Endometriosis Workplace Support

Debate between Patricia Gibson and Justin Tomlinson

Tuesday 29th October 2019 Westminster Hall

[Justin Tomlinson]

That is a really helpful suggestion, which we will make sure is fed in.

[Patricia Gibson]

I welcome what the Minister said about the DWP looking at how it can raise awareness of the condition for frontline staff. Does he agree that it is important to look at how sick pay works? Given the recurrent nature of the condition, it often has a financial cost to women in days lost to sickness. Will he commit to looking at whether endometriosis can be accommodated?

[Justin Tomlinson]

I will come to that in my speech, so I ask hon. Members to be a little patient. I will cover most of the points raised.

When, of the four Departments, my Department and I were selected to respond to the debate—one of four Ministers could have been selected to respond—my initial reaction was: do I know much about this? I was contacted by a former employee, Kamya Gopal—she is happy for me to name her—who had this condition. When I employed her, we had had a conversation and made some relatively easy changes that involved being sympathetic: she had to go for short-notice GP appointments; we took into account a need for urgent toilet breaks when doing visits, making sure we were not too far away; and we took things on a day-to-day basis. For a reasonable length of time, no changes were needed. Sometimes they were, and we just accepted that, and it worked. The key thing is that it was easy for me to make those changes, and I as an employer benefited, for four years, from a really valuable member of my team. It was a win-win from having the confidence to have that conversation. She made it clear to me—this has come across clearly in hon. Members’ speeches—that it affects everyone differently. For her, it is a family trait, but they all have different symptoms and challenges to overcome. It all comes down to having that conversation.

Linked to that, another impact is the need to use disabled toilets. Kamya has a RADAR key—it is a hidden disability—and recently someone challenged her for using the disabled toilet. She had to explain, which was embarrassing for her and for the lady who challenged her. That is why I pay tribute to the hon. Member for East Lothian (Martin Whitfield), who has been championing Grace’s sign, which is fully supported by my Department, to raise awareness of hidden disabilities and hidden health conditions and avoid those confrontational, embarrassing situations.

It is important that people with health conditions get the support that enables them to stay in work, and productive in work. Such support is wide-ranging and relies on employers being open to discussing health matters with their employees in a respectful and constructive way.

I am on my fifth Secretary of State as a Minister in the DWP, and I have many roundtables with different stakeholders. We were talking about disability employment yesterday, and it was interesting how there has been a shift in focus to ensuring that people do not drop out of work due to disability or a health condition. Collectively we must do much more in that area. I am encouraged that there is increasing awareness and recognition of hidden disabilities, and hidden health conditions in particular. There is still a huge way to go, but there is a willingness in society to do better.

Endometriosis is a serious condition; we have heard about the ways that it can be debilitating. For the estimated one in 10 women in the UK who suffer, the condition can have a huge effect on their daily lives, including their ability to work to their full ability. As the examples quoted by various Members today show, diagnosis is not always straightforward. Problems arise because symptoms can vary significantly, and because diagnosis tends to require invasive procedures. I do not profess to be a health expert, but it is clear that because endometriosis is seen as a taboo, that will impact on the ability to diagnose and provide support. Members have spoken powerfully about how we have to do much more in that area.

The challenging nature of the condition is recognised within the health system, which now has specialist training. NHS England has developed a service specification for severe endometriosis under the specialised commissioning area of complex gynaecology. That is a good step. It is the beginning of the journey and we will have to see what difference it makes, but I am encouraged that it is starting to happen.

Through these measures diagnosis and treatment should improve, but we must also consider the effect on the ability to work. A survey by investment firm Standard Life found that one in six women with endometriosis report having to give up work because of the severity of their symptoms, with almost all—some 87%—reporting that the condition affected their financial position in some way.

Individual women feel the harmful effects, but employers and the economy as a whole lose out. The leading charity, Endometriosis UK, has estimated that the total cost to the economy of the condition is £8.2 billion; the cost from loss of work is a key contributor to that figure. As outlined in the Work Foundation report, such an impact means that the days of dismissing topics such as these as “women’s issues” are long gone. We know that both the health and work landscapes must be more aware of the condition and its symptoms, for the sake of the women who suffer from it and in order to build a healthier and more productive society for all.

One way that people in work are protected is through the Equality Act 2010, which is the principal means through which disabled people are protected from discrimination in Great Britain. Other than for a very few exceptions, the Act recognises a disability by the impact on the person’s life rather than by the condition itself. Importantly, that means that women with endometriosis are protected by the Act if their condition has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. I recognise the points that have been highlighted about how we need to improve the awareness and the enforcement of the Act, and about wider support. I will come on to some of the work in that area.

Individuals are also protected in law against unfair dismissal. While those legal protections exist, sufferers continue to face barriers to work and barriers in the workplace, as we have heard. More must be done to raise awareness of hidden conditions. Workplace cultures must adapt to spread understanding of the importance of supporting individuals with health conditions and the value of open discussions about health in the workplace.

