ESA and Personal Independence Payments

Nadine Dorries Excerpts

Wednesday 30th November 2016 Westminster Hall

[Angela Crawley (Lanark and Hamilton East) (SNP)]

I beg to move,

That this House has considered employment and support allowance and personal independence payments.

It is a pleasure to serve under your chairship, Ms Dorries. First, I wish all my constituents a happy St Andrew’s day. It is a privilege to bring the difficulties of many of my constituents to the House for consideration, and those of the people across the UK who have experience of trying to access support when they need it most through either employment and support allowance or personal independence payments. Since I became an MP, a large percentage of the constituency casework that I or my staff have dealt with has been a result of ESA and PIP issues.

Owing to the very nature of the benefit that they are trying to access, these people are vulnerable. Many are experiencing serious illness for the first time in their lives and are facing a huge process of adjustment. That is hugely stressful, and this process is hugely stressful for those individuals, who often feel dehumanised and part of a process. The assessment procedure only serves to make things worse. Of the ESA and PIP cases that my office has dealt with—I will discuss one particular case in detail today—many have involved complaints about the assessment process. These assessments are often inhumane, needlessly stressful and unfair to claimants. Many other cases have required intervention following unsuccessful personal independence payment claims, the vast majority of which have been overturned on appeal.

My constituency is sadly not an anomaly when it comes to appeals figures. The latest statistics on appeals against PIP decisions show that 65% of appeal decisions found in favour of the claimants. Not only does that highlight a deeply flawed system, but it clearly shows that a number of people who are subjected to these highly stressful and often prolonged, protracted processes to get the support that they need are ultimately entitled to that support. The statistic of 65% of appeals overturned evidences that, and unless the Government can tell me statistics to the contrary, I am going to assume that their system is not working. It suggests that the system needs to be radically reformed. The high appeal and overturn rate is unacceptable—and unsuccessful on the Government’s part, if they are trying to drive down the number of illegitimate claimants—particularly when it impacts so negatively on the claimants who require this support the most.

If you will indulge me, Ms Dorries, I want to turn to the case of my constituent, Donna. I have the permission of my constituent to raise this issue, and they have asked me to do so in order to illustrate the impact of the benefits system on their life and to highlight the serious inequality they face. Donna, who lives in Carluke, is a mother of two children. She has a supportive husband. She established a café called the Hope Café, which is a mental health charity, and she is an advocate and a champion for supporting those with mental health problems. I commend Donna on her bravery in opening up to me so fully about her experiences with the Department for Work and Pensions. She has given me permission to share her story in full, because she hopes that it will illuminate the effect of malpractice and the effect that the assessments had on her life.

Donna became seriously ill with severe depression and anxiety 10 months ago. She told me that her mental illness made her believe that her two young children, aged eight and 10, would be better off without her in their lives. She told me that her mental illness made her believe that she was useless and worthless and had no skills worth sharing with the world. It made her think that her close friends and family were ashamed of her for being weak. That is the mindset of someone in the grip of depression, and it is incredibly difficult to break out of. Months later, thankfully, she is recovering, and as her background is working in mental health, she is keen to use her personal story to highlight the flaws in the benefits system and hopefully improve the process for others.

Donna went through the application process for both personal independence payment and employment and support allowance, which she found, in her own words, extremely harrowing. She first contacted my office to ask whether we could intervene to support her, as she was required to attend capability assessments for ESA and PIP. Donna, being logical and thinking that this would be an end in itself, asked whether she could endure one assessment. We are aware that this is not how the process works. Instead, Donna underwent an employment support work capability assessment and was asked back for a further personal independence assessment. On both occasions, she endured the lengthy assessment procedures, because these are classed as two separate benefits and the assessments are carried out by two separate providers. She found both assessments incredibly difficult. She told me that the questions she was asked made her re-live the worst days of her life, and she felt that if she had not got the award, it would have been overwhelming. At points, it made her want to give up.

Let me make the point clear: people experiencing severe depression already feel worthless. Being rejected for financial support gives concrete evidence for what they believe, in their minds, to be fact. For many people, it is the last straw. Donna told me that she was not surprised that, as a result, the suicide rates that she deals with every day are increasing.

