Work Capability Assessments

Neil Gray Excerpts

Wednesday 13th December 2017 Westminster Hall

[Justin Tomlinson (North Swindon) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh, and to follow the hon. Member for Wolverhampton South West (Eleanor Smith)—I have many happy childhood memories of visiting Wolverhampton. I pay tribute to the hon. Member for Glasgow East (David Linden), who demonstrated his passion for this very important subject. He is clearly representing his constituents in a very strong way.

The importance of this debate is shown by how well-attended it is, particularly with other things going on in the main Chamber. That is because there is an opportunity to influence what the Government are doing. Following the Green Paper, they have demonstrated that they are willing to listen, engage, consult and make changes. We have a new Minister—the Minister for Disabled People, Health and Work—who is widely respected and who is determined to be accessible, to listen and learn, and to improve the situation.

The work capability assessment is not a new thing—it was introduced in 2008. There have been five independent reviews, more than 100 recommendations to improve it have been made and more than 100 recommendations have been enacted. Almost weekly, the Government are considering ways to make further changes. Each and every hon. Member, through our experiences of casework and of sitting through work capability assessments, can feed into the process and suggest changes.

I am a former disabilities Minister. The work capability assessment was not in my remit, but I made representations on behalf of many of the groups that have already been mentioned—Parkinson’s UK, Multiple Sclerosis Therapy Groups, Mind and others—and found that the policy makers and experts are willing to listen and change the scripts, including on how questions are asked and how things are identified, particularly when people have fluctuating health conditions and when health conditions are less common, such that an assessor does not regularly come across them. We have come along in leaps and bounds.

It is clear to me that the examples given today by Members—I presume other examples will be given by the Members who follow me—show that the system is still not right. That is why it is so important to have a Minister who is keen to engage.

I will make a couple of broad points, and then I have some asks. Many people ask why we have assessments. I wondered that myself when I arrived as a Minister. I thought, “I could save the Government a fortune. We could do away with assessments. They are expensive. The Treasury—George Osborne—is very keen for us to find savings, and this is a bit of an easy win.” The reality—we saw this as we transferred from disability living allowance to PIP—is that the assessments, ignoring the cases where they have gone wrong, are there to help build the case.

Under DLA it was purely a paper form. In that written document, most of us here would have articulated the challenges we face in our everyday lives pretty well, and we almost certainly would have got the benefits to which we were entitled, but many people navigating the system were not able to do that for a variety of reasons. Only 16% of claimants under DLA accessed the highest rate of benefit. Under PIP, that figure is 26%. That is because in some parts, the assessment has helped build people’s cases, particularly those with deteriorating health conditions at the beginning of that journey. The assessors are able to say, “At the moment, your day-to-day life is not too affected, but it is likely to be before too long.” The system triggers the ability to reassess and, in the majority of cases, that benefit and support is increased. The principle of the assessments is good. That is why the then Labour Government introduced them in 2008. The assessments are not Conservative ideology, but are done to assist people. Where the assessments go wrong, there is a problem, and that is why it is absolutely right to have this debate to engage and help shape the future.

[Neil Gray (Airdrie and Shotts) (SNP)]

When the hon. Gentleman was a Minister, we had a very constructive relationship on the points we are debating. Does he accept that one problem with the assessments is that they assess people on their best days and make an assumption on what their best days look like, not their worst days? If there was a change in assumption, that might help.

[Justin Tomlinson]

I thank the hon. Gentleman for his intervention, and in particular for his very kind words. It was always a pleasure working with him. He is certainly one of my favourite Members on the Opposition Benches in the way he engages and shapes things, although my comment might not help him in Scotland. The theory is that, if the assessments are done correctly, they are a judgment over a period of time. They should not be a judgment just of the isolated moment someone is in the assessment. It is meant to make a judgment on the typical challenges someone has to overcome over a period of time. That is an important point to make, and the system should be recognising it.

