PARLIAMENTARY DEBATES HOUSE OF COMMONS OFFICIAL REPORT GENERAL COMMITTEES

Public Bill Committee

WELFARE REFORM BILL

Eighteenth Sitting Tuesday 10 May 2011 (Afternoon)

CONTENTS

CLAUSES 78 to 83 agreed to. Adjourned till Thursday 12 May at Nine o’clock.

PUBLISHED BY AUTHORITY OF THE HOUSE OF COMMONS LONDON – THE STATIONERY OFFICE LIMITED £5·00 PBC (Bill 154) 2010 - 2012 Members who wish to have copies of the Official Report of Proceedings in General Committees sent to them are requested to give notice to that effect at the Vote Office.

No proofs can be supplied. Corrigenda slips may be published with Bound Volume editions. Corrigenda that Members suggest should be clearly marked in a copy of the report—not telephoned—and must be received in the Editor’s Room, House of Commons,

not later than

Saturday 14 May 2011

STRICT ADHERENCE TO THIS ARRANGEMENT WILL GREATLY FACILITATE THE PROMPT PUBLICATION OF THE BOUND VOLUMES OF PROCEEDINGS IN GENERAL COMMITTEES

© Parliamentary Copyright House of Commons 2011 This publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through The National Archives website at www.nationalarchives.gov.uk/information-management/our-services/parliamentary-licence-information.htm Enquiries to The National Archives, Kew, Richmond, Surrey TW9 4DU; e-mail: [email protected] 805 Public Bill Committee10 MAY 2011 Welfare Reform Bill 806

The Committee consisted of the following Members:

Chairs: †MR JAMES GRAY,MR MIKE WEIR

† Baldwin, Harriett (West Worcestershire) (Con) † Miller, Maria (Parliamentary Under-Secretary of † Bebb, Guto (Aberconwy) (Con) State for Work and Pensions) † Buck, Ms Karen (Westminster North) (Lab) † Newton, Sarah (Truro and Falmouth) (Con) † Curran, Margaret (Glasgow East) (Lab) Paisley, Ian (North Antrim) (DUP) † Elliott, Julie (Sunderland Central) (Lab) † Patel, Priti (Witham) (Con) † Ellison, Jane (Battersea) (Con) † Pearce, Teresa (Erith and Thamesmead) (Lab) † Elphicke, Charlie (Dover) (Con) † Sarwar, Anas (Glasgow Central) (Lab) † Fovargue, Yvonne (Makerfield) (Lab) † Smith, Miss Chloe (Norwich North) (Con) † Gilmore, Sheila (Edinburgh East) (Lab) † Swales, Ian (Redcar) (LD) † Glen, John (Salisbury) (Con) † Timms, Stephen (East Ham) (Lab) † Grayling, Chris (Minister of State, Department for † Uppal, Paul (Wolverhampton South West) (Con) Work and Pensions) † Willott, Jenny (Cardiff Central) (LD) † Green, Kate (Stretford and Urmston) (Lab) † Greenwood, Lilian (Nottingham South) (Lab) James Rhys, Committee Clerk † Hollingbery, George (Meon Valley) (Con) † McVey, Esther (Wirral West) (Con) † attended the Committee 807 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 808

Department do to ensure that that does not happen? If Public Bill Committee the Department encourages advocates to go along, it would be helpful if that were to happen everywhere and Tuesday 10 May 2011 they could participate as and when necessary.

Maria Miller: Although I do not want to stray too far (Afternoon) into the work capability assessment, I assure my hon. Friend that we very much believe that advocate supporters [MR JAMES GRAY in the Chair] have an important role, and we certainly see them playing an important role within the personal independence Welfare Reform Bill payment scheme and the work capability assessment. There could be circumstances in which advocates might not have a positive role within an assessment process, Clause 78 but I am sure that such cases will be few and far between. ABILITY TO CARRY OUT DAILY LIVING ACTIVITIES OR It is important to us that advocates have a role, MOBILITY ACTIVITIES whether in the PIP scheme or the work capability Amendmentproposed(thisday):201,inclause78,page56, assessment. If there were instances in which that was line 29, at end insert— not happening and my hon. Friend brought it to my ‘(d) allowing a suitable person, as defined under attention or the attention of my right hon. Friend the regulations, to participate with or on behalf of the Member for Epsom and Ewell, the Minister, I am sure claimant in a consultation to determine the questions that we would be interested in looking into the matter mentioned in subsections (1) and (2).’.—(Jenny further. Willott.) It is, of course, essential to get the PIP processes 4pm right. No conclusions have been reached yet on the Question again proposed. delivery model for the new assessment, and we are therefore keen to work with disabled people and disability The Parliamentary Under-Secretary of State for Work organisations to develop appropriate processes that reflect and Pensions (Maria Miller): I will continue with my and cater for individuals. I hope that with those reassurances, comments on the amendment. As I was saying before my hon. Friend feels that it is appropriate to withdraw we adjourned, I was not sure whether it was the intention her amendment and feels encouraged that we are very of my hon. Friend the Member for Cardiff Central to much in the same place on this issue. table an amendment that would allow an individual to have another individual attend an assessment in their Jenny Willott: I am reassured that the Minister sees place, but that is what the amendment would do. the role of an advocate as important in the process and The face-to-face consultation will play a pivotal role that the Department is “encouraging” their involvement. in the assessment as a whole, allowing the nuance of “Encouraging”is a good word; it is positive and proactive, how a health condition or impairment affects the individual and I am reassured that it reflects the Department’s specifically to be explored in a two-way discussion. It attitude. There are problems with how the work capability also provides an opportunity to observe an individual, assessment will be rolled out across the country. Given consider their mental state and directly assess any physical that the Minister has highlighted her belief that advocates impairment, if relevant. As such, it is critical that the will play an important role in PIP assessments, I hope individual themselves be part of the process wherever that the Department will take on board some of the possible. issues with work capability assessment advocates when We recognise the importance of ensuring that the PIP assessments are rolled out. assessment process is appropriate to an individual’s I am reassured by the Minister’s words, however, and circumstances and appreciate that face-to-face consultations I appreciate that the wording of the amendment has may not be appropriate in absolutely every case—for some unintended consequences. I clearly did not mean example, when there is sufficient evidence on which to that someone should be able to attend an assessment in make an assessment for those individuals with the most place of someone else. Given that the wording is dubious, severe impairments or those who are terminally ill. I beg to ask leave to withdraw the amendment. My hon. Friend raised concerns about the work Amendment, by leave, withdrawn. capability assessment and the role of advocates within Jenny Willott: I beg to move amendment 202, in the system. I assure her that individuals are encouraged clause 78, page 56, line 29, at end insert— to bring someone along for support if they feel that it ‘(d) exempting certain groups from a requirement to would be useful. Atos Healthcare, the organisation that participate in a consultation to determine the provides the work capability assessment, ensures that questions mentioned in subsection, (1) and (2).’. training includes guidance on how to work effectively with advocates. The Chair: With this it will be convenient to discuss amendment 218, in clause 78, page 56, line 40, at end Jenny Willott (Cardiff Central) (LD): From my insert— experience and that of other hon. Members, I understand ‘(9) Regulations shall exempt people with prescribed medical that there are instances in which people have not been conditions from the requirement in subsection (4)(c), including in allowed to take the advocate into the assessment with prescribed circumstances where the individual is— them, and other times when an advocate has been (i) severely mentally impaired; allowed to go in but not to say anything, participate in (ii) a double amputee; any way or even assist in the assessment. What will the (iii) deaf/blind; 809 Public Bill Committee10 MAY 2011 Welfare Reform Bill 810

(iv) undergoing haemodialysis; of the issues that I wish to flag up are probably slightly (v) severely visually impaired; and/or different, although they sit happily with the points that (vi) meets the requirements of special rules set out in she made. Clause 80.’. Amendment 218 would secure automatic entitlement to the personal independence payment for the severely Jenny Willott: The amendment is about exempting disabled. The emphasis that is different is that those some people from the initial assessment. The Minister conditions would be the same as for those who already mentioned in her comments on the previous amendment automatically receive DLA because of the consistency that the Government see that some people should be argument and the message around that. I hope that my exempt—those with terminal conditions, in particular. argument will become clear as I progress through my She mentioned some other exemptions as well, so I will points. be brief, and grateful for more detail. I remind the Committee that the categories are: severely As the principle has already been accepted, the mentally impaired; double amputee; deaf-blind; undergoing amendment is for teasing out a little more what the haemodialysis; severely visually impaired; and terminally Government are thinking. I appreciate that the proposal ill, which is already covered by clause 80. I understand does not need to be in the Bill, but it is a good opportunity the argument that I am sure the Minister will make—she to raise some of the issues. Until now, some cases have has already done so this morning: some people believe been exempt from regular assessments; a selection is set that there should not be automatic entitlement because out in amendment 218. I was trying to be less prescriptive the issue goes to the heart of the principle of what is about some cases, but others are laid out clearly. Some trying to be achieved. It is not about defining people by disabilities are so serious—people are born with certain their disability, and it is not about an impairment-linked conditions—that they will never change. Assessing those disability benefit. I understand those arguments, but my in the most severe categories seems a waste of time and limited proposal would not undermine the principle. I money. have had some interesting discussions with groups and For some groups, in particular those with various individuals about the matter. mental health conditions, assessment worsens their My amendment would improve part 4 of the Bill in condition. I have examples from casework, as I am sure two major ways. First, it would greatly reduce anxiety other Members have. In a work capability assessment, a among severely disabled people who fear having a test GP may in effect sign people off, by stating that it would to prove their disability, and would have to have one not be appropriate for them to go to regular reassessments again and again. It would provide a cost and administration for the purposes of continuing their employment and saving on the needless assessment. It is important to support allowance, on the basis of the detrimental appreciate that the amendment would give automatic effect on mental health. How that works involves a entitlement for only six conditions. At the moment, number of issues, and it applies to a very small number around 41,500 severely disabled people of working age of people, but through the amendment I hope to explore automatically receive DLA. In the grand scheme of whether there can be a similar mechanism for PIP reform, which will affect 1.8 million people of working assessments. age on DLA, the change would be small, but would Some of the disability organisations have suggested a make a massive difference to those who are incredibly tiered approach to assessment, so that we start with the anxious about going through a face-to-face assessment. paper evidence in the self-assessment and from medical To put the matter into context, I had asked the professionals. If the evidence justifying a PIP is already Minister how many new claimants of working age for there, so be it; if more evidence is needed, that person PIP payment could be identified year on year, so that we can go to a face-to-face assessment. That would mean had some sense of the scale. She could not say; I got that not everyone needs to go on to that second stage that answer on Monday. However, if the number is and some cases could be decided earlier, on the paperwork. 1.8 million overall, around 600,000 will have to be The Government are looking flexibly at the issue. reassessed per annum, which is around 11,500 every Lord Freud recently said in the other place that the week or around 2,300 every day. That is a monumental Government would not insist that people were seen face exercise, so my amendment to exempt 41,000 is a small to face if that was matter. Given the circumstances in which the people “not realistic, helpful or appropriate”—[Official Report, House of involved live, it is also reasonable. Lords, 10 March 2011; Vol. 725, c. 1749.] The Minister will know that there is widespread A similar point was made in the Government response support within the disability movement for an amendment to the PIP consultation, so I know that they are minded to retain automatic entitlement for those with severe to be flexible. disabilities that will clearly not change during their The amendment need not be included in the Bill, but lifetimes. Many organisations understand the social it provides an opportunity for the Minister to clarify the mobility model and the arguments about people not circumstances and possibly to expand a little on the being defined by their impairment, and they argue their types of cases in which people will be exempt from case strongly. The Disability Benefits Consortium says: the initial assessment. I hope that the Government will “PIP will not have any ‘automatic entitlements’. However, if it be generous about whom they consider to be in that is clear that certain impairments will always meet the criteria for category. PIP then PIP should include automatic entitlements in these cases, as they provide an easy way of awarding benefit to people who are certain to qualify and mean money is not wasted on Margaret Curran (Glasgow East) (Lab): I will speak assessments that could be spent on supporting disabled people. to amendment 218. I thank the hon. Member for Cardiff PIP should include automatic entitlements for those cases where Central for some interesting points. My points are an individual’s impairment means they will always meet the similar, but my emphasis in this amendment and some criteria for the benefit” 811 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 812

[Margaret Curran] process—although, again, we are told that that process and consultation on the assessment is ongoing and is by and everyone will know that. The Royal National Institute no means complete. We have had that discussion and I of Blind People has described the move to end automatic will not repeat those points but, none the less, many entitlement for certain conditions as people face anxiety about the matter. “a retrograde step which would not only introduce uncertainty One set of draft indicators that are causing concern for claimants, but would remove an administratively straightforward are those that affect the severely visually impaired. Of process from a small number of well-defined groups. This runs counter to wider efforts to streamline benefit administration.” course, that is relevant to the discussion on clause 78, as the severely visually impaired are one of the groups that Another quote is: the amendment seeks to cover with regard to automatic “The case for the deaf blind and severe visual impairment entitlement. I presume that Committee members know higher mobility provision is very strong. The numbers of visually that the previous Labour Government worked very impaired people getting DLA (where visual impairment is the ‘main disabling condition’) are broadly the same as the numbers hard and successfully with disabled people and their registered, so automatic entitlement based on registration and organisations to campaign for those with severe visual certification evidence would be accurate, objective, administratively impairments to be automatically entitled to receive the simple, cost-effective and easy for claimants to understand. Existing higher rate of DLA mobility. Under the current proposals, experience of DLA, where an assessment is carried out by a some 25,000 severely visually impaired people stand non-specialist, is that the assessment is often inaccurate or clear possibly to lose out as a result of the decision to medical evidence is misinterpreted”. discard a hard-fought-for and much-agreed-upon policy development. 4.15 pm What is more, according to the draft indicators before We must address the stress and anxiety of face-to-face us today, it is becoming increasingly apparent that the assessments for those who clearly need help. Wholesale Government plan not only to stop thousands of severely reform of DLA will have massive implications for millions visually impaired people from automatically receiving of disabled people, as I have already said. We cannot PIP, but to go a step further and separate claimants into underestimate or brush aside the level of anxiety that two specific groups: those who have adapted to their many people feel about that. The prospect of going visual impairment and those who have not. That raises through a face-to-face assessment and having ultimately ambiguity and questions about what aids and adaptations to prove their disability to receive help is incredibly will be taken into account. I ask the Minister for clarity stressful and worrying for many, many disabled people. on that because a lack of clarity raises alarms and Let me quote one example of what someone has said: concerns. “My other general concern - as someone with no sight at all I am obliged to note that the Minister supported and who is registered deaf blind - is the withdrawal of automatic automatic entitlement for severely visually impaired entitlement. I can’t really see the point. Certification as vision people no later than June 2010, when she indicated that impaired is done by an eye consultant with whom one usually has she was: “committed to making sure that help gets to a long-term relationship and who knows your case history and the impact of your sight loss intimately. I cannot see how a so the people who need it.” called ‘objective’ assessment can replace this.” She went on to say: Wherever possible, we should do anything to try to “We’ve taken steps today to extend the higher rate mobility ensure that the transition to PIP is as smooth and calm component of Disability Living Allowance to severely visually as possible. Surely protecting the severely disabled from impaired people”. facing an assessment is one way in which we can do that. We know that the Government plan on spending The Minister was pleased that 22,000 people benefited £675 million on the establishment and administration from that. I cannot understand how in June she was of PIP. That is a huge amount of public money and I pleased, but she is now trying to take away that automatic am sure that we will continue to talk about it. However, entitlement. just a small amount could surely go some way towards The core point that I am trying to make is about the dealing with my concerns. guarantee of the entitlement, so that people know they I shall refer to some of the points made in the will receive it, rather than their needlessly having to go briefing paper that the Minister issued last week, which through an assessment that everyone knows they will picks up some of the matters raised by the hon. Member probably pass, with the administration costs that go for Cardiff Central. The briefing note published by the with it. It is important that we look at those issues and DWP last Friday suggests that some people may not be see whether we can amend the Bill appropriately. subject to face-to-face assessments. It states that assessments This is an important amendment. It seeks to avoid will be carried out with a trained assessor but, in some needless assessment that will both cost the taxpayer cases, a paper-based assessment may be more suitable. money and put unnecessary stress on the disabled person Just to repeat the comments made by the hon. Lady, I who must now prove that they have a severe disability would be grateful if the Minister said what that will before they are given support. Does the Minister think actually mean. Although a paper-based assessment is that people with the conditions listed in the amendment, better than a face-to-face assessment, it is still an assessment such as severe mental impairment and those I have and it means that we are taking away that automatic already described, should always have to undergo an entitlement and guarantee. The use of such an assessment assessment? Currently the Bill automatically gives PIP does not fundamentally address my points. to only one group of people—those who are terminally The briefing note has also produced some draft indicators ill. While we agree with that decision and welcome it, we that are beginning to shape our understanding of the urge the Government to go one step further. The issue Government’s direction in relation to the assessment matters fundamentally to the people in this category 813 Public Bill Committee10 MAY 2011 Welfare Reform Bill 814 and their families. They are waiting for us to give have an automatic entitlement to the higher rate of ground on this matter, so I hope that the Minister will mobility component. I think that she was seeking to look at those arguments. make the point that, if someone is reassessed, there is no further support if they are already on the higher rate. Maria Miller: We have reached an important point in Secondly, the Minister seemed to imply that the the debate. We have found an important point of difference Opposition did not seek to treat disabled people as between the Government’s approach to the reform of individuals. The point about automatic entitlement is DLA and the Opposition’s approach. One of the firm, made in a joint submission for the visual impairment underlying principles of what we are doing is to recognise sector, which speaks on behalf of a number of people each and every disabled person as an individual. That is dealing with visual impairment and deaf-blindness. I do important. For too long, disabled people have been not feel that we are out of kilter with the views of the labelled by their disability rather than considered as disabled people whom we seek to represent. individuals. Blanket assumptions have been made about what people can and cannot do simply because of their Maria Miller: I apologise if I misunderstood the hon. conditions. We do not feel that that is an appropriate Member for Edinburgh East. I did not realise that she way forward and the responses to our consultation was particularly focusing on those groups. When an would tend to suggest that many others would agree individual is in ongoing receipt of the highest benefit, with that stance. there may always be ways in which we can assist people We recognise that people live varied and complicated to look for new ways to try to support them with their lives and do not fit neatly into boxes. Many people will impairment. PIP might have a role not in removing the have multiple conditions. The hon. Member for Glasgow support that is there, but in ensuring that they get access East referred to individuals who are deaf-blind. That is to the right level of support. a condition that deteriorates over time. There is a risk in The hon. Member for Nottingham South mentioned simply saying that an individual does not require some briefings that she received from various groups. She sort of touch point with the Department to make sure may be aware that there is a difference of opinion that their needs are being met. Individuals who are between groups on whether it is appropriate to look at looking for support from various benefits should be an individual’s impairment and passport them through able to make sure that they are in receipt of the right as a result of a specific impairment. That is a debate for level of support for their conditions. another day. It is an important principle that we look at the people first and foremost and at the effect that the Sheila Gilmore (Edinburgh East) (Lab): If the person condition has on their ability to participate in daily life. is already receiving the highest rate of benefit, what is the purpose of further assessment at that stage? Is the Department putting itself in the role of a key worker for Kate Green (Stretford and Urmston) (Lab): I want that individual to access other forms of support and is specifically to ask the Minister about the point she that something the Minister envisages the Department made a moment ago about the possibility of assessment doing? in people’s own homes. Of course that would be welcome and appropriate in a number of cases. However, many Maria Miller: The hon. Lady mentions individuals people cope better in their own homes than when they who are in receipt of the highest support. I am not sure are out and about. Will the Minister assure us that the which conditions she is thinking of. Those conditions individualised approach that she talks about will properly might change over time. It is impossible to say that one reflect whether people can function, not just in their would just exempt people from having a reassessment homes, but in the wider community? simply because they were in receipt of the highest support. I should like to assure the Committee that, in Maria Miller: The hon. Lady makes an extremely some situations, individuals might not need to come important point. We are in no way suggesting that the forward for face-to-face assessments. We could assess proposal is an attempt to reduce or identify inaccurately them through a paper application process, with supporting the support that an individual needs. As we move evidence that they did not need a face-to-face assessment. forward, it is right to explore different ways to assess I have been in discussions about various other individuals. The hon. Lady might be aware that we opportunities as well, particularly for people with serious already undertake some home visits where appropriate—this mental or cognitive impairments where it would be is not a completely new idea—but she is right to caution difficult for them to go to an unfamiliar place. We are and to want to ensure that the assessment is accurate. already exploring opportunities for the potential of A number of hon. Members referred to the DLA home visits or assessments in more familiar places. The blind measure recently put in place. It is important that previous Government created this principle so that lone the Committee knows why the Government decided to parents could go to interviews while they were in receipt proceed with that. The previous Administration worked of income support. They would go to Sure Start centres on that important measure for a number of years, for assessments—an extremely good way to ensure that because of DLA’s failure to tackle or accurately assess individuals regularly attended the interviews, being mindful the needs of individuals who are blind. Our decision to of the restrictions that might affect them. proceed with the measure underlines the DLA’s shortcomings. Its assessment criteria simply do not Lilian Greenwood (Nottingham South) (Lab): I want accurately pick up the needs of individuals who are to pick up two points. First, my hon. Friend the Member blind. We talked earlier about mobility and the fact that for Edinburgh East said that, under the current rules, because someone could not walk, they will be deemed those who are deaf, blind or severely visually impaired as in need of further mobility support. The current 815 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 816

