Yesterday I took part in a debate on Personal Independence Payment – the new benefit due to start replacing Disability Living Allowance from next year. I’ve reproduced my speech below but if you want to read the full debate you can do so here.
Sheila Gilmore (Edinburgh East) (Lab): It is a pleasure to speak under your chairmanship, Mr Sheridan. Given the colour of your shirt and tie, you are obviously celebrating “Think Pink” week or whatever it is. That is germane to some of the people who have to claim the kind of benefits that we are dealing with today.
I sincerely welcome the hon. Member for Battersea (Jane Ellison); I am sure that she will indeed be joining the Select Committee. We have missed our Conservative members at the last few meetings. It might be thought that we would find that a bit of a relief, but actually it is very good to have the debate that we usually have. I am sure that the hon. Lady will be relieved to know that it is a Select Committee in which we do not necessarily spend a lot of time berating one another; there is often a wide area of agreement.
I would like to take up a couple of points before going on to the more detailed issues that I wanted to raise. People think that this is a change for the worse because of the context from which it started. That is very important to remember. It is still about reducing the number of people who will be on PIP compared with DLA. That is in the Department’s own impact assessment. It is about saving money. That not only coloured the beginning of the process, but has continued to colour the process. People are very concerned that things may get worse for them or members of their families.
I take slight issue with the comment made by the hon. Member for Battersea that previous Governments left all this in the “Too difficult” tray. My right hon. Friend the Member for Stirling (Mrs McGuire), who will be answering this debate on behalf of the Opposition, will have the scars to prove that that was not the case. Changes were made to many of the benefits that existed; I do not think that it is true to say that nothing changed.
I find slightly odd some of the language that has been used in relation to the need to reform DLA. The suggestion has sometimes been that it is a very old benefit that has to be modernised and brought up to date. In fact, it is not that old—20 years old is not Victorian; it cannot even be described as post war. There is a tendency to exaggerate some of the claims, and if people do that, there is a danger—
Jane Ellison: On the point about exaggeration, I take the point made a moment ago about where things started—the way a debate starts out and how it is framed can influence the tone of it thereafter. I accept that point.
Would the hon. Lady accept that there is a duty and responsibility on those who support the best interests of disabled people not to assume the worst in every circumstance—not to highlight only the cuts aspect or whatever of reforms, but to present them in a more balanced way? Many important reports, including the two I referred to in my speech, are based on opinion surveys of disabled people or their families. Colouring opinion by misrepresenting the facts feeds directly into how people feel and becomes self-perpetuating. I seek balance on both sides in the tone used in the discussion.
Sheila Gilmore: I would not suggest that exaggerated comments have not been made. In answering or writing to constituents, I certainly find myself at times being careful to say, “I think this is wrong” or “I think this should not be done”, while not panicking people, so I tell them that it is not happening tomorrow, that there is time and that they should seek advice. It is important that people are not unnecessarily concerned.
The atmosphere in which the debate is ongoing is not helping. It is easy to blame the media, but there is still a tendency on the part of Ministers, whether they intend to or not, to juxtapose benefit claimants with hard-working people. Only the other week, the Prime Minister spoke about people heading out to work in the early hours of the morning, seeing their neighbour’s curtains closed and feeling rightly angry.
That neighbour with the curtains closed might be a night-shift worker or someone with an illness, which might not be visible. It is clear that those with mental health difficulties or less obvious conditions are those who people see and think, “What are they doing on benefit? How is that happening?” It does not help to compare and contrast continually in that way. It engenders some of the responses that we get.
The Government have to be careful about how they present their statistics. There have been improvements of late, in that not quite such provocative statements have been made in response to statistics, but it is not all about media spinning. There is a tendency with the statistics—this week, for example, on the outcome of ESA assessments—to emphasise how many people are found fit for work, with an undertone of, “which means that they were previously scroungers or not entitled to the benefit.” We have not had the migration statistics on ESA, so they were new claimants; they are claiming for the first time.
Let us have a comparator. Let us see what happened previously with incapacity benefit, for example, when people claimed for the first time. I hope that we are careful not to fall into the same trap when the PIP statistics come out. Some 50% of those who try to claim DLA are refused, so if 50% of those who try to claim PIP are also refused, I hope that it will not be hinted at or suggested that that in some way proves that people were getting a benefit that they should not have had. Remember what a baseline is and look at it that way.
Teresa Pearce: Does my hon. Friend agree that a possible unintended consequence of such media reports and skewed statistics is that employers who have read those reports may be more prejudiced against people with disabilities, who already face prejudice, who want a job, and against those who have been on benefit and want a job? It makes it more difficult to get those people back to work.
