PARLIAMENTARY DEBATE
Social Security and Employment Support for Disabled People - 6 March 2019 (Commons/Commons Chamber)

To ask the Secretary of State for Work and Pensions if she will make a statement on the changes that her Department intends to make to social security and employment support, including the assessment process, for disabled people and people with health conditions.

Yesterday the Secretary of State provided the House with a written statement, and delivered a speech to Scope that included, among other announcements, an announcement about changes in the delivery of health and disability benefits.

We are making significant progress in improving people’s experiences of claiming disability benefits by working through the recommendations made by several independent reviews of personal independence payments and the employment support allowance, but we need to continue to make improvements in order to give better support to people with health conditions and disabilities. The written statement set out a number of additional measures that we will implement to make improvements, now and in the future, in support for disabled people and those with health conditions.

We will improve and simplify people’s experiences by no longer undertaking regular reviews of PIP awards for claimants at or above the state pension age unless they tell us that their needs have changed. We will also transform the delivery of assessment services. We have established a health transformation programme to undertake the significant task of combining the currently separate work capability assessment for ESA and universal credit and PIP assessment services in one unified, integrated service from 2021. We are extending the contract for the health and disability assessment service, which includes the delivery of the work capability assessment, and aligning it with the duration of the extended PIP contracts. That will allow for a safe and stable service now, and as we make the transition to the new integrated service.

The Department for Work and Pensions will also be testing how we can increase engagement and build a trusted and strong relationship between work coaches and people who are awaiting assessments for universal credit or who are found to have limited capability for work. The Minister for Employment will take that forward.

The health transformation programme will be co-designed with disabled people. The Secretary of State and I will engage regularly with disabled people, disabled people’s organisations and charities. All of us, whatever our age or need, want an equal chance to live a life of opportunity and fulfilment. We intend to support disabled people during all the phases of their lives, so that the pursuit of equality is a shared goal.

Thank you for granting the urgent question, Mr Speaker. I thank the Minister for her response. I am, however, disappointed that the Secretary of State was not here to respond, and that the Minister has had to respond to an urgent question rather than making an oral statement, given the extensive scope of the proposals.

I welcome yesterday’s announcement that there would be no PIP reassessment for disabled people above the state pension age, but why are not all disabled people—particularly those with progressive conditions such as motor neurone disease, multiple sclerosis and cancer—being exempted from repeat assessments? I have a constituent with terminal secondary breast cancer which has gone into her bones, and she has been refused PIP.

The launch of a transformation programme whereby PIP and WCA assessments will be integrated by 2021 is interesting, given that the Government have previously said that that could not be done. How exactly will the two assessments be merged? Who is involved? I am grateful that the Minister has said they will be co-designed with disabled people, but will she commit to supporting the principle of “nothing about you without you”? Will there be a pilot? If so, where and when, and what would be the sample size? Will there be an independent evaluation?

Who will provide the new service? There are real concerns about the profiteering enabled by this Government at the expense of disabled people. There are also worrying reports in various GP journals this week that the medical records of claimants will be made available to the DWP or their social security support will be denied. So I will be grateful if the Minister can confirm that this is not, and will not be, Government policy. Obviously there are huge issues around privacy and ethics.

There is also strong evidence of the physical and emotional harm that these assessments are having on disabled people, over and above their condition. What is being put in place before 2021 to improve the poor quality, validity and reliability of these assessments?

On UC and the role of job coaches in determining limited capability to work, the detail was most unclear in the written ministerial statement. Can the Minister expand on it and confirm that work coaches may start an assessment to determine a claimant’s capacity to work? Can she also confirm a shift in the Government’s approach to sanctions and expand on her Department’s approach to conditionality?

I welcome the review into the inadequacy of social security support for disabled people and more widely. Poverty is a political choice, and 4.2 million disabled people have been pushed into poverty as a result of the £5 billion in cuts since 2010. So what form will this review take and, again, who will be involved?

On the Government’s more ambitious targets to get disabled people into work, again the pendulum is swinging back. The Conservative general election pledge in 2015 was to halve the disability employment gap, but it is actually 4.4% lower than 2015. Then in 2017 there was a pledge about 1 million additional disabled people getting into work, but there was nothing about access to work.