[Maria Miller] I take issue with my hon. Friend’s key point. It is important that we help people as their conditions change DLA assessment simply does not take enough account and evolve over time and that we have a real understanding of individuals who have sensory impairments. Presumably, of the multiple conditions that they face. The way in the Opposition agree, which is why they introduced the which conditions change can be variable. Blanket treatment measure in the first place. of individuals opposes one of the key and underlying principles of PIP, which is that of treating each person 4.30 pm as an individual. The broad condition types are listed in amendment 218, Margaret Curran: May I ask the Minister to clarify which was tabled by the hon. Member for Glasgow what she has just said? She seemed to be arguing that East. They do not necessarily say much about need and the Government extended a benefit that they did not the impact that the impairment has on the individual. agree with because it was not structured or organised We may not need to see some people with such conditions properly and it had fundamental flaws. Why did on a face-to-face basis, but that may be the only way in the Government agree to extend a benefit that they which we can truly understand the support that other fundamentally disagreed with? people need. Exempting individuals with prescribed conditions would Maria Miller: We agreed to implement the DLA fail to reflect any co-existing condition that an individual blind measure because we want to ensure that support may have. Such conditions could have a far greater is there for people who need it. As the previous impact on the individual, but that may not be identified Administration had identified, DLA was not supporting simply because they are defined by the principal condition. people who were blind. They proposed a measure that It is precisely for those reasons that, although we accept took an extremely long time to introduce. The legislative and appreciate that face-to-face consultations are important structure of DLA meant that the allowance was not for the majority of people, we will have exemptions, but easy to amend. Such provisions are mainly defined not we will not state them in the Bill. in regulations but in primary legislation. In a nutshell, the reason why we have introduced this measure is that Margaret Curran: Did I hear the Minister correctly we want blind people to get the support that they need when she said that there will be exemptions? Will she and, at the moment, DLA fails to give them that. clarify what those exemptions will be? Maria Miller: As I said earlier, there will be situations Lilian Greenwood: Will the Minister clarify how many where a face-to-face consultation may not be required blind people are missing out on the opportunity to get because of paper-based evidence. There may well also extra help with the costs of their disability? How many be cases where such a consultation may not be required extra people will be able to claim PIP and how much in a prescribed place because of a serious mental or will it all cost? cognitive impairment, and we could then provide home visits. As my hon. Friend the Member for Cardiff Central said, the important thing is that we ensure that Maria Miller: If the hon. Lady had been following the way that we assess individuals is as flexible as it can the earlier part of the debate more closely, she would be. We have also made it clear that we will continue the know that we cannot define that yet because we are in special rules for terminally ill people, and we do not the process of finalising the assessment. We will produce plan to ask them to attend face-to-face consultations. I more detailed figures in the future. hope that those comments reassure my hon. Friend and At the risk of us all incurring the wrath of Mr Gray, the hon. Member for Glasgow East and that my hon. we should perhaps go back to the issue at hand in Friend will feel able to withdraw the amendment. amendments 202 and 218. For most people, a face-to-face consultation with a trained independent assessor will The Chair: Order. I am conscious that it is rather play a key role in creating a much fairer, more objective warm in the Committee Room, and therefore hon. and more transparent assessment process. Such a Gentlemen may, if they wish, take their jackets off. That consultation will also provide individuals with the is contrary to my normal practice; I will not be doing opportunity to put across their own views on how their so, but hon. Members may. health conditions or impairments impact on their everyday lives. We recognise the importance of having a system Jenny Willott: We have had an interesting debate that is flexible to meet each individual’s needs. As I have about exactly how the proposal will work. I am aware outlined, we will have those flexibilities inbuilt in our that we have strayed into the territory of the next group system. of amendments, so I am sure that the debate on them In proposing these amendments, my hon. Friend the will be quick. I am glad that the Government will Member for Cardiff Central mentioned individuals who consider paper assessment to be appropriate for some are born with disabilities and conditions that do not people. change. She said that they could benefit from an assessment exemption. At this stage, we do not propose that the Stephen Timms (East Ham) (Lab): I think that I new PIP would apply immediately to children. We want understand where the hon. Lady is heading with her to take time to learn from the initial implementation of remarks, but I urge her to stick to her guns with the PIP and then look at how we can simplify the assessment amendment. From the Opposition’s point of view, she process for children as we move forward, working in made a telling case in introducing her amendment, consultation with our colleagues in the Department for which was expanded further by my hon. Friend the Education and the Department of Health. Member for Glasgow East, and we have had a vague 817 Public Bill Committee10 MAY 2011 Welfare Reform Bill 818 and unsatisfactory answer from the Minister. I hope Jenny Willott: I am glad to hear that, and I hope that that she will press the amendment to a vote, and if she the Government keep an open mind about who they does, she will find a good deal of support from the might consider for running the assessments as well. I Opposition. hope that, in keeping that open mind and learning from how the system works in practice, the Minister will Jenny Willott: I thank the right hon. Gentleman. He consider, over time, adding categories and conditions to has not yet heard my remarks, but I will disappoint him, the list that would be exempt from initial face-to-face because I do not plan to press the amendment to a vote, assessments. She referred to flexibility. I hope that the and I will now explain why. Government will consider extending that flexibility as I am glad that the Government accept that it is not we learn and possibly include other people in the exempt appropriate for everyone to have a face-to-face assessment. category, so that we learn from the experience as PIP is That principle is quite important. I am also glad that rolled out. Given that there are already exemptions and they are exploring alternative ways of doing an assessment, that the Government intend to make them, it seems because those of us who have been Members for a while clear that the amendment is not needed; it is already are always coming up against cases where people have possible to make exemptions. not been treated appropriately for their disability. Taking that into account and doing assessments in different Stephen Timms: Does not the hon. Lady accept that places might make the system simpler for people to the Minister has plainly refused to give her the reassurances participate in. Our recent debate on advocates is a that she is seeking? I accept that there is another mechanism crucial example of why we need them to be encouraged by which such things might be done, but the Minister to be part of the system and for them to be accepted as has given absolutely no assurance that that will happen. part of it. If we assess a broad range of people, it will be hard for many of them to get a fair hearing without Jenny Willott: It is clear that the amendment is not support and advocates working with them during the necessary. We do not need to amend the Bill for such assessment. things to happen. I might not completely agree with the Kate Green: Does the hon. Lady share my puzzlement Minister on how many people are exempt, who is exempt at what the Government are assessing in respect of the and how that operates, but it seems clear to me that the people whom she encompasses within her amendment? amendment is not needed for that to happen. Their conditions are severe and unchanging, and it is clear that even paper evidence will simply reinforce Maria Miller: Perhaps the right hon. Member for evidence that was received two, four, six and eight years East Ham is not clear about what I said, so perhaps I ago. should make it absolutely plain that, where we have sufficient evidence to make an assessment for someone Jenny Willott: Amendment 202 actually relates to the with the most severe impairments, we would not expect initial assessment only, and the next amendment that to undertake a face-to-face consultation. I tabled is about the ongoing reassessment of people. I agree with the hon. Lady that an assessment is not necessary for some people who should be entitled to Stephen Timms: Will the Minister give way? PIP. I understand where the Minister is coming from when she says that she wants everyone to be assessed at Maria Miller: The right hon. Gentleman cannot intervene the beginning of the system, but I have some issues. on an intervention. Some people should be exempt, but the Minister has We could therefore provide individuals with an alternative made it clear that there will be some exemptions, and we to face-to-face assessment as part of that process. I do have to see, in time, who the Government include in not think that there is a huge gap between us. those exemptions. I hope that the Government will keep an open mind and see how the system works in practice, because there Jenny Willott: We are discussing how many people is a whole world of difference between the theory—the are considered exempt—the categories and conditions way that legislation and guidance are put together—and for which the Government would consider an exemption how it is implemented. An awful lot of the cases that we from the initial assessment. Clearly, the legislation does have seen as Members of Parliament, where people not need to change for that to happen. There is now a have had difficulty with the structures currently in place, debate about who is considered in that category and were never foreseen, or the difficulty was caused by the what process there is for considering more people. way that something was implemented, rather than the bare bones of the structure. It will be important to see Kate Green: The hon. Lady talks about categories how the system is actually implemented on the ground. being deemed exempt from face-to-face assessment, but A lot of that will involve working with Atos and how it my understanding is that the Minister is saying that implements the system. The Department can have various individuals will not be required to go for face-to-face policies in place, but if they are not implemented by assessment. Does the hon. Lady accept that that is Atos, we have a whole load of problems. rather different from the assurance that she seems to think that she has heard? Maria Miller: I absolutely endorse what the hon. Lady says. This is an iterative process and we will always 4.45 pm learn along the way, but may I gently remind her that Atos has not been chosen to implement this programme? Jenny Willott: I do not understand exactly what the Any assignment of that contract will be done through hon. Lady is saying. I apologise if my language is not the usual procurement processes. precise enough but, from what the Minister has said 819 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 820

[Jenny Willott] This should be a brief debate, because we strayed into this territory in the debate on the previous amendment. today, it is clear that the Government will put in place a The amendment is designed to make it possible for process in which not everybody is expected to go for a some people not to have to go for reassessment, so that, face-to-face assessment. My concern was that the legislation after the initial assessment, they do not have to be was going to make it compulsory for everybody to have reassessed regularly. In some cases, it is a waste of a face-to-face assessment whether or not that was resources to do that when people have a condition that appropriate. It is clear from what the Minister has said we know will not change, or will certainly not get any that there is a process for identifying people—whether better. Reassessments were raised with me by a constituent categories of people or individuals—who do not need a whom I mentioned earlier and whose 29-year-old son face-to-face assessment. I wanted to hear the acceptance has Down’s syndrome and a mental age of less than six. that such assessment is not appropriate for everybody. I That condition is never going to change—it probably am sure that there is going to be an ongoing debate on will not get much worse, but it certainly will not get Third Reading, and in the other place when Bill goes to better. His condition will be constant throughout his the House of Lords, about the individuals or categories life. Reassessments seem to me to be a waste of time and to which assessment should apply . money, and it causes stress for him and his family to go through them regularly. Stephen Timms: Several Committee members find That point applies to a range of different conditions; themselves in a slightly difficult position. We agree with there are degenerative conditions such as Parkinson’s, the case that the hon. Lady has put to the Committee motor neurone disease and multiple sclerosis, where and disagree with the response that the Minister has there will not be an improvement, and someone will given. We would like the opportunity to vote in favour only get worse over time. I appreciate that the Government of the amendment that the hon. Lady has moved and in effect want to keep tabs on how somebody’s condition support the argument she has put to us. I hope that she is progressing, and I hope that the Minister can confirm will give us that opportunity. today that they will consider paper assessments in circumstances where people’s conditions will not improve Jenny Willott: I am sorry to disappoint the right hon. and they will not be taken out of eligibility for PIPs. Gentleman, but I do not intend to push the amendment We have already discussed necessary exemptions for to a vote. It is quite clear that we do not need such a the initial assessment, but slightly different criteria apply measure in the Bill. There is going to be a lot debate in to regular reassessments. There is probably a fairly future about which categories and individuals should be limited group of conditions and a limited number of exempt, but we do not need the amendment in the Bill people involved, and it should be possible to do an for that to happen and for people to be exempt. I beg to assessment using a medical assessment, prognosis, GPs, ask leave to withdraw the amendment. consultants and so on, rather than requiring people to come regularly for reassessment. Given that we have Hon. Members: No. had a lengthy debate about this issue, that is all I will Question put, That the amendment be made. add, but I hope that the Minister can reassure us on The Committee divided: Ayes 10, Noes 14. those matters. Division No. 10] Margaret Curran: I want to make a few points. Although AYES similar arguments were made about an earlier amendment, there are a few points of principle wrapped up in this Buck, Ms Karen Green, Kate amendment too, and I wish to draw attention to them. I Curran, Margaret Greenwood, Lilian Elliott, Julie Pearce, Teresa take the point that this is about reassessment, and Fovargue, Yvonne Sarwar, Anas perhaps we cannot cover the principle of assessment Gilmore, Sheila Timms, rh Stephen itself. However, enshrined in the amendment is the notion of categories of people, not individuals, and that is not in step with what the Minister has said, so I think NOES that we need to resolve that issue. I support what the Baldwin, Harriett Miller, Maria hon. Member for Cardiff Central said, as it is reasonable Bebb, Guto Newton, Sarah to look at categories. We are talking about a very Ellison, Jane Patel, Priti limited number of people, which will not undermine in Elphicke, Charlie Smith, Miss Chloe any way the general thrust of the Bill. Glen, John Swales, Ian Hollingbery, George Uppal, Paul The hon. Lady also discussed the Government’s McVey, Esther Willott, Jenny intentions. The implicit purpose of looking at individuals, rather than categories, is to keep tabs on people with Question accordingly negatived. such conditions. I have not yet heard a satisfactory argument about why it is necessary to keep tabs on certain people, or what the purpose is of doing so. If it Jenny Willott: I beg to move amendment 203, in is to ensure that people receive a range of support to clause 78, page 56, line 29, at end insert— assist them with their conditions, I would accept that argument, but I do not regard that as a function of the ‘(d) exempting certain categories of people from any requirement to participate in an assessment (or repeated Department for Work and Pensions. It is more likely to assessments) where their diagnosis, or available medical be the function of the health service, or social care and other expert evidence, is deemed sufficient to support. If it is to be the function of the DWP, that is a determine the questions measured in subsections (1) very significant development, which should be clarified and (2).’. this afternoon. It is very important to try to understand 821 Public Bill Committee10 MAY 2011 Welfare Reform Bill 822 exactly what is in the Government’s mind. If there are that, at the moment, the Department is able to deal with other benefits to which they think people are perhaps such requests in less than six days, which is to be not entitled, perhaps the Minister will explain that. We commended. I hope that my comments and the existing have not received proper clarification about those matters provisions in the Bill to accommodate such circumstances, at all, but the principle that the hon. Lady is promoting if the need arises, will allay some of the concerns in the amendment is worthy of consideration and support. expressed in the heated debate on the amendment. It is important that such concerns are expressed and that we Maria Miller: I do not want to repeat the points that I talk about general principles, but it is also important made on the previous amendment, but I will summarise that we touch on some of the practical realities as we our view for my hon. Friend the Member for Cardiff progress. With that, I hope that my hon. Friend will feel Central and reiterate some points that I have made. it appropriate to withdraw her amendment. Although we think that face-to-face consultations are an important part of the process for most people, we Jenny Willott: I appreciate the fact that the Government accept that it will not be appropriate in every case. In are considering different and less intrusive ways of particular, where we have strong enough evidence to reassessment. I hope that they make progress, because make a decision on entitlement, a face-to-face consultation the process of reassessment can be extremely stressful, may not add very much value, and in such cases, a generating significant anxiety for many people, in particular paper-based assessment of an individual may well be those with mental health problems. For those with more appropriate. All individuals should be assessed, lifelong, unchanging conditions, facing yet another but we want the process to be tailored to individual reassessment seems more of a drag. I am glad the circumstances and, most importantly, to be carried out Government are considering less intrusive reassessment. sensitively, as emphasised in Professor Harrington’s review. Margaret Curran: I urge the hon. Lady to press the Lilian Greenwood: I am trying to understand the amendment to a vote. I take the point that the Government Minister. She seems to be saying that there will be a are addressing some of the concerns that have been reassessment, albeit a paper one. If people are in receipt expressed, but we need to take the opportunity to make of the higher rate of PIP and they have a lifelong or provision in the Bill and to resolve some of what we are degenerative condition, the purpose of the reassessment beginning to hear as contradictions, otherwise the people process is not clear. For example, if they are deafblind whom she is describing and whose cause she has advocate or have multiple amputations and are in receipt of the will not get the anticipated outcome. The best way to higher level, why do they need to be reassessed at all? achieve that is to stick with it and to press the amendment to a Division. Maria Miller: I hope to address that very issue, if the Jenny Willott: First, the Minister has clarified the hon. Lady will allow me. fact that the issue is dealt with in the Bill. Secondly, if As the Committee knows, we are indeed considering Opposition Members wanted to press the matter to a the detail and the likely operational processes of the vote, they should have tabled their own amendment. new personal independence payment. We recognise the They did not table any amendments on the matter, importance of getting it right, which is why we are although it was entirely in their hands to do so. working with disabled people and their organisations as I am sure that it will become clear as the process we develop such matters, ensuring that we can cater for continues that there are people whom it is simply not individuals and individual circumstances. worth reassessing—it is not worth if from their perspective If we should decide—for example, as a result of and it is not worth it from the Government’s perspective. testing the assessment or in the light of operational I am reassured that the Minister clarified the fact that experience—that we need to deem certain individuals the Government will look at that in future and that the exempt, we already have the powers to do so in power is already in the Bill to take that into account. As clause 78(3)(a). For that reason, I cannot accept the the power is there already, the process will need to adapt amendment of my hon. Friend the Member for Cardiff with time. Strong views are clearly held across the Central, because it would duplicate an existing power in House and by members of the public that there are the Bill. However, perhaps the hon. Members who people whom it is not worth reassessing and who should participated in the debate can, in summary, accept that be exempt from the initial assessment. Given that the it is our overwhelming desire to treat every person who Government have accepted both those principles and applies for or is in receipt of a PIP as an individual. the power is in the Bill, I beg to ask leave to withdraw That is the main premise of this benefit. the amendment. We fully understand the issues raised in the consultation and in today’s debate. For some individuals, the standard Hon. Members: No. approach is not an appropriate way forward. We have Question put, That the amendment be made. already made provision in the Bill to consider the matter further. In all cases, it is right to have a tailored and The Committee divided: Ayes 10, Noes 14. flexible approach so that we can, wherever possible, Division No. 11] accommodate the needs of disabled people, in the way in which we would accommodate the needs of every AYES other person in this country, not simply labelling them Buck, Ms Karen Green, Kate by their condition. Curran, Margaret Greenwood, Lilian As I have said, the Bill includes clear provisions on Elliott, Julie Pearce, Teresa terminally ill people. Those separate provisions, in clause 80, Fovargue, Yvonne Sarwar, Anas allow people to be dealt with quickly. It is remarkable Gilmore, Sheila Timms, rh Stephen 823 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 824

