Disability Benefits and Social Care

Sheila Gilmore Excerpts

Wednesday 20th June 2012 Commons Chamber

[Sheila Gilmore (Edinburgh East) (Lab)]

Does my right hon. Friend agree that after closures like this, people often end up on benefits? In my constituency, a Blindcraft factory, not Remploy, was closed by the then Lib Dem council. The majority of the people who worked there have not been found jobs in the wider economy, which would have been desirable, and they are back to being unemployed and sitting around at home.

[Mr Byrne]

My hon. Friend makes my point for me. When the reform of ESA and back-to-work programmes such as the Work programme are failing so badly, shutting these factories down without providing real answers about their future will, I am afraid, have terrible consequences in communities all over the country.

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[The Parliamentary Under-Secretary of State for Work and Pensions (Maria Miller)]

As the right hon. Member for Birmingham, Hodge Hill (Mr Byrne) seems to be rather hazily acquainted with some of the facts and the reality of his time as Chief Secretary to the Treasury, perhaps I may take some time to recount to him some of the facts, in particular that spending on disability living allowance increased by 40% between 1998 and 2010 and that the welfare bill rocketed by the same amount. Indeed, in a decade of unprecedented growth and rising employment, improvements in the life chances of disabled people were, sadly, few and far between.

Members do not have to take my word for that. The hon. Member for Dagenham and Rainham (Jon Cruddas) has said:

“We need to address some home truths about the Labour government’s welfare changes…they have seriously eroded the protection of disabled people...The methodologies that underpinned much of our argument are questionable.”

Those are telling words. Labour’s something-for-nothing culture was more than just their Government borrowing money they did not have. They failed to tackle welfare reform. That has corroded people’s trust in the system, and it is disabled people who are left to deal with the fall-out.

[Sheila Gilmore]

The Minister will be aware that research shows that at least half of the 30%—or 40% now—increase in DLA payments was due to demographic changes. The Minister should not give an exaggerated picture of what has been going on.

[Maria Miller]

The hon. Lady will know that that 40% figure is an absolute truth. She will also know that the majority of the increase has nothing to do with demographics. She should look at the figures more carefully. Unfortunately, now that Labour is in opposition, it is more willing to engage in the petty politics we have just heard—points scoring—than in a meaningful debate about how to transform disabled people’s lives.

We must not forget that for disabled people independent living is about far more than disability benefits or social care alone: it is about individuals having choice, control and freedom in their daily lives; it is about attitudes, and making sure disabled people receive equal treatment; and it is about us in society, and the make-up of the communities in which we live. I hope that in the winding-up speeches Labour will answer more fully why it still believes in the segregated employment that my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) mentioned earlier.

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[Maria Miller]

The hon. Gentleman is absolutely right to bring up the challenges in ensuring that the right support is in place for people with fluctuating conditions, particularly those with mental health problems. That is why so much emphasis has been put on that in the reform of how the work capability assessment works and in other areas, too. In the reform of the DLA, we are focusing on that issue—

[Sheila Gilmore]

Will the Minister give way?

[Maria Miller]

If the hon. Lady lets me finish my reply to the last intervention, that would be helpful. We must ensure that across the board we recognise that for many people who are not in employment, mental health problems are the primary cause. We need much broader understanding of how to ensure that we help people with mental health problems to get into work, whether that is through the Work programme or the work capability assessment.

[George Hollingbery]

rose—

[Sheila Gilmore]

rose—

[Maria Miller]

I will give way to my hon. Friend, then to the hon. Lady, then I really must move on.

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[Maria Miller]

Will the right hon. Gentleman let me finish my comments on this point? I think his hon. Friend the Member for Edinburgh East (Sheila Gilmore) was expecting to intervene, too, so perhaps a little more civility is called for.