Finally, what is the Minister going to do about the cultural changes needed in her Department to ensure that disabled people and other claimants do not feel demonised, even dehumanised, as happens all too often?

I fear I will test your patience, of Mr Speaker, if I try to answer all of those questions at once, but I will do my best.

I welcome the hon. Lady’s tone and her welcome for the measures we announced in the written ministerial statement. Clearly we have been listening very hard to Members across this Chamber and, most importantly, to disabled people themselves about the changes they would like to see, and that is what has driven the changes we are going to be making. I absolutely want to confirm that throughout the process—in fact this is how we work now—we engage fully with disabled people, enabling them to help us develop the services which are for them.

The hon. Lady touched on a few points about people being repeatedly reassessed. I remind her that we brought in the severe conditions criteria so that people who have reached the highest level of support on PIP will not be routinely reassessed; we have introduced a 10-year light touch review so that many people with the sorts of conditions and illnesses the hon. Lady described will not be undergoing further reassessments. We also have a special process for people who are terminally ill. I undertook research in the summer—and I have been delighted to work with the hon. Member for Bridgend (Mrs Moon) on the work she has been doing—looking again at how the special rules for people at the end of life are working. We have worked very closely with the medical profession, which I think was not often aware of the special processes that could so easily be put in place to enable people to get benefits within days. I will shortly be announcing new guidance which is the fruition of the work we have been doing over the last few months.

I want to remind everyone that in the transition from DLA to PIP many more people with mental health conditions are now receiving support, particularly at the highest levels. Concerns have also been raised about work coaches and their ability to work with people with disabilities and health conditions, and I want to reassure the House that all of our work coaches are receiving extensive training and will continue to do so. Over 10,000 work coaches have already received training in mental health services, so I believe that that personal relationship that we want all people claiming benefits to have with their work coach is a possibility and is happening the length and breadth of the country.

We are looking at conditionality and have taken up the recommendations given to us. When people with severe disabilities and health conditions apply for UC there is no conditionality; that conditionality will be switched off, and then as the relationship develops with the work coach, if and when they are prepared to take those steps to work, they will be fully supported by their work coach and other resources that they have available.

As would be expected, we listened to and worked with a range of stakeholders before the announcement to develop the new service. I can absolutely commit to the House that the co-design will be ongoing and there will be plenty of opportunities for everyone in the House to be involved in how we take that forward. But the simple ideal behind it is to reduce the number of assessments people have to take and reduce the amount of information they have to give to the Department. We have all heard in our surgeries each week particularly in terms of people in receipt of both ESA and PIP that they can be asked to complete a whole number of forms where they give us the same information, and are going to assessments where they give the same information. The whole aim of this is to reduce that and to simplify it, so that people give us the information once and we are able to make the best decision we can right from the outset.

It never made sense to me for us to pay different contractors who compete with each other to recruit competent staff to carry out assessments which make many disabled people feel they are involved in a duplicatory process, which adds to the stress. So may I strongly welcome today the decision to combine the ESA and PIP assessments? That will make the system more efficient and hopefully provide more dignity for disabled people.

I thank my right hon. Friend for his question. This builds on some of the work he started when he was in the Department. It is very much based on listening to people and their experience of the current benefit system. I could not agree more that we need to have a much more streamlined, simplified process under which people tell us the information once, we gather it once, and we are able to make the best possible accurate decisions the first time.

I really would have hoped that, today of all days, the hon. Lady could have found it in her heart to welcome the changes that have been asked for by so many people inside and outside this Chamber, and to recognise the great work that has been done by disabled people, and those who work with them, to engage with us so constructively and enable us to move forward and tackle the issues that she is describing.

The hon. Lady is right to say that we said yesterday that we were going to be more ambitious in enabling more disabled people into work, because we have made such good progress. Since 2013, over 930,000 more disabled people are now in work. Over that time, the disability employment rate has increased from 7.4% to 51.5%, and the gap between the disabled employment rate and the overall employment rate has been reduced to 30.2%. I do not want to see any disabled person out of work when they would like to be in work, but we have made progress and that is why we have committed to reviewing our targets and to being more ambitious. Access to Work is a great scheme, as we all agree, and it supported record numbers of people last year, including more people with mental health conditions and more young people with learning disabilities. The Access to Work fund is demand-led, and it grows every year because every year we are seeing more disabled people into work, and that is what we want to do.

