[Steve McCabe in the Chair]
It is a real pleasure to be in a debate that you are chairing, Mr McCabe—I think this is the first time it has happened for me. I apologise to all my colleagues because I have a great deal to say on the issue, and I propose to say it and then, hopefully, to take some interventions. I am very grateful to them for attending to listen to the debate, which has provoked an awful lot of interest not just from fellow colleagues, but from individuals who have contacted me. I thank all the people and organisations who have contacted me; I have read all the submissions they sent.
The Government’s present agenda on disability is to reduce the number of people receiving disability benefits and the amount of money they receive. There has been a marked increase in the number of constituents coming to my office to seek help in connection with disability benefits, particularly with the personal independence payment process. In preparing for this debate, I have worked very closely with, and I am very grateful to, Wrexham citizens advice bureau and the welfare rights service of Wrexham Council.
In recent months, it seems that the Department for Work and Pensions has targeted the Wrexham postcode, inviting large numbers of working age, pre-existing disability living allowance claimants to move to the replacement benefit, PIP. Failure to respond to the invitation results in the existing DLA award ceasing, with an associated knock-on loss of any premiums—for example, means-tested benefits, Motability car tax, blue badge entitlement and so on. At any time in the Wrexham area, about 10,000 people have been in receipt of various combinations and levels of DLA, and considerable numbers of them are now going through the migration process, which is almost entirely driven by DWP, not by the claimants themselves.
The DWP invitation gives people a limited amount of time to claim PIP and return the paperwork, with a claim form of about 40 pages in length. Many claimants struggle to complete social security benefits claim forms and seek help to do so. If constituents do not respond, the DLA stops. That is one way of the Government achieving their objective to reduce the benefit paid.
One constituent of mine—a former nurse—has a degenerative neurological condition, yet her PIP assessment resulted in her losing her Motability car, an outcome repeated and experienced by sufferers of Parkinson’s disease, according to a briefing sent to me before this debate. This does, of course, secure the Government’s objective of reducing the benefit paid to disabled people.
The changes to the system are being made against a backcloth of withdrawing specific benefits advice, reductions in legal aid eligibility and reductions in funding for citizens advice bureaux, welfare rights advisers and other sources of advice. The result is that little advice is available for vulnerable people, which further helps the Government to reduce the benefit paid. In any event, the system operated means that applicants invariably complete the long, complex forms without advice and without any knowledge of the criteria applied to award PIP. As a consequence, it is very often the case that the initial application results in previous recipients of DLA being awarded PIP, if at all, at a lower level.
When an application is made for mandatory reassessment, again the applicants have no detailed knowledge of the criteria, and the reasoning applied by assessors and communicated to the applicant is set out without specific reference to the points awarded for each individual disability. DLA was assessed by health professionals. The Government now contract private businesses such as Capita to carry out assessments. In Wrexham, the largest town in north Wales, there is no geographic base for personal assessments to be carried out and applicants are requested, as a matter of course, to travel more than 40 miles to Rhyl for an assessment. That is a disincentive to vulnerable people to proceed with the application.
On Monday evening, in the excellent “Dispatches: The Great Benefit Row”, presented by Ade Adepitan, we saw the shocking mindset of a number of the assessors. However, the views expressed in that programme reflect what I am told by my constituents. Individual applicants are subjected to rudeness from assessors when they question the obligation to travel distances. When one constituent of mine asked to have an assessment in Wrexham, rather than travel the considerable distance to Rhyl, the conversation went: “Do you receive DLA?” “Yes.” “Use the bloody money to get to Rhyl.”
When the mandatory assessment is completed, the appeal process is complex and difficult and, again, there is a paucity of advice available to applicants. There has been a huge increase in the number of individuals seeking advice in my office, and there are real capacity constraints in handling the quantity of them. Applicants are often vulnerable, stressed and upset by the whole process, and are intimidated by the complexity of the forms.
Will the hon. Gentleman give way?
I am sorry but I am going to continue. I will try to take interventions later.
Applicants are also intimidated by the manner of the assessors and the way in which assessments are set out when they are presented to applicants. Having considered a number of the assessments personally, I find it difficult to draft responses to the assessments effectively. The process is much more difficult than drafting court pleadings—I am a solicitor—and, without training and support, it is very difficult even for those experienced in drafting documents.