Donna told me that her illness affected not only her, but her whole family; however, she has been lucky to have great support from her family and friends. Many others are not so lucky. For many people, where would they be without family support? At the point of rejection from the benefits system, who are they supposed to turn to? Donna’s case highlights the fact that no consideration is given to the detrimental effect of the system on the already overwhelmed mental state of a person going through the assessment process. The reason they are in that position in the first place is often because of circumstances beyond their control. Consideration must be given to each individual applicant and their circumstances. The recent film “I, Daniel Blake” by Ken Loach highlights both the hard-hitting, honest and gritty reality and the brutality of this Government’s policies.

Donna also brought up the fact that assumptions are made about claimants based on the observations of the health care professionals. She asked for a copy of her medical assessment report and was disgusted that comments were noted about her appearance, personal grooming and whether claimants are tired or sweating. The comments were as follows:

“Looks tired…looks thin…underweight, clothing loose, dark circles under eyes ... unkempt, untidy … unwell … troubled … sweating … pale … facial expression showed no emotion but was tearful … restless … fidgety… difficulty coping due to anxiety … seemed agitated … poor rapport, poor eye contact … withdrawn … self-harm thoughts identified … no delusion … no obsessive ideas … unable to complete five rounds of ‘serial sevens’ … unable to calculate correct change when asked a sum … unable to spell ‘world’ backwards … unable to remember three objects first time … had insights into their illness.”

I ask the Minister: is this the kind of system that the Government have set out to achieve? Is this a system that offers fairness, dignity and respect? Where, ultimately, is the humanity in that process? Although many of those factors may be indicative of illness, many are circumstantial and subjective, given the particular illness that someone may or may not be assessing. For example, how would Donna’s entitlement have been affected if she had been immaculately dressed, had been having a good day or did not exhibit some of the behaviours outlined in that prescriptive list?

It has taken Donna 10 months to feel better. For seven of those months she has been awarded personal independence payment, and for the past four months she has been receiving employment support allowance. Access to those benefits has been vital to her recovery. Donna wishes to return to work when she can, and she can manage her own health. She knows her limitations, yet at this stage, due to her recovery, she faces the prospect of losing those benefits, which help her to sustain her family at this already difficult time. She is all too aware that if the support is removed too soon—which could mean pushing her back to full-time work—while she is at a vital stage in her recovery, she could end up right back at the beginning again.

Like physical illnesses, mental illnesses take a long time to heal, and there is no consideration of that in this process. Donna suggested that it would be helpful to her health to have a phased return to work—as a professional in this area, she knows only too well about recovering from depression—whereby she could still claim benefit and return to work slowly to build up her strength. Permitted work was explained to Donna, but as she knows only too well from her professional experience and from talking to others, as soon as a claimant lets the Department for Work and Pensions know that they are able to work for a few hours, they are ultimately called for reassessment and asked to go back to work full time. Donna told me that she would like to do a few hours a week volunteering, to get back herself back on her feet, but the criteria apply even to voluntary work. There is no middle ground.

Donna’s case illustrates that the work capability assessment is not fit for purpose. Sadly, that chimes with the calls from mental health organisations across the country, including Citizens Advice, the Disability Benefits Consortium, Mind and the Scottish Association for Mental Health. They have highlighted that the tick-box method of the work capability assessment fails to identify claimants suffering from debilitating mental health problems, and it certainly fails to take their needs into consideration.

I mentioned figures for personal independence payments earlier. Similarly, the latest figures show that 59% of initial ESA decisions were overturned on appeal. The Government have made one small concession on ESA by scrapping the retesting of chronically ill and disabled claimants—so one small part of the system now relies on common sense over bureaucracy—but that has simply fixed one part of an altogether broken system. Although exemptions from repeated assessments for chronically ill claimants and those with long-term illnesses are welcome, it is extremely disappointing that the Department for Work and Pensions and the Secretary of State have not considered that for PIP claimants.