The first concern people raise is why the appeal rates are so high. They say, “If the rates are so high, there must be a fundamental problem.” Actually, if we drill down, the vast majority of successful appeals are where additional evidence is provided late, whether orally or in writing. The solution is that we must do more to access people’s health records in advance. Before data protection people come down on me like a tonne of bricks, that can be voluntary, but it should be a given.

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[Alex Burghart (Brentwood and Ongar) (Con)]

It is a pleasure to serve under your chairmanship, Ms McDonagh. I congratulate the hon. Member for Glasgow East (David Linden) on securing this important debate. It is always refreshing to be in a debate where there are so many shared views from different parties. I congratulate him on the tone with which he conducted his speech.

I echo some of the comments that remind us of how we have come to this position. There is absolutely a need for a work capability assessment within our benefits system. It is extremely important that people who suffer from physical and mental conditions have their conditions assessed to see whether they are able to work today or tomorrow. It allows the state to give them the requisite support that they need and deserve.

When the Labour party introduced the system in 2008, it did so with the laudable intention of creating a benefits system that identified what people could do rather than what they could not. That is a value to which we should remain attached. I am not sure that between 2008 and 2010 the then Government managed to achieve that. To be honest, I am not sure that we have managed to achieve it since, but the value of that principle is one that we should hold dear.

I should prefix what I say with my belief that there is substantial room for improvement within the system and perhaps a need to go back to some basic values. One thing that I find often gets lost in the powerful and personal stories that I come across in my surgery, and that colleagues from all parties come across in theirs, is that the system works well for a great many people. Of the 1.6 million people who completed the assessment process between October 2013 and December 2016, 85% did not appeal, so the vast majority were content with the decision that was made. Only 3.5% of the 1.6 million had a successful appeal. I do not wish to belittle those numbers because that 3.5% still represents tens of thousands of people, many of whom have very serious conditions, and many of whom will have been left substantially worse off by a negative decision. I want us to remember that the system is not wholly bad, but that there is substantial room for improvement within it.

[Neil Gray]

The hon. Gentleman quotes figures that I am happy to accept, but does he accept that many people who have been through the system, particularly with work capability assessments, feel so frustrated by the process they have gone through that they self-deny the support that might be available to them, and that that is perhaps part of the reason why there is a low appeal rate in some periods?

[Alex Burghart]

I absolutely accept what the hon. Gentleman says, but I think he would accept that some people do not appeal because they are pleased with the outcome. That is why my hon. Friend the Member for North Swindon (Justin Tomlinson) mentioned that the Government and the previous Government have always been in a process of ongoing review—we have had annual reviews and a Green Paper. I am sure everyone has read “Improving Lives”, published last month, which sets out the Government’s future commitment to reform, and that we all welcome it.

As a member of the Work and Pensions Committee, I have been fortunate enough to come across a great many cases and a great amount of submitted evidence. It is becoming clear to me that there are four key areas in which we should seek to improve the system. The first, which resonates with a lot of what has been said, is the accuracy of the assessments. I have had people through my surgery in my constituency who have presented me with information that is clearly wrong and clearly relates to somebody else. Basic errors creep in before we even get to the validity of the assessment process. That makes me think that the accountability system for the accuracy of the reports should also be revised. If an assessment company sees its assessments overturned, there should be consequences. I would certainly like, at the very least, the cost of the assessment process to be charged to that assessment company, and I would certainly be open to the idea of compensation for people who had been wrongfully denied benefits because assessments had been mishandled.

The matter is bound up with the question of expertise. The Work and Pensions Committee questioned witnesses from the major companies the other day about the level of expertise that they employed.

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[Neil Gray (Airdrie and Shotts) (SNP)]

I am pleased to sum up this important debate on behalf of the Scottish National party with you in the Chair, Ms McDonagh. I congratulate my hon. Friend the Member for Glasgow East (David Linden) on securing it. I pay tribute to the way that he has started his time in Parliament because he has, without doubt, been one of the most active and effective Members of the 2017 intake, and I am proud to work alongside him.