My hon. Friend the Member for Meon Valley (George Hollingbery) is absolutely right to say that disability living allowance will not be counted within the benefit cap. People who are in receipt of DLA will not be subject to that cap. That is a really important point to make and it is the sort of detail that can make all the difference. The same is true of his comment about the carer’s allowance, which will be outwith universal credit although the universal credit will also recognise the important role that carers play. As this is carers week, we should pay tribute to their role in our communities and our constituencies. I also pay particular tribute to the work of the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), to make more support available for carers, especially through carers’ breaks and by ensuring that carers are able to continue their important role.

[Sheila Gilmore]

I want to follow up on fluctuating conditions. Professor Harrington has been mentioned in the debate. He endorsed work carried out by charities on the fluctuating condition and mental health descriptors, so why have the Government chosen not to follow that up?

[Maria Miller]

We absolutely are following that up. I know that the hon. Lady follows such matters closely, so perhaps I need to ensure that she has more details, because I would have anticipated that she knew we are carrying out more work to ensure that there we have a robust evidence base, as she would expect.

I shall draw my remarks to a close. Given that this is an Opposition day debate, I had hoped that we would hear some clear ideas from the Opposition about what they would do; instead, we have heard the same confusion.

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[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I oppose the motion, muddled as it is, and support the Government, based on the principle, which underpins their benefits system reforms, that people should always be better off in work than on benefits; on the fact that disability living allowance needs to be reformed and overhauled for the benefit of the people who receive it; and on the fact also that the Government are increasingly committed to putting in place social care reforms and reforms that benefit carers and people who look after those with disabilities.

It is important to pay tribute to the previous Government’s laudable aims on a number of those objectives, and in that respect we are all Blairites. Tony Blair said, as we believe, that people should be better off in work than on benefits, that we have an over-complex benefits system, and that we live in a country where there is generational worklessness on many estates throughout the land. Those problems are all unacceptable, but it has fallen to this Government to tackle them, and it is a great pity that after the previous Government’s 13 years in power, many still exist and, in fact, became worse rather than better.

The principle that underpins the reforms under discussion is the idea that people should always be better off in work than on benefits. This Government have inherited an over-complex benefits system that is comprehensible only to experts, and the fact that it is so complicated means that the people most in need of benefits find it difficult to access the benefits to which they are genuinely entitled.

The system often lets down the most vulnerable in our society, too, and DLA is in great need of reform. People who have historically been categorised as disabled under the system that we inherited have sometimes been written off by it, even though we know that someone with a mental health problem, or with a physical illness, can greatly benefit from engagement in the workplace. The act of working, and of being part of the workplace, is an important part of the rehabilitation and medical care of somebody who suffers from a mental health condition.

[Sheila Gilmore]

The hon. Gentleman makes the mistake of confusing DLA with incapacity benefit, which has now become employment and support allowance. DLA is not a benefit that writes people off into unemployment; it exists to help people to meet the additional costs of disability, and many people who receive it are, indeed, in work.

[Dr Poulter]

I am not making that mistake at all. The point is that the previous Government’s benefits system put people in a category in which they were characterised as not fit for work, often for the long term. But it is important that somebody who has a mental health problem, or who has an intermittent or a lapsing physical illness such as multiple sclerosis, can, if they are able to, work. People with mental health problems—there is very good medical evidence to support this—often benefit from engaging in work. It improves their mental health and is an important part of their recovery.

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[Sheila Gilmore (Edinburgh East) (Lab)]

A lot of strange things have been said by Government Members: they say that the Labour Government did nothing to reform benefits, yet say, “You invented the work capability assessment, so you’re responsible for it.” It cannot be both. As a new Member in 2010, I came here intent on criticising the implementation, not the principle, of WCA, regardless of who formed the Government. I made that clear in one of my first speeches. The fact that someone might think it a good thing, in principle, to carry out an assessment does not mean that the specific form of assessment we have been using has worked.

