Disability Benefits Assessments

Marsha De Cordova Excerpts

Tuesday 1st February 2022 Westminster Hall

[Sir Gary Streeter (in the Chair)]

I remind Members to observe social distancing. Before I call the Member to move the motion, I will make a short statement about the sub judice resolution.

I have been advised that the Government have applied to appeal the findings of the High Court on the lawfulness of the UK disability survey. Those proceedings are therefore live before the courts, under the terms of the House’s sub judice resolution. However, Mr Speaker has exercised discretion to allow reference to the issues concerned, given their national importance. Nevertheless, Members should remember that those matters are still before the courts, and they are encouraged not to discuss those legal proceedings in any detail.

[Marsha De Cordova (Battersea) (Lab)]

I beg to move,

That this House has considered disability benefits assessments and the Government’s health and disability green paper.

It is a pleasure to be here under your stewardship, Sir Gary.

I thank all right hon. and hon. Members who have come along today to debate this important issue, which affects many of our constituents. I thank all organisations that have supported disabled people and provided briefings for this important debate, including Z2K, Sense, Marie Curie, Mencap, the Royal National Institute of Blind People, the Multiple Sclerosis Society, the Cystic Fibrosis Trust, Rethink Mental Illness, the Young Women’s Trust, Scope and the Charities Aid Foundation.

I also say a special thanks to Citizens Advice Wandsworth, the South West London Law Centres and the Wandsworth food bank, which have supported people in my constituency. I pay tribute to the tens of thousands of disabled people who have been victims of the cruel and callous assessments for the employment and support allowance and the personal independence payment.

In the short time I have been an MP, I have raised the question of social security for disabled people on many occasions. The system should act as a safety net that is there to support each and every citizen in need, as envisaged by the Beveridge report of 1942, which was about strengthening the social contract for those facing hardship in our society by removing the five social ills. However, there is an ever-growing link between poverty and disability, and social security is no longer seen as a basic right.

Disabled people are usually in receipt of employment and support allowance, universal credit, disability living allowance or PIP. As is the case for ESA, disabled people claiming universal credit must undergo the work capability assessment in order to be found to have limited capability for work. PIP is designed to meet some of the extra costs of living with a disability. Since its introduction, however, almost half of those who were previously on DLA and were reassessed for PIP have either completely lost their award, or had it reduced.

--- Later in debate ---

[Sir Gary Streeter (in the Chair)]

Order. Marsha, before you respond, I remind everyone that interventions should be brief.

[Marsha De Cordova]

I thank my right hon. Friend for his intervention. He is absolutely spot on; it is so important that these decisions are got right first time around. I will come on to that issue later in my speech.

The overwhelming body of evidence shows that the assessment frameworks for both ESA and PIP are not fit for purpose. They use a series of points-based, functional descriptors and a tick-box approach. PIP looks at an individual’s ability to carry out a series of everyday activities relating to daily living and mobility, and the WCA is supposed to test someone’s capability for work, based on various activities. Its main flaw is its failure to include real-world factors, and it takes no consideration of how carrying out work could affect a particular person’s health. For example, I heard from one person who was asked to touch their toes, no matter how much pain they were in or how such an activity relates to their doing work.

For more than a decade, there has been a growing mistrust of assessors as a result of the errors in reports, and many people do not feel that they are being treated fairly. Research by Demos revealed that WCA assessors assume that people are not telling the truth or are exaggerating their condition, and many people report being treated as if they are making a fraudulent application.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

I thank my hon. Friend for giving way and for bringing this important issue to the House. Like other Members, for years I have been receiving heartbreaking stories from constituents in Hampstead and Kilburn about the degrading tribunal process that they are forced to sit through just to access the disability benefits that they desperately need. One constituent told me that she had been to a tribunal on four occasions. She won each time, but while she was waiting for each decision she lost all her other benefits. That included her specially adapted car, leaving her trapped at home. Does my hon. Friend agree that the Green Paper lacks ambition on this issue, and that it is fundamentally unfair that anyone in that situation should lose their social security benefits?

[Marsha De Cordova]

I thank my hon. Friend for her intervention. She is absolutely spot on. The knock-on effect of someone being turned down for the support they are entitled to leads to their losing other forms of support, as was the case with her constituent who lost their Motability vehicle.