Sheila Gilmore: I hope that employers would not form that view, but there are dangers.
If the Government wanted to reform, the way to start would have been to discuss seriously the issues around DLA, not to start from an assumption that it was somehow old-fashioned, not working and that people did not understand it, so we had to throw the whole thing in the air and start all over again. That leaves aside how the reform was couched in terms of financial savings.
If the Government wanted to make a change, it would have been helpful to have the discussion and carry out the research. If we think back to when the White Paper came out in late 2010, an extraordinarily short time was given for people’s responses. It was a generalised paper, and the extensive response to it was responded to in a very simplified fashion. That did not help. If we had sat down with a lot of the groups in the first place, we might have come out with a better ending.
Obviously, as a Select Committee, we look at the details. The hon. Member for Battersea was correct to say that we have to be careful that we do not end up seeing the trees and not the wood, but details are part of the job of a Select Committee. One thing that we all say, and we all feel strongly about, is that we must get the assessments right first time, which is precisely what appears not to have happened with the WCA.
We know that the cost of appeals is met by the DWP, not the provider.
Stephen Lloyd: I completely concur with the hon. Lady about the statistics on the WCA and the level of successful appeals. Does she agree that the changes to the WCA that the coalition Government have brought in, with Professor Harrington’s reports, will mean that the first assessment is wrong for fewer people and that the new WCA is more effective and productive?
Sheila Gilmore: Unfortunately, the statistics do not yet show a huge change. The latest statistics show a small reduction in the number of successful appeals, but the number is still very high. Statistics always lag back a few months, so it may be that further improvements are still to come, which would be good. It is particularly important that we get this benefit reform right.
Many people, including those in the disability field and Opposition Members, have asked whether there is any penalty of any sort on the assessor for not doing the job as they should. We are constantly told that we cannot have the information because it is all commercially sensitive. I can understand that perhaps being the case during the tendering process, but I am not clear why it is deemed to be quite so commercially sensitive once the contract is awarded. We still do not know. Public money is going to these organisations, so it is important that we have confidence that this time there is a system in place.
The Select Committee’s recommendation was:
“DWP contracts with private companies for the delivery of the PIP assessment”
“directly link the payment of public funds to the production of reliable assessment reports that are ‘right first time’.”
Now that the contracts have been awarded, I hope that the Minister can tell us whether that has been done and whether it will be monitored and reported on. Obviously, if the assessments are much better, there will not be many penalties, but we need to know now whether that link has been made. It would give people more confidence in the process.
The Chair of the Select Committee, my hon. Friend the Member for Aberdeen South (Dame Anne Begg), briefly mentioned contracting. The PIP assessments have been let on a regional basis. In Scotland and the north of England, Atos won the contract, but it appears to be subcontracting to NHS Lanarkshire to carry out the assessments.
If Atos is not doing the work, what is it getting out of the contract? How much of the contract price goes to Atos and how much to Salus? Salus is the not-for-profit arm of NHS Lanarkshire; it does other forms of occupational health work, which is why it was selected. It is not unreasonable to ask those questions. Such arrangements are becoming all too typical in this new world of outsourcing to large, all-purpose, public service, private companies.
We saw it in the Work programme. At the apex are the big boys such as G4S, A4e and Serco. Sometimes they do the work themselves; sometimes they subcontract; sometimes the subcontractors subcontract. At the bottom of the heap some of the sub-subcontractors see little of the payments. That is a major problem.
What are some of those big companies being paid to do? Are they being paid just to put the contract together? Are they just creaming something off the top? They are certainly not shouldering the risk for their subcontractors, because when those get into trouble—with the Work programme, at least—they are not bailed out by the prime contractor. The main contractors do not carry a financial risk of that kind.
We need to know what is happening with the process. The question arises whether it might not have been easier to contract the work in the first place directly to the NHS. If we talk about these things a lot, it is because people naturally think there may be a connection. My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) pointed out that in statements that have been made in the past the connection with WCA was made overtly. It is not only we who make it.
The question of targets has been controversial. Atos has said there are no targets in relation to WCA. The Government have vehemently denied that there are targets. However, it now seems clear from people who have worked as health care professionals in this field for Atos—and this came out of the television documentaries in the summer as well—that there are expectations about normal and correct outcomes of assessments. Health care professionals whose performance deviates from those expectations are audited so that their performance can improve towards them. We must ask ourselves at what point an expectation becomes a target, or when there is very little difference between the two.