I want to talk, in particular, about how the change from disability living allowance to personal independent payments is likely to take place. I draw attention to a report published in Scotland and based on work by the Learning Disability Alliance Scotland, which took the proposed test, as published, and ran workshops with about 135 people with learning disabilities to see how the test would work in practice. It found that 12% of DLA recipients would not be awarded PIP. Given that there are 24,500 people with learning disabilities in Scotland, nearly 3,000 could be at risk of losing their entitlement.

The report refers to one case study involving a woman with Down’s syndrome living in the Gorgie area of Edinburgh. At the moment, she receives the low level of the care and mobility components of DLA, which makes a huge difference to her life. The care component means that she can cook meals with fresh food, which is particularly important to people with Down’s syndrome, and the mobility component allows her to get reliably to and from her part-time job in a local supermarket. She can afford the bus fares and can get a taxi if she makes a mistake or gets lost. The awards also help her to cover additional costs. For example, a learning disability means that sometimes she leaves the heating on by mistake and so has higher heating bills. Her DLA means that she can pay these bills without too much worry and difficulty. Under the proposed test, however, she scored only four points, which would mean her losing £41 a week, or £2,000 a year.

The report found that 30% of those in receipt of the mobility component and 40% of those in receipt of the care component would receive less under PIP. For example, Frankie, who lives in a small town in a small group home run by a voluntary organisation, receives nine hours of support a week from paid staff as part of his living accommodation. He has a learning disability, cannot read, has a long-term health condition that requires periods in hospital and has mobility problems. At the moment, he receives the medium rate care component and higher rate mobility component of DLA. Under the PIP assessment, he scored some points in some areas, such as living needs—he needs help using appliances and understanding written communications—but that amounted to only seven points. That means he would not get those benefits and would be £85 a week worse off—£4,400 a year.

[Yvonne Fovargue (Makerfield) (Lab)]

Does my hon. Friend agree that the changes to the legal aid system whereby access to welfare benefits advice will either be severely curtailed or not available at all will severely affect people’s attempts to appeal against these decisions, which appear perverse?

[Sheila Gilmore]

As my hon. Friend says, there are considerable problems with people being able to access legal advice on making appeals, but it is extremely difficult to access advice generally, given the cuts. We are certainly seeing that in my city, where the advice shop—one of the main advice centres—cannot see people for two weeks. Consequently, appointments are made two weeks in advance. Following an assessment result, people sometimes get a letter telling them that they have three weeks in which to appeal, yet it is difficult for them to get even basic advice in order to make an appeal. That is the reality that people are facing on the ground, so we need to look hard at the proposed tests.

Another important aspect of this debate—the Select Committee on Work and Pensions draw attention to this, and I hope that the Minister will consider it seriously—is that if we follow the pattern used with the employment and support allowance, people will be tested and re-tested, even though nothing in their circumstances has changed. One of the Select Committee’s recommendations was that limits should be placed on the number of re-tests under the new PIP. That is not to say that people should not be tested, but if they are re-tested constantly we may run into the problem of people having their next test virtually before they have finished their last test or their last appeal. That is not helpful, particularly for people with mental health problems, for example.

[Nadine Dorries (Mid Bedfordshire) (Con)]

Does the hon. Lady agree that there is a balance to be struck, in as much as those in long-term care—the very vulnerable people she is talking about—should perhaps not be subjected to re-testing in future, whereas the others are entitled to a face-to-face reassessment, and that that is what should happen?

[Sheila Gilmore]

I do not disagree with the hon. Lady, in the sense that there has to be the flexibility to look at people’s exact circumstances. The point I wanted to make is that we need to impose some limitations, because the stress of having to go through the process is extremely great for some people, and their illness can be made worse.

Although I have taken interventions, and therefore have extra time, I do not want to take up too much time, because one or two other people still want to speak. The Minister who opened the debate would no doubt respond by saying that we are scaremongering—that what we have described will not come to pass under the test and that everything will be fine. Indeed, she has gone further than that. She has said on numerous occasions that one of the reasons for having a new benefit and not simply changing DLA is that people who currently do not qualify—people with communications difficulties, she has suggested, or people with mental health difficulties—will now qualify under the new benefit. That suggests that more people will be entitled to PIP. I want to know how she can square that with making savings of the size that the Government say they want. If more people who do not currently receive the benefit will qualify, that suggests that even more people will claim than at the moment.