My hon. Friend made a typically forthright and incisive speech, drawing on his constituency experience and the expert testimony of groups who support and campaign for people with disabilities or long-term health conditions. He rightly called out a number of the flaws in the current work capability assessment process and the running of employment and support allowance, and he is right about the lack of information and data collection by the UK Government on the impact of cuts to ESA and wrong decision making at WCA level.

I am sure that the new Minister will question the high success rate of appeals against decisions made after work capability assessments. As has been said, a two-thirds success rate for appeals calls into question whether the system is working for those it is supposed to support, and I am sure she will raise that issue with her Department. Those who appeal against WCA decisions can only claim jobseeker’s allowance to receive an income, which adds additional conditionality and stress.

Other Members have made valuable contributions. The right hon. Member for Knowsley (Mr Howarth) made an important intervention about the way people with mental health conditions are treated, and I hope the Minister will consider and respond to that in her closing remarks. The hon. Member for Waveney (Peter Aldous) was typically challenging of the Government, and he based those challenges on casework experience that will be familiar to us all. The hon. Member for Wolverhampton South West (Eleanor Smith) spoke from her practical experience in healthcare and made a critical intervention.

The hon. Member for North Swindon (Justin Tomlinson) —a former Minister—made a typically considered speech and accepted that there are issues with WCAs. He also made a good point about access to medical information, which we all agree is a constructive change that the Minister could consider. That issue is a major stumbling block for constituents I have represented who have problems with the WCA.

The hon. Member for Strangford (Jim Shannon) made a strong case and did what too few of us do in this House, which is to pay tribute to the efforts made by staff. In my office, Lawrie, Margaret, Carrie, Adam, Michael and Lesley see and deal with these issues on a daily basis, and they do a power of work to support affected constituents.

This is the first—and perhaps only—time that I will say I agree with the hon. Member for Brentwood and Ongar (Alex Burghart), but there has been cross-party consensus in this debate that work capability assessments are not working. I hope that the Minister will take that on board.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson), as always, made a passionate and erudite speech. She was right to say that not much has changed in debates on this issue since I have been in Parliament, but the Minister has an opportunity to make changes, based on the suggestions that have been put forward today.

My hon. Friend the Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry) was also right, because the people who I see before an assessment in my constituency surgeries and office are petrified. They are terrified because this process has the potential to rip security away from them. It is a fundamental point in their journey through the process, and it is a difficult time because of their experiences and those of people around them who have previously gone through it.

In conclusion, I hope that the Minister came to this debate in listening mode, has engaged with it, and will leave in action mode. The personal and expert testimony that she has heard today should give her all the ammunition she needs to instruct a full review of work capability assessments, as called for by my hon. Friend the Member for Glasgow East. The system clearly is not working and is not fit for purpose. We welcome the move to exempt people with certain conditions from having to suffer reassessment for ESA, but that highlights the need for a proper and full review of the whole system. Such a review should be based on the Scottish Government’s principle of establishing a system that is fundamentally based on dignity and respect for those who need its help.

[Siobhain McDonagh (in the Chair)]

Order. We are grateful to the hon. Member for Glasgow East (David Linden) for withdrawing his right to sum up at the end of the debate, so the shadow Minister and the Minister have until 4 o’clock.

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[Sarah Newton]

I will not—I have very little time. I can of course follow up the hon. Gentleman’s point after the debate.

The timing of the debate is important for another reason. I welcome the fact that the Work and Pensions Committee is doing an inquiry into ESA and PIP assessments. I assure hon. Members that I will not only participate in that inquiry—I look forward to going along to the Committee next week—but pay attention to its findings and consider them. It is clear from this debate that we are all committed to ensuring that people with health conditions and disabilities have the right support.

In the past couple of weeks, I have visited assessment centres that are undertaking work capability and PIP assessments, and I have seen NHS doctors, nurses and health professionals bring their professionalism and compassion to their work. They are the same people we could meet if we go to an appointment to see a GP or are treated in our local hospital. I have seen compassion and professionalism in the assessments, but I accept that there are improvements to make. We can always do a lot more.