It is essential to have detailed knowledge of the points awarded for individual actions in order to respond properly to assessments made. The reality is that most applicants do not have that information themselves and do not have adequate access to expert advice to help them. I quote the experience of one of my constituents, Lindsay Usher, who sent an email to me earlier this week. She says:
“I am a carer for my husband John who had a major stroke, aged 55, in October 2010 that left him with various disabilities. He was awarded indefinite DLA...and recently had correspondence to say that he had to now apply for PIP. I made the initial telephone call on his behalf and then the 40 page booklet appeared. We duly completed it and that in itself is stressful. John could not have done it on his own due to the complexity and ambiguity of the questions. They repeatedly try to trip you up and the stroke has left him with a degree of cognitive impairment. We returned it by the due date, 24 March. The receipt was acknowledged by the DWP by text message.
John then received a letter from Capita dated 28 March informing him that he would be assessed face to face by a ‘health professional’ at his home address on 11 April at 08.00 a.m. John takes about an hour and a half to get up, washed and dressed independently in the mornings (this information was written on the PIP claim form) but even though the timing of the appointment was not ideal we decided to accept it as the wording in the letter from Capita includes, in bold, ‘It is important that you go to this appointment. If you fail to go without a good reason, the decision-maker at the Department for Work and Pensions is likely to refuse your claim’. It’s quite intimidating. A further reminder letter dated 2 April was received from Capita confirming the appointment with the same ‘It is important that…’ sentence. Finally a text message was received from Capita on 6 April once again confirming the appointment…Roll forward to the appointment day…Alarms set for 06.00 a.m. Ready, waiting, stressed and nervous by 07.45 a.m. No sign of ‘health professional’. No email, no phone call, no text message. So I telephoned the Capita ‘Enquiry Centre’ at 08.56 a.m. The lady who answered had no idea why John had been ‘stood up’. I said we would give it a while longer. By 10.32 a.m. I phoned again. We got the obligatory ‘sorry’ but I told the young lady I spoke to that she could not be held responsible for the ‘health professional’s’ failure to appear.”
Another constituent became enmeshed in an argument over whether he was able to fully wash the top half of his body, as he has the use of only one arm due to a stroke; the assessor accepted that he could not wash the whole of the bottom half of his body. Parliamentary colleagues have approached me since this debate was listed to tell me of similar accounts affecting those they represent. This degrading assessment process makes sense only if it is understood that the policy’s central objective is to reduce the benefits of these disabled people. All these procedural steps work towards that end and make it more difficult for claimants to apply.
It made me sick to the stomach to see further personal independence payment cuts proposed in the Budget and to see the Minister defending them even before the Budget speech was made. At the same time, the Government cut capital gains tax and corporation tax. This rotten system endures and is often run by rotten people—we saw some of them on Monday night’s programme on Channel 4—who treat vulnerable people and their families with absolute contempt.
If the Minister wants to help disabled people—I respect him, and I am telling him what my constituents are telling me—will he now ask his Secretary of State to carry out a fundamental reappraisal of this appalling system? If he wants to salvage his reputation, that is the only way he will be able to do so. If he wants respect, he and his Department, and those who his Department employs and commissions, need to start treating vulnerable disabled people with the respect they deserve.
Everything my hon. Friend has said is applicable to the Delyn constituency in north-east Wales. It might help Members and the Minister to know that the value of the contract to Capita over 60 months in central England and Wales is £121 million. We can get better value and better, more compassionate performance out of that contract.
I congratulate the hon. Gentleman on securing this debate. He is right that this is a massive issue. “Dispatches” highlighted the concerns that many people have about the PIP assessment. The same firm is contracted to carry out PIP assessments in Northern Ireland, where we have one of the highest DLA claimant rates in the whole United Kingdom because of the troubles. Like me, does he feel—perhaps the Minister will respond to this—that there is a great need for those who carry out the tests to have a higher level of competency?
The hon. Gentleman is absolutely right. There is clearly a major problem, and MPs are seeing that in their constituencies across the United Kingdom. The purpose of securing such debates is to draw to the Minister’s attention to the mistakes made by Government. All Governments make mistakes—mistakes were made under a Labour Government—and there is a real mistake in this particular case that he needs to address.
Given the information that we have, this is an extremely valuable and timely debate. As the chair of the all-party parliamentary group on disability, I have particular concerns about the lack of involvement of individuals such as mental health professionals and general practitioners in gathering the information. Does the hon. Gentleman agree that that should be standardised as part of the procedure?
Absolutely. These assessments, which often deal with vulnerable people who in many cases have particular complex medical needs, need to be carried out by individuals who know what they are talking about and who have not just been sent on an away day to establish whatever criteria Capita want to apply to let as few applications through as possible.
I congratulate my hon. Friend on securing this debate. One of my West Lancashire constituents had their mobility car repossessed following a PIP assessment, but that was before a mandatory reconsideration or a tribunal to reconsider the case. Where is the natural justice? Does he agree that that is just one more area where the PIP process is ineffective? It is not always cost-effective, and it is certainly uncaring in its treatment of people. All of that has consequences for those being assessed, and it is time for the Government to reconsider their absolutely appalling approach to this problem.