The Minister has also said that we should not worry about the tests because they are going to be a “conversation”, and are not really going to be a test. She has also said that we should not worry about the time limits on tests because a test should take as long as it takes. That all sounds wonderful, but I would like to know—the Minister has to answer for us—how it squares with cutting costs. Indeed, it will add to the administration costs, so is that included in the contract with providers? We do not really know what the terms of the contract are, and if those things are not in the contract, they will not happen. Therefore, for all the warm words about having conversations, being relaxed and the tests taking as long as they take, what the Minister has described will simply not happen unless we are given clarity on whether it is in the contract.

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[Paul Burstow]

I have so little time—I have minus 10 minutes, in theory—that I would like to ensure that I respond to the points that have already been made.

Disability living allowance has been mentioned by a number of hon. Members. It is worth saying that Labour left the assessment process as a piece of unfinished business; it did not properly take into account all those with sensory, mental health and cognitive impairments. The move that this Government are making to the personal independence payment gives us the opportunity to ensure that we do take proper account of the impact of mental health needs and fluctuating conditions. The right hon. Member for Stirling (Mrs McGuire) said in her summing up that the Labour Government dealt with the issue of life awards in 2000. Yes they did—they changed the name to “indefinite awards”. Some 70% of those are still on the case load and they have just been given a different name. The reality is still the same.

The hon. Member for Edinburgh East (Sheila Gilmore) talked about PIP assessments, and I want to tell her that the Government are still considering the findings of the consultation on the assessment process. The consultation closed on 30 April and we will be publishing the response to it, along with the current consultation that we are doing on the detailed design, in the autumn, before this House properly debates those matters as part of the regulations.

My hon. Friend the Member for Chippenham (Duncan Hames) talked about Labour’s legacy of subcontracting out to Atos the decision-making process, and fettering, in a way, the way in which decision makers could act. He is absolutely right about that, which is why we have given back flexibility to decision makers. Indeed, we have moved away from the hard, harsh and tough approach taken on work capability assessments by the previous Government. We have taken the recommendations of Professor Harrington’s independent reviews seriously and implemented all of them. We are building on his recommendations, following his engagements with charities, on how we make sure that the assessment process is more accurate and does properly reflect fluctuating conditions and takes into account those with mental health conditions. Again, that point was raised by my hon. Friend.

[Sheila Gilmore]

rose—

[Paul Burstow]

I cannot give way during this debate. A question was asked about whether Professor Harrington will continue to undertake reviews. He will be conducting a third and final review—the legislation commits to two further reviews—but I think that after three reviews he gets time off for good behaviour. The Government are not telling him to go—if he wanted to stay, we would be happy for him to do so. The reality is that he has done a good piece of work on behalf of this Government and we want to make sure that that is followed through.

The hon. Member for Wansbeck (Ian Lavery) asked a number of questions, as did my hon. Friend the Member for Chippenham and others, about Remploy. Let me be clear about the consultation process: the objective is to preserve jobs. We made a number of announcements, on wage subsidies and on the £10,000 to support employee-led bids. We did that in response to expressions of interest that we have already received. Discussions have taken place between Remploy and bidders, as part of the normal commercial process. My hon. Friend asked about social enterprise businesses, and there has been engagement with them. The whole process will run for five and a half months. The previous Government’s modernisation plan was meant to turn this sector around, but we still face a £68 million loss, which is why we are making the changes that we are having to make now. My hon. Friend asked whether the consultation report will be published. Yes, it will. We are also making sure that when individual discussions take place with employees, there is a discussion about the contribution that the £8 million support package constitutes. The hon. Gentleman also asked a question about the accrued rights of existing members of schemes, and I can assure him that those will be protected.