I hope the Minister will take heed of the problems I have discussed with the work capability assessment and consider the effects that the process can have on the mental wellbeing of claimants. I respect the hard-working staff at the Department for Work and Pensions who ultimately are asked to administer this Government’s policy. My constituents and people up and down the UK deserve a social security system that is designed to offer people dignity, respect and fairness. It is time that the Government stepped up to their responsibility. We are all citizens, we are all human and we all deserve respect.

Let me add that when the responsibility for personal independence payments is devolved to Scotland—I am sure the Minister will come to this point—we will look to design the system appropriately. As she will be aware, it takes time to get the system right, because ultimately we are talking about the most vulnerable people in society. They deserve a social security system that gives them fairness, dignity and respect. I am sure we can all agree on that.

[Nadine Dorries (in the Chair)]

I now call Mr Shannon—you are on the list, Mr Shannon. Did you put in to speak?

[Jim Shannon (Strangford) (DUP)]

I did indeed, Ms Dorries. Absolutely. I am more than happy to be called—I am just surprised to be called right away.

[Nadine Dorries (in the Chair)]

You are first on the list today; I know it is unusual.

[Jim Shannon]

The first shall be last and the last shall be first. Whenever it happens, it is always good to be called. Thank you very much, Ms Dorries—I actually thought that the hon. Member for North Swindon (Justin Tomlinson) might have been asked, so I was looking at him, but no doubt he will participate at some stage.

I thank the hon. Member for Lanark and Hamilton East (Angela Crawley) for setting the scene well. We are back to discuss this matter again in Westminster Hall, and it would be remiss of me not to give a Northern Ireland perspective on where we are. I am grateful that the Minister is in her place and all of us in the House appreciate it when she responds. I will give my opinion today—and others will give examples—of where the system is falling down. I have to highlight those key issues because my staff and I deal with them every day of the week. We see people across the table from us with angst and anxiety and all the associated issues of stress, and we say, “How can we help them and do things better?” I will speak about some of those things today.

I have recently spoken about the changes to the employment and support allowance work-related activity group and what that means for people. The biggest issue is that the Government need to understand the difference between “ill” and “unable to work”. That, in a nutshell, is what the debate is about—the interpretation by the Department for Work and Pensions of what it means to be ill and what it means to those people who sit across the table from me every day and tell me they cannot work. The hon. Member for Lanark and Hamilton East referred to people being pasty, sweaty and anxious, and my staff and I see those things every day of the week.

In the last month, we have seen in my office a former ward sister, a former construction business owner and a social worker, all of whom are now on ESA. Let me be clear: I do not believe for a second that those people are choosing not to work out of laziness. Who would want to go from earning £500 a week down to £75? People do not, but that is what happens.

The inference from the Government in this whole policy is insulting—I say that with respect—and more importantly, is based on a false premise that cannot be allowed to stand. I have to challenge that in the House, respectfully and kindly, and say it to the Minister and Government directly. As hon. Members know, I do not criticise—I do not feel that that is necessarily what I do—but I need to highlight the issues and ask nicely for genuine compassion and understanding.

The rationale seems to apply to PIP applicants as well. PIP is supposed to be for the help that people need to work. Apparently, the PIP assessment is intended to provide

“a more holistic assessment of the impact of a health condition…on an individual’s ability to participate”

in everyday life. It covers sensory impairments, development needs, cognitive impairments and mental conditions, as well as physical disabilities. Those five categories cover everything—medically, physically, healthwise——that there can be. The assessment looks at the extent to which the individual is capable of undertaking various activities. For some activities, someone can score points to help to meet the threshold for PIP if they can undertake that activity only by using an “aid or appliance”. That could include such things as artificial limbs, colostomy bags, walking sticks and non-specialist aids such as electric tin openers and long-handled sponges.

I want to highlight two cases, one of which involves a young lady who has ulcerative colitis. My age is such that I can probably remember the day she was born. I have got to know her very well over the years due to her diagnosis with this unseen disease, and how it has affected her and other people in my constituency. She worked in the civil service but was granted medical retirement before 30 because her employer could no longer facilitate her working. A Government employer could not accommodate her ability to work one day and not the next, as her illness dictated.