Severe Disability Premium

Debate between Patricia Gibson and Justin Tomlinson

Tuesday 7th May 2019 Commons Chamber

[Justin Tomlinson]

The priority in our reforms is to make sure that the most vulnerable get the most support within the system. Without knowing all the details of that case, it is difficult to comment, but I am happy to look at the details.

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

Has the Department contacted all those who have lost out on payments? If not, when will the Department do so? Will the Minister commit to ensuring that absolutely no burden is placed on claimants in applying for back payments of the severe disability premium, and that his Department will take on the burden of gathering the available evidence to ensure that payments are made as soon as possible?

[Justin Tomlinson]

The judgment was given only on Friday, but we are urgently considering all the options available to us. Once we are in a position to do so, we absolutely will make sure that we communicate with all claimants.

Ten Years of the Work Capability Assessment

Debate between Patricia Gibson and Justin Tomlinson

Wednesday 24th April 2019 Westminster Hall

[Justin Tomlinson]

We all recognise that suicide is a tragic and complex issue, and we take it extremely seriously. We take the death of any claimant seriously and, where we are made aware that a person has died and it is suggested that that might be associated with the DWP directly, a review will be undertaken to identify whether any lessons can be learned and can be actioned.

[Patricia Gibson]

Will the Minister give way?

[Justin Tomlinson]

Let me make some progress, because this is a very important point about the MR process. We are in the early stages with a new way of looking at MRs, but there have been very positive results, and we will now roll this out to all the PIP dispute sites. We intend to do the same for the ESA sites as well.

The second stage has to do with the appeal process. Again, we recognise that people will submit additional, late written and oral evidence.

[Patricia Gibson]

rose—

[Justin Tomlinson]

Let me just make this point. I want to explain one of the challenges. The shadow Minister, the hon. Member for Battersea (Marsha De Cordova), talked about a 30-week wait, in some cases, for an appeal. The person may have got the additional evidence in week six, but then the system is saying, “I’m sorry, but you’re going to have wait another 24 weeks until we can actually take that into account.” That is clearly not an ideal situation, so we are looking at how we can lapse appeals, where there is new evidence, to reconsider the decision with the additional evidence and be able then to give them a different decision. If we do not think that that should change the decision, they have the right to carry on right through to the final appeal process, but if it is something that is clearly going to change the decision, we should act as quickly as possible.

[Patricia Gibson]

Will the Minister give way?

[Justin Tomlinson]

In a second. Over the past five years, only 4% of work capability assessment ESA decisions have been revised at appeal, but we recognise that it is in no one’s interest that things should be picked up only after a lengthy appeal process, so we are absolutely committed to being proactive in this area, and this issue will be a real priority.

[Patricia Gibson]

I thank the Minister for giving way. I just wanted to ask for clarification on one point that he made, which was about appeals being successful because of new or additional information. How does he respond, then, to the fact that people who go on to appeal do so on the basis that the information that they see about themselves is badly or very badly expressed and incorrect, and to Citizens Advice saying that 81% of the customers it sees have inaccurate information recorded about them, which leads to a wrong decision?

[Justin Tomlinson]

I am coming on to how we can do more to ensure that the right evidence is put into the system at the earliest possible moment and in the right way. We do not want people who should be getting support to have to go through a lengthy process unnecessarily. We all agree on that, and I hope that hon. Members can see that what I am describing is an important improvement. It is still at an early stage, but as I have seen in previous debates, it is the sort of thing that stakeholders want us to do, and we are rightly going to take it forward.

Let me come on to the point about evidence. It is referring to the integrated service. There is a bit of confusion in terms of what people thought that this would be. The view was that it ultimately would be a panacea whereby people would go for one single assessment for PIP and for the work capability assessment. The reality is that very few people apply for both benefits at a similar point in time. However, for the very few people who do, it might make sense for them to have, if they wish, both of the assessments on the same day instead of having to come in on the Monday and then again on the Wednesday. That may be what people want to do, but we are talking about very small numbers.

The thrust of this is to share evidence if the claimant wishes that to be done. One point that many hon. Members made was about the challenge that often arises of getting the evidence, whether from the GP, the physiotherapist or the hospitals, in a timely manner and in a way that is helpful for their assessment. If they have managed to do that once and they would like us to use that evidence again, with their consent, that is something that we would seek to do as part of building the new digital system and ensuring that the claimant has consistent, better information. Being able to share evidence will reduce the burden of providing the same evidence multiple times. It could potentially lead to fewer face-to-face assessments if we can gather crucial, vital, clear-cut evidence earlier in the claim.

I want to pay tribute to all the stakeholders, the medical experts, the charities and all the MPs across the House who regularly engage on this issue. Over the coming months, we will be doing a series of roundtables and regional events to gather further evidence, with a real emphasis on those with real experience of this area, so that we can further improve the system. We want to build trust, transparency and consistency and we want to improve the claimant’s experience through a more personalised and tailored approach. As a returning Minister, I am committed to supporting disabled people and those with long-term health conditions to claim and receive the benefits to which they are entitled and to ensuring that people are treated fairly and with dignity. I thank all the Members across the House who have contributed today.