NOES perhaps some of the organisations lost faith in it. Will Baldwin, Harriett Miller, Maria the Minister assure us that that will not happen? What Bebb, Guto Newton, Sarah processes and steps does she intend to take to ensure Ellison, Jane Patel, Priti that is the case? Elphicke, Charlie Smith, Miss Chloe Glen, John Swales, Ian Hollingbery, George Uppal, Paul Maria Miller: I assure my hon. Friend the Member McVey, Esther Willott, Jenny for Cardiff Central and the hon. Member for Stretford and Urmston that consultation is at the heart of this Question accordingly negatived. programme of work, right from the start. The latter asked for an assurance that this is not only about high-level consultation. It is easy to reassure her on 5pm that, because we have been working with a group of Jenny Willott: I beg to move amendment 204, in specialist advisers of disabled people, representatives clause 78, page 56, line 40, at end insert— of organisations and health care professionals on the development of the assessment criteria, and we will ‘(7) The Secretary of State must consult with appropriate organisations prior to drafting regulations made under continue to work with them on testing the criteria to sections 78(3), 78(4) and 78(5).’. ensure that the criteria are working in the way in which we want. As we move forward this summer, we will be This is a less controversial issue. The amendment is doing grass-roots consultation and testing, and we will linked to the previous amendments that I have tabled. be talking to disabled people about our assessment and It is about the importance of consulting disability asking people to take part in testing the criteria. That organisations and individuals with disabilities. I am will provide the rich feedback that hon. Members have sure that the Minister agrees that it is important to discussed today to ensure that we get the new PIP consult at an early stage to avoid the mistakes made by assessment right from the start. the previous Government in designing the work capability assessment. If we can make the system better right from We will continue to work with disabled people and the start—particularly for things such as fluctuating their organisations. We are planning to involve them in conditions, which are a perennial problem in the assessment a number of ways as we design the operational processes— process—we can make life much easier for the people the way in which the assessment will be carried out. We who are undergoing assessment. have set up a dedicated PIP implementation consultation group specifically for that purpose. Membership has I appreciate that the process is different from the been drawn from a wide range of national and grass-roots WCA and that the system is entirely new. The fact that user-led organisations. My officials and I have met it is an entirely new type of assessment and a totally many of them already, and we look forward to the work different benefit means that it makes sense to involve they are going to be doing with us on this most important disability organisations and individuals from the start part of the process. Many of them are people who have to try to get it right. I know that the Government expressed an interest in working with us on the operational consult constantly. In discussing an earlier amendment, processes, and I look forward to progress as we move the Minister mentioned the consultation that has already forward. taken place with organisations representing disabled people. I would be grateful if she were to reassure us We will ask the group to look at the practical way in that the Government will consult both organisations which operational issues will be developed. The initial and individuals, because they have an important voice list of issues will be discussed at the group’s first meeting that needs to be heard. We should ensure that we do not on 16 May. I hope that that reassures the Committee make the mistakes of the past, and that we design a that consultation and co-production are at the heart of system that needs fewer changes once it has been put in the development of PIP. I stress that our approach is place. not only about meeting legislative requirements. The development of PIP will be, as the WCA has been, an iterative process in which we actively seek out opportunities Kate Green: I am pleased that the amendment has to learn from our experience to ensure that we make the been tabled, for the reason highlighted by the hon. changes necessary to make it the success that we all Member for Cardiff Central. It is clearly important that want it to be. That is why we have already published we improve the process from the outset, rather than initial draft assessment criteria, which are available on having to catch up later by putting right badly designed our website. Members of the public can access them provisions. now and e-mail or write in with their comments on the Will the Minister outline how the consultation process assessment criteria. We are being open and transparent will be carried out? Will there be written consultation, about how the new support is being developed. We with an invitation for people to put in written submissions? intend to publish a second draft of the assessment Will there be an opportunity for proper detailed work criteria in the autumn, building on the comments that to be carried out with disability organisations and disabled have been made. I assure Committee members that we people to design the detail of what the assessment will view this as an ongoing process and we will continue to look like, and not just a high-level and generalist work with disabled people and their organisations on consultation in which those organisations and people the criteria after that point, as we work towards finalising express concerns? The lessons that I learned from the draft regulations to submit for parliamentary scrutiny. early stages of attempting to design the WCA were that We are absolutely committed to transparency and that there were initial attempts to do that round table engagement with disabled people. I hope that what I detailed design work with disability partners. After a have outlined today will show that consultation is not at time, that process became more difficult, and ultimately a very high level—to use the phrase of the hon. Member 825 Public Bill Committee10 MAY 2011 Welfare Reform Bill 826 for Stretford and Urmston—but is at grass-roots level. be confident that assessments will result in the right We see that as integral to the way we work. I hope that decision. One reason why an incorrect decision might given the reassurances about the key role of consultation be made is that the person carrying out the assessment and engagement, my hon. Friend will feel it appropriate does not have enough expertise about the impairment. to withdraw the amendments and continue to work with us with her thoughts on how the assessment and the operational processes work in practice. 5.15 pm Before our debate today, we all received a briefing Jenny Willott: I am reassured by what the Minister from the Disability Benefits Consortium, from which I has said; clearly, a lot of work is already going on and shall quote a couple of sentences: will be ongoing. I appreciate that the work capability “It is essential both for the applicants, and for the integrity of assessment is very different from the PIP assessment, the benefit, that the assessments are carried out fairly and effectively. but I hope that we can learn lessons from it when Studies have shown that various groups have been disadvantaged designing the PIP assessment—how it was implemented in the past due to assessors not understanding certain conditions. and what changes have been needed since then—and in This causes distress to the applicant and their family; and can particular incorporate the recommendations made by lead to a tribunal process which is costly to the state and often Professor Harrington. I am glad that so much consultation ends in the initial decision being overturned.” is going on. Piloting is a really important way of ensuring That is the point that the Disability Benefits Consortium that the problems are ironed out before the regime is made to the Committee. implemented, rather than testing it on people and finding The amendment applies to all types of impairment, out that it does not work when it has already been but we are particularly concerned about two particular brought in. types, with which we are becoming familiar in Committee. The first is fluctuating conditions and how they will be Maria Miller: Just for clarification, we are not piloting assessed—the hon. Member for Redcar raised the point the study; we are testing it with real individuals to earlier today—because they may appear less severe than ensure that we know it will work well. they typically are on the day of the assessment, and there are plenty of examples of erroneous assessments. If the person conducting the assessment has access to Jenny Willott: I apologise for the wrong use of “pilot”; expertise and guidance for dealing with the impairment, I meant “testing”. It is crucial to the credibility of the there is a much better chance of being able to make a new assessment, as well as to having a system that correct assessment when it is carried out. works, that it is well tested and worked through with individuals with disabilities and the organisations The second group, which we discussed during earlier representing them. If it does not have credibility and is debates, is people with mental health impairment. We not seen to be fair, it will not work. It is important to have been reminded that in his independent review of ensure that people are involved at an early stage and the WCA, Professor Harrington found evidence that throughout the process, so that they feel that their some mental health conditions may be being inappropriately voices are listened to and so where it does not work, the assessed at present. The briefing notes circulated by the problems are identified and changes are made. Clearly, Government on PIP, which we all received on Friday, those things are already happening. strike me as muddled on what we can learn from the WCA about the assessment for PIP. The Minister has I beg to ask leave to withdraw the amendment. touched on that a couple of times today. The notes Amendment, by leave, withdrawn. state: “Employment and Support Allowance and Personal Independence Stephen Timms: I beg to move amendment 217, in Payment are different benefits paid for very different reasons. Any clause 78, page 56, line 40, at end insert— direct comparison between the Work Capability Assessment…and the new assessment for Personal Independence Payment is not ‘(7) The Secretary of State shall ensure that any assessment therefore possible or helpful.” carried out under this section is performed by an individual who has access to sufficient skills and expertise appropriate to the It is an odd turn of phrase to say that it is not possible, impairment type of the claimant, as defined in regulations. and then to say that it is not helpful. Those couple of (8) The Secretary of State shall issue clear guidance outlining sentences from paragraph 8 on page 8 of the briefing the needs of different impairment groups for the use of note at least make the position clear. The Government professionals assessing people under this section.’. believe that lessons cannot be learned and that a direct The amendment has two main purposes, both of comparison cannot be drawn between the two. which relate to the individuals who will carry out I do not agree with the statement, but it is at least assessments. The amendment’s first aim is to require clear about the position. Although the benefits are assessors to have access to sufficient skills and expertise different, there is no doubt that the WCA and the new about the impairment type of the claimant whose assessment for PIP, given what we received from the application is being assessed. The second half of the Government at the end of last week, have striking amendment fulfils our second aim by requiring the Secretary similarities, at least in how they look. But the Government’s of State to issue clear guidance about the needs of briefing is clear, and having told us that the direct different impairment groups, which will be used by comparison is not possible or helpful, it states: those who carry out the assessment process. “’We are, however, seeking to learn from the experience of the As my hon. Friend the Member for Glasgow East has WCA. As part of this we are looking closely at the findings of the explained, we recognise that it is right to reform the first independent review of the WCA carried out by Professor DLA and accept that it is perfectly sensible to use a Malcolm Harrington in order to inform the design of the Personal medical test as the basis for assessment, but we need to Independence Payment claiming and assessment processes.” 827 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 828

Having said that such a comparison is not possible or conducting assessments has access to a basic standard helpful, the Government go on to say that, after all, of expert advice to which they can turn. Secondly, the they are making a comparison. That seems to be a bit of fact that the guidance would be written down means a muddle. that there would be a degree of accountability on the Let me declare my position. I agree with the second assessor to ensure that this expertise is applied in practice. part of that paragraph, which says that there are lessons Thirdly, having a universal set of guidance would help that we can learn, and disagree with the first part, which to eliminate inconsistencies that might otherwise exist says that it is neither possible nor helpful. It is important in practice between different individuals or between that the design of the PIP assessment process responds different parts of the country. It is possible that that to the recommendations that the Harrington review guidance might also touch on the issue that the hon. identified and set out for the WCA. Member for Cardiff Central raised in her contribution about different practices in different parts of the country I will quote Mind on the lessons that it thinks that we on whether or not an advocate or a friend can attend should learn from the work capability assessment: the assessment process along with the person being “Mind supports the call for clear guidance for DWP staff assessed. The Minister helpfully clarified that that should carrying out the new PIP assessment We know from our experience always be permitted except in exceptional circumstances. of the Work Capability Assessment that DWP staff do not always have adequate knowledge and understanding of the ways in The most recent report by the House of Lords Merits which mental health problems impact upon people’s lives, and of Statutory Instruments Committee states: their ability to participate in society. Nor do they always carry out “In its 23rd report the Committee noted evidence that 40% of the assessments in a supportive or suitable way, as the following appeals against a decision that an individual is capable of work quotes from Mind’s website demonstrate.” are currently upheld, so the quality of the guidance material It draws attention to comments that were made by three provided to staff and the consistency of their decision making will be crucial to the scheme operating as intended.” people who have been through these processes. The first person said: That seems to be an example of a case where the lessons learned from the WCA should also be learned for the “The assessors can hugely influence the answers by how they word the questions or how much they bother to probe to get the assessment process for PIP. I hope that the Minister can full truth. People with mental health problems feel ashamed of welcome the intention of our amendment. how bad things are and are unlikely to easily tell a stranger about their intimate difficulties unless that person bothers to ask in a way that is not judgmental and not many assessors are bothered.” Kate Green: I share with my right hon. Friend a wish to draw on at least some of the lessons that we have The second person said: learned from the experience of the introduction of the “When the documents came through and I saw the report from work capability assessment. As the Minister has the medical assessment I couldn’t believe it - in fact I thought they comfortingly acknowledged, we are discussing a test had sent someone else’s by mistake, it was so full of inaccuracies.” with a very different purpose this afternoon. None the The third person said: less, there are some interesting points that we can draw “When I saw the report I thought they’d muddled me up with on when we look at where some of the discrediting of someone else - it was so far from what happened in that room.” the WCA in the eyes of disabled people and those who It is clear that for people with mental health impairments, work with them has occurred. They perceive that the there is a great deal of scope for getting things wrong. independent assessors, the Atos assessors in the case of This amendment is intended to minimise the likelihood the work capability assessment, are not suitably qualified of mistakes by ensuring that the assessor has access to or do not have a suitable appreciation of or suitable appropriate expertise and guidance. expertise to assess the condition of the person in front of them. Proposed new subsection (7) stipulates that the assessment must be We have heard repeated reports from disabled people who have been through the work capability assessment “performed by an individual who has access to sufficient skills that it felt like a tick-box exercise, that it was routine and expertise appropriate to the impairment type of the claimant.” and that it was not focused on their particular circumstances I am not proposing that the person conducting the and condition. It is really important that for the gateway assessment must necessarily themselves have that expertise. assessment for the PIP we have professional, expert Given the very large number of people who will be people who can temper what will presumably be the assessed—my hon. Friend the Member for Glasgow structured approach to making the assessment with East has talked about the number of people going their own expertise and experience in making judgments through this process—it may not be possible or practical and interpretations in relation to the answers and for everyone carrying out the assessment to have that information that they receive. expertise. None the less, those conducting assessments This is not just a matter of technical expertise. It is should have ready access to somebody who can guide not just a matter of having, for example, someone who and advise them on how to make an accurate assessment assesses someone with MS being a specialist in MS, or of the various types of impairment that they will need someone who assesses someone with a visual impairment to deal with. The precise details of what would constitute having a long-term specialism in blindness. Although access to or sufficient expertise would be set out in that might be useful, it is unlikely to be sufficient if the regulations under this proposed new subsection. person making the assessment lacks what in the business Proposed new subsection (8) specifies that the Secretary context are often called soft skills. Those are the skills of State must issue clear guidance outlining the needs of around empathy and the ability to interpret and to different impairment groups for the use of professionals communicate. Two-way communication was mentioned assessing people under this section, which is important earlier today, and it means that the way in which the for several reasons. First, it ensures that every person disabled person offers a response to a question or an 829 Public Bill Committee10 MAY 2011 Welfare Reform Bill 830 investigation is placed in an intelligent context. That is to that matter; work on developing the assessment is something that disabled people feel has not always ongoing, as it is on the individual skill sets that will be happened in their experience of the assessment for the needed to carry out the assessments. ESA. In his opening remarks, the right hon. Gentleman It is important that the assessor recognises that the described PIP as a medical assessment. It is not a setting in which they meet the disabled people for the medical assessment; it is more of an objective assessment, assessment is not necessarily the only setting in which and that is important. The hon. Member for Stretford that disabled person will want to operate. We talked and Urmston said something similar on Second Reading, earlier about assessing people in their homes. That and it is an important point because that is one of the could be useful and appropriate, but it will only give the things that marks out PIP from other assessments. Now assessor a picture of the way the disabled person works that we have a first draft of the assessment criteria, we in that setting. The person carrying out the assessment will look at the matter in more detail and link it to our will need to be sufficiently expert and experienced to work on testing the criteria. translate what they can see in front of them in the home Early thoughts suggest that PIP will not necessarily setting to the wider social setting in which the disabled be administered by doctors, and that a broader range of person may need to operate. individuals may have more appropriate skill sets and be When I met Atos, the provider of the work capability better able to carry out the assessments. Those include, assessment a few weeks ago, I was interested to learn for example, allied health professionals such as occupational that it uses a whole range of professionals to carry out therapists or physiotherapists. We are exploring that the assessments. Those professionals could be GPs or suggestion in our testing, and talking about it to disabled medical professionals with full medical degrees. They people. It is an important part of building the trust could be nurses with a particular specialism, generalist referred to by the hon. Lady. nurses or occupational therapists in some cases. The Regardless of who is chosen, I assure the Committee explanation that was offered to us was that these people that the assessments, including face-to-face consultations, had had additional training by the company providing will be carried out by fully trained independent and the test, which in a sense rendered their initial professional approved assessors. Assessments for ESA and the DLA qualifications, as Atos saw it, as a matter of secondary are currently carried out only by health care professionals importance. who have been approved by the Department’s chief medical adviser on behalf of the Secretary of State. 5.30 pm Those doctors, nurses and physiotherapists have passed That is all very well if the training that the people strict training and experience criteria and have received carrying out the assessments receive is good enough for additional tailored training approved by the Department. them properly to carry out the tests and to deal with a Similar arrangements will apply for PIP and will include whole range of conditions that they may come across. If broad training in disability analysis as well as training it is not clear that the people carrying out the assessments on specific impairments. As I said at the start of today’s are trusted to understand and appreciate the conditions debate, disability is one word but it has many thousands that they meet and seek to assess, there will a real of different meanings. It is important to get the training credibility problem—Ministers might want to think of health professionals in that area right, and we have about that at an early stage. Will the Minister say learned from the work capability assessment, which I something about the sort of standards that will be put will come to in a moment. into contracts for the assessment process to ensure that credibility in terms of the expertise, qualifications and skills provided by the assessors is both perceived and Stephen Timms: I can well see how the use of real? physiotherapists adds choice of a kind. What sorts of skills would the Minister expect an assessor to have in On who might be given the contract to carry out such the case of people with mental health impairments? assessments, what discussions has the Minister had so Can she envisage a counterpart to a physiotherapist, for far about the specific levels of staff training and qualification example, who could carry out the assessment when the required, and the areas and issues that such training impairment is a problem of mental health? should cover? What monitoring and quality assurance processes does she expect the DWP to put in place to ensure that assessments are carried out by appropriately Maria Miller: I thank the right hon. Gentleman for qualified experts and skilled professionals? Will those his question. The very fact that we are assessing such a processes be kept under regular review, and can she wide range of different disabilities means that we need a assure us that feedback from disabled people who have range of people available to assess. Many people who been through the assessments will form part of that have a more physical disability might have allied mental- procedure? health problems, so I am not sure that one would necessarily want to say that one set of individuals has Maria Miller: I thank the right hon. Member for East one type of assessor and that another set has another Ham and the hon. Member for Stretford and Urmston type of assessor. for their contributions. I fully agree with the right hon. If the right hon. Gentleman will forgive me, he is still Gentleman that the skills of assessors and the training falling into the trap of simply pigeonholing people and support available will be critical to the success of based on their assessment. Many disabled people will the reforms. The hon. Lady put her finger on the issue have a physical impairment, a sensory impairment when she said that if we are to engender trust, we must and perhaps even a mental-health impairment. I do have a group of people who are appropriate and have not think that we can go down the route that he is the right skill sets. We are giving a great deal of thought suggesting. 831 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 832

Stephen Timms: I presume that the Minister would There is a great deal to be learned from Harrington, not argue that a physiotherapist would be an appropriate and I hope that the right hon. Gentleman can understand person to make an assessment of an individual when a where the mix-up has come in terms of his interpretation mental-health problem was being assessed. What kind of the policy document. Ensuring that an individual of people would be appropriate in that case? who has been assessed has the opportunity to feed in properly and that their voice is heard; that evidence is Maria Miller: People who have access to trained gathered from the right people; that assessments are individuals who have specialisations in mental health conducted by people with the necessary skills and training; could well be how that problem would be dealt with. and that those assessors have access to expert support This is one of the many lessons that we are learning. where it is needed—we have learnt all those things very Perhaps I can use the Harrington review as an example; clearly from the Harrington process, and we will take the right hon. Gentleman highlighted that he felt somewhat them forward to the assessment and PIP. confused about some of the information put out by the On the other aspects raised by the right hon. Gentleman, Department on Friday about the policy documents that I should say that fluctuating conditions have come up we have issued around the assessment criteria. To clarify consistently. All hon. Members would expect that; it is that for him, I should say that we are learning and will very much to the fore of all our minds. It clearly always learn from what we are doing with the WCA. exemplifies why we need individuals who have the right The policy document that he was referring to discussed sort of training, but also have access to experts in other the assessment criteria. It would not be helpful to try to areas of disability to ensure that they are able to identify learn from the assessment criteria of the WCA in particular, accurately when somebody is dealing with the realities because those criteria are to do with work, not everyday of a fluctuation condition. We have designed the draft living, which is what PIP will be looking at in future. We criteria to take account of physical, sensory, mental, can learn from the development process of the WCA intellectual and cognitive impairments, and it is essential and from its implementation. that this assessment also deals effectively with variable We can particularly learn from the issue that the right and fluctuating conditions. hon. Gentleman raises about the professional skill set The assessment will not—I repeat, not—be a snapshot of the people undertaking the assessment. That is probably of one day, but will consider an individual’s ability to one of the biggest things that we have learned from the carry out activities over a period of time; we are suggesting whole Harrington process. Harrington clearly said in a year. We will consider impacts where they apply for his report that there is a need to ensure that those the majority of the time. The expertise of the assessor in undertaking assessments have good qualifications and looking at that on an individual case basis will be an access to the sort of expert advice that the right hon. important part of getting the implementation of this Gentleman mentioned. We are considering, therefore, new assessment right. That is why we will continue to the use of mental, intellectual and cognitive champions look at the skill sets of assessors, with disabled people to support the assessment process for PIP in much the and their organisations, to ensure that we get the balance way that Professor Harrington discussed developments right and that we have in place the sort of expert in how we ensure that we have the right assessment training that the hon. Member for Stretford and Urmston skills in place for the WCA. talked about.