I congratulate my hon. Friend on his speech and on securing this debate. Are not the shortcomings that he rightly describes underlined by the success rate at first-tier tribunal appeals? The Barton advice centre in my constituency has an 82% record in overturning such wrong decisions.
Everything my hon. Friend says is happening in Neath. What is the Department for Work and Pensions doing to ensure that the healthcare professionals who undertake the assessments are mental health specialists, as Capita claims? What exactly does “mental health specialist” mean? Are they qualified mental health nurses, doctors or carers? In one case in Neath, a report was done by a paramedic.
It is a pleasure to serve under your chairmanship, Mr McCabe. I pay tribute to the hon. Member for Wrexham (Ian C. Lucas), who cares passionately about his constituents. I have enjoyed working with him on a wide range of issues relating to my role. I genuinely understand why he takes such a close interest in this subject, and I will do my very best to address the points raised both by him and in the interventions that he kindly allowed.
I want to make a few basic points absolutely clear at the beginning. This is not about reducing the number of claimants or the amount of money spent; it is a fact that the number of claimants and the amount spent will increase in every single year of this Parliament. PIP is a modern and dynamic benefit to help cover the extra costs faced by people with disabilities. By way of comparison with the old system, 16% of DLA claimants would expect to get the highest rate of benefits; it is 22.5% under PIP. An example of where there is a big difference is in hidden impairments, such as mental health conditions. Only 22% of those with a mental health condition would qualify for the highest rate of DLA, but under PIP it is 68% because the system is better designed to take such cases.
That situation comes about because, under DLA, claimants were predominantly assessed on the form they filled in—it was a long, complicated form. I accept that the PIP form is still not the simplest form, but it is better than the old DLA form. Some 70% of people who were given a benefit under DLA had no medical evidence, and the problem with that is that people will often under-diagnose, particularly if they have a hidden impairment. They might take for granted the challenges that they face and think that they are the norm and not something for which they should get support, whereas we recognise as a society that they should get that support.
The job of the assessors is, in effect, to help people fill in their form to a better standard than under the old DLA system. The Government determine how much is paid and how many points people need in order to qualify, so we are at the end of the system, but the assessors are there to assist claimants in making the very best case that they can make.
I appreciate that people with mental health conditions or learning disabilities are likely to do better, but the 2010 Budget clearly set out, on page 40, table 2.1, line 23, that DLA reform was solely designed to reduce spending on working-age DLA expenditure by £360 million by 2013-14 and by more than £1 billion by 2014-15. To claim that PIP is about being more generous to disabled people is just plain dodgy.
No, it is the reality that every year the number of people either on DLA or PIP—as Members can imagine, people are increasingly switching to PIP from DLA—is rising and the amount being spent is rising. That is what is happening. As things stand today, 1.32 million people have gone through the PIP process. About 745,000 claimants are now on PIP, and about 1.5 million claimants remain on DLA.
I say gently that that is a little muddled, but I will come on to explain things. Under DLA, not only was the form complicated and people did not necessarily have the medical evidence, meaning that they could be under-diagnosed, but they were not reassessed. Many Members have implied today that we should not reassess people, but the reality is that every year the condition of one in three people will change so significantly that they should be on a different level of benefit. For the majority of those people, their condition is getting worse, not better.
Under DLA, we found that people were on a lower rate than they should have had for decades. Under the PIP process, there is a lot more evidence, which we use to say, “Right, this person has a fluctuating health condition, or a degenerative health condition, that will probably get worse, and they are currently only on the standard rate, but we have an expectation that they will probably progress to having a requirement for an enhanced benefit at a certain period of time.” We flag that up in the system, and that person would then automatically come in for reassessment.
People who are already on the highest rate and have a degenerative condition are not likely to have intense reassessments on a regular basis. It may very well be that many years pass before there is a telephone call to ask, “Are conditions still the same?” That is something that the old DLA system failed—
Does the Minister appreciate that my constituent Linda Isaac, who is currently receiving chemotherapy for bowel cancer, who has waited for 19 weeks only to be denied PIP and another nine weeks for a mandatory reconsideration, will not appreciate the modern “dynamic” PIP system that he is talking about?
I understand that point. It is difficult to comment on an individual case, and I am happy to look at such cases after the debate. The hon. Lady and I have worked together carefully on a number of cases, and I am happy to extend that invitation again.