Supporting Disabled People to Work

Debate between Patricia Gibson and Justin Tomlinson

Thursday 28th March 2019 Commons Chamber

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

The Tory vice-chairman, the hon. Member for Braintree (James Cleverly), is reported to have said that no Minister for the disabled will be appointed until the Brexit chaos has passed. Will the Minister tell us why that is? Three Members have asked this question already, but to no avail. It is disturbing that the Minister seems to be blaming MPs for the lack of a disabilities Minister because they have not supported the Prime Minister’s doomed deal. What signal does he think this sends to disabled people about the Government’s priorities? Why are disabled people paying the price for this Government’s Brexit chaos?

[Justin Tomlinson]

As I said in my earlier answers, I am happy to attend and support debates and meetings. I am also proud to have served as the Minister for disabled people a few years back, and my passion has not diminished one bit. We all collectively owe it to those people who need that extra bit of support to do everything we can, and I am proud to do that.

Widowed Parent’s Allowance

Debate between Patricia Gibson and Justin Tomlinson

Wednesday 23rd January 2019 Westminster Hall

[Justin Tomlinson]

In terms of the way other European countries do this, that is part of our work, because we are looking at what has worked, what the potential unintended consequences are and what can be done to mediate that. That is shaping much of the work. I absolutely understand why the hon. Lady would love me to be able to give a specific timeframe, but I cannot do so, other than to say that it is an absolute priority for us to do this and to do it thoroughly and properly and to avoid unintended consequences. We absolutely recognise the importance of this.

[Patricia Gibson]

I am gratified by what I think the Minister said, which is that eligibility based on marital status cannot be determined purely on the basis of convenience. I am glad that he seems to have said that, but like the hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts), I ask him to assure the House right now that the children will be at the heart of any way forward that the Government embark on.

[Justin Tomlinson]

Many of the things that we do as a Government rightly recognise the importance of children. As the state, we have a duty of care to ensure that all children, regardless of background and circumstances, have the opportunity to unlock their full potential. Whichever political side they are on, every individual Member would echo that, in their own terms.

As I said, we have recognised the importance of the hearing. We are keen to do this thoroughly. We are taking it very seriously. We wish to do it as swiftly as possible, but it has to be done absolutely right. Let me give further reassurance. Although there is no one simple or obvious solution following the declaration of incompatibility, the officials are working very carefully, and ultimately I will return with potential solutions. This must go through the House’s legislative process, so all Members will have further opportunities to shape what we then believe would be the right conclusion. We are working very closely with our counterparts in Northern Ireland, recognising that the specific case was from there. But this must be done very thoroughly.

In conclusion, we are carefully considering the McLaughlin court ruling. We recognise that we currently have incompatible law on the statute books, and we are actively considering all options. With the introduction of the bereavement support payment, we have demonstrated that we will seek to make sensible and positive changes to target support at those most in need.

It is very clear that the hon. Members present feel strongly that the emphasis has to be on the children; I have heard that loud and clear. As I said, it has always been our intention to assess the impact of the bereavement support payment, which we will do once we have sufficient data. We are committed to supporting the bereaved and ensuring that they receive the right support at a difficult time. I echo my tribute to the hon. Members who care so passionately about this subject. It is a real priority for the Government and for me, and as we make progress I will be very happy to meet again, individually, those who are interested, in order to update them on the work. I want to be inclusive, because we all want the right outcomes. It is just that the issue is complex. There was not a clear steer, which meant that there could not be a quick fix, but the issue is a genuine, real priority for us.

Question put and agreed to.

Widowed Parent’s Allowance

Debate between Patricia Gibson and Justin Tomlinson

Wednesday 5th September 2018 Commons Chamber

[Justin Tomlinson]

May I first express my personal condolences to the family at this distressing time? I understand the points that the hon. Lady makes, and they are being considered. In the short term, I urge hon. Members to look at the other potential benefits that could be offered to support families, including universal credit and tax credits. I will return to update the House fully as soon as I can following the ruling by the Court last week.

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

In a debate on 2 March 2017 on bereavement support benefit, I pressed the then Minister on the issue of cohabiting couples. I pointed out that they are treated as couples for other benefits such as tax credits, but I was told that extending eligibility to cohabitees would “increase spend” and be “complex to administer”. Despite what the Minister has said about legal certainties, we know that many bereaved cohabitees and their children have lost out because of the UK Government’s reluctance to recognise them as families. In the light of the Court judgment and the hardship caused to bereaved cohabitees and their children, does he agree that the Government should apologise for their inaction and that, as soon as can possibly be arranged, this needs to be corrected retrospectively so that justice is obtained for the people affected?

[Justin Tomlinson]

This issue was considered at great length in debates on the Pensions Act 2014 and the subsequent regulations. It is not straightforward. How do the Government act as judge and jury in situations in which someone could be living with a different partner? At a time of great distress, the emphasis has to be on providing appropriate and quick support particularly targeted at those in the most need. Following the ruling in the Supreme Court, the points raised will be considered and I will come back as quickly as is appropriate to provide an update to the House.