Kate Green: Will the Minister say whether she has Finally, I would like to turn my attention to the any plans to make use of the expertise of specialist requirement to issue clear guidance. As expected, we disability organisations in offering training, particularly will shortly begin the commercial process to identify awareness training, to potential assessors? For example, who will be responsible for undertaking the personal I know that the National Autistic Society has offered to independence payment assessment on a national basis. I provide such training to the DWP and its contractors in assure the Committee that, whoever is successful in this the past, but it feels that, from time to time, its offer has process, clear guidance on how specific health conditions fallen on deaf ears. or impairments should be assessed will be available to staff undertaking the assessment. That guidance will also be made available to the public. Maria Miller: There are two responses to that. One is “absolutely.” Drawing on the experience of the WCA We will also ensure that there are clear monitoring and the role of some of the mental-health charities in and quality assessment and assurance processes in place, supporting development in that area, we will be looking in much the same way as we spoke about earlier today to work closely with specialist organisations in the in the debate about the provision of Welsh language training that is put forward. I would, however, take that access. It is that sort of quality assurance process that one step further and say that we also need to look at the can help to ensure that we give every person who applies important role that user-led organisations can have in for the personal independence payment the sort of helping disabled people in this whole process. quality assessment and experience that we expect. The hon. Lady may be aware of an announcement Given those assurances, I hope that the right hon. that I have already made about a £3 million pot of Gentleman will feel that we have a shared agenda. money to help develop the role of such organisations Given my clarification on what was included within the throughout the country. In some areas, such as Norfolk policy papers that were issued on Friday, I hope that he and Essex, we have strong user-led organisations, but is assured that we will be learning very much from our we do not in other areas. It is that sort of user-led experiences of the WCA, some of which were as a organisation that can provide a great deal of support result of the work that he did when he was a Minister in for disabled people through this process, and that will this Department. I hope, therefore, that he will withdraw be extremely important as well. his amendment. 833 Public Bill Committee10 MAY 2011 Welfare Reform Bill 834

Stephen Timms: I am grateful to the Minister for her It is worth reminding the Committee again of the clarification that the briefing note did not mean what it huge scale of the operation that will be required to said. I will draw her attention, again, to how it actually assess people for PIP. My hon. Friend has already reads: referred to this. Some 1.8 million working-age people “Any direct comparison between the Work Capability Assessment who currently receive DLA will have to go through the (WCA) and the new assessment for Personal Independence Payment new assessment by the end of 2015 and beginning of is not therefore possible or helpful.” 2016. On top of that, there will be a steady stream of I am glad that she is making such comparisons and that new applicants and a fair number of appeals. We are she is willing to learn the lessons from that. considering a very large number of people having to be assessed for PIP over a rather short time. If the Government 5.45 pm get this wrong, or the process starts to go wrong, the The Minister’s suggestion that physiotherapists might implications could be very far-reaching and there would be used in future to assess people with mental health not be much time to put things right. impairments could cause some concern. A lot of work would be required to assure people that those individuals Harriett Baldwin (West Worcestershire) (Con): I wonder can make accurate assessments. I am not ruling out the whether the right hon. Gentleman has read section 7 on possibility of such people being used, but a lot of work page 12 of the briefing notes. It goes into the timetable will need to be done. I am grateful to her for recognising in great detail. It outlines how the process might be that much hangs on this measure and that a lot of work tested and refined and then tested again. I just want to will have to be done to ensure that it is an effective understand his distinction between testing and piloting. process. As I do not intend to push my amendment to a vote, I beg to ask leave to withdraw it. Stephen Timms: The pilot for which I am arguing has Amendment, by leave, withdrawn. the characteristics set out in the amendment. However, as I said, it should be in one or more specified areas, not Stephen Timms: I beg to move amendment 219, in just in one place or a particular centre. The pilot should clause 78, page 56, line 40, at end insert— assess the impact on specific, identified groups of people, ‘(10) The assessment process specified in Regulations under including those with fluctuating conditions and mental subsection (3) shall, prior to its national implementation, be the health conditions. After the pilot has taken place, the subject of a pilot, which— Secretary of State should produce a written response—an (a) shall operate in one or more specified areas; and assessment—of the experience of it. If one could have a (b) shall assess the impact on specific groups of people, test with all those characteristics, I would be perfectly including those with fluctuating conditions and mental happy to say, “That’s fine and will do.” At the moment, health conditions; and I do not know whether it does. Perhaps the Minister will (c) shall receive a formal response from the Secretary of State.’. set out for us in a moment whether the test that she envisages will meet those three criteria. The amendment intends to insert in the Bill a requirement that the medical assessment to ascertain eligibility for There are several specific reasons for needing to be PIPs should be the subject of a pilot before its national cautious about the matter. First, and probably most implementation. It specifies three characteristics of the importantly, we need to ensure that the process assesses pilot. First, it should operate in one or more specified people’s circumstances properly. As we have already areas. Secondly, it should assess the impact on specific discussed, we need to learn that lesson from the groups of people. Thirdly, it should be the subject of a establishment of the WCA. The Minister made the formal response from the Secretary of State. Although point that the process is likely to be iterative. I hope that it is a relatively modest amendment in its scope, establishing most of the iteration will take place in the piloting a proper pilot is important for ensuring that the transition before we start applying the assessment to people who to PIP is not fraught with problems. We debated some currently receive DLA. If we are still trying to modify of the reasons for that when we considered the previous the system once we are in the large-scale process of amendment. putting existing benefit recipients through the new assessment, that could be a recipe for serious problems. My hon. Friend the Member for Glasgow East has I suspect that that point is likely to be made at the rally already made it clear that we do not oppose the and event tomorrow. establishment of an objective test to assess eligibility for PIP, and we firmly supported the reform of the gateway. There are certainly lessons to be learned from the None the less, the Government need to tread very WCA. Obviously, as the Minister says, I was involved in carefully.We have already heard some sensible suggestions, setting up the employment and support allowance and including those from the Liberal Democrat members of therefore in setting up the WCA. However, the Harrington the Committee. The hon. Member for Cardiff Central, review pointed out that the process still needed further who is not in her place at the moment, was rebuked by refinement. For instance, Professor Harrington found the Minister earlier for talking about a pilot when she evidence that some mental health conditions might should have referred to testing. I am much more persuaded currently be inadequately assessed. It is probably unrealistic by the suggestion of the hon. Member for Cardiff to expect any new assessment process to be entirely Central here. I am not quite sure what the distinction is without fault at the beginning. That is why we need to between piloting and testing. Perhaps the Minister can do everything possible to iron out the difficulties as clarify that in her answer. Perhaps the difference is in early as possible in a pilot phase, rather than once the the scale and the seriousness of the exercise that is assessment is being used in earnest. envisaged, with piloting being a step higher than testing. It is of the utmost importance that we identify and If that is the case, I feel that piloting is the appropriate address as many problems as possible before the assessment action. process is implemented across the country. A proper 835 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 836

[Stephen Timms] which the Government need to work hard to minimise. Being able to point to proper pilots along the lines I pilot would help us achieve that. Launching into a described would help. large-scale exercise of reassessing people who are financially The Scope submission quoted one survey respondent dependent on DLA using a test that had not had the who said: difficulties thoroughly ironed out would create a serious problem. Significant numbers of people would lose “If I lose DLA, along with the changes to other benefits, I fear becoming homeless.” benefit unfairly and would be caused a great deal of distress unnecessarily. I hope that the Minister agrees Leonard Cheshire Disability quoted someone who said: that we should avoid that. “I am happy at the moment in my life; I get to go out and see friends and family. However, if DLA mobility is taken away I will be a prisoner in my home!’” Ian Swales (Redcar) (LD): Will the right hon. Gentleman tell us whether his Government did such a thing when Those individuals, whose circumstances we do not know the work capability assessment was introduced. If so, much about, might well go through the assessment how did it go; and if not, why not? process and find themselves completely protected, so that they do not lose out at all. However, a lot of people do not feel confident in that. A proper pilot process Stephen Timms: We did and, of course, the big difference would help disabled people to feel confident that the with the work capability assessment is that that has not new system will be clear, fair and transparent. as yet been applied to existing recipients of incapacity Many stringent criticisms have been levelled against benefit. It shortly will be. By the time it is and the the work capability assessment, and Professor Harrington’s Government have set out their proposals for doing so, recommendations on how it can be improved have been we will have had a number of years’ experience of how accepted. We have the opportunity to avoid such negative it works for new applicants. The difference here is that perceptions when the PIP is introduced. While I am the new assessment will be applied from the start to talking about what outside organisations have said, I people who are dependent on disability living allowance. refer to a point made by Mind on the lessons to be learned from the work capability assessment: Ian Swales: I have one point of clarification. Was an “In order to avoid the significant problems that have arisen initial phase done in a specific geographic area or was it with the WCA, it is vital that the new PIP assessment is piloted rolled out nationwide? extensively to ensure that it is working fairly and effectively before it is extended to all DLA claimants...it was only when the assessment was independently reviewed by Professor Harrington that the Stephen Timms: Once the ESA was introduced in DWP would recognise the flaws in the process. It is of fundamental September 2008, if I remember rightly, it went nationwide importance that an assessment of this kind is both valid and —but, as I said, for new applicants only. My concern is reliable, and that any issues flagged-up by such a pilot are properly that what we are discussing will be rather different. addressed before moving forwards with full reassessment.”

Kate Green: We learned considerably from the experience Charlie Elphicke (Dover) (Con): Does the right hon. of the work capability assessment and, in particular, Gentleman accept that the case put by Mind is that the difficulties were uncovered when it was being piloted for work capability assessment is somehow ineffective and roll-out nationally. Does my right hon. Friend agree riddled with problems? with the suggestion in our amendment not only that there should be piloting but that full implementation should not take place until the consequences of the 6pm pilot and the learning from it have been taken on board Stephen Timms: No. What it points to is that the and implemented? work capability assessment has needed significant modification and refinement since it was introduced for Stephen Timms: My hon. Friend makes an important new applicants in October 2008. We have had two and point. We have a later amendment suggesting a period half years’ of experience now, and in the light of that we in which the new assessment should be applied to new are able to make some changes to it. I am suggesting applicants before being applied to those currently receiving that there needs to be something comparable to that DLA—but we shall come to that debate later. with the assessment process for the personal independence payment. Otherwise there will be serious problems when A second reason is that, regardless of how effective severely disabled people have the new assessment applied the PIP assessment process turns out to be, it will be to them and it is not quite right. valuable for those affected to have the greatest possible confidence in it. All of us have received correspondence from groups who represent disabled people expressing Charlie Elphicke: I am loth to pay tribute, but it deep concern about the replacement of the DLA with seems that the work capability assessment was an inspired the PIP. The Government need to recognise that a piece of work by an inspirational Minister. I put it to substantial number of disabled people currently receiving the right hon. Gentleman, while I am blowing sunshine and financially dependent on DLA are terrified at the around the Committee room, that many of the lessons prospect of the changes proposed. learned from the work capability assessment should in I am not saying that the Government should back off principle be transferable. Is it not the case that many of or not proceed, but they must recognise that a lot of those things can be learned and taken on board from people are very anxious. For a large number of people, the improvements that have been made in the past two the planned new tests will cause a great deal of anxiety, and half years? 837 Public Bill Committee10 MAY 2011 Welfare Reform Bill 838

Stephen Timms: I am grateful to the hon. Gentleman There is a danger of rushing ahead too quickly, for his kind remarks. I think that it is probably either my before the assessment has been properly worked through, right hon. Friend the Member for East Renfrewshire and the difficulties identified and removed. There is no (Mr Murphy) or my right hon. Friend the Member for point putting people through a flawed assessment process, Kingston upon Hull West and Hessle (Alan Johnson), only for it to be necessary to assess them again, perhaps the former Secretary of State, who deserves his generous through an appeal mechanism when the problems have tribute. been ironed out. If the Government proceed too rapidly without the necessary safeguards in place, they may I agree with the hon. Gentleman—I am glad that the waste a lot of money instead of saving it, as well as Minister has accepted it as well—that we do need to causing a lot of unnecessary anxiety. The three compelling learn lessons from the WCA process for the one we are reasons for proceeding carefully and starting with a embarking on. It seems that the stakes are a lot bigger proper pilot are to ensure that people’s circumstances here, because many people who are financially dependent are assessed accurately and fairly, to allow disabled on DLA feel a good deal of uncertainty about their people to have full confidence in the process, and to position once they have been through the new assessment ensure that we do not end up wasting money by for PIP. Some extra work to reassure them at this stage implementing a flawed assessment. would be well worth doing. That is the aim of the amendment. The amendment proposes that the pilot should show three characteristics. The first is that it should operate Now that the hon. Member for Cardiff Central is in one or more specified areas. In that way, it should be with us again, I will repeat the point that I made earlier, possible to ensure that the pilot covers a reasonable that I agree with her about piloting; I am less convinced cross-section of the population demographics and the by what the Minister said about testing. I think she was different circumstances in different parts of the UK. right to use the word “piloting”, although it may be that That should be possible by choosing areas. we mean the same thing. I look forward to the Minister’s Secondly, the amendment proposes that the pilot explanation of the testing she has in mind. This needs should assess the impact of the assessment process on to be a serious exercise because of how much is at stake. people with specific types of medical impairment or The case is strengthened by the fact that on paper the disability. This is a radical overhaul of access to disability new gateway looks very like the work capability assessment. benefit, and there could be types of impairment that are I have some sympathy with the assumption made by the not assessed adequately at the first attempt. The amendment hon. Member for Cardiff Central that Atos would draws attention to two that we have already discussed: apply. She was rebuked by the Minister, because of fluctuating conditions and mental health impairment. course there has to be a tendering process. It is difficult It is right to spend a fair amount of time and effort to to understand who might do it, other than Atos in ensure that the assessment process works well. practice. That is certainly the view of the disability The third characteristic of the pilot is that it should organisations, too. I can understand why the hon. Lady be the subject of a formal response by the Secretary of made that assumption. State. If the pilot is to be effective, there should be a Another reason why the case for piloting is even statutory requirement on the Government at least to stronger is the scale of the exercise—the 1.8 million respond to its findings, and to put them in the public people to whom it will be applied from the outset. Right domain. That would help to ensure that the lessons of from the beginning, the intention is that existing DLA the pilot were learned and applied instead of being recipients will have this assessment applied to them, not ignored. Perhaps more important, it would help to give just new applicants. We have a later amendment on confidence to existing DLA recipients and others who schedule 10, suggesting that that will be ill-advised. I will apply for PIP in future that their concerns will be will not run through the arguments now. However, that properly addressed. also highlights why the case for piloting is so important. There is a strong case for a pilot of PIP, given the The stakes are very high indeed. If there are any doubts scale of the proposed changes and the number of people in Committee today, they are likely to be vanquished by who will go through the assessment. The case for it is the rally and the representations that all of us will very strong and, like so much in the Bill, the effects of receive tomorrow. precisely what the Government are going to do will hang on the detail. I hope that the Minister recognises There are also financial considerations to be aware that the amendment would take us in the right direction. of. There is a great deal of concern from people with disabilities that the Government’s approach to PIP is being dictated essentially by a cuts target. The Government Sheila Gilmore: It is important to look not only at a have decided that they need to make 20% cuts, and the test—the criteria against which people will be measured— finer points of how they do that are a secondary but at the whole assessment process. Some of the discussion consideration. That is the worry for organisations that has been about the independent test in which people represent people with disabilities. The truth is that too must show how they cope with certain day-to-day activities, much is at stake for too many people. The Minister whatever they might be. I fully understand that we need assured us that her approach is principled, and I welcome to get that correct—deciding what ought to be measured that, but it was not clear during the debate on ESA. I and how to do so—but we must also look at the am pleased that she has been able to affirm that, on this assessment process, almost from start to finish, to see issue, the Government’s starting point is principled, and how it works in practice. A pilot would enable that to be that the budget consequences must be worked out second, done. and not be determined up front, which is a worry Although the test is different, some of the process because that would be the wrong way of going about could be similar to that of the ESA. The first Harrington reform. report told us about severe flaws not only in the kind of 839 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 840

[Sheila Gilmore] used those terms interchangeably in my previous existence. However, in Government circles, pilot takes on a different criteria being measured and whether the narrow test legal meaning. was correct, but in the process as a whole, including If we piloted PIP, we would have to take legal powers what sorts of information were looked at, what weight to reassess entitlement to disability living allowance and was given to the Atos testing process, Harrington’s assess entitlement to PIP by taking an approach termed criticism that there was too much rubber-stamping of “testing” as opposed to “piloting”. We could therefore that test when decisions were made, what happened examine the impact of the new assessment on recipients when decisions were made and how few decisions seemed of DLA without withdrawing their entitlement to their to be given a reconsideration, for example. All that was current benefits. That is important because, as the right really about a process. hon. Gentleman drew out very well in his contribution, If we want to get this right, we ought to have the we are trying to introduce an assessment that will enjoy opportunity to see how it works in practice. I suspect the confidence of disabled people and not in any way that looking at certain small bits and consulting on put them in a position of feeling anxious about the others will not reveal some of those flaws. Many aspects support that they will receive. of the ESA probably looked okay or viable until the One of my concerns about taking the right hon. new applicants became a pilot. I am not convinced that Gentleman’s approach, given the legal implications of a that was the right thing to do. However, what gave rise pilot versus a test, is about what would happen to to considerable concern among those who experienced individuals who were reassessed in the period during the process, the organisations supporting them and which we were reporting on the pilot. If we set aside the many of us who met constituents and dealt with such word “pilot” and consider the content of what he issues was the fact that, so often, the people who suggested, he might find that there is little difference appealed were successful in those appeals, thus suggesting between our approaches other than that slightly legalistic —endorsed by Harrington, I think—that a symptom of term. I think that that is the case, and I am sure that he something flawed in the process. We sometimes talk too will let me know if it is not. narrowly about that part of the process which is the Our approach to testing clearly meets the right hon. independent test. Gentleman’s first two criteria of being able to operate in We do not need to get precious, necessarily, about one or more specified areas and evaluating the impact who did what and whether it was right before. When I of the new assessment on specific groups, including first encountered people having difficulties with the people with fluctuating conditions. On the third—to ESA process, I agreed that we had to take action to receive a formal response from the Secretary of State—we reach a situation in which people were not pushed into a will publish a report and provide an update to draft siding for a long time, on a benefit perhaps because it regulations in time for that to be discussed in the other was more convenient for them. However, when I recognised place, as I mentioned earlier. We have similar objectives that individuals had serious difficulties with the process for the next set of activities; perhaps we are just calling that they were being put through and that their lives them slightly different names. were being made very difficult indeed, I realised that there is a huge difference between having an idea—a good idea—and the practice and implementation. Stephen Timms: I am encouraged by what the Minister has said about the clause. Is she saying that some of the If we have the opportunity and time to carry out a testing will have been carried out by the time it is pilot, it would be a means of avoiding some of the debated in the other place? I am anxious to establish unnecessary mistakes and expense. The expense of the that after the test or pilot, whichever it is—I, too, appeal process that might result from a flawed assessment thought that they meant the same, but I stand corrected process could be avoided if the work was done in by her explanation—a report should be written about advance. I hope the Minister is prepared to consider the the lessons learned from it. Will that document be amendment. available in time for the debate in the other place, because that implies that the testing is imminent and Maria Miller: This is another turning point in our will have to be brief? debate. I was pleased to hear the right hon. Member for East Ham say that we had reassured him on taking a Maria Miller: As I have said, in the summer, we want principled approach, which is first and foremost in our to move forward to testing the draft criteria on current minds. I am glad that he understands the need for an recipients of DLA, and we will consider our findings objective test and for the reform of the gateway. I hope from that before the Bill reaches the Lords. We anticipate that, in this debate, I can also reassure him about our producing information about that testing in advance of approach to testing. We all have the same objective: we the debate there. want the assessment and the process by which it is It might perhaps help the right hon. Gentleman if I administered to be effective for disabled people from go through exactly what we intend to do in more detail. day one. Drawing very much on the findings of the WCA, our approach will give us far more flexibility than the sort 6.15 pm of mass-scale pilot that was done in the past. This week, At the risk of being pedantic—I hope I did not as he will know, we published an initial draft of the rebuke my hon. Friend the Member for Cardiff Central, assessment criteria, but that is absolutely not the end of but if I did I apologise profusely; it was not my intention our development work. We will continue to refine those to do so—I simply drew attention to the fact that initial draft criteria as we move forward, working with “pilot” and “testing” apparently do not mean exactly disabled people and their organisations to ensure that the same thing. My background is in marketing, and I the criteria work as they need to. 841 Public Bill Committee10 MAY 2011 Welfare Reform Bill 842

We will then test the criteria over the summer, to The group will form part of our development and ensure that they accurately and consistently assess testing process. That approach is important and has individuals, and consider the impact of the assessment. been well thought through as a way of working actively As part of that testing, we will consider the impact of together with disabled people to refine both the assessment the assessment on specific impairment groups, such as and the operational processes with hands-on involvement, those with mental health conditions, learning disabilities instead of simply putting an assessment into a pilot and sensory impairments. The exercise will provide a area and then walking away from it for six months and vital opportunity to learn, early on and without affecting seeing what happens. We will work with people on an customers’ current benefit claims, how the new assessment iterative and hands-on basis to obtain solutions to the criteria will work on the ground. It will be a safe problems that arise, instead of simply walking away and environment in which we can understand how the new waiting for a report to be written. I think that that is the assessment will work. right approach. Testing and our work with disabled people’s organisations Of course, we are seeking to learn from our experience will inform the next draft of regulations to be published of the WCA, and as part of that we are looking closely in the autumn and the Bill’s final stages in the other at the processes used in ESA, particularly the pilots place. We will also consider further testing afterwards around Aberdeen and Burnley. We are also drawing along similar lines if we think it necessary. The resulting further on Professor Harrington’s report to see how regulations will, of course, be subject to full parliamentary we can ensure that we have maximised PIP’s design scrutiny, including debate under the affirmative procedure. beforehand.

