Disability Benefits: Assessments

Debate between Wendy Chamberlain and Justin Tomlinson

Monday 4th September 2023 Westminster Hall

[Justin Tomlinson]

Absolutely. It would be valuable twofold. I talk to a lot of the assessors, and I know we are all going to highlight where there are challenges, but something like 95% of claims go through. Satisfaction is still relatively high for those claimants; as I said, we are spending £10 billion. The vast majority of assessors want to get it right first time and want to have that knowledge and support, so if we can allow some assessors to specialise, they can develop their training with charities and health organisations with specific knowledge of the area. That will increase the chance of getting the decision right the first time.

Not everybody presents with one single health condition, so it may be that people would have a hybrid assessment in two parts. There would be a general assessment, which in many cases would pick up things on the mental health side that people did not realise were having an impact on their day-to-day life; there would also be a specific assessment of the primary health condition. As the hon. Member for Bristol East (Kerry McCarthy) so clearly articulates, where people have fluctuating health conditions we really need the knowledge to ensure that we are looking not just at one particular day but, as the guidance says, at the typical impact over a one-year period.

During covid, we had a significantly reduced workforce. All our health assessors have a medical background and then have extensive training, and they were the first port of call for secondments to the NHS to provide the covid jab, so we had an incredibly depleted workforce. That really focused our mind on the volume of assessments. At Work and Pensions oral questions earlier today, I raised a point about whether lessons have been learned on extending the severe conditions criteria. When we looked at it, we estimated that about 250,000 to 300,000 assessments, with a change, could be lifted out of the system every single year. That would speed up the process for those who remain and would obviously be beneficial for those 250,000 to 300,000 people.

At the moment, PIP does not look at individual conditions—it is about the menu of health conditions that have an impact on someone’s daily life—but I think that, in some cases, we can do so. We have shown that with the changes to the special rules for the terminally ill, which will look at health conditions. I will give one example, but no doubt there are many organisations that would lobby for a change in respect of particular health conditions.

Motor neurone disease is a horribly degenerative disease, and there is a pretty clear trajectory once someone has been diagnosed, so I have never understood why on earth we assess people who have it. From the moment they have been diagnosed, we should be able to say, “We expect their condition to go like this,” and then provide an automatic level of support. They would start at the lower level immediately after diagnosis and, as their condition, sadly, deteriorated, they would automatically move on to the highest level. If, sadly, their condition deteriorated more quickly, they would be able to contact the PIP assessors, speak to the MND specialist team, have a light-touch conversation—a GP’s note would probably be sufficient—and be automatically upgraded.

[Wendy Chamberlain (North East Fife) (LD)]

I am grateful that the hon. Member has brought up MND. Does he agree that one thing that the current system must do is prevent delays? Not only do people with the condition sometimes deteriorate more quickly, but the adaptations that local authorities are making, and so on, mean that we are making the process much more difficult on every front for people with MND.

[Justin Tomlinson]

Absolutely, and that was one of the drivers behind our changes to the special rules on terminal illness. From the point of diagnosis, PIP is a gateway benefit that will unlock extra help from local authorities, so it will certainly speed up that process.

Before the Minister panics and thinks that he would need an office akin to Fort Knox because every single health group would lobby him and say, “These rules should apply to our particular health challenge,” let me say that the way around that is to look at the Industrial Injuries Advisory Council, which already operates within the DWP. In effect, that is a separate, independent body of medical and scientific experts with far greater brains than mine. They are the ones who decide which health conditions qualify for industrial injuries benefits. We could apply the same principle and, as medical care and scientific knowledge evolved, they could update the guidance. That could potentially lift 250,000 to 300,000 people out of the process and help some of the most important people. Since the changes on terminal illness came into force, we have seen all pluses and little else. I hope that the Minister’s commitment to trying to pilot initiatives in this area will continue, ahead of the White Paper.

Many colleagues have mentioned the appeals process. There are different ways of looking at the statistics but, by and large, for the vast majority of people who are successful in the appeals process, either at the mandatory reconsideration stage or at the end, that is because of additional evidence that is presented. We have to look at why that additional evidence is being presented so late in the day. There are many things that could be done. The Department could be more proactive in chasing up sources that have supportive evidence. Getting evidence from a GP is a bit of a postcode lottery. Some GPs will reply to a claimant immediately and give chapter and verse; some are much slower. Some will seek to charge. Some do not necessarily have the right information.