Returning to some of the fundamental points that hon. Members made, it is right that our system focuses on what people can do, not on what they cannot do. We embrace the social model of disability. We want to break down barriers to work and ensure that people can truly reach their full potential in our society and in work, because we know that good work is good for health. I have met many people who would be considered severely disabled, and they tell me that they want an opportunity to participate in society and to work. In my few short weeks as a Minister, I have already seen inspirational work in our NHS and among providers of support for people with disabilities that enables people to have a role in our society. People who have been cast aside, rejected and put on the scrap heap for the past 30 years are now being supported into work.

I am pleased to see the Under-Secretary of State for Health, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), with whom I work in partnership in the Department of Health, here today. We visited a fantastic project run by a mental health trust in London. The doctors said, “We had written off these patients. We never thought that somebody with such a severe mental health problem would ever work, but we have changed our minds because of the programmes we have been putting in place in our hospitals.” We have to focus on listening, learning and developing our systems so that more people like those my hon. Friend and I saw last week have an opportunity to play their full part in society.

Of course, some people are too poorly to work, much as they would like to do so. Every year, the Government spend more money on disability benefits and benefits for people with heath conditions, and it is clearly set out in our spending that we will continue to do so. We are spending more than £50 billion—more than the defence budget—on such benefits, so the idea that we are cutting support to people, as many hon. Members said, is simply wrong.

Any financial support system has to go through a process of evaluation to ensure we get the right support for the right person, and it must be individually based. My vision is very clear: each person is an individual, and no two people are the same. People who on paper have the same medical reports for the same condition will have very different prospects and will be able to do different things. The system must be tailor-made to support them. That is what we are doing in our future strategy, which we set up last week.

Labour introduced the work capability assessment in 2008, and we all agreed that it was not good enough and was not fit for purpose. Since then, it has been under constant review, and we have made more than 100 recommendations. Whenever we find good new ideas to improve it, we implement them. We regularly engage with disabled people and stakeholder groups to ensure that we listen, learn and make improvements. Probably the most significant improvements have been in mental health. Work capability and PIP assessors, and frontline staff in the DWP—the people in the jobcentres and those who make decisions about benefits—have all undertaken mental health training to ensure they are sensitive to the needs of people with mental health conditions.

There is a person behind every statistic, so I am leery about using statistics, but I cannot allow some of the misinformation we have heard today to remain unchallenged. We undertake 1 million ESA assessments every year. Since April, 8% have been appealed and only 4% have been upheld. I know there is a person behind every statistic, and I know the impact that that can have on people, but it is not fair to say that, in the majority of cases, the system does not work. In the majority of cases, it does work.

[Neil Gray]

Will the Minister give way?

[Sarah Newton]

I want to answer the points that have been raised.

We are not satisfied with the appeal rate. That is not a “good enough for me” measurement of the process. I am interested in the experience of the individual claimant and their journey through the process. Independent customer satisfaction surveys are undertaken, and the latest shows an 83% highly satisfied or satisfied rate. I am not going to be satisfied until it is 100% of claimants, but hon. Members have indicated that everybody is having the most terrible experience, which is simply not the case.

I am not complacent, and I want to highlight some of the improvements that are under way. We have representative groups that include charities and disabled people, and we are always looking at what more we can do with the forms and the process. Videos are going to be put up on our contractors’ websites so that, before people go along to the assessments, they have got information about what to expect, what they can bring with them and the people they can bring along to support them so they are not scared. I do not want anybody to be terrified about going to the assessments. We are doing a lot of work with healthcare professionals to ensure that they have continuous improvement. We are particularly focusing on mental health.

I am sorry that I have not been able to address all the concerns that were raised. As I say, I will write to hon. Members, and I am taking careful note of the Work and Pensions Committee’s work. I agree with everyone that we want a system that treats people with respect and dignity, gives them the personal, tailor-made service that they richly deserve, and enables them to play a full part in our society.

Question put and agreed to.

Resolved,

That this House has considered work capability assessments.