Stephen Timms: The Minister has set out some of the groups that will be assessed in the test. Will she add Stephen Timms: Will the Minister indicate the envisaged people with fluctuating conditions to the list that she scale of testing? Are we talking about dozens or hundreds read out? of people? What is the approximate order of magnitude?

Maria Miller: It would be almost impossible not to consider fluctuating conditions when considering individuals Maria Miller: As the right hon. Gentleman will expect, with mental health problems or, indeed, many of the I need assurance that our testing is robust and will other impairments that I outlined. I can absolutely and provide the sort of evidence that the Government can fully assure the right hon. Gentleman that my right have confidence in. I will write to him with more details, hon. Friends the Secretary of State for Work and Pensions but I anticipate that it will involve many hundreds of and the Minister of State and I will consider the issue people—several hundreds, I am told. He may be aware closely. We want to get it right from the start, and we that we have done some initial probing work with DLA will do everything that we can to ensure that. recipients already, as part of the initial criteria development phase. This is something that we are putting at the heart of our work. Ian Swales: On fluctuating conditions, we talked earlier I want to drive home the point that we are undertaking today about advocacy. To what extent will the process a more holistic, end-to-end test of the process. Picking take account of relevant medical information? I am up on the points made by the hon. Member for Edinburgh thinking of conditions such as ME. Medical records for East, we are ensuring that we know how the process will sufferers would be very relevant to the assessment. Will work end-to-end before it is introduced in April 2013, they be available to the assessors? again reflecting some of the lessons learned from the Harrington review and involving co-production with Maria Miller: The hon. Gentleman brings up an disabled people. important part of the testing process, which will involve In addition to those assurances, the Bill requires the ensuring that the right information is available. He will Secretary of State to commission an independent report recall from earlier debates today that the Government on the operation of the assessment when it has been want to take a flexible approach to what information is implemented and to lay that report before Parliament. taken into account when an assessment is made. Other That thorough and fully independent review will allow members of the Committee will consider that issue, us properly to decide how the assessment is working particularly as we go through our testing processes. and its impact, thus allowing us to refine it if necessary. Alongside that, it is important to pick up on In contrast with DLA, providing the assessment criteria another point, as the right hon. Member for East Ham in regulations will enable us quickly to change things as did in his remarks. This is not just about the assessment; and when we believe it would be prudent to do so. That it is about the operational post-processes as well. is an important innovation that PIP offers. We are already involving disabled people and their I hope that my comments reassure the right hon. organisations in the development of the benefit’s Gentleman that, although we do not intend to pilot, we administration, including the assessment process. We intend to achieve the objectives that he set out in his are setting up a dedicated personal independence payment amendment before we implement PIP, utilising the implementation consultation group, as I mentioned, experience of disabled people, and to evaluate its impact which will draw on a wide number of national and after implementation. Adding formal pilots would delay grass-roots, user-led organisations. The first meeting these important reforms and the important benefits will be held next week. We want to ensure that we that they will bring for disabled people. On that basis, I involve disabled people at all stages of the operational hope that the right hon. Gentleman will find it appropriate design. It is no good getting the assessment right if the to withdraw his amendment, but I will listen to his operation does not work in practice for disabled people. comments. 843 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 844

Stephen Timms: I do not agree with the Minister’s criteria; the consortium has come up with three. There final point. It is so important that the assessments are is a bigger issue in the context of the activities of daily right that if the price is a bit of delay that is well worth living. Can the Minister say something more about the having, because proceeding with a flawed assessment rationale for the list of nine that the Government have would do so much damage. Nevertheless, the Minister come up with in contrast to the alternative proposal? has made some helpful points and provided some information that I was not aware of. I should like to Maria Miller: I thank the right hon. Gentleman for reflect on what she said. I do not know whether she will initiating this stand part debate and for giving us the write to me, but if she does, perhaps she will reflect on opportunity to talk a bit more broadly about such that information as well and consider whether the proposals matters, although I will focus my remarks on the issues that she has set out this afternoon are sufficient for the he has raised about the activities that are included in the job that needs to be done. For that reason, I will not assessment criteria. The assessment criteria that we press the amendment to a vote and beg to ask leave to have put forward have been developed by an independent withdraw it. group of specialists in health and social care and disability. Amendment, by leave, withdrawn. That group includes a wide-range of professionals who have looked at what they feel are the most important 6.30 pm proxies for assessing somebody’s care and mobility needs. The activities that they have chosen—and I emphasise Question proposed, That the clause stand part of the that they have chosen them, because we wanted that Bill. sort of independent advice on this—provide a more holistic assessment of the impact of disability than the Stephen Timms: I have a question for the Minister. existing DLA criteria, considering the impact of the full The clause is about the ability to carry out daily living range of impairment types. For example, the introduction activities or mobility activities. The note that we were of communication, as has been mentioned, is a significant sent at the end of last week explains that the proposal is departure. to focus, under the daily living heading, on key everyday I have only just seen the Disability Benefits Consortium activities essential to enabling participation and submission, but we welcome the active involvement of independence. We have been told in the briefing that such groups in the discussion that we will have on the there are nine such activities: planning, buying food and assessment criteria. I welcome the time that the consortium drink, preparing and cooking food, taking nutrition took to look carefully at our proposals to see whether and so on. there are other areas that might need to be addressed. I The Disability Benefits Consortium, which I think can assure the right hon. Gentleman that we take all only saw that note yesterday when it was made more such submissions very seriously, and we are looking widely available, is—as the Minister will know—critical carefully at whether there are other ways that we can of that approach and has described it as a “tick-box hone and shine our assessment criteria to ensure that approach.” It has made it clear that it would prefer what they are the best that they can be. I underline, however, it describes as a more holistic approach. However, it that we are not trying to be able to take into account says that given the Government’s commitment to a set every aspect of an individual’s life, and I am sure that list of criteria, it has proposed an alternative set of eight the right hon. Gentleman would agree that that would criteria, which it argues assess the wider range of activities be unmanageable. We are looking for a reasonable set of necessary to leading an independent life. They provide a proxies to assess the abilities of an individual to participate more accurate measure of the costs faced by disabled in everyday life. people. Those eight criteria are, first, maintaining a clean and safe living environment; secondly, preparing Stephen Timms: I appreciate that the consortium list for the start or the end of the day; thirdly, social is new—of course, I think that the consortium did not participation; fourthly, communicating with others; fifthly, see the Government list until yesterday. The consortium preparing and consuming food and drink; sixthly, list contains communicating with others, which is also maintaining health and condition management; seventhly, in the Government list, but separately, its list contains dealing with utilities, such as gas and electricity; and “social participation”. It struck me, looking through eighthly, adaptations. the other items on the Government list, that there is not Looking at the consortium’s list of eight there clearly really anything that addresses that, apart from the point is not surprisingly some overlap with the Government’s about communicating. I think that one can see the list. However, it is clear that the consortium’s list is reasons why one might want to consider the ability for wider in scope than that of the Government. It could be people to participate socially in a broader way, and I argued that the consortium’s list contains a more rounded wonder whether the Minister thinks that there may be appreciation of what is involved in securing independence some merit in that. and is perhaps a fuller list of the things that ought to be considered when dealing with what the Minister has Maria Miller: Behind some of our thinking on said she wants the assessment to take into account. The communication is the very issue that he raised—the Government’s list, which was sent around at the end of ability for an individual to communicate with people last week, by contrast, is rather narrower. The consortium’s who they know well, and those who they know less well. list is a more rounded set. Some innovations that we have been discussing on Is the Minister in a position to comment on why the mobility will also have a beneficial effect on people’s Government’s list of nine is better than the consortium’s ability to be part of their community. An important list of eight? I could ask a similar question about the part of that is being able to have that social interaction, mobility assessment—where the Government have two and, because the DLA does not adequately take into 845 Public Bill Committee10 MAY 2011 Welfare Reform Bill 846 consideration some of the mobility problems that people disability. That period should be extended from six to with sensory impairments have, the lack of social interaction nine months. Essentially, that is what this amendment can be a casualty of that. seeks to do. I absolutely want to look carefully at all submissions To be clear, we would also extend the required period on the assessment criteria that we have put forward, condition that currently exists around DLA, extending whether they are from disabled people’s organisations it from nine months to a year under the PIP. However, or from disabled people themselves, and we would want we would extend the provision after the receipt of the to do that anyway, even if the right hon. Gentleman had benefit rather than at the beginning. That is the fundamental not raised that point in the stand part debate. As I have point, because we believe that extending the waiting underlined throughout this debate, it is about getting period at the beginning unfairly penalises those disabled this right. I believe that the invaluable help that we have people who need extra help to cope with their disability had from the group of independent experts in developing early on in their treatment. Ultimately, the change that the new assessment criteria has been extraordinarily we are proposing could lead to a reduction in costs. If useful, and I hope that they will be able to work with us we move in quickly to help people and give them the further on looking at suggestions such as those that the support they need, that can stop their condition right hon. Gentleman has cited in the debate today. deteriorating. If their condition deteriorates, that would With that explanation, I hope that hon. Members are sometimes require other expenditure from other parts happy for the clause to stand part. of the state, as it were. Question put and agreed to. Clause 78 accordingly ordered to stand part of the Bill. Charlie Elphicke: I am sure that the hon. Lady can predict what I am going to ask her. Can she tell the Committee what the direct cost of this group of Clause 79 amendments would be?

REQUIRED PERIOD CONDITION: FURTHER PROVISION Margaret Curran: I thank the hon. Gentleman for Margaret Curran: I beg to move amendment 220, in putting that question. I was feeling very neglected by clause 79, page 56, line 45, leave out ‘6’ and insert ‘3’. him. He had not intervened on me once and I was feeling very disappointed about that. I am glad that I attracted his attention sufficiently for him to ask a The Chair: With this it will be convenient to discuss question. the following: amendment 221, in clause 79, page 57, line 3, leave out ‘6’ and insert ‘9’. Of course, the hon. Gentleman is raising a very Amendment 222, in clause 79, page 57, line 15, leave serious point and in preparing the amendment we have out from ‘previous’ to second ‘months’ and insert ‘3 months of course given some serious thought to the associated means the 3’. costs. There are two points that I want to raise with him. First, I pursued the Minister and the Department Amendment 223, in clause 79, page 57, line 17, leave to try to get some figures about the cost of these out from ‘next’ to second ‘months’ and insert ‘9 months measures but the cost is quite hard to determine, because means the 9’. we cannot actually determine the costs. If someone claims the benefit at three months, how would we then Margaret Curran: The amendment would retain the assess the costs? What would the journey be to six three-month waiting period that claimants must wait months? That information is quite hard to extract. before they are eligible to receive the personal independence What we have tried to do is to balance the fact of earlier payment. However, the proposals would go on to extend application and earlier eligibility by extending the period the period that the claimant must show that they will after an application to nine months. I will go on to say be with that disability to nine months, rather than six that a number of the organisations in the sector substantially months, which is currently the case with the disability agree that we can save money if we intervene early. That living allowance. is prevention. Sometimes, if we do not intervene early, a We agree with the extension to a year. We are just person’s condition deteriorates and we might have to arguing for a different balance within that year, because provide substantially more support, particularly social we believe that this is a question of fairness and balance care support. So there is a complex argument about in reform and I will explain why, hopefully quite briefly. costs that the Government, a number of organisations I repeat the point that this change is a part of the and I myself are involved in. reform process that we support. There is a clear case for Secondly, many charities are deeply concerned by the reforming the gateway to the personal independence Government’s decision to make disabled people wait for payment, to ensure that the new benefit goes to those six months before they can apply to receive help. The who need it. I think that we all agree on that. Unlike the Centre for Mental Health, Mind, Rethink, the Royal Government, however, we do not believe that the right College of Psychiatrists and the Scottish Association way to do that is to make disabled people wait for six for Mental Health issued a joint statement, which said: months before they are given the support that they “The early stages of a mental health problem are the vital clearly need to help them to meet the extra costs associated point for intervention to take place and support from PIP at this with living with a disability. We do not think that that is time could have a hugely beneficial and preventative effect.” the right way to go about reform. The Multiple Sclerosis Society has similar concerns, We believe that it would be better to keep the initial saying: three-month waiting period before people can apply for “We are concerned that this will unfairly disadvantage people PIP and instead extend the time after they receive the with sudden-onset needs who will have to wait an additional three benefit during which they must show they have the months to get the vital funds to help them manage their condition, 847 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 848

