Work Capability Assessments

Debate between Neil Coyle and Eilidh Whiteford

Tuesday 9th February 2016 Westminster Hall

[Dr Whiteford]

As ever, the hon. Gentleman makes an important point clearly. There is no reason why people’s medical history should not be included in the assessments. Often, consultants—sometimes it is a GP, but in cases of serious illness it is more likely to be a consultant—are in a position to provide insight into the longevity of a condition as well as its immediate acute effects.

[Neil Coyle]

Is the hon. Lady aware that the Government, during the last Parliament, also shortened the timeframe within which individuals can provide independent medical evidence? As it takes longer to see a consultant or specialist, that inevitably means that some people cannot provide that information in time, which contributes to the number of reassessments, the backlog and the cost to the taxpayer.

[Dr Whiteford]

The hon. Gentleman is absolutely right. The shortening of the timeframe makes it extremely difficult for people to contribute, which is why that opportunity needs to be included right at the start. If people can nominate someone—an advocate, a consultant, a GP or a community nurse—to provide such information as part of the application process, we could get around a lot of those problems.

For people with complex disabilities, people who suffer from more than one condition or people whose condition fluctuates, the tick-box exercise of the work capability assessment fails to capture the impact of their health on their ability to work. Around half of those in receipt of employment and support allowance have a mental health condition, yet the work capability assessment has proved poor at accurately assessing conditions that are not visible, and people with mental health or incapacity issues are not always able to articulate well the effects of their condition.

I pressed hard during the last Parliament for improvements to how mental function champions operate within the assessment process, but there is increasing evidence that as things stand, the work capability assessment causes so much distress and anxiety for some people that it is actively harming their health, pushing them further away from being able to work and—in extreme cases such as the ones mentioned by the hon. Member for Glasgow East—towards harming themselves.

The Royal College of Psychiatrists has expressed serious concerns for some years about the impact of the work capability assessment on the health of people with mental illness, but as evidence of harm grows, the college is becoming more outspoken. As my hon. Friend the Member for North Ayrshire and Arran pointed out, robust research conducted at the universities of Liverpool and Oxford suggests a correlation between mental health problems and the roll-out of work capability assessments. That backs up the findings of voluntary sector service providers such as the Scottish Association for Mental Health, which has extensive experience of people who use its services suffering setbacks in their recovery due to the assessment process.

The bottom line is that too many people are still being wrongly assessed. We know that because of the extraordinary success rate when claimants who have been found fit for work appeal that decision. Between 2010 and 2013, it hovered around the 40% mark; since the introduction of mandatory reconsideration in 2013, it has shot up to around 54%. In other words, more than half of those who appeal are likely to get the original decision overturned. Successful appeals on that scale indicate major underlying flaws in the assessment process, and they cost the Government a lot of needless time and money. More than that, they mean that sick and disabled people are left feeling abandoned and desperate for months without the support that they need. The human cost is enormous, as is the financial cost, as the National Audit Office has pointed out.

We must also remember those who do not appeal but who are nevertheless extremely unwell or seriously disabled. Many people in our constituencies who are destitute or living in extreme poverty are people whose access to ESA has expired, or who have been found fit for work but cannot qualify for jobseeker’s allowance—because they really are not fit for work and cannot comply with the conditions attached to JSA, or because they have tried to comply but have been sanctioned, or because they have disengaged from the system altogether and have simply dropped out of view.

I have no idea how many people fall into that latter category, but I know that I am meeting such people regularly. They live off other family members or friends, some of whom are themselves not wealthy, and they depend on food parcels from church voluntary groups or food banks. Consequently, when the Government consider how they might proceed with a replacement for the WCA, they need to take on board the systemic failures of the current approach and think beyond simplistic functionality.

The first and probably the most valuable thing that the Government could do is to work with disabled people and their representatives from the outset. Throughout the past few years, health and disability organisations have been coming forward with constructive suggestions to improve the existing system, and contributing to the successive reviews. Some of their ideas have been taken on board, at least partially, but the opportunity presented by a new White Paper to get stakeholders around the table and—more significantly—really listen to what they say has never been more important.

