. In general—as in the case about which I met the hon. Member for Garston and Halewood last week—common sense is not being applied. We must make sure that the rules and guidance that are in place are consistent across the board.

A number of hon. Members highlighted that in Liverpool and Merseyside, home visits are not offered. Between 15% and 20% of claimants in Liverpool and Merseyside have actually been offered home visits, as they should be. If, for a variety of medical reasons, travelling to the assessment is a barrier to accessing the benefit, that should be taken into account. Certainly, when I was the Minister with responsibility for disabled people, we improved the communication by making it more proactive to encourage that. We want the assessment process to work for the claimant.

I also welcome our introduction of the video relay service for those who are deaf and use British Sign Language. That is important not just for PIP, but across all frontline services.

[Maria Eagle]

I thank the Minister for giving way when he has only a little bit of time left. The delay to tribunal hearings is a severe problem. Can he address that before he concludes his remarks?

[Justin Tomlinson]

That is the key thing that I will address, but I will cover one last matter first.

Some 600,000 claimants currently access the Motability scheme. I echo the comments about what a wonderful scheme it is. I think it is the second-largest purchaser of motor vehicles after the Chinese army, so it has significant buying power and is very important. I visited a car salesroom that dealt with Motability and that said it was the dream customer. Some 144,000 people who were formerly on DLA and did not access the higher rate of mobility now do, following re-assessment, and they can therefore access the scheme. That goes back to the point about the 31% against the 15%.

Those who were on DLA on a higher rate, and who could therefore lose their car, will get to keep the car through the £175 million transitional fund that was set up. They keep the car for eight weeks, and then they can either take £2,000 or keep the car for up to six further months, but with a lower payment at the end if their appeal is unsuccessful. That provision was brought in because of a recognition that the appeal process, which I will come to in a moment, often took longer than the time for which the claimant could keep the car. That meant that a car could be taken away, only to be given back two weeks later. When the difference is very close, Motability Operations can exercise some discretion. Fundamentally, the challenge is the length of time of appeals, and that is probably the most tangible concern that has been raised by all who have spoken. I emphasise that the absolute priority is getting it right first time. If we could get every decision right first time, we would not have to worry about mandatory reconsiderations and the appeal process. We all agree on that.

The MR process was introduced to try to intercept cases in which mistakes are made and stop them having to go through the appeals process, which is a real challenge and reduces capacity, and thus bring down the time for other cases. Although I accept that very few decisions appear to change, about 22% of cases are actually picked up by MR. It is absolutely right to focus on that, however, and I think we all recognise that more decisions could be changed. Often, a lot of the MR process is just checking the current processes. The nub of the matter is that the appeals process often considers late, additional evidence. The common-sense point is that we should be doing a lot more, and we are testing that concept by asking whether there are any obvious gaps that we can pick up. Has there not been a GP note? Has supporting evidence that we suspect will be presented not been submitted?

[Maria Eagle]

The case that I mentioned, which has now been fixed, involved a woman who should really just have had another appointment at home. That was not picked up on a mandatory reconsideration. There is surely a point at which some common sense should be injected.

[Justin Tomlinson]

Absolutely. That is what we are testing, so that we can assist claimants by strengthening areas where there are obvious gaps. It would be quicker for the claimant, and we would benefit, because those gaps reduce capacity in the process. We are working with Her Majesty’s Courts and Tribunals Service to try to address the capacity issue, in terms of both the new digital service and recruiting additional judges and tribunal panel members. That cannot come quickly enough.

It is true that the majority of successful appeals are successful thanks to late evidence. We should see that as an opportunity to look at how we can do more to get such evidence in the first place. We are committed to learning those lessons to improve the process for everyone.

It has been a pleasure to respond to this debate. The group of hon. Members who have spoken are passionate about this matter, and they are real champions for their constituents. I have listened to all the points that have been raised, and I will look at the individual pieces of casework. We have a collective duty to keep applying common sense to improve the situation, and we are heading in the right direction. That is welcomed by stakeholder groups, but there is still more to do, and I am committed to doing what I can to support that work.

[Maria Eagle]

I am grateful to the Minister for his constructive approach to the points that have been raised, and I am glad that he and the Department seek to improve the administration of the benefit. From our experience on Merseyside, there is still some way to go. Some simple things can be done, such as getting the assessments right and doing more to ensure that those who conduct them are properly trained and conduct them correctly.

For goodness’ sake, let us cut the amount of time that it takes to get through the process and restore some basic common sense, so that our constituents, many of whom are the most vulnerable people in our communities, are not put through the mill to obtain a benefit that should be theirs by right and is intended to make their lives easier. Instead, because of the way that the benefit is administered and the mistakes that are made, it ends up making their lives much harder.

Question put and agreed to.

Resolved,

That this House has considered the administration of personal independence payments on Merseyside.