I understand the reasons why the Government and the civil service had to take a decision and say, “Look, we are going to have to terminate your employment.” However, that is where the problem started, and I cannot understand how they expect someone else to employ her when they let her go. It should be understood why this lady is no longer able to work and why her employer, the civil service—she was Government-employed—had to let her go. Why is this young lady in this conflicted position? She is asked, in respect of PIPs, “What job can you do? Where can we find you some work?” Let us be honest: that wee lassie would love to work if only she had the opportunity, but she cannot because of her disability. She is on ESA and is dealing with the stress of the proposed changes. We should never underestimate the impact of the stress of this position. I stress that as strongly as I can, because I see that all the time. She rang to make an appointment for her PIP form to be filled out. How will she be assessed? That is the question I am asking. She is currently on the higher-rate DLA—deservedly so, by the way. Will that be taken away from her? Ministers would say no, but the experience we have had so far in my office is raising fear in our mind and the minds of constituents. I see that all the time.

The young lady’s condition has not improved one iota since her last DLA application. If anything, I would suggest that it has worsened, and there is real concern that the PIP changes will not help. The stress makes her even more ill. It is a vicious cycle that is repeated over and over again. The PIP is for people who need help for hygienic purposes and for safety issues, but the problem is that that is not being translated into the new proposals. I genuinely hold the Minister in the highest esteem. From her response, we need to understand how the system works and how it can help the people on whose behalf we are here to make a plea, so that we can take away the stress and hassle.

On 11 March, it was announced that the number of points awarded in the PIP assessment would be halved for aids and appliances for “dressing and undressing” and “managing toilet needs”. Why would the Government reduce the points for things that are needed? I cannot understand that. As a result, 290,000 claimants will no longer receive the daily living component, and a further 80,000 will receive the standard, rather than the enhanced, daily living component. Budget 2016 estimated additional savings of £1.3 billion a year by 2019-20. That is great but where does it leave my constituent, who needs help during the night?

[Nadine Dorries (in the Chair)]

Order. Mr Shannon, lots of people wish to speak. Would you try to keep your speech to about nine minutes so everybody has an equal amount of time? Thank you.

[Jim Shannon]

I did not realise that. I will try to go at my Northern Ireland speed, which is very fast. The young lady I was talking about needs her sheets changed at night, and often replaced entirely, as well as someone to come in and take care of her during her bad periods. Her DLA paid for a carer to help her. Will PIP do the same? The answer should certainly be yes, but the points system is not set up for illnesses such as ulcerative colitis and Crohn’s disease. The Crohn’s and Colitis UK website contains a link to a PDF offering help and advice on the PIP for sufferers. The PDF is 70 pages long—that is how complex the system is and how much help people need to fill out the application. If that does not put off someone who is seriously ill, I do not know what would.

Is this what was intended by the Government’s welfare reform? Did they intend to make it so complex and intricate that many people will give up and live in sub-standard conditions, rather than get the help they need to live with their illness? We should be concerned about people retreating inwards, their lack of confidence and the problems they face.

Ms Dorries, you have given me a time limit. I just have two more paragraphs to get through very quickly. I wholeheartedly believe that the new system is failing people. I had a doctor on the phone to say that his patient’s decision was made without the assessor taking the time to request any information about the patient from the surgery. The doctor said, “Jim, if he doesn’t get this help he will have to go to a nursing home at 46 years of age.” The care packages that health trusts put in place are not sufficient to handle people who are not able to pay privately for the additional support they require. On their behalf, I again ask the Minister, most sincerely, kindly and humbly: please look at this benefit, remember why it was set up and understand that, for many, it is the difference between having support to live and simply being able to exist. Do not continue to push these ill people, many of whom suffer from mental health problems due to the stress and strain of long-term illness. In this House, MPs are called to protect and help the vulnerable, but that is not what this new ESA and PIP system does.

--- Later in debate ---

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

Rather than commenting on the film, which is a dramatic portrayal, will the hon. Gentleman comment on the “Dispatches” programme? That was not fictional; it was an actual portrayal of the assessment process that people go through.