I also urge the Government to go back to the work that was done around the evidence-based review of 2012-13 and the alternative assessment that was developed under that process. I know that Ministers were not convinced by that review at the time, but a lot of water has flowed under the bridge since then, a much stronger evidence base has been developed and I think there is a lot of substance in that review, not least in the way that it suggests descriptors that would account for the impact of pain and fatigue on a person with an illness or a long-term condition. That review could really usefully inform a new approach.

Lastly, I urge the Government to learn from international experiences. The UK does not have a disproportionately high number of sick and disabled people compared with the rest of the OECD. Clearly, there are regional variations, even within the UK, with higher numbers of claimants in economically deprived or heavily industrialised areas, where health outcomes and life expectancy are significantly lower than average. On the whole, however, we are grappling with the same challenges as other industrialised countries and on a broadly similar scale.

A number of countries have used what have been called “real world incapacity assessments” that take account of a person’s age, skills and work experience, as well as their health or disability, when assessing their fitness for work and considering what kind of work they might be able to do. This seems just to be common sense and means that someone is assessed as a rounded human being. The same condition with the same severity will affect two people differently in relation to their ability to work, depending on whether their work experience has been in physically demanding manual jobs, whether they sit at a desk or whatever. The Government should explore the models used in other countries to see what is working well.

We all agree with the Government that the social security system needs to support people to move towards work, but it also needs to provide a safety net and a dignified life for those who are not fit for work, and not only those who will never return to work but those with long-term conditions and those who need time to recover from serious illness or injury.

The work capability assessment has failed a lot of sick and disabled people, and it has proved extremely inefficient. What follows must be better, and I hope that the Government’s keenly anticipated White Paper will reflect the concerns that have been raised today.

Benefit Sanctions

Debate between Neil Coyle and Eilidh Whiteford

Wednesday 16th December 2015 Westminster Hall

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

I beg to move,

That this House has considered benefit sanctions.

I am very pleased to have the opportunity to lead this short debate this afternoon. Members will be aware that I have debated this topic with Ministers several times in the past, and that I have been at pains during those debates to raise concerns about the impact of conditionality on vulnerable claimants. At the forefront of those debates has been the disproportionate level of sanctions imposed on people with mental illness. I met the Under-Secretary of State for Disabled People not long ago to discuss some of the ways in which the Government might address the acknowledged shortcomings in the regime for those with serious mental illnesses and other fluctuating conditions. However, I am glad that the Minister for Employment is responding to today’s debate, because I think the wider issues sit far more appropriately in her portfolio.

As I have argued before, one of the reasons why the sanctions regime is failing vulnerable people so badly is the underlying problem with the work capability assessment. High levels of sanctioning among people who are ill or very disadvantaged is, in part, symptomatic of people being found fit for work when they are not really fit for work. Until that gets fixed, I fear we are destined to go round in circles. But that is not the whole story. Although I do not think anyone would dismiss the value of conditionality in the benefits system per se, the conditions that the Government set need to be proportionate and fair, and I do not think we can say that at the moment, particularly for the more vulnerable claimants.

The Government’s announcement a few weeks back that they intend to pilot a so-called yellow card scheme for sanctions in the new year is, I think, an acknowledgement that the system is not working very well at present. I hope the Minister will take the opportunity today to set out in more detail how that warning system will work in practice, and, specifically, what protection there will be for those who are identified as vulnerable.

My main call today echoes the calls I have made previously, and that the Work and Pensions Committee made in the previous Parliament, for a full independent review of the benefit sanctions regime. That is necessary and long overdue. I fear that tinkering around the edges of the system will not resolve the systemic weaknesses, and this afternoon I want to highlight a growing body of evidence that sanctions are not only failing to support claimants into work, but are actually having a counterproductive effect, undermining the Government’s policy objectives and causing unacceptable levels of hardship and destitution to vulnerable and disadvantaged people.