Where someone has already gone through a work capability assessment, which is very similar—I know there is potentially a review of whether we should have two separate assessments, but this is the case as it stands today—there will already be a lot of information on a similar system, and we should at least ask the claimant whether they would like us to look at that information. Remember that it is the claimant’s information and we should not do that automatically, but we should ask to bring that information over.

We should be proactive in encouraging claimants to bring a trusted colleague with them to the assessments. That is within the rules, but how assessors allow it is very inconsistent. Some assessors will encourage the colleague to speak. Some will tell them, “No, you’re not being assessed; you are just there to provide moral support.” We need consistent guidelines. In my opinion, they should be allowed to speak. I have sat in on a lot of assessments; a lot of people are understandably overwhelmed, and arguably do not do themselves justice in what they say. Sometimes, when a person has had a condition for so long, they just take it as the norm that, for example, they no longer sleep at night. Their partner who is woken up by their not sleeping at night would probably be better at articulating that. We should be doing that.

We also started testing phoning claimants at the mandatory reconsideration stage and asking them to tell us, in their own words, why they disagreed with the decision. One speaker mentioned earlier that the mandatory reconsideration success rate is only about 11%. My understanding is that when we piloted proactively speaking to the claimant, that figure went up to about 40%; when I talked to assessors doing that at the time, they felt they could go even further. We would invariably find that a claimant’s GP had told them something but they had not provided us with the information, or had not been able to get it, and we could chase the GP on their behalf and get that information.

We also allowed people to be lifted out of the system. In the past, people had in effect to take their chances. They had to wait for the MR, and once they triggered the independent appeal the Department could not come back and say, “Now you have provided us with this evidence, we agree with you and wish to do that,” because they were stuck waiting for the judge, which can be up to a 12-month wait. We changed the rules so we could lift people out, but if people still did not agree with us they had the right to stay in the process. All those measures that can help lift people out of the process would be very welcome.

I also want to highlight the need for us to start signposting support and help. PIP is geared up to identify people’s challenges and then to identify society’s financial contribution towards the impact on their daily lives, but we stop there; we do not signpost people on PIP to additional support that may exist in their communities. I visited many wonderful and innovative mental health pilots across the country—we will all have done loads of visits in the summer recess, seen something and thought, “Gosh!”—but time and again people said to me, “Our problem is that we can’t find enough people to come and test these things out.” Yet the PIP database has the list of all the people who have been identified as having a mental health issue. I am not saying that they should have to do it, but at the very least we should be writing and saying, “Right, you’re in this particular postcode. These are the local charities and organisations, this is the local authority, and these are the local health pilots to do with your primary condition, or menu of conditions, that may be of interest to you.” I think that would be hugely beneficial to many of the people who go through the system.

Social Security and Pensions

Debate between Wendy Chamberlain and Justin Tomlinson

Monday 6th February 2023 Commons Chamber

[Wendy Chamberlain (North East Fife) (LD)]

It is a pleasure to follow the hon. Member for Broadland (Jerome Mayhew), who made a thoughtful contribution, although obviously there are differences of opinion on some of the things he said.

I am pleased to contribute to this year’s debate. The Minister’s initial contribution was pretty factual and to the point, but these debates are always an opportunity for Members to comment generally on social security and uprating. I am pleased that this year’s debate is slightly less controversial than last year’s. Indeed, I think there has been relief on both sides of the House that the uprating will be in line with inflation. That means we have not seen the triple lock abandoned and benefits will be uprated in line with inflation. However, those conventions have been broken previously, so the challenge is that people are already behind as a result of previous commitments having been reneged on. But I am pleased to welcome this uprating.

In recent years it has become increasingly clear how important the social security safety net is as a public service. As I have said previously, covid has meant that some people who never expected to be supported by the state have had to access that support. That is the reality: we never know when we might need support. We might become injured or ill; the company that we work for might go under, maybe because it cannot get enough staff and cannot open its full hours, and therefore does not have the productivity it needs to keep going; or indeed, we might need to care for loved ones. Social security is, and should be, there to make sure that no one is left behind.