Returning to the hon. Lady’s questions about the contracts, it is really important to me that, while we are going through such a fundamental transformation of our assessment process, we have safe and stable delivery for people who are applying for benefits. That is why we have extended the contracts to 2021, to align with the PIP contracts. We have not just accepted the existing situation, as the hon. Lady knows, and I am grateful for the work undertaken by the Select Committee on this. We have been pushing for continuous improvement within those contracts. The new contracts have higher standards for service delivery, and I would be happy to put a letter in the Library so that people can see the terms of the new contracts and see that they are driving forward improvement. We all want to see the right decisions being made at the first opportunity. We do not want to see people having to go through mandatory reconsideration and then on to appeals in the courts, and we have a whole series of reforms to ensure that that does not happen.

I welcome what was in the written statement yesterday and what the Minister has reiterated about the more ambitious target to get more disabled people into work. As an aside, I also welcome what the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) said earlier. As a former Minister for disabled people, I am particularly attracted to the more ambitious target that we had in our 2015 manifesto. Indeed, I may have had a hand in writing it myself. On the substantive question, if we are going to get more disabled people into work, we need to ensure that the social care system—over half of whose budget is spent on working-age adults, not on older people—works better with our social security system and with the other means that we have of helping disabled people to become more independent. I urge the Minister to publish the social care Green Paper as soon as possible, and to start that much-needed debate so that we can deliver those policy changes that many disabled people across the country are crying out for and give them the opportunity to live more independent and fulfilling lives.

I very much thank my right hon. Friend for his contribution in the Chamber today and for all the work that he did when he had the privilege of holding this office. He is absolutely right to say that we want to be more ambitious. We will be looking carefully at how we can set ourselves really ambitious goals to ensure that everybody in our country has the opportunity to fulfil their potential in work, and that business, civil society and the public sector can draw on the talents of the very many disabled people who are unemployed at the moment. He is also right to talk about the importance of adult social care. It is of course the Department of Health and Social Care that leads on this, but I work closely with it and I have been encouraging it to go ahead and publish that very important Green Paper so that we can take forward those urgent reforms and enable more people to live independent lives.

I cannot help but feel that this announcement was a missed opportunity to completely overhaul the punitive PIP assessment progress, which is deeply flawed and continues to be criticised by claimants and stakeholders. The latest PIP assessment tribunal statistics show that from June to September 2018, a staggering 72% of cases found in favour of the claimant. The Minister will be aware that Scotland is taking a wholly different approach, proposing to significantly reduce the need for face-to-face assessments, introducing rolling awards with no set end points, and ensuring that those with fluctuating conditions will not face additional reviews. That is what a system based on dignity and respect looks like. What are this Government doing to address the fact that claimants are still being wrongly assessed at such a staggering rate? Will she look at what the Scottish Government are doing to reduce the burden that is being placed on disabled claimants? Will she also agree to study carefully the responses to the consultation announced yesterday by the Scottish Government on delivering a fairer disability assistance benefit programme in Scotland?

I thank the hon. Gentleman for his questions. I should like to reassure him that I do indeed work with my opposite number in the Scottish Government, and that we are working closely together as we go through the process of devolving PIP and other benefits to Scotland. Actually, we are testing and learning a great deal from each other. The UK Government are investing a great deal in health and work trials, and we work collaboratively on those. We are always prepared to learn from any part of the United Kingdom. I absolutely agree that too many people are having their decisions overturned on appeal—we want to ensure that we get all the decisions right first time—but it is worth keeping this in perspective, because 10% of all PIP claims go to appeal and only 5% are overturned. However, as I always say from the Dispatch Box, one person’s poor experience is one too many. We have been doing a lot of work with the Courts and Tribunals Service to bring down waiting times, and I hope that all Members will join me in welcoming the fact that we now have a new PIP online appeal service. Since November, people can resolve their appeals online, which is enabling far swifter resolution of those issues.