[Nadine Dorries (in the Chair)]

Mr Tomlinson, the same applies to you as applied to Mr Shannon.

[Justin Tomlinson]

I will not be long. I am glad that the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) intervened. I have a feeling that she will not let me intervene on her later, so I can link this in nicely. The “Dispatches” programme showed an isolated incident that was totally unacceptable. The individual was moved, and rightly so. That is why we have external inspectors. Remember that we are talking about 1.8 million people, and I urge her to take up my invitation to go and view an assessment. Hearsay is not the right way to hold Governments to account. This is so important that people in positions of responsibility need to invest some time in going to see what is actually happening.

--- Later in debate ---

[Patricia Gibson]

Surrounded by such a wealth of opportunity, it is hard to keep up. Nothing in the system that my constituents experience is seen as an opportunity. It is seen as extremely negative, intimidating and humiliating. When the hon. Gentleman talked about the assessments, perhaps I misunderstood him, but if I have I certainly am not alone. One might think that these assessments always resulted in somebody’s entitlement or benefit being increased, but I can assure him that in my constituency that is almost never the case.

The hon. Gentleman, perhaps in the interests of trying to be helpful to the Chamber, talked about how we should go and see an assessment taking place. Perhaps this is just me—I have not done a survey or anything—but these assessments are not a spectator sport. We are talking about people’s lives. The people who go through them very often find them humiliating and damaging. If I were to go through one of those assessments, the last thing I would want is an audience. Perhaps I might want a member of my family, or a close friend, but I certainly would not want my MP, who would in effect be a stranger, although their name might be well known to me. I certainly would not want the occasion to become a spectator sport. We must be careful about MPs filling the galleries when people are having their lives exposed and deconstructed by strangers.

This is a debate about social justice. Employment and support allowance is a form of financial support for people with life-limiting conditions whose ability to live a fully satisfying life, something we would all hope for, is effectively removed. That should be remembered during debates such as this one—and during the assessments. The hon. Member for North Swindon has informed the Chamber that the assessors are there to help, and I am sure that they think so too, but claimants feel stressed. They are confronted by assessors who are, by definition, strangers and who have little or no knowledge of their condition. We have all heard stories: for those who have not heard them, Parkinson’s UK can keep them going all day. There are stories, for example, of people with Parkinson’s being asked by the work capability assessor, “How long are you likely to have Parkinson’s for?”

We know that the criteria for work capability assessment are flawed and that people whose conditions fluctuate are always at risk of what might, strangely—as it is all relative—be called a good day. Such things are not taken into account by the work capability assessment, and nor is the impact of pain and fatigue, or the degenerative nature of conditions such as Parkinson’s. As a result, too many employment and support allowance applicants are placed in the work-related activity group, instead of the much more appropriate support group, which recognises that the claimant is simply not well enough to work. I reassure the hon. Member for North Swindon that I know that the Government have reversed the need for repeated work capability assessments for the chronically ill—that is welcome, but it simply does not go far enough. It is a matter of great concern to all fair-minded people that from April 2017 people placed in the employment support work-related activity group will receive £30 a week less than someone in the same situation today. That makes the failure of the system more alarming.

Flawed criteria are a particular difficulty for people with conditions such as Parkinson’s in receipt of disability living allowance—I could mention a range of conditions but time forbids it—when they are being assessed for PIP. Under DLA, if a person could walk no more than 50 metres they would be eligible for support. For PIP that distance has arbitrarily—randomly, it seems—been reduced to 20 metres. That is such a short distance that it is not a useful or helpful estimate of a person’s mobility. Given the fluctuating nature of some conditions and the failure of the process to register such fluctuations, many people are losing their Motability vehicles, on which they rely heavily.

The hon. Member for North Swindon will be interested to know that recent investigations found that under DLA 82% of people with Parkinson’s received the full mobility payment, whereas under PIP that has dropped to 40%. That is a massive drop, and those people lose their vehicles within 28 days of an assessment decision being made against them. I do not see how anyone can come to this Chamber and say that that is acceptable. Those people are being isolated in their own homes and effectively punished for their illness. Their dependence on family members increases.