If there are such expectations, what cognisance will there be of regional variations in ill health—and even variations within regions? Partly because of industrial history, certain forms of ill health are more prevalent in some areas and they are likely to have a greater number of people with certain conditions than others. If there are to be targets or expectations, whatever we may call them, such things must be taken into account. However, since we do not know the guidance, we do not know whether they are taken into account. I hope that they are.
If the Government want people to be more confident about the changes, they must be more open and transparent about them. In the absence of such openness and transparency people reach conclusions, rightly or wrongly, which tend, in modern parlance, to go viral around the disability community. People then get very frightened.
Another aspect of the matter that has, I suppose, come out of the WCA experience, is to do with what kind of assessment is being carried out and the attempt to restrict complex conditions to a simple set of descriptors. The aim from the outset seems to have been, certainly with WCA, to create a system that could perform large numbers of assessments and achieve reliable and replicable results. People have often complained about a tick-box approach, and that seems to me to be a direct result of that attempt.
It is not just bad practice by Atos; sometimes, critics concentrate too hard on Atos and not enough on the underlying system. I think that what happens is inherent in the adoption of what is effectively a computerised test approach. I am sure it was sold to the Government as the IT answer to carrying out assessments. I think that we all know that IT magic miracle cures are often oversold by those who sell them. Before the Minister says so, I know that it was the previous Government who introduced the WCA and the form of test in question. The fact that they turned out to have inherent difficulties should not mean that we should not criticise them and consider whether we were perhaps naive to think an IT solution could deliver all that was needed.
Mrs Anne McGuire (Stirling) (Lab): Does my hon. Friend also accept that the previous Government had already established some monitoring and evaluation of the WCA as it was initially introduced? They did not go for a big bang approach but were going to role it out gradually, so that lessons could be learned.
Sheila Gilmore: Certainly the system had been operating for some time before the roll-out to all the existing invalidity benefit claimants, but it is not clear that the evaluation was put in place first. I think at the time we said that as some concerns were being considered, and new ways of doing things were being found, it would have been more sensible to put those changes in place before moving everyone else across.
The WCA experience tells us that IT is a tool, and should never become the master of the process. The computerised test should not be the whole of the assessment process. What comes through loud and clear from Professor Harrington’s report is the importance of seeing the computerised assessment as only a part of the whole. Gathering essential documentary evidence early in the process is important. I often heard the previous Employment Minister say that people come to WCA appeal tribunals with information that was not there in the first place—as if people keep it hidden at home and deliberately wait for the appeal to produce the information. Many of the appellants say that no one asked them for it. Some people have even said that they turned up at assessments with information that was not looked at. We must ensure that information is made available from the outset.
The other important thing, according to Professor Harrington, was that DWP decision makers should not simply rubber stamp the computerised assessment. They should consider the position in the round—look at the documentary evidence and consider the situation again. That change should now be in place for the WCA, and there are signs that that is happening, although when I have asked the Government questions about how many Atos assessments are changed by DWP decision makers, I have been told that the information is not kept in that form. Again, it is quite difficult to know exactly what is happening.
The Minister’s predecessor gave us to understand that the PIP assessment would be very different. In the Government’s response to our report, they said:
“The face-to-face consultation, as part of the Personal Independence Payment assessment, is fully intended to be a two-way conversation between the claimant and the health professional, allowing a detailed exploration of how the claimant’s health condition or disabilities affect their day-to-day lives. The discussion at the consultations should not be mechanistic and should be tailored to individuals. This is being clearly expressed to potential providers as part of the tendering for Personal Independence Payment assessment contracts and will be set out in detail in the supporting guidance for providers and their staff. The guidance will stress the importance of positive interaction throughout all aspects of the assessment. The contract will require assessors to have excellent interpersonal and communication skills, including the ability to interact with people sensitively and appropriately.
The Department is not placing targets on the time required for face-to-face consultations and is making clear to potential providers that consultations will need to be as long as necessary to reach evidence-based conclusions on individual cases.”
That sounds wonderful, and if it happens we will definitely have a much better assessment process than the WCA one that we have criticised. I have a problem reconciling it with the contract approach. Has it been built into the contracts? How will it work? If an assessment on one day, for one person, takes as long as is needed, what happens to the other people sitting in the building waiting to be assessed?
Are those people going to be sent home or asked to come back another day? What effect will that have on the number of assessments carried out? What are the targets or expectations of how many assessments should be carried out each week or month? There is a conflict—a tension, at least—between those hopeful and optimistic words and a contract-based system that has expectations of putting through a large number of people over a short space of time.