Assessors often do not have an adequate understanding of the specific disability, impairment or health condition that is being assessed. Although it is accepted that no one can be an expert in all these conditions, it is essential that all assessors receive appropriate disability awareness training and have access to condition or impairment-specific expertise and tools. The charity Scope has rightly called for the categorisation of assessors into groups for specialisms such as mental health, learning difficulties and so on.

[Paul Blomfield (Sheffield Central) (Lab)]

I thank my hon. Friend for giving way; she is making a powerful case, as she often does on issues relating to disability. I wonder whether she could comment on another aspect of the system that is broken, namely the backlog on work capability assessments. I challenged Ministers—not the Minister of State, Department for Work and Pensions, the hon. Member for Norwich North (Chloe Smith), who will be responding to the debate—about that in November, and I was told that they were working flat out to resolve the problem. In December, there were still 335,500 cases, which are waiting an average of 150 days to be dealt with. I have constituents who are £128 to £340 a month short because of this, and that is having a crippling impact on their family budgets. Does she agree?

[Marsha De Cordova]

I absolutely and wholeheartedly agree with my hon. Friend’s comments. I really hope that when the Minister responds to the debate, she will set out how the Government intend to tackle this backlog so that disabled people receive the vital support they need at the right time and do not experience such severe delays.

As I was saying, how can it be right that someone who had been assessed by a physiotherapist for their mental health condition was awarded zero points, despite providing evidence from their psychiatrist and their doctor about their condition? At an appeal tribunal, they won and were awarded 45 points, but it should never have got to that stage. I know that many of my hon. Friends who are here today have constituents who have experienced exactly the same thing.

Evidence is an essential part of the assessment process, and it is vital that assessors engage with it. They should make best use of all pre-existing evidence from experts, including healthcare professionals. At present, anyone who undergoes an assessment is not provided with a copy of their assessment report, and that should be an automatic part of the assessment process. Who knows? That could lead to better decisions being made.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I congratulate my hon. Friend not just on securing the debate, but on everything that she has done on disability issues since she came to the House. Does she agree that we need to support calls for an independent public inquiry into the deaths of claimants, including those who have gone through the work capability and PIP assessment process? We do not know the causes or the scale of those deaths. Surely that work needs to be undertaken as quickly as possible.

[Marsha De Cordova]

My hon. Friend is absolutely right. I commend her for her impeccable work on the rights of disabled people and tackling inequality. I will come on to the point that she raises, because she is absolutely right. We have long supported the call for an independent public inquiry into these deaths, because it is a scandal that that has not been addressed to date.

People should have a choice about how assessments are carried out, be it face to face or by audio. The process has to be accessible and inclusive. The Disability Benefits Consortium rightly calls for the establishment of an independent regulator of social security assessment, with the power to compel evidence from the Department for Work and Pensions and properly hold the Government to account.

Assessments are carried out by private contractors including Atos, Capita and Maximus. Last November, DWP announced that it would spend £2 billion on disability assessment contracts with private profit-making companies over the next five years. Given the millions already spent, it is clear that these private companies are not providing the best value for money. Labour has long called for all assessments to be brought back in house. That would provide for better scrutiny, accountability and value for money for the taxpayer. Does the Minister agree, and will she take action to address that?

Post assessment, the aim must be to get the decision right first time, but time and again, that has not happened. By the end of 2020 in Battersea, one in five disabled people in receipt of PIP had had their awards reduced, and one in three had their awards completely stopped. Citizens Advice Wandsworth shared the experience of someone who was assessed for both ESA and PIP within three days of each other. In their WCA, they were found to have limited capability for work as they could not walk 50 metres. However, they were awarded zero points for mobility in their PIP assessment, which concluded that they could walk 200 metres. This resulted in them losing their Motability car, so they could no longer drive to work, and they now have to claim universal credit. Surely that is not how the system should work.

With the introduction of mandatory reconsiderations, there has been a marginal improvement, but in 62% of MRs in 2021, the result was to go ahead with the initial decision. Many disabled people feel that the MR process is yet another barrier to their right to pursue an appeal to the independent tribunal. Since 2010, some 587,816 disabled people have been forced to appeal to a tribunal for their ESA. In 2020-21, 76% of PIP appeals and 74% of ESA appeals were successful and decisions were overturned at tribunal.