[Margaret Curran] The Minister and the Government argue that this is a proper recommendation because it aligns DLA with the for example those with MS who experience a bad or disabling waiting period for attendance allowance. I have to ask relapse. By the time that they are able to apply for PIP, the period whether it is right to apply that to people who are of the greatest need may well have passed. They may well have working, many of whom face sudden onsets of conditions experienced significant costs and generated significant debts and that no one was expecting. I do not know whether that difficulties.” parallel is quite as sound as the Government suggest. That quote from the Multiple Sclerosis Society makes it Many we know would argue that it should be the other clear that this issue is not just about ensuring that way around—that the attendance allowance should be people get the help they need when they need it. There is aligned to the three-month period, rather than doing it also an argument for preserving the preventive mechanism, the other way around. I am sure that the Government to ensure that the impairment of a disabled person is and the Minister are aware of that. not allowed to worsen as they sit and wait for half a Elsewhere in the briefing note it states that, in practice, year before the Government take note and help them. It most people will have completed some or all the qualifying is not only an issue of cost but a health issue, in terms of period of the required period condition when their assisting disabled people. claim is submitted. I am not quite sure what is meant by One particular group who are deeply worried—I am that. Is that the six months, or the three months? I sure that the Minister is aware and has had representations presume that that is the three months, but even if it is, as we have had on this side of the House—are cancer I think that adding another few months to that exacerbates charities. In an open letter to the Secretary of State, a some of the conditions that many people face. Throughout group of cancer charities highlighted why the change is the briefing note and, as I said earlier, throughout many especially problematic for cancer patients: Government submissions on the introduction of PIP, “Firstly, we are very concerned by the proposal that people the emphasis is on those with the greatest need. If the with cancer will have to wait six months before they claim the new Government intend to shift the goalposts with DLA Personal Independence Payment (PIP), which will replace DLA. eligibility fundamentally, they must move the supporting We know that even the existing three-month wait for DLA is structures that go with that, and shifting the waiting extremely problematic for people with cancer. Cancer treatment time from three to six months does not do that and, in often starts very quickly following diagnosis and the needs associated with cancer can escalate rapidly. In the first six months following fact, could undermine and counteract the proposal for diagnosis, people with cancer face dramatically increased outgoings people with the greatest need, because sometimes those to cover expenses such as travel and parking for hospital appointments with the greatest need are captured within that three-month and extra fuel costs. Without support for these costs as soon as period. need arises, people with cancer will face increasing levels of Essentially, we recognise the overall framework that hardship and some will get further into debt.” the Government are introducing within the year. I think Without straying too far on to that subject, I know that that some of the charities recognise that shift. We would the Government are concerned about debt. be willing to go with that shift, but there is a question of balance. It is that critical period of three months. We will lose many, many people. Many people will go into 6.45 pm debt. Many people will face enormous difficulty at a The briefing note from the Department has released time when they are already facing difficulty in terms of further details about that and about the required period disability and ill health. I do not think that there is a condition. I think that the Minister will argue that they proper balance and that underlines yet again the deep will go some way to address the point I have just made concern people have about the scale and pace of change. about up-front costs, particularly for people with hospital The amendment asks the Government to reconsider. appointments. The Government acknowledge that there are extra costs at the start, particularly in cases of a Yvonne Fovargue (Makerfield) (Lab): I want to reinforce serious illness such as cancer, or indeed a disability. The my hon. Friend’s remarks. Often, for people who experience briefing note goes on to say: a sudden catastrophic event, the costs come up front in “While we acknowledge that some impairments or conditions the first three months. I will give an example of someone may appear long-term at their outset, and that additional costs who is personally known to me who was mugged and may arise as a result, this may not always be the case. Where disability-related costs do arise early on, for instance as a result of dragged in front of a car. She suffered a serious brain having to make frequent hospital visits for treatment, additional injury. Not only did she have to cope with the costs of support mechanisms provide an element of coverage before the dealing with that and adapting her house, but her qualifying period is satisfied, for example through the NHS travel mother had to give up work to look after her. They costs scheme or other social security benefits.” waited three months, the qualifying period, before her Of course, other interventions are there through the mother could claim carer’s allowance for looking after NHS and through other benefits and such like, and we her. To wait six months would have meant an incredible recognise that. The cancer charities, however, will tell us and catastrophic drop in their income. that that is a particularly narrow example and a very The qualifying benefits that people get from carer’s limited definition, which shows a very limited understanding allowance and from local authorities are important in of the costs involved when people experience cancer, that time, and the loss of income by anyone who suffers sadly. They particularly emphasise issues such as new an illness can be very detrimental. Citizens Advice has clothes, extra fuel costs, aid adaptations and things like said that one fifth of people who get into debt, and such wigs, shoes and special diets, which, if someone is serious debt that they end up in court with mortgage experiencing cancer and having to pay those costs without arrears, do so because of an illness. To extend the much money, really do matter. I ask the Minister for her qualifying time to six months at a time when there are thoughts on that. extra expenses and when extra emotional and physical 849 Public Bill Committee10 MAY 2011 Welfare Reform Bill 850 support is needed from partners and family will put of the gateway to a valuable and universal cash benefit. people in an incredibly difficult position, and I urge the It is our view that the proposed six-month qualifying Committee to support the amendment. period and the six-month prospective test meet the appropriate criteria and are consistent with the definition Maria Miller: We have reached one of the difficult of long-term disability used for the purpose of the points in our debate on disability living allowance and Equality Act 2010 and recently issued guidance connected the new personal independence payment. We are dealing to it. I know that the increase in the qualifying period with difficult issues, as the hon. Member for Makerfield has caused a great deal of comment and concern among pointed out. I will outline the Government’s intention disabled people and their representatives. Equally, as I on clause 79 regarding the amendments, and I hope to have said before, it has actually found some support as provide some clear and genuine reassurance to the hon. well, because of how it simplifies the approach to how Ladies who have spoken. we define disability. The measure to increase the existing qualifying period I want to take the opportunity to stress that most from three to six months is not meant to be a punitive people will not have to wait six months before they start one, denying disabled people access to support. It is our to receive PIP. That is because the six-month qualifying view that support in the short term should be met by period starts at the point when somebody is first entitled existing, albeit mainly means-tested, support mechanisms, to PIP, regardless of whether a claim has been received. with PIP kicking in at a stage when additional costs Perhaps I can provide a practical example of how that become burdensome to all regardless of income. It is works by using the case of somebody who suffers a about balancing the needs of those who can be reasonably serious stroke. From the point of the stroke onwards, expected to meet some of their needs in the short term they could be meeting the conditions of entitlement for with the needs of people who cannot. PIP and would theoretically pass the assessment conditions. In my example, the person has had a stroke, but does Margaret Curran: Can I recast the question that the not submit their claim form until they have completed hon. Member for Dover asked me? Do the Government extensive in-patient hospital treatment and rehabilitation, anticipate savings from the proposal, and if so, what is which may take five months. That would mean that five the scale of the savings? months of the qualifying period have already elapsed at the point that they make their claim, and they would be Maria Miller: I will be honest and open with my in receipt of the benefit soon after. It is an important answer. I would like to reassure the hon. Lady and my point, and one that is often misunderstood, that most hon. Friend the Member for Dover that the principal people will not be submitting a claim on the day that aim of extending the qualifying period from three to six they become entitled to that benefit. In fact, the research months is not about savings. We do not expect the that we have suggests that few people currently make a measure to provide any significant savings. It is a principled claim for DLA before the existing three-month qualifying measure to bring PIP in line with the common definition period has been met, and many put their claim in long of disability used in the Equality Act 2010, to provide after that. We would expect the same sort of pattern of an appropriate measure of long-term disability that can behaviour with PIP. be robustly assessed, and to align with the qualifying As we have heard today, there have been examples of period for attendance allowance. The hon. Member for how those rules already affect many disabled people, Glasgow East asked in the beginning what I have learned and I appreciate that, in some instances, there may be from the consultation. What we learned was that people immediate costs that people incur in the early months appreciated and welcomed the simplification of the when a disabling condition or impairment begins to definitions, which is important for the Committee to have effect. Clearly, that is something that we need to note. take into account, because, as I said at the outset, it is I should thank Macmillan Cancer Support and Disability our view that support in the short term for people who Alliance for their immense work in providing briefings have sudden-onset conditions can and should be met for hon. Members who are participating in the debate. from existing means-tested support, leaving PIP to do I would like to thank them for actively doing that. the job that it was designed for, which is to ensure that I would also like to thank the hon. Member for Glasgow the financial support is in place when those costs become East, in tabling the amendment, for so explicitly accepting too burdensome for somebody to deal with. the principle that PIP is to be paid to people who have After having set our thinking out, I hope that I can long-term conditions. PIP cannot be all things to all provide the hon. Lady with the reassurance that this is people. It is there to provide support for people who an absolutely clear way to pull PIP and attendance have long-term conditions and who are facing some allowance into alignment with the Equality Act 2010, additional costs associated with that, and PIP will go which was enacted under her party’s Government. That some way to try to ameliorate that situation. provides some consistency, which is unfortunately not With disability living allowance, people must satisfy a always the case in this area. three-month qualifying period, as the hon. Lady pointed out, and a six-month prospective test. Those rules were Sheila Gilmore: There have been a number of occasions put in as something of compromise when the old attendance when fairness and equalities have been prayed in aid of and mobility allowances were merged in 1992, and, as certain changes. It would be equally reasonable to equalise the hon. Lady pointed out, attendance allowance continues things in a different way.Just because attendance allowance to apply a six-month qualifying period to this day. has a six-month period, why is that being equalised to While those rules have operated for nearly 20 years—much six months rather than attendance allowance being longer in the case of attendance allowance—we must equalised to three months? Has the Minister also considered consider what an appropriate measure of long-term the concern of cancer charities that there are considerable disability is in the 21st century, which should form part additional expenses that are not met by other sources? 851 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 852

7pm older. Therefore the loss of income for people who are claiming PIP in the first three months is likely to be Maria Miller: I understand the hon. Lady’s point. much greater. The definition of long-term disability in the Equality Act is consistent with our approach. We are taking our lead from the pretty fundamental pointer in the way Margaret Curran: I thank my hon. Friend for making that Parliament has chosen to define disability in the that substantial point. It goes some way to confirm my past. The hon. Lady may not agree with the Equality hesitation about the Government’s approach. Act—I do not think she was in Parliament when we debated it in detail before the general election—but that Maria Miller: I am sorry to interrupt the hon. Lady, is certainly the principle that we are following. I hope but I want to make it clear that PIP is not an income she will think that is an appropriate thing for us to do. replacement. If an individual loses earnings, they will Another point that I should clarify, as it is something be able to apply for the appropriate out of work benefits. that the hon. Lady picked up on, concerns people who I wanted to make that clear because there is so much have to reapply for PIP, which is particularly pertinent confusion about the role of DLA, and I do not want for individuals whose condition may deteriorate following that confusion to roll over into PIP. a period of remission. An individual in that situation will not have to fulfil the qualifying period again. Hon. Margaret Curran: Of course, the Minister is right Members may be aware of that but I want to make it about that, but I think that my hon. Friend was making absolutely clear. I hope that with that set of comments a slightly different point, although it was connected. the hon. Lady will feel it appropriate to withdraw her amendment. Kate Green: Does my hon. Friend share my puzzlement at that remark from the Minister? DLA and PIP are not Margaret Curran: I thank the Minister for the many means-tested, as the Minister said, yet she implied in points of clarification that she offered this afternoon. I her remarks earlier this afternoon that need in the first pay tribute to her good manners. I should also thank all three months will be met by means-tested support. I am the organisations for their briefings. The Opposition do not sure what she is talking about. not enjoy the same level of support as the Minister does from her officials, so those briefings are greatly appreciated. Margaret Curran: That question of other support is That is evident today from the way we have used them. why I am so troubled by the Minister’s contribution. It May I also thank the Minister for clarifying the point is clear to me—it is a hard reality that we were obliged about savings? This is a debate about how we manage to address in government—that many people in that the reform. There is some disagreement between us on three to six-month period will have no other support that, but I appreciate her clarification that this is not a available. That is what the cancer charities have laid out drive to save money and that essentially we are having a in graphic detail. Some support might be available, such different discussion about that. as NHS support for travel costs, but substantial support I am not broadly persuaded by what the Government is not. The charities tell us directly that if we take away are doing. With the greatest respect to the Minister, I do that benefit, restrict it even more or change the period not think that she realises the scale of concern that from three months to six months, people will be in organisations have about the measure and the personal substantial need and will fail to have that need addressed. impact it will have on a number of people who have had The Minister said that the measure is not about experiences in this area. My hon. Friend the Member savings and that there is no drive to make the Government for Makerfield made a significant point and gave a do it. I cannot see that there is any strong rationale for graphic illustration quoting the evidence from Citizens the measure other than tidying up, which seems to be Advice about the reality that people face. The Government the argument that she is making. Given that, I do not should be guided by that reality. think that we should take this step. It would have such a Perhaps the argument is about what is short term and negative impact on the circumstances of people in what is long term. It seems to me reasonable to stay particularly difficult need. with three months and balance it out by nine months. As I understand it, we would be consonant with the Lilian Greenwood: I want to pick up on the point requirements of the Equality Act if we went for three about consistency with the Equality Act. Is it not the months and nine months, rather than six and six as the case that conditions including HIV, cancer and multiple Government propose. The Minister made my argument sclerosis are automatically included in the definition of for me in some ways with her example of a stroke disability under the Act from the point of diagnosis, victim. I have not heard anything to convince me that it with no waiting period of three, six or 12 months? is reasonable for a stroke victim to wait six months rather than three months. If someone has the full impact of a stroke and it has incapacitated them, it is reasonable Margaret Curran: Yes. That reinforces the point that for us to continue to set their eligibility at three months. I was about to make in conclusion. The measures are a significant part of the Bill and have raised considerable concerns, as the Minister recognised in her introduction. Yvonne Fovargue: Does my hon. Friend agree that Disabled people will be looking closely at what we when the argument about aligning through attendance decide today. On that basis, I will push my amendment allowance is examined more fully it does not hold up? to a vote. People who claim PIP are more likely to be earning, and Question put, That the amendment be made. more likely to be in work and to lose that income, than people who claim attendance allowance, who tend to be The Committee divided: Ayes 10, Noes 14. 853 Public Bill Committee10 MAY 2011 Welfare Reform Bill 854

Division No. 12] hospital. The average cancer patient makes 53 trips to hospital, costing on average £325. That is a huge amount AYES of money for a lot of families. For children with cancer, Buck, Ms Karen Green, Kate specialist units are sprinkled around the country, and Curran, Margaret Greenwood, Lilian there is often much further to travel, which increases the Elliott, Julie Pearce, Teresa cost of petrol and brings additional potential costs such Fovargue, Yvonne Sarwar, Anas as accommodation, child care for siblings and so on. Gilmore, Sheila Timms, rh Stephen There are also the other costs associated with having a disability. However, for people with a sudden onset NOES condition, items such as special adaptations come all at Baldwin, Harriett McVey, Esther once and at the beginning. They have a very heavy Bebb, Guto Miller, Maria up-front loading of the costs associated with their condition Ellison, Jane Newton, Sarah and disability. Such costs—travel, extra heating bills Elphicke, Charlie Patel, Priti and adaptations—are exactly the sort that PIP is designed Glen, John Smith, Miss Chloe for. We have just had a discussion about whether PIP is Grayling, rh Chris Uppal, Paul an income replacement, which clearly it is not. The Hollingbery, George Willott, Jenny considerations I am talking about are the things that PIP is designed to cover. Question accordingly negatived. The Government said in their consultation on PIP, and the Minister has repeated today, that there are The Chair: Order. Before we come to amendment other sources to pay for those additional costs in the 199, we have decided to press on this evening. If that is first six months, such as NHS travel costs, employment all right with the Committee, perhaps Members could and support allowance, social services support and so be brief and to the point. I will try to keep them on. However, they are either means-tested or are not absolutely in order, if that is all right all round. available for people who are in work or on statutory sick pay. It often takes a long time to get through the Jenny Willott: I beg to move amendment 199, in clause 79, assessment process for social services support from page 57, line 6, at end insert ‘, or local authorities. Extra support at the beginning would (c) for persons who experience a sudden onset physical or not be there through those methods either. mental condition, whether, as respects every time in the next 12 months, it is likely that if the relevant The amendment is only one way forward; I accept ability were to be assessed at that time that ability that there other ways. I also accept that the wording is would be determined to be limited or (as the case probably not perfect. I found it difficult to express in a may be) severely limited by the person’s physical or helpful way. It is not the wording one would want to see mental condition. in the Bill. ‘(11A) Regulations must make provisions as to— (a) what conditions are to be considered “a sudden onset physical or mental condition”; Jane Ellison (Battersea) (Con): My hon. Friend makes (b) the amount or rate of payment which can be made a point that has been made to many of us in representations. under subsection (1)(c) above.’. Although it is welcome that the Government are consulting I will be brief. The amendment looks specifically at separately on DLA for under-16s, it has been highlighted people with a sudden onset condition, such as a cancer to me that for those in the 16 to 18-year-old bracket, all diagnosis, a car accident or a stroke. As has been the things described by my hon. Friend can affect a discussed, there is a clear start to the condition rather whole family. Most 16 to 18-year-olds are, in reality, than a slow build-up. It is already hard for people with children living at home; particularly if they have a sudden onset of a disability to have to wait three sudden onset illness, they would be treated in that way. months to get disability living allowance. Only a small number of people are affected, but I want to read 7.15 pm briefly an account by Karen, who has been diagnosed Jenny Willott: My hon. Friend is right. There are with cancer, which was passed to me by Macmillan. It many issues that go alongside, not just the cost, particularly clearly explains the issues: when children or young people are affected. The financial “When you are diagnosed with cancer the last thing you need is and emotional implications for the family as a whole money worries. You need to focus on getting better, but cancer is expensive. I had to leave my job when I started chemotherapy and are significant. The amendment would require the immediately the costs started to mount up. I was paying to travel Government to define a sudden onset condition, which to and from hospital to get treatment and had higher energy bills I suspect is easier said than done. If a claimant fits those because I was at home more. Before long I was really struggling to criteria and can show that they are likely to have the pay my bills and was getting into more and more debt. Despite disability for the following 12 months, they would become needing help straight away, I had to wait three months before I eligible for PIP immediately. The amendment would could get my DLA. Eventually I got my DLA and it made a retain the requirement to show that the disability will massive difference. As well as the DLA I was able to qualify for remain for 12 months, but it enables people to claim PIP the disability premium on tax credits and got more council tax benefit and housing benefit. If I had had to wait six months there up front. is no way I would have been able to cope financially. I would have The Minister has said that cost is not an issue, but it got further in debt.” might be, particularly if people are given the benefit up For many people with a sudden onset condition, the front, as an extra six months would have to be paid. The first six months is when the costs are greatest. That is amendment would leave open the possibility to vary why there is concern about the proposal. For example, payments over that time. Payments could be reduced cancer patients have to pay for travel and parking at later on, for example, so that they were cost-neutral. 855 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 856

[Jenny Willott] us anything of the effect that that condition has on an individual or how long those effects will last. That is a People could claim earlier, but the payments would be response to the intervention of the hon. Member for withdrawn at a slower rate later on. That would enable Edinburgh East, too. We must have some principles by people to get the money up front when they need it which we develop this new assessment, one of which is most, but it would put them on the same footing as that this is a benefit for individuals who have long-term other people who are receiving the benefit. Over time, conditions. We have drawn our definition of “long-term” they would receive the same amount. from the Equality Act 2010. I appreciate that this is a difficult issue. As I have I do not want to detain the Committee any longer said, I am not sure that the wording of the amendment with my explanation, but in winding up, I want to is the right vehicle, but I want to raise the issue. Many reiterate that the required period condition is a necessary, people have concerns about this group of people. It is a proportionate and pragmatic measure to distinguish small group, but they are in a particularly difficult between short-term and long-term need. PIP is not, predicament. I would be grateful to the Minister if she with the exception of the rules for terminally ill people, told us what discussions she has had with the relevant designed to meet needs over the short term, even where organisations, which are concerned about this. Are the they can be assumed to be long term eventually. Our Government looking at alternative ways of taking such view is that the existing support mechanisms to meet circumstances into account and doing something for shorter-term needs provide adequate and focused support those people? for the vast majority of individuals. I urge my hon. Friend to consider withdrawing her amendment. Maria Miller: I thank my hon. Friend for the amendment. Unlike the previous one, this amendment seeks to vary Jenny Willott: I thank the Minister and appreciate the required period conditions, so that people who what she is saying about the varying impact of different experience a sudden onset condition can access PIP conditions on individuals. I am slightly disappointed in immediately without having to satisfy the six-month the response, although I understand where she is coming criteria. from. I hope that she will look at whether anything can My hon. Friend knows this, but PIP is not about be done to help such individuals. There is a bit of a gap children at this point. I will look at the issues that she here. In the past, everyone had to wait for three months has raised when we consider how PIP affects children in before they were eligible to apply, but the gap between future. Officials and I have had good discussions with three and six months can be significant. I do not have the various cancer support groups and other organisations any wish to press the amendment to a vote; I am not that have expressed opinions on this issue, and we will convinced that the wording is the way forward. I am continue to do so. Such discussions are an important glad that the Minister is talking to organisations that part of the Bill’s progress. are concerned about these issues. I am aware that for some people with sudden onset conditions, such as those described by my hon. Friend, Maria Miller: Given the expediency of time, I did not there may be immediate costs associated with their go into some of the problems around the wording of condition, but, equally, there may not. That gets to the the hon. Lady’s amendment. I thank her for clarifying it heart of the issue. As she heard me say earlier, PIP views with the Department. As she knows, it is defective, so it people as individuals, rather than labelling them by would be difficult to incorporate it into the Bill anyway. their condition. We are getting to some tough decisions. Achieving Jenny Willott: I absolutely accept that; I was endeavouring the consistency that I am looking for requires us to take to open the issue up to debate, so that we could discuss some tough decisions. I want to stay true not to labelling the concerns that people have raised. I hope that the disabled people by their conditions, but to treating them Government will continue to look at the issue and as individuals. This is a case in point. discuss it with the organisations that are working on it. It is an area that could do with some further development. Sheila Gilmore: I am now puzzled by the nature of With that, I beg to ask leave to withdraw the amendment. those tough decisions. The Minister indicated earlier Amendment, by leave, withdrawn. that cost is not the reason for this provision. Is consistency Clause 79 ordered to stand part of the Bill. a tough decision? Is consistency always to be favoured Clause 80 ordered to stand part of the Bill. over fairness or humanity?

