Asked by: Duncan Baker (Conservative - North Norfolk)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, pursuant to the Answer of 17 December 2021 to Question 92099 on Social Security Benefits: Terminal Illnesses, whether she plans to amend legislation to implement changes to (a) the Special Rules for Terminal Illness and (b) Attendance Allowance, Disability Living Allowance and Personal Independence Payment during the current session of Parliament; and what discussions she has had with the Northern Ireland Executive on ensuring parity between social security systems in the UK following the recent passing of the Social Security (Terminal Illness) Bill by the Northern Ireland Assembly.
Answered by Chloe Smith
The Department plans to amend legislation to implement changes to the Special Rules for Terminal Illness in Attendance Allowance, Disability Living Allowance and Personal Independence Payment as soon as possible, subject to Parliamentary processes.
The Department works closely with the Department for Communities in Northern Ireland within a legal and non-statutory framework for co-ordination and reciprocity in social security arrangements. In the case of changes to the Special Rules for Terminal Illness, engagement began during policy development and in an evaluation into how the benefits system supports people nearing the end of their lives. This close collaboration continues as the 12-month approach is being implemented to ensure that parity is maintained between the two benefits systems.
Asked by: Baroness Meacher (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether the National Institute for Health and Care Excellence (NICE) has developed or accredited any (1) information, or (2) guidance, to support clinicians to care for a person living with a progressive or terminal illness who wishes to voluntarily stop eating and drinking with the intention of accelerating their death.
Answered by Lord Kamall
The National Institute for Health and Care Excellence (NICE) has published a guideline Care of dying adults in the last days of life which makes recommendations on maintaining hydration, including taking into account the wishes of the person and discussing the risks and benefits of clinically assisted hydration. NICE has also published Shared decision making, which includes guidance on communicating risks, benefits and consequences. Additionally, NICE’s guideline Decision-making and mental capacity includes recommendations on advance care planning, including helping people to exercise their right to personal autonomy as far as possible. Copies of these guidelines are attached.
Asked by: Beth Winter (Labour - Cynon Valley)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, whether it is her Department's policy that claimants with verified progressive neurological conditions can be exempted from health-related social security medical assessments.
Answered by Chloe Smith
Awards of the health and disability related benefits are not made based on a person’s condition or diagnosis but rather on how their condition limits their abilities. People can have very differing circumstances so we have developed assessments which are designed to measure the impact of a person’s health condition or disability on their work-related or daily living needs, including the level at which they should be paid.
In Sept 2017 the Department introduced Severe Conditions Criteria (SCC) for Employment and Support Allowance and the health component of Universal Credit. This stops unnecessary reassessments for those with the most severe and lifelong conditions. In 2018, we introduced new guidance on Personal Independence Payment (PIP) assessments which ensures that claimants on the highest level of support whose needs will not improve receive an ongoing award of PIP with a light touch review at the 10-year point.
Where a claimant is nearing the end of their life they are able to claim benefits under the Special Rules for Terminal illness (SRTI). The SRTI provide access to benefit without waiting periods. Awards are made on the basis of a paper-based assessment and claimants usually receive the highest rates of benefit. The Department announced that it would replace the current 6-month rule for determining eligibility for the Special Rules for Terminal Illness with a 12-month, end of life approach.
The Shaping Future Support: Health and Disability Green Paper published 20th July 2021, explored the possibility of testing a new Severe Disability Group for those with severe and lifelong conditions to access ESA/UC and PIP. This could simplify the process by removing the need for a long form or a face-to-face assessment for this group and build on existing provision such as Severe Conditions and Special Rules for Terminal Illness.
Asked by: Jessica Morden (Labour - Newport East)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, with reference to the Written Statement of 8 July 2021, HCWS166 on Disability Benefits, whether the Government plans to bring forward legislative proposals to implement the replacement of the current 6-month rule for access to benefits under the special rules for terminal illness with a 12-month, end of life approach, for the personal independence payment and attendance allowance in the next Queen's Speech.
Answered by Chloe Smith
The Department is committed to supporting people nearing the end of their lives. We plan to amend legislation to implement changes to the Special Rules for Terminal Illness across five DWP benefits, beginning with Universal Credit alongside Employment and Support Allowance this year. This will be followed by Attendance Allowance, Disability Living Allowance and Personal Independence Payment when Parliamentary time allows.
Asked by: Jessica Morden (Labour - Newport East)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, further to her Department's announcement on 8 July 2021 that it would scrap the six-month rule for access to benefits under the Special Rules for Terminal Illness, if the Government will bring forward legislative proposals to implement this change for the Personal Independence Payment and Attendance Allowance in the next Queen's Speech.
Answered by Chloe Smith
The Department is committed to supporting people nearing the end of their lives. We plan to amend legislation to implement changes to the Special Rules for Terminal Illness across five DWP benefits, beginning with Universal Credit alongside Employment and Support Allowance this year. This will be followed by Attendance Allowance, Disability Living Allowance and Personal Independence Payment when Parliamentary time allows.