I produced a list of things that had gone wrong in the claims procedures of my constituents, and I provided it to the Secretary of State’s predecessor to help her to shape these reforms. Will the Minister undertake to dig that paper out and have a look at it, and to ensure that those reforms can be implemented?

I think I can go one better than that, because I would like to invite my hon. Friend in to meet me and go through his paper with me, given all the hard work that he has put in, to ensure that we get this right.

We all support any improvement in the lot of disabled people, but my constituency has one of the highest percentages of disabled people, because of past industrial diseases and so on, and I remember the grief that was caused to so many people when they were forced to reclaim or to appear before various groups of people to be reassessed. There are too many people who are still in that category, and I hope the Minister will be able to assist with improving that situation. I also want to ask her about the situation regarding Remploy. We had a big fight in this Chamber over Remploy, as she may remember, and we were told that alternative jobs would be available, but can she give us the actual figures? I know that too many people in my constituency who were employed in Remploy are still out of work.

The right hon. Lady raises an important point about reassessments. Through a series of measures that we have taken this year, and through the ones that we have announced, far fewer people will be reassessed. We want to ensure that people are getting the support they need. Under the old legacy system, people were just parked on benefits for a very long time, and they were missing out. The evidence of that is the amount of people who get more money on PIP than they did on DLA. It is important that people are assessed to ensure that they are getting all the support to which they are entitled. Remploy in Wales is doing a great job as part of our health and work programme, and we have also introduced new supported ways of employing people, such as the intensive personalised employment support—IPES—programme. I would be very happy to write to the right hon. Lady to describe what is happening in Wales, and if she does feel that people who should be in employment are not in employment, she should please come and meet me so that we can look at those cases.

I warmly welcome the changes that my hon. Friend outlined. Last week, the Scottish Government announced their timetable for replacing personal independence payments, disability living allowance, attendance allowance and carer’s allowance, which will now not be completed until 2024, three years after they initially promised. Will she reassure me, my constituents and all in the House that the Department for Work and Pensions and the UK Government did all that they possibly could to ensure that the Scottish Government were set up for this and that actually there is resistance from the Scottish Government to taking the powers?

I thank my hon. Friend for that very important question. She is absolutely right about the absolute commitment of my colleagues in the DWP to ensure that the Scottish Government can take on those powers. We have not created any delays whatsoever; the delays are all in Holyrood.

A few moments ago, in Prime Minister’s questions, the hon. Member for Paisley and Renfrewshire North (Gavin Newlands) raised the case of a constituent who turned up for a disability assessment, was faced with a long wait and eventually had to rebook the appointment. The Prime Minister suggested that she or perhaps the Minister before us would look into the case, but it is not an isolated matter. I, too, have constituents with exactly the same experience, including a gentleman who last month at an appointment with the Centre for Health and Disability Assessments was forced to wait for an hour and 40 minutes, despite having told the CHDA that the nature of his condition meant that he would need to be seen very quickly.

I very much welcome the Minister’s offer to place in the Library information about the contract that has been issued to the assessment companies. We need to be able to scrutinise the performance standards and the rate at which the companies are achieving or failing to meet them. Will she repeat that commitment to the House, so that we can be absolutely clear that the information will be available to us?

I was not in Prime Minister’s questions to hear that particular example, but of course I will follow it up with great urgency. It is not acceptable for people to have appointments cancelled at the last minute or to be asked to wait. That is certainly not the service that we expect from our contractors.

I have made the commitment to publish the standards that we are insisting on in the contract. We monitor compliance with the standards very carefully, and there are penalties in the contract if people fall short of the high standards that we expect of them. Every person with a health condition or disability must be treated with respect and dignity.

I thank my hon. Friend and her colleagues for listening so much and for making these changes, but will she look at the face-to-face assessments and at whether more could be done with paper-based reviews or home visits? It is pretty difficult for some people to get to the assessment centres, certainly from my constituency, and some people who have mental health conditions find the assessments incredibly stressful.