Maria Miller: I am sure the hon. Lady would expect Clause 81 the Government to try to be consistent. We are trying to make it easier for people to understand the premise PERSONS OF PENSIONABLE AGE from which we start. I understand the point she is making, but, equally, I hope that she understands that Margaret Curran: I beg to move amendment 224, in we have to operate within a framework. That is what I clause 81, page 58, line 6, at end insert am discussing today. ‘otherwise than by virtue of an award made before he attains that I do not want to labour the arguments that have age.’. already been made, but many of them are similar, as my Hon. Members will be glad to know that I shall be hon. Friend the Member for Cardiff Central has said. mercifully brief on the amendment, which I hope is As with the previous amendment, the key here is that straightforward. It would include in the Bill a commitment neither the existence of a condition nor a diagnosis tells that the personal independence payment would continue 857 Public Bill Committee10 MAY 2011 Welfare Reform Bill 858 to be paid to those over the age of 65 by virtue of an Margaret Curran: I beg to move amendment 247, in award made before they reach that age. That would clause 83, page 58, line 34, leave out ‘meets the condition ensure that the current rules regarding over-65s and in subsection (2)’ and insert ‘is an in-patient of a hospital.’. disability living allowance remain unchanged following the introduction of the personal independence payment. The Chair: With this it will be convenient to discuss The Minister can probably guess what I am going to the following: amendment 225, in clause 83, page 58, say, because she has heard me say this before, and I can line 37, leave out guess what she will say in return. As the clause stands, a ‘or a resident of a care home’. person will not be entitled to the daily living or mobility Amendment 226, in clause 83, page 58, line 40, leave component for any period after they reach pensionable out subsection (3). age, unless specified in subsequent regulations. Will she put that in the Bill? Margaret Curran: Thank you, Mr Gray, for that I know that the Minister gave a reply to a parliamentary ruling, which is much appreciated. I am sure that we are question, which stated: all feeling a bit weary, but this part of the Bill will “we intend in regulations to allow individuals already in receipt of certainly wake us up, because it is the most controversial personal independence payment when they reach state pension element and the one that has received by far the most age to continue to receive the benefit, subject to the entitlement attention. conditions continuing to be satisfied.”—[Official Report, 31 March 2011; Vol. 526, c. 447W.] There are no surprises in what the Opposition will say I have moved the amendment merely to offer the this afternoon. The Government are well aware that we people who have concerns about losing their benefit the do not believe that the DLA mobility component should clarification that we will be rock solid on the measure. I be removed from those in residential care homes. We suggest that the Minister put the proposal in the Bill. believe that the Bill fails the compassion test because it contains this clause, which will remove the mobility component of DLA for people in residential care homes Maria Miller: I am happy to respond to the hon. and put nothing appropriate in its place. We support Lady’s amendment and to set the record straight. We sensible, careful and compassionate reform to DLA, plan to make regulations that allow people who are but this measure will leave many disabled people trapped already in receipt of PIP and who have reached the in their own homes. upper age limit to continue receiving their award into There have been various developments in the story of retirement, which I think is exactly what she is looking the DLA mobility component cut, so it might be helpful for. As with DLA, we envisage having linking rules that to the Committee if I provide a brief summary of how will allow individuals who have a short break in their we got here and try to clarify exactly where we are now. claim after pensionable age to claim PIP, provided their Originally, the Government stated that 60,000 people claim is made within a given period. would be affected by the decision to remove DLA Subsection (3) will enable regulations to be made to mobility from those in residential care homes: specify such provisions. As the hon. Lady will understand, “We estimate that approximately 60,000 people who claim DLA and live in residential care will be affected by this measure such things are best dealt with by regulation to give us in Great Britain.”—[Official Report, 3 November 2010; Vol. 517, the sort of flexibility that we need with those provisions. c. 819W.] With that clear assurance, I hope that she will feel that it The Government have since updated that estimate, is appropriate to withdraw the amendment. and they are now on record as stating that the change will affect about 80,000 people, at a cost saving to the Exchequer of £160 million. I am sure that people are Margaret Curran: On the basis of what the Minister familiar with that figure. On 23 March, the Prime has just said, I beg to ask leave to withdrawn the Minister told the House that the Government would amendment. not remove the mobility component of DLA. When Amendment, by leave, withdrawn. pressed by the Leader of the Opposition— Clause 81 ordered to stand part of the Bill. “Will the Prime Minister explain why he proposes to remove the Clause 82 ordered to stand part of the Bill. mobility component of disability living allowance from 80,000 care home residents?”— the Prime Minister categorically said: “The short answer is that we are not.”—[Official Report, Clause 83 23 March 2011; Vol. 525, c. 944.] The Budget Red Book, which I know that Members PERSONS RECEIVING CERTAIN SERVICES have here today, flatly contradicts the Prime Minister’s statement on two key points. It confirms that the Government plan to remove the mobility component of The Chair: In a change to the published selection list, DLA from claimants in residential care, with £475 million I intend to select amendment 247. The reason why I taken from people in residential care by 2015-16 and a have decided to do so is that, although amendment 247 cut of £150 million more from the mobility component has not been tabled with the notice that I would ordinarily of DLA than originally forecast in the comprehensive require for selection, I am satisfied that the amendment spending review last year—of course that reflects the represents a revision of amendments 225 and 226, which 20,000 extra people who will lose the mobility component. were tabled with adequate notice. In this instance, unusually Following widespread condemnation of the decision and for that reason, I am therefore prepared to select to take the mobility component away from those in this starred amendment. residential care homes, the Government once again 859 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 860

[Margaret Curran] That was a very disappointing response, given that she knows about the parliamentary as well as the public changed tack and told us that that decision was now interest in the review. The fact that the review, the subject to a review. I am sure that many Government outcomes of which are so monumental to so many Members welcomed that review. The Minister knows people and have stirred up such controversy, will not be that I have asked a series of parliamentary questions published really begs many questions. Today, we are about that apparent review, which seems to be shrouded calling for full disclosure of the review, much of which in secrecy. will be shaped on what the Minister actually says in response to the amendment. I am assuming that the 7.30 pm Government will go ahead, as they planned, although there are many inconsistencies. However, perhaps the For the record, I asked the Minister when she expected hon. Lady can explain why we have had to fight for such the results of the review to be published; whether people things. living in state-funded residential care will be eligible to receive payment of the mobility component of PIP; Let me put on the record the Opposition’s resistance what plans she has to engage disabled people, groups to the cut. I have been asked to do so, and feel obliged and organisations in her Department’s review of the to do so on behalf of many charities that have campaigned proposal and what the terms of reference were for the against it. Charities are campaigning against the changes, review. I tabled those questions some time ago, and I warning that they are fundamentally unfair, target the received a reply today—perhaps in good time for the most vulnerable people in the country and will mean Committee. My right hon. Friend the Member for East people becoming Ham has had similar experiences. “prisoners in their own homes”. The Minister replied: Such credible and respected charities would not use “The Government received a great deal of feedback on the such phrases lightly. Richard Hawkes, the chief executive proposal”— of Scope, the publisher of “Disability Now”, said: I am sure they did— “The government position has varied massively and this leads “announced in the spending review, to withdraw the mobility to fear and anxiety in the minds of disabled people and their component of disability living allowance (DLA) from people in families. If the Prime Minister’s comments mean that the government residential care homes…In response to the concerns raised by is going to withdraw that clause, that would be very welcome, but individuals and organisations, we announced that we would not DWP have confirmed that that is not the government’s intention. remove the DLA mobility component from people in residential care from October 2012 and that we would review the existing The assault on the most vulnerable is characterised by the evidence and gather more to enable us to determine the extent to callous removal”— which there are overlaps in provision for mobility needs of people the words of the chief executive of Scope, not mine— in residential care homes. “of the mobility component of Disability Living Allowance The work is being carried out by civil servants in the Department (DLA) for people living in residential care, which will simply for Work and Pensions and has included, among other things, increase dependency and mean many people will literally become discussions with individuals and groups of disabled people as well prisoners in their own homes.” as with organisations which represent them.” Mark Goldring, the chief executive of Mencap, said: Charlie Elphicke: I am listening with great care to the “The removal of the DLA mobility component and the squeezing case the hon. Lady is putting forward. Does she think of local authority budgets, which help fund residential care that, in principle, it is right or wrong that people receive homes, is a double blow for people with a learning disability. They the mobility component in a residential care home rely on this money to access the community and live a fulfilled when they are not mobile nor will be mobile or able to life. Through this cut the government is targeting some of society’s most vulnerable people who cannot always fight for their rights go anywhere whatever? Should such people receive or themselves. It also suggests that the government does not believe not receive a mobility component? that people in residential care who receive DLA are entitled to live independently.” Margaret Curran: I thank the hon. Gentleman for his Again, people will be aware of the comparison with contribution. He always makes for a lively debate. I hospitals, which was particularly provocative. Mark heard a colleague say, “That is not the issue”. It is Goldring continued: indeed not the issue. In fact, we dealt earlier, under a different part of the Bill, with people in those circumstances. “This cut will take us back to the days when people were left in care homes with just four walls for company and will undo We are saying categorically that those who are eligible decades of progress. Mencap is calling for the government to for the mobility component if they live in residential urgently review this proposal and prevent this devastating blow to homes should be treated exactly the same as anyone else some of the UK’s most vulnerable people.” who is eligible for the mobility component. In its submission to the consultation on reform to DLA, the Social Security Advisory Committee argued Charlie Elphicke rose— that the proposal to remove the mobility component should not go ahead, arguing that it would substantially Margaret Curran: Can the hon. Gentleman bear with reduce the independence of disabled people who are me, as he might want to come back again as I refer to being cared for in residential accommodation. It stated: certain criteria? I was just about to finish reading the “We consider that the proposal to remove the mobility component response I received from the Minister about the review. from people in residential care should not go ahead. This measure She continued: will substantially reduce the independence of disabled people “When the work is complete we will make a final decision on who are being cared for in residential accommodation, which the way forward. We have no plans to publish the findings of this goes against the stated aim of the reform of DLA to support work.”—[Official Report, 9 May 2011; Vol. 527, c. 1003W.] disabled people to lead independent and active lives.” 861 Public Bill Committee10 MAY 2011 Welfare Reform Bill 862

The Minister will know that a large group of influential The motion was successfully passed by the Liberal charities from the disability and social care sector have Democrat party and I hope, when it comes to a vote, produced a report on the Government’s proposal to that their Members will bear that in mind. scrap the DLA mobility component. The report highlights In conclusion, this element of the Government’s the fact that at different times the Government have proposals has been subject to great controversy and has used eight different arguments, which have shifted to been heavily criticised. The goalposts have changed justify this one cut. The report outlines why each argument significantly over the past four months: first, there was is deeply flawed: the issue of double funding; then there was overlap and “We are particularly concerned about the Government’s continuing chaos, and everything we heard in the oral evidence shift in rationale for this cut and the lack of supporting evidence. sessions showed that there was no shred of evidence for 1. The responsibility for mobility/transport costs should be met that; and then there was the review and the real concerns by the care home provider about how it has been conducted. 2. DLA mobility is being misused and needs reforming In fact, some people would have us believe that no cut 3. DLA mobility is being used to purchase wheelchairs when this is taking place at all. If that is so, why are we having to cost should be met by the NHS Wheelchair Service deal with this provision in the Bill and why is that saving still flagged up in the Red Book? Unless the Minister 4. The change will align the rules for people living in residential care with people in hospital makes another announcement today, which would stretch credibility a bit far, that is my understanding. If there is 5. There is an overlap in transport provision for disabled people. no cut, supporting the amendment to make that clear Schemes such as dial-a-ride provide for the transport needs of should not pose any difficulty. I have heard Committee individuals with a disability members welcome the review in the sense that there will 6. Local authorities should be assessing and meeting personal no longer be a cut and that the benefit will still be mobility needs protected for disabled people. If they believe that to be 7. Local authorities’ contracts with care homes should cover the case, they should categorically support the amendment, personal mobility needs which would send a strong signal. The removal of the 8. People in NHS funded residential care do not receive DLA clause from the Bill would also have the advantage of mobility”. reassuring people such as Mr Greenwood, who are so One person has given substantial, powerful evidence, worried. which I wanted to quote in full, Mr Gray, but I will not If there are inconsistencies, the Government should because he has asked us not to go into it in depth. It is a sort them out with the proper authorities—the care substantial part of the argument, so I will briefly quote homes and local authorities—but they should not make the end, if I may. I will not go through the substance of disabled people the victims of those inconsistencies and it, but may I state for the record that the gentleman’s of any overlaps in the system. If we care about the name is Vincent Greenwood? His memorandum on evidence that we have all received, the only option is to behalf of his son stated: support the amendment. It would categorically protect the interests of those living in residential homes and “Simon Greenwood is aged 30, is severely learning disabled with a mental age of less than 2 years. Simon is also autistic.” ensure that they receive the benefits to which they are entitled, because they receive precious few benefits and It is a powerful illustration of why the use of the they need them. mobility component adds enormously to the quality of his son’s life. He concluded: Sheila Gilmore: This issue has been running for several “The evidence given…shows how important the mobility allowance months. Even before the consultation and the discussion is to my son’s life and the ability of his care home to give all about the need to reform DLA, it appeared to be a residents as full and independent a life as possible. I also believe one-off issue. Without a doubt, the proposal appeared most care homes have alternative but equally effective arrangements. to be a savings measure. No less a person than the I hope I am mistaken but my fear is that the Government are in Prime Minister repeatedly stated that the reason for it danger of confusing complexity with disorder and believing a was to equalise the position with people in hospital, problem to exist where it does not. Therefore I urge the Committee to ensure that the Bill and associated Regulations do not have the whose situation is said to be equivalent. That was either effect of removing the mobility component of PIP from severely an example of equalising downward, to which I referred disabled people in care homes.” earlier, or it was a misconception about what it means to be in residential care and in hospital. I have a few comments from the Liberal Democrat spring conference. My intended targets for those comments The intervention made by the hon. Member for Dover are not with us this afternoon, but I will read them out suggests that he still labours under the same misconception for the record, because they do in some way aid our that people in residential care are like people in what I understanding of the strength of feeling. At their spring describe as nursing homes—they are so ill that they are conference earlier this year, the Liberal Democrats tabled nursed in bed. It takes a long time for DLA to be a motion to highlight their strong opposition to cut removed. People in hospital, usually for a relatively DLA mobility from those in residential care homes. I short period, clearly suffer from an illness that is over will shorten the quotes, Mr Gray, in line with your and above their usual disability, which is why they are instruction. there. The days have long gone when people spent long periods in hospitals that were equivalent to what are “Conference regrets the recent decision to remove the mobility now residential homes. component of the new Personal Independence Payment…from people in residential care and from children in residential schools 7.45 pm with effect from October 2012…The outcome of the cut for adults is not in accord with the principle of fairness because it What became clear during the discussion was that we affects the poorest recipients and allows those people who pay for are talking about not only elderly people, whom some their own care to retain the Mobility Component.” folk think should not go out too much and need not be 863 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 864 mobile if they are in residential care, but young disabled In other words, would people who currently receive the people. They can participate, and are encouraged to benefit be transitioned to PIP, at which time we would participate, not only in social activities, but in training, look again at their need for and entitlement to that education and employment, and to meet their care benefit, or at some point between now and 2013, will a needs—rather than having round-the-clock 24-hour care decision be made about what is happening to those at home, which might be another option for some—they people as a group? are in a residential facility. We may have started from a If there is double payment, and the evidence from misconception, but we are now in a position where the many people is that there is not, the only way to longer we debate the matter, the more convoluted the establish that would be for the Department for Work arguments become, as my hon. Friend the Member for and Pensions to contact local authorities up and down Glasgow East suggested. the country to ascertain what people pay for and do not pay for, and what their contracts with care homes cover. Charlie Elphicke: Far from being a luddite, I am If there is an ongoing process to ascertain whether there clear-sighted and focused about the nature of elderly really is an overlap and a duplication of payments, it is residential care, having had personal experience of it. not clear that it is happening. It is not clear that The hon. Lady makes a fair point, however, about requests for information are going to local authorities. younger people’s residential care, providing there is no Many allegations of double payment have been made, double counting. Older people’s residential care is my although little evidence has been adduced. I cannot see concern, because if the allowance is not used to get out an easy way of gathering it without making contact and about, how can it be properly targeted? with local authorities, though that will be an expensive process, putting a lot of people to a lot of effort. Sheila Gilmore: People have to apply for benefit under Having been in politics as a local councillor, I know both the DLA system and the proposed PIP, so it is not that proposals can be made that on the face of it sound simply handed out, with people saying, “Here you are, like a good idea. However, when examined further, it is in residential care—here’s your mobility allowance.” I realised that the proposal is inherently bad. There are understand that people will still have to make an individual times when it is true that, “If you are in a hole, stop application and they will doubtless have to demonstrate digging.” This is one of them. that they meet the criteria. My hon. Friend the Member Kate Green: I strongly endorse the comments of my for Glasgow East referred to one of those criteria, hon. Friends. I also want the Minister to be crystal clear which is in a separate section that deals with people who about the Government’s attitude to proposals affecting are unable to make use of a mobility payment. people entitled to the mobility component or disability Under the measure, people will have to meet the living allowance in residential care homes. Like my hon. criteria to enable them to participate in society. We have Friends, I am confused about what we are reviewing, heard much about what personal independence payment and why the savings identified by the Government is meant to be about. It is to enable people to have the remain in the Budget Red Book. freedoms that the rest of us have. That might be to meet I want to add a few remarks about the reasons why friends and participate in clubs on a social basis, to this particular Government proposal has excited so volunteer, or—especially for some of the younger, working- much concern across so many organisations and families, age people in that situation—to hold down a job or and across all parties. I have been struck by the depth of undertake training. Any concerns about people not concern across the House about the matter, as I am sure needing benefit are addressed by the fact that they have the Minister has. There are a few points about which we to apply for it, which they will have to do under the need to be crystal clear, to understand why my hon. personal independence payment, and as we have heard, Friends tabled the amendment. there will be tests in that process. First, we are looking at the position of care homes. The suggestion of ruling out a group from the benefit Many care homes receive their funding from local does not sit well with what we have heard in our authorities in block form. It is not necessarily broken discussions. Even this very afternoon, we have been told down by the items of expenditure purchased, or by the how important it is not to categorise people by group or individuals and the items bought for them. Even if allow them to have automatic entitlement to a benefit there is some funding by local authorities of mobility by group, because we must look at people as individuals. for individuals in some residential care settings, it is It seems strange, therefore, that the proposal suggests often extremely difficult to identify. It is not the usual that someone should not receive the benefit because of way that the funding package is constructed for care their group category—because they are in a residential homes. We are looking at a very murky and confusing care facility. I argue that individuals in that situation picture, if we start to read that kind of financial support should be considered individually. Saying that someone into the existing contracts. clearly does not meet the requirement or cannot make However, many residential care homes expect to receive use of it is very different from saying that anyone in that people in receipt of DLA as a precondition of taking situation should not be covered. them on. They know that they come with that source of It was unclear what was meant by the review. The funding, to enable them to access their own mobility proposal has its own savings category, which is quite needs and requirements. To be able to provide the separate from any other financial savings that some quality of care that they want, it is important for care people might feel will be made from this reform; it homes to know that they have residents who will be comes as a distinct line in the Budget. I was left unclear mobile because they have access to the DLA mobility some weeks ago about whether there would be a review component. That becomes, in some instances at least, a of the specific proposal or whether the proposal was precondition of the acceptance of a disabled person to being put into the mix to be considered as part of PIP. the residential care setting. 865 Public Bill Committee10 MAY 2011 Welfare Reform Bill 866

It is important to realise what could happen if those Whatever the merits of the hon. Gentleman’s argument care homes no longer receive those residents and the for targeting to avoid some of the money potentially payments made for them by local authorities. The overall going to people at the very end of their life and who financial impact on residential care homes could be could in no sense benefit from mobility support, the very damaging. It has been suggested that many of assessment process should be capable of determining them would be forced to reduce wages to care workers. whether there is an entitlement to mobility payments, as We all know that poor wages lead to poor care, which my hon. Friends have pointed out. It is utterly wrong to none of us wants to see for our most disabled individuals. remove such payments wholesale from everyone simply As my hon. Friends have said, it has not been possible by dint of their being in residential care. to uncover any specific evidence of duplication of payments. I am interested in what the hon. Gentleman said All the witnesses who gave us evidence on this matter, about the circumstances in which it might be wrong for while accepting that it might exist, had never seen it, people to move out of their residential care setting. despite their extensive experience in the disability field. Conversely, the National Autistic Society has pointed The Disability Alliance has made clear that, if the out the damaging effects of people being confined to Government were suggesting that there is a statutory their home and being unable to go out and undertake obligation on local authorities to fund mobility needs social activities. That can have an extremely harmful for residents in care homes, it is completely unclear effect on their behaviour and well-being. where such statutory obligation sits. My hon. Friends pointed out that some people in We know that people in residential care settings are residential care homes, none the less, leave their homes living in what is their home. As my hon. Friends have to access education or training. Some are leaving their rightly pointed out, a benefit to assist mobility should homes to access employment. The mobility component not operate differently because of the nature of the can be used, for example, to assist them in acquiring a home setting. I remind the hon. Member for Dover that Motability car. Removing the mobility component, which we must not confuse profound disability with immobility. will remove their ability to pay for transport, such as People may experience severe levels of need and disability, special taxi services or the acquisition of specially adapted but it does not mean that they should not be entitled to cars to drive themselves, will remove them from paid move around in the community as part of their daily employment. Not many people are in that situation, but life. surely we do not want to remove from profoundly Let me tell the Committee about Hamza, the profoundly disabled people who are able to take paid work the disabled adult son of my constituent Mrs Khan-Sindhu. financial support that enables them to do so. He is in his early 20s and, as a result of brain damage at birth, he is a wheelchair user. He is doubly incontinent 8pm and has profound learning difficulties, but he loves I look forward to the Minister’s clarification of the being able to go home to visit his extended family at the Government’s intentions. If we are to assume that everything weekends. Without the mobility component of disability Ministers have said in recent weeks can be taken in the living allowance, which enables his family to afford upmost good faith, then, as my hon. Friend says, there specially adapted transport, he would not have that should be no difficulty for any Member in supporting pleasure. I am sure that no hon. Member would want the amendment. It is probably our last chance to offer people such as Hamza to be unable to enjoy such real reassurance to profoundly disabled people and quality of life. their families that there will be proper recognition of their serious concerns. I look forward to the Minister’s Charlie Elphicke: The hon. Lady makes a powerful response. point about targeting, but let me give her another case based on my personal experience. I had to look after my Maria Miller: I welcome your decision to accept the father for the last 10 years of his life. He had Alzheimer’s late amendment 247, Mr Gray, to ensure that we have a and was in an elderly people’s residential home. Holding full debate on the issue tonight, because it is important his power of attorney, I was fiducially obliged to claim not only for members of the Committee but for those on his behalf the highest amount that I could. That listening to the debate. I hope I can provide Members meant the mobility component, but I did not want him with some assurance and clarity on this issue, because it to go anywhere. If he went out for more than five is an important one that has, as the hon. Ladies have minutes, he would forget who he was and where he was said, prompted a great deal of discussion, debate and and would become lost. That was the nature of his comment. condition. It is a serious issue. Surely the mobility First, I want to turn to another aspect of the amendments component should be targeted at need and utilisation, that the hon. Member for Glasgow East tabled on her rather than being handed out to everyone who wants to party’s behalf. Currently, payment of the care component claim it. of DLA stops when a person is in a care home, and payment of the care and mobility components stops Kate Green: The problem with the Government’s when a person is a hospital in-patient. That ensures that position is that it is a blanket withdrawal of the benefit there is no double payment for the same need. However, from predominantly working-age adults. People have to any mobility component of DLA continues to be paid be of working age to make an initial claim, although the to people in residential care. Clause 83 replicates the payment may continue beyond retirement. We are talking existing rules for the daily living component for people about predominantly working-age people, younger middle- in residential care, and for both the daily living and aged people. For many such people it may be right, in mobility components for people in hospital. In addition, terms of their quality of life and access to social and the clause provides for the extension of the non-payment other activities, that they receive the personal independence of the mobility component for people in residential care payment or the mobility component of DLA. if there is an overlap of provision. 867 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 868

