Disability Assessment Services

Patricia Gibson Excerpts

Wednesday 13th March 2019 Westminster Hall

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

Thank you, Sir Christopher. I will be as brief as possible.

Support for those living with a disability is a mark of a civilised society but, as we have heard, the process that too many seeking support have to go through is often found to be daunting. That is certainly the case in my constituency. The rate of successful mandatory reconsiderations and appeals demonstrates that the process is fundamentally flawed. Evidence-based reviews conducted on behalf of the DWP have identified a pervasive culture of mistrust around PIP and ESA processes. That is simply not good enough.

There is no place in a welfare system for private companies, because that immediately introduces the profit motive. Looking after and supporting our sick and disabled should not be influenced by how much profit a private contractor can make. The Scottish Government will therefore remove the use of private companies for assessments.

We all have cases of constituents who have had an unfavourable decision made about them because information on them has been inaccurately recorded. Unbelievably, for example, someone with a heart condition has been assessed by a mental health professional, or vice versa. How does that promote faith in the assessment system? We need an overhaul of the system, a true recognition of the fact that life costs more for someone who lives with a disability. That is not a matter of opinion; it is a matter of fact. For that reason, in Scotland the bedroom tax has been fully mitigated by the SNP Scottish Government, because we know that people who live with a disability are disproportionately affected by the tax.

The PIP evidence-gathering process should be streamlined—that is the way forward. The stress and bureaucracy that claimants are put through, which I see every day in my constituency, are unacceptable. They cause real harm to people who are already struggling every day with serious and debilitating conditions. The system must take more account of the often very vulnerable people with whom it deals, and be redesigned accordingly. Otherwise, when our constituents need support, they will continue to face cruel and unnecessary barriers. Scotland is building a social security system that is fair to all. I urge the Minister to look critically at the system in place and do what she can to improve it for the people who use it.

--- Later in debate ---

[The Minister for Disabled People, Health and Work (Sarah Newton)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I am grateful for the number of Members from across the House and all parts of the country who have come together for the debate. There is a compelling debate going on in the main Chamber, yet many Members chose to prioritise this debate, which is to the great credit of everybody who has participated.

I pay particular tribute to my hon. Friend the Member for Chichester (Gillian Keegan) for her passionate, eloquent and well-informed contribution. She was joined by many colleagues who shared examples of the poor treatment that their constituents had faced in going through the assessment services. That is exactly why we made the announcements last week about the transformation of the way that we undertake assessments.

Our approach has been one of wholesale continuous improvement—to the personal independence payment since it was introduced, but also to the work capability assessment, since it was introduced by the Labour Government back in 2008. There have been numerous independent reviews, the Select Committee did an excellent inquiry and the Department has embraced and implemented a great number of recommendations. We are committed to continuous improvement, as the hon. Member for Ellesmere Port and Neston (Justin Madders) asked us to be. I thoroughly agree with him and want to reiterate what he said: we should treat others as we would like to be treated. Everyone should be treated with respect and dignity, and I can assure him and my hon. Friend the Member for Chichester, who also raised that point, that there is no complacency at all; there is an utter commitment to improvement.

[Patricia Gibson]

Will the Minister give way?

[Sarah Newton]

I will not; I have little time, and I was asked many questions. If I do not manage to cover all the questions that Members asked, I will of course write to them. It is great that we often have debates in this Chamber on this subject. I am sure there will be other opportunities to ask questions, perhaps in oral questions to the DWP on Monday.

My hon. Friend the Member for Chichester asked some questions that I particularly want to answer. She made a good point about how people feel when they go to an assessment, as well as about the location, how people look and what clothes they wear. People forget that the assessors are fully qualified healthcare professionals; they are the same people they might see if they went to A&E on a Saturday night. As part of our transformed service, we are looking carefully at where we can co-locate services. That could be in NHS or local authority facilities, but they need to be in a place where people will feel more comfortable.