In the past, disabled people have had to wait long periods of time before their cases have been heard at tribunal. Given the impact of the pandemic on backlogs, as my hon. Friend the Member for Sheffield Central (Paul Blomfield) mentioned, can the Minister update us on the current waiting time and tell us the plan for addressing the backlog?

Poor decisions have come at a huge cost to the taxpayer. Between 2017 and 2019, the Government spent £120 million fighting PIP and ESA claims, and the consequences of this failing system are devastating. We all remember the case from 2017 involving Stephen Smith. He was 63 when he was found fit for work, despite having been diagnosed with numerous health conditions. After he failed his WCA, he was forced to live on just £67 a week. He died soon after, weighing just six stone. Only last month, we heard of a disabled man who was in hospital in 2019, as he was severely ill and very vulnerable to infection. The DWP refused to allow him to submit an electronic claim, forcing him to attend a jobcentre in person. He died in April 2020.

In 2019, the Government revealed that 5,690 people had died within six months of being found fit for work under the WCA in the last decade. There is no stronger indictment of a failing system than more than 5,000 people dying just months after being denied vital social security. Labour has been proud to support calls for an independent public inquiry into these deaths, because we need justice for each and every one of them.

The Department’s treatment of disabled treatment has resulted in unimaginable suffering for tens of thousands of disabled people and their loved ones. Rather than enabling disabled people to live more independently, successive Tory Governments have created a hostile environment. The long-awaited Green Paper was a missed opportunity to reshape social security and support for disabled people. I am sure there is agreement across the House that the current system is complex and simplification is needed, but the merger of payments and assessments for PIP and ESA is not the answer. They are two fundamentally different assessments requiring different information. One is means-tested income replacement, and the other is not. There is no doubt that any move towards that could lead to absurd decisions and have catastrophic consequences.

Worryingly, the Green Paper did not address the levels of social security. Cuts to universal credit, with the removal of disability premiums worth £180 a month and the removal of the work related activity component in 2017, have left some severely disabled people destitute. Last month, two severely disabled men won a legal challenge over the DWP’s failure to protect them from the cliff-edge loss of income of £60 a month following their move from legacy benefits to universal credit.

Since 2010, more than 1 million disabled people have faced sanctions. As a result, many have had to go without, skip meals, miss appointments and so forth. It has had a devastating impact. All the evidence points to the fact that sanctions against disabled people do not work, and there needs to be a permanent end to all sanctions. The Government must move towards a more holistic employment model for disabled people.

We need the right kind of social security system—one that respects the values of the Beveridge report. We need a system that we are proud of, as we are all proud of our NHS. In the past 12 years, we have watched the system diminish and demonise disabled people; that is a fact. Changing the narrative is vital to dismantling the hostile environment that has been created for them. We need to rebuild a social security system that is fair, compassionate and there for us all in our time of need. To do so, we need to ensure that the system provides people with an adequate level of income and a change of culture in the Department.

Will the Minister confirm that before she introduces her White Paper, she will engage with and consult disabled people and disabled people’s organisations? We must avoid what happened with the national disability strategy, which was ruled unlawful last month because it failed to carry out such engagement. Will she also commit to creating an inclusive, accessible application process and assessment framework that is built on compassion and genuinely co-produced with disabled people and their organisations? Finally, will the White Paper address the inadequate levels of social security and commit to considering minimum income levels for disabled people? We need urgent action to transform the social security system from one that penalises and sanctions ill and disabled people to one that supports and empowers them to live independently.

[Several hon. Members rose—]

--- Later in debate ---

[Chloe Smith]

We certainly do have confidence in our consultation and our listening. I will not go into further detail on the strategy because there is so much else that I want to respond to today.

We have made progress, including significant progress towards our commitment to see an additional 1 million more disabled people in work by 2027. As my hon. Friend the Member for Watford (Dean Russell) explained, supported employment is very significant within that, but there is much more still to do, and I welcome the point made by the hon. Member for Strangford (Jim Shannon) that employers also need to rise and play their part in supporting disabled people or people with ill health in the workplace.

There is also more to do to improve people’s experiences of our services and to build their trust in the system. I have heard the comments made today, and that is why our aim in the Green Paper was to improve the experience of disabled people and people with health conditions by listening, learning and improving. We want to make our services easier to access and our processes simpler where we can. We want to make improvements that will help build people’s trust and explore ways to offer more and better support for the people who need it most.