Asked by: Duncan Baker (Conservative - North Norfolk)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, when her Department plans to bring forward legislative proposals to amend the Special Rules for Terminal Illness.
Answered by Chloe Smith
The Department is committed to supporting people nearing the end of their lives. We plan to amend legislation to implement changes to the Special Rules for Terminal Illness across five DWP benefits, beginning with Universal Credit alongside Employment and Support Allowance next year. This will be in advance of changes to Primary Legislation for Attendance Allowance, Disability Living Allowance and Personal Independence Payment which are dependent on Parliamentary time.
Asked by: Apsana Begum (Labour - Poplar and Limehouse)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to make Tafamadis, the only treatment for the terminal illness hereditary cardiac Amyloidosis, available to UK families.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The National Institute for Health and Care Excellence (NICE) is the independent body that makes evidence-based recommendations for the National Health Service on whether new medicines should be routinely funded based on an assessment of their clinical and cost effectiveness. NICE published guidance in May 2021 that does not recommend tafamidis for the treatment of wild-type or hereditary transthyretin amyloidosis with cardiomyopathy in adults. NHS England and NHS Improvement do not therefore routinely commission tafamidis for NHS patients in England. Where a treatment is not routinely commissioned by the NHS, a patient’s clinician may submit an individual funding request if they consider it is in their patient’s best interests to have that treatment.
Asked by: Chi Onwurah (Labour - Newcastle upon Tyne Central)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what steps her Department is taking to tackle stigmatisation of welfare claimants.
Answered by Mims Davies - Minister of State (Department for Work and Pensions)
Universal Credit(UC) encompasses several legacy benefits in one and can be claimed in many different circumstances by those who are entitled. UC is not only for those unemployed and can be claimed by people in various circumstances – such as those with a health condition or terminal illness, balancing parenthood or caring. It can also help to support low income or self-employed earnings.
The Department works hard to dispel any stigmatisation by regularly communicating with the public about benefits through paid advertising, stakeholder and employer engagement and no cost campaigns to help people understand their entitlement and the support we can provide as a safety net and in times of need. During the pandemic this has been particularly important as many people needed to claim benefits for the first time. Meanwhile, we always keenly help people to progress, train and move forward where possible and help the most vulnerable in society to have all the support they are rightly entitled too even in later life right through to pension age and beyond.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, if she will make an assessment of the (a) impact and (b) financial impact on claimants of (i) the three month waiting period for the limited capability for work-related activity element of universal credit for people with severe health issues and (ii) the decision not to backdate payments for the three month waiting period.
Answered by Chloe Smith
Where the claimant is determined to have limited capability for work and work-related activity (LCWRA), an additional amount of Universal Credit (UC) may be awarded. However, before the additional amount is payable, a UC claimant must serve the ‘relevant’ period to establish that they have a long-term health condition. This approach replicates the 13-week assessment period which is applied in Employment and Support Allowance (ESA) claims.
There are no plans to assess the impact of the relevant period or current backdating rules. Where an additional amount of UC is payable, this is backdated to the start of the assessment period following the assessment period in which the relevant period ends.
Throughout the period before the award of the LCWRA addition, claimants will receive the applicable standard allowance plus any additions, reflecting the claimants’ personal circumstances, for example for children, housing costs, childcare costs. They may also be eligible for support through PIP.
There are exceptions to serving the relevant period in UC, including where someone accesses benefits via the Special Rules for Terminal Illness. Where a claimant deemed to have LCWRA in ESA moves to UC, and those claims are continuous, the relevant period does not apply. An exception also applies in relation to claimants whose award ended in the previous six months as a result of their earnings exceeding their entitlement. Where that claimant’s previous award included the LCWRA addition, they do not, on reclaiming, have to serve the relevant period again.
Asked by: Jonathan Reynolds (Labour (Co-op) - Stalybridge and Hyde)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, what assessment her Department has made of the number of DWP assessors (a) challenging or (b) overturning clinical judgements made by medical professionals about a claimant's terminal illness.
Answered by Chloe Smith
The DWP currently provides a balanced and compassionate approach to supporting those approaching the end of their lives. The approach is based on clinical judgement and evidence provided by a relevant clinician like GPs or Specialist Nurses.
A claim made under the Special Rules for Terminal Illness is in most cases supported by evidence from the claimant’s clinician submitted in a DS1500 form. These contain information relating to diagnosis, clinical features and past or current treatment. While they have never been a requirement for a claim under the terminal illness rules, they remain the quickest and most appropriate route to gather evidence to support entitlement in these cases.
Providers use healthcare professionals to provide advice to DWP decision makers about benefit entitlement. They may contact clinicians to obtain clinical information if either a claim has been made under the SRTI but no DS1500 has been provided or for clarification of information provided in the DS1500. The provider healthcare professional will review all available evidence before making a recommendation to DWP decision makers about eligibility.