[Nadine Dorries (in the Chair)]

Order. Will the hon. Lady apply the restriction of nine minutes to her speech?

[Patricia Gibson]

Yes, Ms Dorries.

--- Later in debate ---

[Natalie McGarry (Glasgow East) (Ind)]

rose—

[Nadine Dorries (in the Chair)]

Ms McGarry, I did not get notification that you put in a request to speak, but I could call you for a few minutes if you concluded in three or four minutes.

--- Later in debate ---

[Penny Mordaunt]

Forgive me, but I will make some progress.

That kind of quality support can be reached only through stellar local working. That is why the Green Paper consultation is more than an information-gathering exercise; it is a call to arms. We have to build new commitments and shared outcomes locally. I urge all Members to help us in the consultation process and to come along to the drop-in event in the House on Monday between 3 o’clock and 5 o’clock. It will offer information specific to Members’ constituencies, guidance on how to run an event or get involved in one, as well as bringing partners together to respond to the consultation and thinking about what needs to be done in the local area. During the consultation process, we will continue to develop those networks, facilitated by the flexible support fund, and also busting some of the myths about what local services we will commission to support those on benefits.

I briefly turn to Motability, which the hon. Members for Ayr, Carrick and Cumnock (Corri Wilson) and for North Ayrshire and Arran (Patricia Gibson) particularly focused on. Members will know that a scheme has been set out—I am very grateful to Motability for doing that—to try to help with the transition from DLA to PIP. It is a challenging time for individuals. That scheme is the £175 million package that Members will be familiar with, which enables individuals to keep their car for seven weeks, allows them to buy back their old vehicle and offers a one-off payment of £2,000 to help to meet their continuing Motability needs. Motability is also helping to pay for new adaptions to non-scheme cars, with insurance thrown in. We are aware of how difficult it is—despite that mitigation and the other sources of transport subsidy that might be available—for an individual to be told that they will lose their vehicle with only a few weeks to make alternative arrangements.

There are other problems too. I want to outline one that is of particular concern to me. It relates to people leaving the country for extended periods longer than 13 weeks. That is a problem for students, but it is also a problem for someone who might want to take up a career opportunity, a sabbatical or other opportunities that require travel. Our systems must be able to support someone following their dreams and ambitions. They must enable a person to thrive, so this situation should not be left to stand. We have been discussing with relevant Departments ways to enable PIP claimants to keep their vehicle pending appeal, and we are exploring options to allow those who are not in receipt of the higher Motability component to have access to the Motability scheme. I am also exploring how claimants who are out of the country for extended periods can be better supported. We have a plan and the Treasury’s blessing. This week I have written to Motability to ask for its help in delivering that plan. I anticipate that the plan will require some changes to its processes, but I know that it will do all it can to help us in this matter, as it has in the past. We have a remarkable and unique partnership with Motability, and I hope in my tenure to maximise that.

I have spoken at length about the work-related activity group. Time is short but, briefly, we are looking at a range of measures to help to ensure that someone’s experience of these systems—that is fundamentally the heart of what Members have been discussing today—can be improved and that we are aware of all the issues. That includes looking at developing service user panels to create a real-time reporting mechanism on people’s experiences. We can use those panels to design our benefits systems. There are a raft of other measures that I do not have time to outline today, but they will help us to do that. I will bring forward measures shortly.

The final thing I will do before I hand over to the hon. Member for Lanark and Hamilton East is reassure her that I will be there to assist when devolution transitions further powers to Holyrood. I am already talking to her colleagues there about how we can get the best outcomes for the issues she mentioned. Again, this comes down to all Members of this House—whichever part of the country we represent and whatever our political hue—working together to get the best outcomes in the systems. I hope that all Members will come to the drop-in session next Monday.

[Nadine Dorries (in the Chair)]

Six seconds.

[Angela Crawley]

I thank you for that, Mrs Dorries. I thank all hon. and right hon. Members—

[Nadine Dorries (in the Chair)]

Order.

Motion lapsed (Standing Order No. 10(6)).