Turning to the economy, which is important for the context of this debate, the last two years have been really tough. However, because of our focus on getting people into work, we had the highest level of employment that this country had ever seen when covid hit, and we have succeeded in supporting jobs and livelihoods throughout the pandemic. The economy continues to rebound. With around 1.2 million vacancies currently available, including in many sectors vital for our recovery, we want to get people into jobs that they can do right now. The jobs market presents huge opportunities for all jobseekers. I want to ensure that those opportunities and the world of work are accessible and inclusive for disabled people and those with health conditions.

The hon. Member for Motherwell and Wishaw (Marion Fellows) mentioned the Way to Work campaign. I can reassure her that for those who are unable to take up employment due to their health conditions or personal circumstances, we tailor their requirements to their capability and situation to ensure that all that we ask of them is realistic and achievable.

We understand the pressures that people are facing with the cost of living, and we will continue to listen to people’s concerns, as we have done throughout the pandemic. That is why we are providing support of around £12 billion this year and next to help families with the cost of living.

Many important points were made during the debate about the assessment system and the benefits system. The benefits system considers the impact that a health condition or disability has on an individual’s ability to work and carry out day-to-day activities. As all hon. Members know, decisions are based on an assessment of an individual’s functional ability, not their diagnosed health conditions. Claimants are of course encouraged at the outset of their claim to provide all evidence that is relevant to their case, including medical evidence supplied by their GP or other professionals such as support workers, carers or community mental health nurses. We recognise that attending a health assessment can be a stressful experience, which is why, whenever we are able to assess somebody solely on the available paper evidence, we do so.

It is of course important that the benefits system is fair to both benefit recipients and taxpayers. We think that our health assessments are a fair and robust approach to managing the gateway to benefits, with our decisions based on evidence and objective criteria.

[Marsha De Cordova]

Will the Minister give way?

[Chloe Smith]

I want to acknowledge a point that has been made by a number of hon. Members before I give way to the hon. Lady who secured the debate. That is the point about transparency, which was raised by the hon. Member for North East Fife (Wendy Chamberlain) and others today. Transparency is a key principle in our Green Paper, and will be very important going forward.

[Marsha De Cordova]

I thank the Minister for giving way. She has spoken a lot about the assessment process. Given the overwhelming evidence that everybody has shared, surely she must agree with all of us that the system is flawed, is broken and needs overhauling.

[Chloe Smith]

We are talking about a Green Paper. The point of a Green Paper is to improve the system, so we should continue the debate that we are having.

We are committed to ensuring that people get a good service from our assessment providers. On training, all assessors are of course subject to ongoing quality checks and an audit process, so they all have access to specific training and guidance on a wide range of clinical conditions. To the Labour Members who want us to end the use of private providers, I simply confirm that we intend to continue to use providers.

I now turn to some of the statistics that have been used in the debate.

--- Later in debate ---

[Marsha De Cordova]

I express my warm thanks and appreciation to the hon. Members who have contributed to what I believe is a very important debate. This has to be an ongoing dialogue because, sadly, I feel slightly disappointed in the Minister’s response. We heard from my hon. Friend the Member for Vauxhall (Florence Eshalomi), the hon. Member for North East Fife (Wendy Chamberlain), my right hon. Friend the Member for East Ham (Stephen Timms), my hon. Friends the Members for Bolton South East (Yasmin Qureshi), for Newport West (Ruth Jones), for Middlesbrough (Andy McDonald), and for Cynon Valley (Beth Winter) and the hon. Member for Strangford (Jim Shannon), along with incredibly powerful interventions from my right hon. Friend the Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Hampstead and Kilburn (Tulip Siddiq), for Sheffield Central (Paul Blomfield) and for Oldham East and Saddleworth (Debbie Abrahams).

The Minister did not truly address the issue around private contractors. We have spent billions in funding private companies making profit out of poor, sad and distressing experiences for ill and disabled people and really putting profit before health. That is unacceptable and, frankly, quite disgraceful. The Minister did not address whether she would agree to an independent inquiry into the deaths of so many ill and disabled people. This is a national scandal and in any other environment an inquiry would happen, so it should be happening now for ill and disabled people, because for far too long we have been treated as an afterthought. It must end now. Finally, when the Minister brings forward her White Paper, I hope for her and her Government’s sake that they finally begin to take the lives of disabled people seriously.

Question put and agreed to.

Resolved,

That this House has considered disability benefits assessments and the Government’s health and disability green paper.