Mental Health: Assessment

Marsha De Cordova Excerpts

Tuesday 22nd January 2019 Westminster Hall

[Marsha De Cordova (Battersea) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Ryan.

I start by congratulating the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing this debate and on making a truly powerful speech, in which she shared some of the evidence that she has received as a result of the call she put out for accounts of people’s harrowing experiences of their mental distress and of accessing the social security system. She highlighted that it was actually down to a number of voluntary sector organisations—charities and other bodies—to help those individuals through the claim process, and many of those organisations rely on funding they receive from the European Union.

The hon. Lady said that what is lacking in the whole process is adequate training of the healthcare professionals involved. It is vital that they be trained adequately. We know that there are meant to be mental distress champions, but ultimately their influence is not being felt by those going through the assessment.

Many Members, in speeches or interventions, spoke about the appeals process. It is recognised that there is concern about it, as there is such a high success rate for appeals, which I will come to later.

The hon. Lady absolutely hit the nail on the head when she talked about the change from the disability living allowance to the personal independent payment, and the impact that change has had on so many claimants. My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) highlighted in an intervention the report published today by York University, which shows that people with psychological conditions were 2.4 times more likely than claimants without such a condition to have their DLA award stopped when they were being assessed for PIP, so there is clearly a problem. Many people assume that the policy intention behind PIP was to reduce the number of people in receipt of such support. There should be parity of esteem for those with physical conditions and those with mental health conditions, because PIP is there to contribute towards the extra costs of living with such an illness or condition.

We know that disabled people, particularly those who experience mental distress, have been let down by the assessment framework. Many people would say that the framework is innately flawed. As of May 2017, half of those claiming ESA and a third of those claiming PIP were described as having “mental or behavioural disorders”.

The Department for Work and Pensions has spent more than £1 billion on outsourcing the assessments for these benefits to providers such as Capita and Atos. However, those providers are falling woefully short of the DWP’s own performance standards. More than half of the assessment reports by Capita have been graded as unacceptable, so we know that there are clear problems with the way that the assessment framework is being used by these providers, which has obviously had a great impact on those experiencing mental distress.

Many Members have today shared—as Members have done constantly throughout their time in Parliament—the heart-wrenching accounts of constituents whose assessment left them in deep despair and distress. If anyone has not heard such accounts, they should think back to February last year, when the Work and Pensions Committee received an unprecedented amount of evidence from individuals sharing their experiences of the PIP and ESA assessment and framework, and of the distress that they caused them.

There have even been reports of people who have admitted being suicidal being asked why they had not killed themselves yet. Like the hon. Member for Lanark and Hamilton, I do not know how an assessor could ask somebody that. I would like to think that the Minister will ensure that that does not happen again; it really should not.

There have been reports of assessors overlooking someone’s mental distress, and asking inappropriate and offensive questions. I will give just one example. An individual diagnosed with borderline personality disorder, depression and anxiety lost his job and had a mental-health breakdown, so he applied for PIP twice, but was turned down twice. Obviously, the process began with his filling out the claim form, collecting all the medical evidence requested of him, and finally having to endure the humiliating face-to-face assessment. The process of trying to claim PIP caused that individual—David—great anxiety. He spiralled out of control into self-harm, and eventually overdosed on drugs.

No assessment for essential social security support should lead to anyone spiralling toward self-harm. The Minister will agree that we have to consider whether it is right for the burden of providing medical evidence to fall on the claimant. Will she commit to removing the burden of collecting medical evidence from the person claiming PIP and ESA?

When David went to a tribunal, he was awarded PIP, based on the same evidence that the DWP had previously deemed insufficient. However, we know that David’s story is not a one-off; it is all too common. Since 2013, 71% of PIP decisions have been overturned on appeal, which is a clear indication that there is inaccuracy and poor decision making in the assessment process. Denying more than 100,000 disabled people PIP will obviously have a negative impact on whether people can go on and live independently. The DWP spent over £100 million in administering reviews and appeals between 2016 and 2018. Much of the evidence would have been “inadmissible” in a normal court of law; that was said by a senior judge.

The Minister must consider all recommendations, particularly those of the Social Security Advisory Committee around mandatory reconsiderations, decision making, and ensuring that assessments are recorded. The High Court last year ruled that the negative changes regarding those who experience psychological distress were unlawfully discriminatory. Obviously, that has led to the review of 1.6 million PIP awards.

When does the Minister anticipate that the reviews of the system will be completed, and has a timetable for them been published, so we can see that they are completed? It will be important to know that all those people have got their back payment in a timely fashion.

The DWP is undergoing seven reviews of disabled people who are wrongly being deprived of social security. Five of those reviews are of flawed PIP and ESA assessments. So it is really important that the DWP gets this right. The failings of the assessment framework go way beyond discrimination; they contribute to, or even cause, individuals’ mental distress. In the words of one person,

“Going through the WCA process is the biggest source of worry in my life”.

That is how we are treating some of our most vulnerable people in society.

Labour recognises that there needs to be a radical overhaul of the assessment framework. It was labelled “superficial” and “dismissive” by the UN special rapporteur on extreme poverty. It should be replaced by a holistic, personalised and tailored single assessment, which would treat all disabled people, whether they have a physical or mental health condition, with the dignity and respect that they so desperately deserve.