The Committee was also concerned about the frequency of reassessments. Although we accepted that there should be more reassessments than previously, we had concerns about how often people should have to go back through that process. It is very stressful and expensive for claimants. Stress can affect people’s health and make them worse rather than better.
Dr Eilidh Whiteford (Banff and Buchan) (SNP): I am glad the hon. Lady has raised that point. The whole question of getting to assessments has been one of the biggest issues around the WCA for people who live far away and often depend on relatives or friends to take them. It can mean a whole day trip for a simple—and sometimes unnecessary—assessment process.
Sheila Gilmore: That is where I hope we will see a more flexible approach that in some cases allows for a decision to be made without the absolute necessity of a face-to-face assessment. That should certainly apply in the case of reassessment, even if not always for the first assessment. There will be some cases, even when it is the first occasion, when the obviousness of someone’s situation should make a face-to-face assessment unnecessary.
There is sometimes a reluctance to accept that anybody falls into that category. It is important to give people optimism and hope. I had a constituency case concerning WCA, although it could have applied equally to DLA. A constituent’s son has a number of conditions but basically he is a 21-year-old toddler. He had no concept of what he was to be put through, but his mother did. He had been kept at his special education school for some time beyond normal school leaving age. However, he now had to apply for the benefit. His mother asked whether it was absolutely necessary to take him to an assessment. His inability to handle new situations is so great that she cannot get him into strange places and buildings.
When she phoned to ask about that, she was repeatedly told that there would have to be an assessment and that she would just have to do it. She filled in the form and sent it in. She was then told that he had been granted the benefit without an assessment. That is good, but she had been put through a lot of unnecessary stress, because one bit of the Department did not seem to know that that was possible under certain circumstances. Anyone who had met him would quickly see that the young man was clearly entitled to the benefit and to be in the support group. There was no way he could undertake employment any more than any toddler could.
There are real cases of people who should not be put through all that and the extra difficulties. Apparently, one of the providers is proposing to do quite a lot of home visits and that might take out some of the difficulty. However, that prompts the questions of whether the process will take longer and of how to deal with the large numbers involved. It has been described as a much bigger challenge than the migration from incapacity benefit to ESA. The Department is taking on a bigger challenge before it has completed the previous one.
One problem encountered by people who appeal under the WCA process is that the reassessment comes through quickly thereafter. One oddity is that the decision on the reassessment period is based on the recommendation of the original assessment. The original assessment might say that someone should be reassessed within a year. The person might then appeal and win. If the appeal takes 10 months, that person could still be called back for reassessment two months later, even though the decision to call someone back within a year was based on an original flawed assessment. It does not seem sensible to operate such a procedure. There seems to be no reason why a decision about reassessment should not be reviewed if someone wins an appeal.
The Government response said that the recall time for reassessments could be almost any length; they could be a year or 10 years. They would never again be indefinite. A year is a very short time when one considers that to qualify for the benefit in the first instance, it is necessary to demonstrate that the condition is likely to last for at least a further six months. I would suggest that over-short periods will put everybody through unnecessary difficulty.
Other speakers have mentioned the piloting phase. It defies belief that a proper evaluation of a pilot can be done within two months and then the results applied. That is what is being suggested. The initial roll-out in the Bootle office will start in April. The roll-out to new claimants in the whole of the UK will start in June. There is barely time to get enough data to make an appropriate evaluation, let alone carry out that evaluation and then make changes.
The Department constantly tells us in connection with this benefit and universal credit that it now has an agile system that allows details to be changed as things go along and it can keep rolling out in different ways. That was not our experience with the Harrington changes in WCA. It took months for most of those changes to be put in place. When we asked about it, we were told, “We have got to draw up new instructions to staff. They have to be sent out to staff. New training has to be put in place.” In effect, between the first Harrington report in November 2010 and the following summer, some of the changes began to be rolled out. The explanation we were given for the time lag was that that was the time it takes to go through a process of getting staff ready for the changes.
How is it that suddenly, only a year later, the Department is confident that it can have a pilot, evaluate it and roll out changes and make a real difference to people who are making claims? In October next year, the process of ending people’s DLA claims and inviting them to apply for PIP will begin. The whole process is quite tight and does not give opportunity for proper evaluation and tracking of what is happening to people. Perhaps the Minister can tell us whether there will be a proper evaluation of the Bootle pilot. Who is to carry it out? When will the results be known? Does she think it makes sense to move to the full roll-out in June?