I thank my hon. Friend for his long-standing and passionate championship of the vulnerable people in his constituency and across our country. We have listened very carefully to what he has said and we have increased the number of home visits that can be undertaken but I definitely want to go further and, wherever possible, make decisions based on the information provided by the medical profession, the disabled people themselves or those people supporting them so as to reduce the number of face-to-face assessments. They are all undertaken by qualified healthcare professionals, whose training we keep under review. I want to ensure that we have only those face-to-face assessments that are really necessary.

I congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on securing the urgent question. I share the welcome for the exemption of those over state retirement age from routine reassessments. Will the Government look again at exempting all those with learning disabilities and progressive conditions, including all those who only secured their benefit—ESA or PIP—through the tribunals process? The Minister is right that some disability organisations will welcome fewer assessments, but the fear or anxiety for disabled people is that the high error rate in existing processes will be transferred. Will the Minister give more detail about how that process will be improved and how individual disabled people and disability organisations can help to shape any new process, and when that will begin?

I can reassure the hon. Gentleman that that work is all under way. There have been several independent reviews of PIP and ESA, including one by the Select Committee on Work and Pensions, which made the recommendations that we are working through now, to ensure that the assessments are as accurate as they can be. We are not waiting. The huge benefit of the transformed service is that the DWP will own the whole claimant journey—we are building a whole digital platform—and we will be able to use the medical and other information far more easily to make the right decision the first time. As I said at the beginning, the whole new process will be co-designed with disabled people.

I welcome the announcements to bring in a better service for those seeking to make claims, in particular on the combination of assessments. An issue that is regularly picked up is a more independent record of some of the assessments. What further consideration have the Government given to things such as video recording of assessments, which might not only give confidence to the person taking part, but allow for quality-control reviews and an easier process in tribunal?

I thank my hon. Friend for raising video recording, because our hope is that that will bring a lot of transparency, trust and confidence to the assessments. We are reviewing the findings of a successful pilot. We remain committed to rolling out video recording.

The Minister should know that there really are serious problems with PIP and work capability assessments. I have lost count of the number of constituents who have come to see me in a desperate state because of the lack of understanding and awareness, in particular for those with fluctuating physical and mental health problems. The fact that 83% of people with multiple sclerosis who appeal their PIP case are successful shows how flawed the system is. On that specific point, how will the assessment process and the training and skills of those delivering it change to address such serious problems?

Inevitably, we want to ensure that we make the process better. Each time I come to the Chamber, I describe the steps that we are taking. Specifically on the case of people with multiple sclerosis, or cases brought to me by people who feel that their conditions are not properly understood by healthcare professionals, I ensure that the healthcare professionals meet those people, that they look at the guidance together, and update it and the training used by the frontline people doing the assessments. We get positive feedback from that.

Every year, we look at independent research into the experience of people at the face-to-face assessments. It is really important to me that they feel that they are being listened to, and 89% of people said that the assessor had treated them with respect and dignity. In the high 80s, people are saying that they had time and felt listened to, and that they were able to—[Interruption.] That is still not 100%, which we are working towards, but it is important, because we do not want people outside listening to this debate feeling petrified about going to have an assessment. We know that the vast majority of people have a positive experience when they go along, but we are working continuously to ensure that we improve the process for everyone.

This is welcome news for many pensioners, who do not now have to undergo repeat appointments, but it does not address the fundamental flaw in the system to which the Minister herself has alluded: 72% of PIP and ESA appeals still find in favour of the claimant. Atos, Maximus and Capita are not doing the job properly. Rather than seeking to improve that, will she not consider bringing the assessment in-house so that it can be done properly?

I point out gently to the hon. Lady that 8% of people who apply for ESA go to appeal, and 4% are overturned. I do not want that to be 2%, 1% or 0.1%; I want us to get the decision right the first time, but we must use the information accurately. It is important that we are evidence-based policy makers. When it comes to who will carry out the assessments from 2021, the healthcare professionals doing so have always been clear that by creating this transformed service and our own digital platform, many more people will be able to come forward to say that they can undertake the services, and I would be particularly happy if NHS trusts said that they would do so.