[Maria Miller] you have enabled us to debate amendment 247. I suppose that, to avoid the rather misleading comments I am somewhat surprised that the hon. Lady has the Minister is now making, we should have withdrawn taken the approach she has with the amendments, amendments 225 and 226. I do not know, Mr Gray, particularly given that it would reverse provisions that whether— the previous Government had formally supported—on ceasing to pay the daily living component to people in The Chair: Order. It is simply not possible to withdraw publicly funded residential care. I remind hon. Members amendments that have previously been selected and are that successive Governments have accepted that the therefore on the selection list. We are entering into a care needs of residents in care homes are met through debate on this issue, and the Minister is indicating that, local authority funding, and that is why the care component had amendments 225 and 226, which it is perfectly in of DLA currently stops when a person is in a care order for the Committee to discuss, been moved by the home. Under the amendment, the cost to the taxpayer right hon. Gentleman, there would have been certain last year would have been an additional £235 million. It consequences. As the Minister will understand, the cannot be Opposition Members’ intention to introduce Opposition’s intention was to replace amendments 225 an amendment that would result in the taxpayer paying and 226 with amendment 247, but that is not what twice for the same need. occurred, and it could not occur under our procedure. All three amendments, therefore, are on the Order Paper, Stephen Timms: I think the Minister is discussing an and all three are being debated. It is perfectly in order amendment that was on the amendment paper previously, for the Minister to comment on amendments 225 and not the one we are debating now. 226, but she should bear it in mind, particularly given the late hour, that the intention behind amendment 247 The Chair: Order. The amendments were of course is to replace amendments 225 and 226. on the amendment paper before. They are grouped with amendment 247, so we are indeed discussing them. Maria Miller: Thank you for that clarification, Mr Gray, and I am pleased to hear that the Opposition will not be Stephen Timms: I simply wanted to clarify that what pressing the relevant amendments and will think again the Minister is saying does not apply to amendment 247. about them. I say to the right hon. Gentleman that I would never wish to mislead the Committee—I am sure Maria Miller: Obviously, I am speaking to the three he would not want to imply that I would—and I was amendments on the amendment paper. An amendment simply responding to the amendments he had tabled, was tabled late, which we are happy to debate in addition; which, obviously, is my role. but I presumed that, because the others had been selected I want to send a very clear message to both sides of by you, Mr Gray, and submitted by Opposition Members, the Committee about the new power in clause 83. We those are subject to debate. have already announced that we will not remove the mobility component of DLA from people in residential Stephen Timms rose— care from October 2012, as was originally planned, and we have said clearly that we will review the needs of care home residents alongside all other recipients of DLA, The Chair: Order. The position is quite contrary to either current or future, and not separately. That is normal practice. Owing to amendment 247’s late submission, entirely consistent with what the Prime Minister said we would normally have debated amendments 225 and and what I said previously. Let me be absolutely clear: 226 only. However, because amendment 247 seemed we will not remove disabled people’s mobility. We will quite plainly to be amending amendments 225 and 226, only remove overlaps. it seemed reasonable to accept that late amendment, and, in informal discussions with both sides of the Committee, everyone seemed to agree that that was a Sheila Gilmore: Will the Minister give way? sensible thing to do. If we are discussing amendment 247 grouped with amendments 225 and 226, it is therefore Maria Miller: Perhaps the hon. Lady will forgive me, perfectly in order to discuss all those amendments. but I will not, because if can finish my argument I might address her questions before she asks them. Maria Miller: I thank you for that clarification, Mr Gray. A couple of hon. Members questioned whether our It may not have been Opposition Members’ intention to approach has been consistent, to which I assert that we have submitted that amendment in this way. However, it have been absolutely consistent from the start. Our is clear that these amendments, if proceeded with, would contention is that this proposal is about reducing overlaps make some substantial changes to the provision of in provision—something I am sure all hon. Members support for people living in residential care homes and would want to see. In a time of fiscal problems for our in those paid for by the NHS. In doing so, they would country, we do not want to pay unnecessarily for the also entail quite an additional cost. same provision twice, and that applies not only in this area but in many other areas of government. All hon. Stephen Timms: The Minister is perhaps unnecessarily Members want that, as do our constituents and all detaining the Committee on this issue. Our intention disabled people: they want to ensure that we are spending was to substitute amendment 247 for amendments 225 every penny piece most effectively in their interests. and 226. You have helpfully indicated, Mr Gray, that This is not about reducing the mobility of care home to facilitate debate on this matter tonight, which the residents. We have considered this issue thoroughly, Government want and are perfectly entitled to have, particularly in light of evidence provided by a number 869 Public Bill Committee10 MAY 2011 Welfare Reform Bill 870 of stakeholders, which has been extremely useful in The way in which we achieve that is down to the providing some of the detail. The hon. Member for ministerial team. I can give the hon. Lady an absolute Glasgow East highlighted the fact that the savings are assurance that we are not about removing mobility still shown in the Red Book. Let me again make it clear from people who live in care homes; but what we are to the Committee, some of whom have been Ministers about—wherever we can, in whatever part of and will understand the protocols involved, that the government—is identifying where there are overlaps current position is that care home support is being and removing them. reviewed alongside the broader reform of DLA. The figures in the Red Book make it clear that the savings Sheila Gilmore rose— will be made as part of the Government’s overall programme of reform. That is the situation we are in. I give way to the hon. Member for Edinburgh East, who Stephen Timms rose— tried to intervene earlier. Maria Miller: If Opposition Members will allow me Sheila Gilmore: I want to press the Minister further to continue, they may be reassured by what I am saying. on this point. Earlier, I asked whether this was a review Because of the extensive work being done in this area, of the proposal. The initial proposal, without a doubt, several Opposition Members have asked about the review involved the blanket removal of the mobility component we have been carrying out. This is an important part of of DLA from people in residential care. I asked whether our decision-making process. the intention was to review that proposal or to include the recipients within the overall transition from DLA to Stephen Timms: I do not understand the argument. PIP.I now understand the Minister to be saying that she According to my reading of clause 83, unamended, intends that individual cases will be looked at as and people in residential care will not get the mobility when people are moved from DLA to PIP. People will component. The Minister says that she does not intend have the opportunity to have their cases reviewed. If to take the mobility component away from those people. there is overlap, the benefit will be removed; otherwise, Does that mean that the Government will amend the it will not be. However, surely the financial saving Bill? relating to this blanket proposal remains within the Government’s budget, so is the Minister saying that that 8.15 pm proposal has now been withdrawn in its entirety, with the financial consequences? Maria Miller: What I am saying very clearly is that the way we decide to support individuals in care homes Maria Miller: The hon. Lady probably was not listening will be looked at alongside the support for other recipients to what I was saying earlier. I have made it clear that of DLA. We will not remove mobility support from care home residents’ needs will be reviewed at exactly people if additional support is not in place. the same time as everybody else’s, not separately and not before. So in as much as that is a change, it is one Stephen Timms: Will the Minister give way? that has been agreed to. It is important that we get this right for everybody. Maria Miller: I shall proceed with my comments Sheila Gilmore rose— otherwise we will get even more bogged down in the detail. Maria Miller: Perhaps the hon. Lady could allow me When looking at this issue, we have discovered a to respond fully to her point before she intervenes number of things that need addressing concerning the again. Regarding the finances in the Red Book, it is local provision of mobility support, and I am not clear that we have to make those savings. How we make willing to walk away from some of the problems that we them will be down to the way the assessment is put have identified. There is clearly uncertainty about how together. Care home residents will be part of that whole mobility support works in practice. My hon. Friend the process, as we have discussed for the last few hours. We Member for Aberconwy has graphically described some still have a great deal of work to do on how those of the work he has been doing by talking to care homes assessment criteria will work, and care home residents in his constituency, and the different ways that individual will form part of that. That provides the clarity that care homes identify and meet the mobility needs of Committee members need on this issue. their residents. There are a wide range of different duties and contractual obligations to meet those needs, Kate Green: Is the Minister suggesting that the savings and service providers and residents—and their families—are in the Red Book will arise entirely because double sometimes very unclear about where the responsibility funding will be identified, and DLA and PIP payments lies for mobility funding. The issue might be difficult will not therefore be made for those individuals where and add complications to the debate, but it is an important double funding is in existence? Or is she suggesting that part of unpicking the problem. If we are to address the some of those individuals will cease to qualify as a fundamental issue of ensuring certainty about the provision result of the assessment? What she is not suggesting, I and funding of mobility support for some of the most think, is that the mere fact they are in residential care vulnerable members of our community, we must homes will, of itself, disqualify them in future. acknowledge that the system is far from perfect and requires some intervention and remedial work. Maria Miller: If I can unpick the hon. Lady’s question, Families and disabled people across the board have it is clear that there is a saving that needs to be made. been concerned about the lack of clarity, and to me that That is the fiscal challenge we face as a Government. is unacceptable given that we are dealing with some of 871 Public Bill CommitteeHOUSE OF COMMONS Welfare Reform Bill 872

[Maria Miller] If overlap is ironed out at the cost of disabled people, I would not accept that. If administrative systems are the most vulnerable people in society. In reforming ironed out, I would support it. The Minister has not DLA and introducing PIP, we must recognise the been clear about this in any of the many discussions importance of mobility to residents in care homes, and that I and disability organisations have had with her. members of the Committee can be assured that all None of us is clear; we remain confused about the Government Members take that issue seriously. We purpose of clause 83. Will some people in residential must ensure that we have a system where disabled homes lose their benefit, or will all people in residential people are in control of their lives, whether or not they homes lose their benefit? Will some lose it as a result of are residents of care homes. the review? Will some lose it as a result of overlap? I welcome the commitment made by the Minister I refer the Minister to the Red Book, because the responsible for social care, my hon. Friend the Member column in the Red Book specifically refers to the mobility for Sutton and Cheam (Paul Burstow), to personalised component in residential care. She cannot argue that services for all disabled people, and I hope that that will this is a general, overall saving, which is a general part move towards clarifying and reducing some of the of the PIP assessment. confusion and opacity currently in the system. Those charities that have been vocal about the issue have Charlie Elphicke: First, clause 83 states that regulations pointed out that current provision is patchy at best and “may” provide, so it is conditional and, therefore, it may not always work in the best interests of disabled can be fine-tuned. That is as clear as day. Secondly, people. I do not find that situation acceptable and I give paragraph 2.63 on page 55 of the Red Book contains a the Committee a clear undertaking that we will not clear explanation of what is going on and makes it clear remove the ability of severely disabled people to get out that it will not happen before October 2012. It states: and about. We will always strive to remove overlaps, “Mobility provision for people in residential care will be reviewed and as we move towards introducing the PIP in April as part of the wider reform of DLA to be introduced from 2013, I will make sure that disabled people are treated 2013-14.” fairly, regardless of their place of residence. I hope The paragraph ends with a cross reference to the financial that with those reassurances, hon. Members will find it table. The situation has been clear since the Budget; why appropriate to withdraw their amendments. do people not try reading the Red Book? Margaret Curran: I am speechless: whatever way one describes this measure, it certainly is not clear—no Margaret Curran: We obviously have different definitions wonder people are confused. I am not at all clear where of the word clarity. Every time I engage in this debate— the Government are coming from on this matter, and as believe me, I have done so over a period of months—a the evidence I gave in my opening speech shows, Labour different argument is posed to me. Research that has Members are not the only people who think that. This is been undertaken by credible disability organisations not part of a political agenda; the entire disability has provided clear evidence to support the facts that I movement will agree with us. My speech was based on have outlined. No matter what assertions hon. Members evidence from the disability movement, and the Minister hear tonight, no credible argument has ever been put has provided no evidence to support what I believe is forward to challenge that evidence. her argument. The hon. Member for Dover has said that it is a The Minister says that she does not want us to get “may” now. We do not want a “may”; we want to bogged down in detail, but I repeat: we have no answers abolish it altogether. Let us be abundantly clear about to fundamental questions on this provision. What is the that. The hon. Gentleman has referred to the Red purpose of clause 83? Who does it address and whose Book, but—this goes to the heart of what I am trying to circumstances will change as a result? clarify tonight—although we are now told that a review will be conducted and perhaps there will not be a Maria Miller: I am sorry to detain the Committee, saving, the Red Book already contains a saving, which but which bit of not wanting to remove the ability of has a number and a column attached. Can the Committee severely disabled people to get out and about, and not see the inconsistency in that? wanting to focus only on overlaps, is unclear? Charlie Elphicke: Paragraph 2.63 cross refers to AI in Margaret Curran: We are talking specifically about table 2.2, which makes it clear that the savings in the clause, and as several of my hon. Friends have relation to the DLA mobility component and the gateway indicated, when the Bill was published the Government reform as a whole are cross referred and brought together. made it explicitly clear— That is the essence of the review; the Government are not quite clear in which direction they are going, because, Maria Miller: Does the hon. Lady agree with the presumably, they are listening carefully to the concerns remarks I have just made, namely that it is important of disabled people and looking carefully at double for the Government to have made clear that it is not our charging, which we would expect them to do. intention to remove the ability of severely disabled people to get out and about, and that we are focusing Margaret Curran: That reflects a debate that was held on overlaps? Does she agree that that is a good objective, in the Chamber, in which the Financial Secretary to the and does she support us in that objective? Treasury got himself into exactly the same argument. I think that he was referring to page 55 of the Budget Margaret Curran: First, I do not think the Bill provides report, but Labour Members were referring to page 44, for that and, secondly, it depends on what we mean by if my memory serves me correctly, which indicates that all those things. It depends on what we mean by overlap. the saving is there. 873 Public Bill Committee10 MAY 2011 Welfare Reform Bill 874

I am grateful to the hon. Member for Dover for disabled people’s ability to get out and about. In hearing making the real problem clear, namely that the Government that assurance, I am perplexed as to why she does not do not know what direction they are going in. We know feel it appropriate to withdraw her amendment. the direction in which we are going. We are saying categorically that people who live in residential homes—as Margaret Curran: I am astonished at that. The Minister a category, which completely contradicts everything has not given any answers that would allow me to that the Minister has said this afternoon—should not withdraw the amendment. If she had, then, as with have their mobility component taken away because they other amendments, I would be willing to do that. She live in residential care. That is what the Government has not managed to answer our questions. She has not plan to do, and that is what the amendment is about. explained the purpose of the clause. If the Government are saying, “We originally came forward with a proposal that categorically said that, as a group, we do not think Sarah Newton (Truro and Falmouth) (Con): The hon. that those in residential homes should get a mobility Lady has welcomed the commitment from the Government component”, she could have drawn the comparison, as to make a principled decision. Does she agree that it the Prime Minister did, with people in hospitals. There is not possible to make a principled decision about a was a huge reaction to that comparison. The Government gateway into assessing the level of need and support reasonably said, “That was not what we meant. We that somebody needs, as a firm budget saving? understand that it is a different case and that there are It is reasonable that the Government have identified, differences. We need to look at this again.” in the round, an estimation of the savings with these If the Government said to us, “We are looking at this reforms. Those savings cannot be as precise as the hon. again and we are undertaking a review; we will come Lady is intimating, because it is a principled decision. back to you. We are not sure which direction we are going in”, I would understand that. That would be a Margaret Curran: With the greatest respect, if it were perfectly reasonable approach. I probably would have that, I would welcome it. I do not think that it is a disagreed with it, if I am being honest, but it would have principled decision, however. That is not what the been a reasonable, consistent and clear approach. That Government are saying. Maybe the hon. Lady heard is not what the Minister has said. We will all go back this, but I am asking again whether the savings estimated through Hansard, as will a number of organisations, in the Budget—perhaps they are an estimate, although and find that that is not what the Minister or the that is not what the Chancellor said, and perhaps you Government have said. They have said that they are know the facts better than I do, but that is not what the keeping clause 83 in the Bill, that they are undertaking a document states— review and that they are looking at overlap, but they cannot tell us who that will apply to, what the criteria The Chair: IamsureIdo. and the terms of reference are for the review or who they will be speaking to. With the greatest respect, it would a dereliction of our duty if we withdrew this Margaret Curran: I am sorry, Mr Gray. I will behave amendment, given what we have heard today. myself. I am sure you are well acquainted with the Question put, That the amendment be made. Chancellor too, Mr Gray. Maybe the hon. Member for Truro and Falmouth can answer some of these questions, The Committee divided: Ayes 10, Noes 12. because so far the Minister has not. What is the purpose Division No. 13] of clause 83? Will some, or all, of those who currently AYES receive the benefit lose it as a result of this change and the budget cut? Will some, or all, lose it is as a result of Buck, Ms Karen Green, Kate the review? Will some, or all, lose it as a result of Curran, Margaret Greenwood, Lilian Elliott, Julie Pearce, Teresa overlap? Is the plan for savings a general review? Fovargue, Yvonne Sarwar, Anas Gilmore, Sheila Timms, rh Stephen Maria Miller: Will the hon. Lady give way? NOES Margaret Curran: If the Minister will bear with me, I Baldwin, Harriett McVey, Esther will make my argument. Is the plan a general review, or Bebb, Guto Miller, Maria are we specifically looking at people in residential care Elphicke, Charlie Newton, Sarah homes? It is unavoidable that the Government are saying Glen, John Patel, Priti that we need to look at people in residential care homes Grayling, rh Chris Smith, Miss Chloe and reassess their entitlement to a mobility component. Hollingbery, George Uppal, Paul My amendment says that that is wrong, that should not be done and that the Government have gone about it in Question accordingly negatived. completely the wrong way. Clause 83 ordered to stand part of the Bill. Ordered, That further consideration be now adjourned. Maria Miller: The hon. Lady is asking questions —(Miss Chloe Smith.) about the assessment criteria, which have not yet been finalised. It is not possible to answer her questions. I am 8.30 pm still perplexed as to why the hon. Lady is not hearing my clear assurances that we are not removing severely Adjourned till Thursday 12 May at Nine o’clock.