Monitoring and tracking changes of this sort is important. We need to know how this will be monitored in an ongoing way. I was appalled to discover how little tracking seems to go on of the results of the ESA process. Parliamentary questions that I have asked about the destinations of people who are found fit for work are often answered with, “We do not keep that information. We may know who is on benefit and who is in employment, but as for other things, we do not know.”
The previous Government put in place a research project that started to track such information, but I think that it has now stopped. It had a first and second wave, but there is no sign of the research continuing. Perhaps the Minister will let me know whether I am wrong.
On ESA, the project found that within a year of people being found fit for work, 43% were neither in work nor in receipt of an out-of-work benefit. That is an awful lot of people simply to disappear. There are a whole lot of reasons for that; people may have gone on to jobseeker’s allowance, run out of the contributory JSA or they may have a working partner. Some may have a small pension because they were retired from work early on health grounds—even though they were then found to be fit for work, which is not uncommon.
There may be lots of reasons, but, as a responsible Parliament and Government, we really should know the effect that this measure is having. These people are seeing a substantial reduction in their incomes. They may have been in a two-income household, which then becomes a one-income household plus a benefit and then a one-income household possibly with the additional costs of having an illness of some kind.
What happens to those people and their standard of living is important. It is the same with the change we are discussing. Some may say that making the change will be good. We were even told by the Minister’s predecessor that some people who previously did not get this benefit—especially mental health applicants—will do so now. We may have even more people getting the benefit. We need to know all the information. I hope that we will have a proper research project and that the Minister will tell us that it is being fully funded by Government.
As for the housing benefit changes, the Government have put in place a research project, which is being carried out by one of the universities. A baseline piece of work has been done, so that we know what we are measuring against, and then it will look at the effect of the changes. If we are going to do that, we should have been doing the baseline now, but perhaps we are and I simply do not know about it.
Data collection is important as well. There have been some hints that the Government will be doing less reporting and data collection on benefit recipients. However, if we do not collect the data, we cannot do the research, even if we try to do it later. At the moment, we can find out how many people claiming DLA are doing so in relation to different conditions. We can tell the proportions of people who are receiving the benefit because of Parkinson’s or other such conditions. If we stop collecting these data—I hope the Minister will reassure me that there is no such intention—we will have a much less clear view of what is happening. Hopefully, we will go on collecting them.
Finally, the implications of the change not being a migration are important. People will consider it to be a migration if they had received incapacity benefit and are now on ESA—of course, not every DLA recipient is in that category. The notion that people will necessarily respond, and respond in time, is fraught with difficulty. Possibly the first time people will notice it is when their benefits stop. Suddenly the benefit will stop, and they will say, “What has happened here?” They will go and get advice and then discover that they have missed the boat—they had not gone ahead as they should have done.
The time scales are short. From the letter’s dropping through the door, a recipient has four weeks to get in the first part of the application. When they get the stage 2 form back, they have four weeks in which to return it. Voluntary and advice agencies say that if people are going to get assistance with some of this process—for some people it is very important to get such assistance—four weeks is not a long time. In many areas, people can wait that sort of length of time for an appointment with an advice agency or a welfare rights adviser, so the time scale can be a serious problem.
If people have to get additional information, which the form will apparently ask for, people will need time. The time scale seems short, and that may be revealed by the pilot. Will the Minister assure us that if it turns out that a large number of people are either not making the claim that they should be—they are not responding to the stage 1 letters and are dropping out—or are having difficulty with the four-week period for returning the form, the Government will move to change the process fairly quickly?
We do not want to see a lot of people losing out over this. If, as the Government claim, the change has genuinely been made to improve the situation for people with disabilities and to give them a personal independence payment that enables them to play a full part in our society, we have to get it right. No Government should be unprepared to accept that.
Let me touch briefly on the issue of our Olympians and what people can and cannot do. Sadly, the success of the Paralympics could turn out to be a double-edged sword for some disabled people, although I hope that it will not. Not everyone can be a Paralympian. Just because some people can, it should not be assumed that other people who are not able to find work, volunteer or play sport are somehow not trying very hard. Although it is good for people to see that disability is not about being a victim and that people can do lots of things when they are disabled, we should not make the obverse mistake of thinking that everyone is up to that and that they are just not pulling their weight.
As many of the Paralympians said, DLA was one of the benefits that helped them to achieve some of the important things that they did, whether it was getting to their training sessions or being able to have a carer so that they could concentrate on getting to places, doing their training and having a home. Many of them specifically said how much they benefited from DLA. We must remember that someone can be a Paralympian and still need benefit.