We are seriously looking at how the people undertaking the assessments appear, and at ensuring that their certificates showing that they are fully qualified healthcare professionals are available, so that people have the same confidence when going to their assessment as they do when going to see their GP. Most people have a high degree of trust in their GP, and that is helpful, because that is the point that I want to get to. Repeatedly, GPs and healthcare professionals have told us that they do not want to be the gatekeepers of the benefits system, as that would get in the way of their patient-doctor, or patient-healthcare professional, relationship. We will need to have healthcare professionals undertake assessments, but they need to be separate from NHS services.

We are working closely with the medical profession to make sure that we have as close a relationship as possible, and to obtain information as swiftly as possible. I want to offer reassurance to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) about how we will go about getting medical information in our new transformed service. It will be with patient consent. We will not break into NHS or GP computer systems and extract data somehow. The information will be obtained with the consent of the patient.

I want to reiterate a commitment that I made at the Dispatch Box, when I answered the urgent question about the new transformed service. I want to make sure that disabled people co-design the service with us. We are starting soon on stakeholder engagement to enable that. We will work with the medical professionals—as I said, we will do a lot of work with them over the summer on this—stakeholders and disabled people. We want to improve people’s confidence and trust in the system, and make it properly accessible.

There were a whole range of really good points raised by the hon. Members for Strangford (Jim Shannon), for High Peak (Ruth George), for North Ayrshire and Arran (Patricia Gibson) and for Lanark and Hamilton East (Angela Crawley), and my hon. Friend the Member for St Ives (Derek Thomas), pointing to changes that they would like to see in the training of the healthcare professionals undertaking the assessments. I reassure hon. Members that a whole series of stakeholders—charities or people who work alongside those with particular health conditions—have met those undertaking health assessments to ensure that the guidance given to them is up to date and properly takes into consideration variability in conditions, and to ensure that those assessing people with rare conditions that we do not often come across are aware of that condition and its impact on a person’s ability to live their daily life in the way that we would like them to.

I assure all hon. Members that we give physical and mental health parity of esteem. Many of our healthcare assessors, as well as our frontline staff in the DWP, are undergoing good mental health awareness training, and they all have access to specialists whom they can call on. Through lots of small improvement to assessments, we are beginning to see real changes.

We spend a lot of time working with our colleagues in the Ministry of Justice to ensure that people can access tribunals in a more timely way. The delays are unacceptable. There has been recruitment of a lot of staff, and there is a new online resolution service for PIP, which was piloted and received good feedback from claimants. It will not replace people’s opportunity to have a face-to-face tribunal service, but some people might choose to go that way.

We are looking at improving our mandatory reconsideration process. It is not fair to say that it is a rubber-stamping process—around 20% of decisions are changed at mandatory reconsideration—but we are learning from the work we are doing with Her Majesty’s Courts and Tribunals Service to ensure that we can get more information, including medical information, from the claimant at the mandatory reconsideration stage, so that more decisions can be changed then, without having to go on to appeals.

However, the most important thing is to get more decisions right the first time, and to enable conversation, so that people are confident enough to give us all the information we need when we need it, and that we get that. We are working on that at pace.

In terms of the transformed service, it has been necessary to extend the existing contracts for both PIP and the work capability assessment, so that we have a secure and stable way of assessing the benefits. Developing the new transformed service will take a huge amount of work. We are creating a new digital platform, which we will co-design with disabled people. It will take this year to get that right; only then can we start to introduce the new service.

In the short time I have left, I return to the good point that my hon. Friend the Member for St Ives made about organisations such as the Benefits Resolutions service, formerly known as Bufferzone. I would love to work with him on what we can do to regulate those offering support to people going through the tribunal service. I agree with him; what he described is totally unacceptable. I would also like to work with my hon. Friend the Member for East Renfrewshire (Paul Masterton) and look at the report he mentioned to see what we can do to ensure that improvements are made.

I thank all hon. Members very much indeed; I am absolutely determined, as they all are, to improve these services and ensure that they are the best they can be.