The hon. Member for Blackpool North and Cleveleys (Paul Maynard), who is no longer in his place, mentioned the all-party parliamentary group on ending the need for food banks. I co-chair that APPG, and have been very pleased to have the hon. Gentleman as part of our inquiry team. The final evidence session of our “Cash or Food?” inquiry is tomorrow, and I would be delighted if the Minister could attend our report launch on 22 March—I am grateful to the Under-Secretary of State for Work and Pensions, the hon. Member for Mid Sussex (Mims Davies), for her written response to our inquiry. We are looking at that issue because, as I said in my intervention on the Chair of the Work and Pensions Committee, the right hon. Member for East Ham (Sir Stephen Timms), the only time during the covid pandemic when we saw a decrease in food bank use was when universal credit had its £20 uplift. That suggests to me that people were using those additional moneys for the purpose of putting food on the table.

As I said, this debate is quite factual, but it gives us an opportunity to comment on Government policy and practice. I want to touch on something that the hon. Member for Glasgow East (David Linden) mentioned, which is universal credit for the under-25s. It may have been uprated by 10%, but it remains lower than for the over-25s, and I would argue that there is simply no good reason for that. Indeed, about 18 months ago I wrote to the Department for Work and Pensions on this topic in support of a campaign by One Parent Families Scotland. I was told, in terms that, frankly, I found quite patronising, that the reason for the policy is that the DWP believes young people are more likely to live at home—that was assumed even if they themselves are parents—and generally have lower earnings expectations.

That response totally ignores the experience of the majority of under-25s who claim universal credit. Of course, as parents we would hope to support our children as they take their first steps in the world, and to provide a safe haven to which they could return if necessary. However, that does not help the young people who need to leave home because they are looking for work and there are no jobs in their area; the young people who do not come from stable homes and need to support themselves; or the young parents who cannot stay in their family homes with their own children. I hardly want to deign to give a response to the statement about having lower earnings expectations, but I will say that no one who is out of work and receiving universal credit, or who, as has been pointed out, is in work and receiving universal credit, even at the full amount, is sitting idly by, wondering what to do with that excess income.

As many Members have said today, we are in a cost of living crisis. Universal credit is a safety net, and this Government policy assumes that young people deserve less safety than older people. That is the wrong message. Given the ministerial churn within the DWP and, indeed, elsewhere, I hope that we can review that misguided position. At the very least, I ask the Minister to review one aspect in his closing remarks: reinstating the higher rate for young parents, as it was under legacy benefits. Young parents are most likely to be struggling, and surely they and their children deserve the same support as a family where the parents are just a year or two older.

I will highlight a few other issues, starting with PIP. All of us in this place will have a caseworker who spends a lot of time providing support for PIP appeals, the vast majority of which are successful. It is a long, stressful application process, and we have assessors who simply do not understand the process or what applicants are experiencing, resulting in widespread mistakes that we as MPs end up dealing with. It costs the taxpayer more money to reverse those decisions than to get them right in the first place. The stress makes people who are already struggling even more ill, and as we know, very sadly, some people give up as a result. The system does not work. This issue is so important when the Government are currently looking at measures to deal with the economically inactive—I look forward to hearing their proposals. They want to get people back into work. Now is the time to bring those specialist assessors and the assessment process for PIP back in-house, and to stop lining the pockets of private providers with taxpayer money when they simply do not get the job right.

[Justin Tomlinson]

The hon. Lady raises a very important point about getting the job right. Thankfully, the vast majority of the millions of claims are right first time round, and for those where it sadly goes wrong, on the vast majority of occasions, that is because of missing additional supportive evidence. As such, will the hon. Lady join me in welcoming the Government’s move to a system where, at the mandatory reconsideration stage, rather than waiting for claimants, the assessors have now started proactively contacting them to identify the missing evidence and help them find it? That has seen the number of those able to be sorted quickly more than double.

[Wendy Chamberlain]

I am happy to support any improvements to the process, but what the hon. Member has done is to point out just how complex these processes are and how difficult they can be for people to navigate. It is only when there is a proactive approach that we start to get things right.

Oral Answers to Questions

Debate between Wendy Chamberlain and Justin Tomlinson

Wednesday 25th November 2020 Commons Chamber

[Justin Tomlinson]

I put on the record a tribute to the proactive and constructive work of Scope and many other organisations to support our efforts, which have resulted in record disability employment—up 1.3 million since 2010. Yes, these are unprecedented times, but we have made sure that all the schemes in our £30 billion plan for jobs have disability provision embedded. We will continue with our ambition to have 1 million more disabled people in work by 2027—nothing has changed.

[Wendy Chamberlain (North East Fife) (LD)]

What steps the Government are taking to tackle institutional racism.