The hon. Member for Aberdeen North (Mr Doran) made a very good point about independent advisory groups, and there will be one to examine all the business plans and advise the Remploy board prior to decisions being made about those plans. I also understand the importance of ensuring that any conflicts of interest are carefully handled, and my ministerial colleagues at the Department are certainly very focused on that.

I am the Minister responsible for social care and so I want to address those parts of the debate. We should be honest: successive Governments have failed to tackle social care. In the past 13 years, in a time of plenty, Labour failed to get a grip on the issue. We have a system in this country governed by laws that were written in the 1940s and look back to Poor Law principles. Social care and social work should enable disabled people, older people and their carers to live the lives they want to and that is why we will shortly set out a comprehensive overhaul of social care law in this country, placing people’s wellbeing at the heart of decision making and focusing on goals that matter to individuals. We will build on the excellent report by the Law Commission on social care law reform to ensure that we have a legal framework that supports a much more personalised approach.

As the Government consulted with charities last year and worked with families, carers and others, we heard many criticisms of the social care system we inherited. We heard a long and deep-seated set of concerns about the variability of quality, about people feeling bounced around different systems and not always getting the personalised support that they wanted, and about the system being focused too heavily on crisis and not enough on prevention. We will address those issues in the White Paper we will publish shortly.

My hon. Friend the Member for West Suffolk (Matthew Hancock) and others spoke about funding reform and we will publish a progress report on that matter. We certainly understand the point made in the debate about the unfairness inherent in the system we have today. The flaws in that system penalise thrift and hard work and lead to people facing catastrophic costs. Those hon. Members who have said that we need a cross-party solution are absolutely right and the Government are committed to talks so that we secure just that.

Some hon. Members have talked about social care funding. The truth is that the Government took some difficult decisions during the spending review, but they were the right decisions and social care budgets were protected through the investment of an extra £7.2 billion up until 2014. It is clear that councils that have broadly the same resources available are making very different decisions. Some are cutting services, but many are being smarter and are working with disabled people, older people and carers to come up with better ways of delivering care and support in their communities. Indeed, the most recent survey of councils by the Association of Directors of Adult Social Services found that councils were getting smarter and finding more efficiencies than they had in previous years, as well as fewer cuts. Indeed, this year 77p in every pound that councils have saved in social care budgets has come from smarter working and greater efficiency.

My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) rightly talked about the need to break down the silos in health, social care and housing and we will break them down to ensure that people are not bounced around the system and are treated with the respect and dignity they deserve.

In conclusion, I want to talk about carers, who have been mentioned—rightly, as this week is carers week—by my hon. Friend the Member for Chippenham and others. It is right that we should pay tribute this week to the immense contribution of family carers, but, as others have said, we need to ensure that we do not focus on carers only in carers week. That is why the Government have committed £400 million through the NHS to provide breaks for carers and it is why we are requiring primary care trusts to draw up the plans to demonstrate how they will provide support to carers. This September, they will have to publish those plans and set out how breaks will be provided for carers as well as how many will be provided. Just this Monday, I had the opportunity to visit Crossroads Care in Cambridgeshire to see for myself the difference that those breaks make. A scheme has been introduced whereby GPs can prescribe carers’ breaks. We have discussed carers staying in employment, and tomorrow we will host with employers a carers summit to focus specifically on how we break down barriers so that we can ensure that carers do not feel tipped into crisis and find themselves out of work as a consequence.

The coalition Government are clearing up the mess left by the previous Labour Government—a huge deficit and an unbalanced, debt-ridden economy, after tough decisions had been ducked time and again. The Leader of the Opposition’s motion lacks vision. It shows Labour running away from its responsibilities and record, but the coalition Government are committed to reforming the way in which the country works so that people are in a situation in which work pays. We will ensure that disabled people are included in society and able to contribute to it, and that social care, after decades of neglect by successive Governments, is at long last reformed.

Question put.