I welcome the fact that Ministers are seeking to improve the accuracy of PIP and ESA assessments and to reduce the number of appeals, but it still takes 48 weeks for an appeal to be heard in my constituency. May I ask the Minister to look urgently at how people are treated while they are awaiting an appeal? My constituent had a serious heart condition, and his doctor said he was not fit to go back to work. The DWP said that that was its decision, not the doctor’s decision. My constituent died on his first full day back at work, which he was forced into. He was awaiting his appeal. It is too late for him, but his wife has asked me to take it up with Ministers to seek a better solution for people who are awaiting appeals, many of whom are rightly and justly appealing.

I pass on my sincere condolences to the hon. Lady’s constituent. Of course I will sit down with her to review the case in great detail, because it is a very, very sad to hear what happened to her constituent. Her Majesty’s Courts and Tribunals Service has employed hundreds more people so that cases can be heard sooner. I am particularly pleased that we have introduced an online resolution service so that, once people’s information is uploaded on to the system, DWP decision makers can look at that information. If we can make a decision earlier that could prevent people from having to go to a tribunal, we will do so. I am very hopeful that we will start to see waiting times reduce significantly.

My constituents in Glasgow North East have seen £2 million taken out of their pockets as a result of the transition from disability living allowance to personal independence payment, but that is not the full story. People are often claiming these disability-related benefits as part of a wider series of social security payments, which have been subject to a freeze since 2016. Child benefit, for example, has been subject to a 23% real-terms decline since 2010, so obviously those in receipt will be disproportionately harmed. What will the Minister be doing? Will she write to the Chancellor of the Exchequer about ending the benefits freeze and ensuring that benefits are at least tied to inflation so that people can maintain a level of dignity in our social security system?

It is not true at all that benefits for disabled people have been frozen. This House recently uprated those benefits by 2.4%, and this year we will spend £4 billion more than we spent 10 years ago. All the benefits supporting people with disabilities will continue to grow to 2020. They will be growing throughout this Parliament.

At a recent surgery I held for carers, a woman came along with a case relating to her daughter who has disabilities, and we managed to get a back payment of £22,000 in disability payments. If I had not held that surgery for carers, and if the excellent local carers organisation had not put that lady in touch, her daughter would still be waiting for those payments. We cannot have a situation in which people rely on such fortuitous circumstances to get justice. What can the Minister do about that?

The hon. Lady makes an important point. We know that too many people have been missing out on billions of pounds’-worth of benefits. That is why I hope she will welcome the fact that universal credit and the personal relationship that people have with their work coaches will enable them to understand the full range of benefits available to them. Citizens Advice, working in partnership with jobcentres, will be able to signpost more people to get more support, and I hope Opposition Members will spend some time in their jobcentres to understand the range of services and signposting that is now available from work coaches.

These are very small changes in the right direction, but they recognise that the system does not work. To enable us to better understand the impact of Government policy on ill and disabled people, will the Minister commit to publishing constituency data on the number of UC50 forms that are issued to claimants and the number that are returned? Without proper detailed information, we will not be able to understand the impact on our constituents.

I will take that suggestion away and see whether we can collect that data and whether it is possible to provide it on a constituency basis. I challenge people who say that the whole system has failed because, from the information we have, we can see that millions of people are benefiting from these benefits and that more money is being spent every year. It is important that people have the confidence to come forward and access the benefits to which they are entitled. We remain committed to reforming the work capability assessment, which was brought in by the Labour Government in 2008, and we have taken a lot of time to consult a lot of people. Although everyone can agree that it needs to change, there is no consensus on how it can change. We are continuing that work, because I am determined to see these improvements made.

I think we can all agree that social security staff are under a lot of pressure in dealing with the claimants we have heard about today. Does the Minister agree that those who administer social security should be supported in employment with adequate pay from this Government? Civil servants are receiving 0.25% to 1%—those who took the bribe—but such an increase, in real terms, is a cut.

I thank the hon. Gentleman for his question, because it gives me a wonderful opportunity to pay tribute to the fantastic, hard-working, dedicated and compassionate DWP staff, both in our operating centres and in our jobcentres. I understand from our lead officials in the Department that they have a very good working relationship with the trade unions and that they are listening very carefully. We are working very hard to make sure that people are fairly rewarded.