Last week the homelessness charity, Crisis, published a major piece of research undertaken at Sheffield Hallam University into homeless people’s experiences of welfare conditionality and benefit sanctions. It is a significant and timely piece of work; it is the largest study of its kind ever carried out, and it provides a robust qualitative evidence base for how sanctions are affecting vulnerable claimants. The researchers drew on the experiences of more than a thousand people who use homelessness services in England and Scotland, and looked specifically at the impact of sanctions on their lives and employment prospects. Distressing individual stories are documented in the report, and I urge the Minister and other hon. Members to read it. It deserves to be widely read.

There are many reasons why people become homeless or precariously housed. Often in the past, relationship breakdown has been cited as the single biggest reason why someone will end up homeless, but more recently that has been overtaken by problems with benefits, particularly among those who have been sanctioned. In many cases, though, homelessness is itself a symptom of underlying vulnerabilities. Young people leaving care; people with long-term mental health problems; people with addictions; and people with borderline learning disabilities who have trouble with literacy or numeracy—those are all high risk factors for becoming homeless, but what the Crisis research found was that the most vulnerable claimants were those at the greatest risk of being sanctioned. They also found that, far from pushing people to secure work, sanctions were actually pushing people further away from the labour market. To my mind, that is an extremely serious finding, because it undermines the Government’s assertion that sanctions are helping to bring down claimant numbers and are playing a positive role in getting people into work.

As far as vulnerable claimants are concerned, that is simply not where the evidence leads. Research from the University of Oxford and the London School of Hygiene and Tropical Medicine, published earlier this year, found that

“Sanctions do not appear to help people return to work. There is a real concern that sanctioned persons are disappearing from view.”

Similarly, the Economic and Social Research Council has questioned the effectiveness of conditionality in getting people into work, and the Department for Work and Pensions’ own evaluation of Jobcentre Plus in 2013 concluded that there was no evidence to suggest that knowledge of jobseeker’s allowance conditionality led to actual movement into work. However, there is mounting evidence that sanctions are a key driver of the growth in demand for food banks and are causing unprecedented hardship, and now there is evidence that they are fuelling homelessness.

The number of people being sanctioned has fallen from its peak in the year to October 2013. Since that time, the labour market has improved significantly, and the number of people claiming jobseeker’s allowance or its successor benefit, universal credit, has fallen by 41%, so we would expect to see a corresponding fall in the number of people being sanctioned. What is more revealing is that we have also seen a smaller, underlying downward trend in the proportion of claimants being sanctioned, which has fallen to 4.92% a month in the year to June 2015, from a high of 6.77% a month in the previous year. That, however, is still dramatically higher than the pre-2012 rates prior to the introduction of the new regime, and a staggering proportion of sanctions—more than two thirds—are now overturned on appeal, where claimants challenge the decision. I know from speaking to colleagues in Citizens Advice that it now urges people who are sanctioned to appeal against that first sanction. If people do not appeal against that first sanction, there is a real risk that if they are sanctioned again, the consequences will be devastating for their incomes.

Research carried out by Dr David Webster of Glasgow University highlights a couple of very important statistical limitations of the data that we have on sanctions. First, the recorded stats show sanctions only after reviews, considerations and appeals, so there is a time lag in the data, and the figures do not tell us how many people actually had their benefit money stopped in the first place. Also, and more significantly, as the DWP has been making the transfer to universal credit, new single claimants of unemployment benefits are going on to that benefit instead of on to JSA, and absolutely no data have been published on universal credit sanctions. This is now having what researchers describe as a “significant distorting effect” on analysis, because the number of those at risk of JSA sanctions is being reduced. Moreover, the young single claimants now more likely to be on universal credit—almost half of them are under 25—were previously twice as likely, statistically, to be sanctioned under JSA, so the distortion in the data could be amplified by that, but without hard data, we simply do not know. So we need that data on universal credit.

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I congratulate the hon. Lady on securing this debate. She has made an interesting point about jobseeker’s allowance, but there are data to show that in the past couple of years there has been a significant increase in the number of disabled people in receipt of employment and support allowance who have been sanctioned, up from 1,400 in March 2013 to 5,400 in March 2014, according to the Crisis figures that I believe the hon. Lady was citing.

The hon. Lady made comments about improving the work capability assessment. Even if the WCA were improved, what is her solution to the sanctions on disabled people on employment and support allowance?