The Minister is giving the impression that people on the old DLA are all being upgraded under PIP and retaining their payment. What we see in our constituency casework, however, is people coming off benefits altogether, and he is not addressing that point. Some of those people’s conditions are either getting worse or remaining the same.
I will make one final point, if I may. Will the Minister or his Department take action after the “Dispatches” programme on Channel 4?
I am sure there will be many other opportunities for the hon. Lady to ask me questions, and I look forward to them. Perhaps I have got a foresight of what her next question at Work and Pensions oral questions will be.
I acknowledge that when we first introduced the PIP process there were major problems with timings, but there has been a settled position for about a year now. It currently takes seven weeks for an assessment and 13 weeks—median end to end—to get a decision. The time taken has been reduced by about three quarters since June 2014.
I will now touch on the TV programme, which is obviously topical. I was as appalled as everybody else who watched that programme. To the credit of Capita, it has reacted quickly and the individual concerned— Mr Barham—has been dismissed, and rightly so. We have not been made aware of any evidence that this is a significant issue; it seems to be a disgracefully appalling but isolated one. We have been told, “The overwhelming feedback gathered so far is one of frustration, disappointment and anger about how this individual has let everyone down, undermining the hard work and effort that everyone puts in daily to deliver and continually improve the level of service provided both to the Department and the PIP claimant community.” Capita has assured me that it will conduct further checks to make sure that this incident was an isolated one, and I was genuinely as appalled as everybody else who saw that programme.
Before the programme was screened, individuals had been saying to me that the assessors’ attitudes were wrong. I recounted one particular case, and I have been given other examples that I did not have time to cover today. Will the Minister please speak firmly to Capita and tell it to start treating people with respect?
Let me make some progress and then, if I have time, I will take some more interventions.
The hon. Member for Wrexham made a fair point about the limited time for a claim. It is actually a month, but people can ask for longer. They automatically get two weeks without any questions, and further extensions are considered depending on the circumstances. For example, if somebody says, “I will need assistance in filling the form in”, additional time will be given. If people struggle to fill in the initial forms on their own for a variety of reasons, the Department will send people to help them do so as quickly as possible.
As I highlighted earlier, the PIP forms are shorter and simpler than the old DLA forms. That does not mean that they are absolutely perfect yet. However, part of my role and my officials’ role is that we regularly meet charities, other stakeholders and users of the service, who make suggestions. There are continuous improvements, and I would expect that to keep happening. The hon. Gentleman raised a fair point, and we have a taskforce on our wider communication, with representatives from all the major charities going through things with a fine-toothed comb. I am grateful for all their help and support in that regard.
At the very beginning of the process, if an individual has a condition that means that we have concerns about their ability to return forms, that is flagged up so that we do not just automatically let them drop off the system. We can then be proactive in trying to contact them and contract people who can provide support for them, to make sure, as I say, that they do not simply drop out of the system. That is a very important point.
We are constantly reviewing the quality of the system—that is really important—and one change we made recently was to add a further 10 days for the assessment providers to be able to gather and consider further evidence. That came about because of the 60%-odd success rate in the appeal process, which a number of Members have mentioned. To put that into context, it involves about 2% of total claimants; as I have said, about 1.3 million people have gone through the system. When I first became the Minister and I saw the figure on successful appeals, the first thing I did was to visit the Cardiff office. I said, “Right. Presumably every time one of these is assessed on appeal, you down tools, sit down, analyse what we have done and make sure we never do that again.” Actually, more often than not a decision is overturned because of additional evidence that has been provided—the key word is “additional”—either oral or written. So in theory the decision at the beginning was right, based on the evidence that was given, but we as a Department rightly provide people with two further opportunities to submit additional evidence for a reconsideration.
All Members will share our frustration in this sense—in an ideal world someone would phone up for a claim, give their national insurance number, we would have full access to all their medical records and they would not have to go and find the reports from their doctor or occupational therapist. Former Governments had a good go at achieving that, but for a variety of reasons it has not happened. We therefore ask people to submit new evidence.
A typical example of what can go wrong for a claimant is that they get their GP’s evidence and put that in with their application, but they do not think to get the evidence from their occupational therapist. However, when we send them the letter that does not give them the benefit rate that they were hoping for, the information in it is clear enough for them to think, “Ah! If only I had done that.” They then have those two further opportunities to submit evidence. So the majority of the 65% or so successful appeals are because of additional evidence being submitted, not because of mistakes in the system.
I am grateful to the Minister. His position seems to be that the process is right and that it is the fault of individuals for not submitting information at the right time. Would it not be in the Department’s best interests to save money by ensuring that the decisions are right first time, by allowing individuals enough time to get their medical information in.
We have just added a further 10 days to the process, recognising that point. We want to get the right decision for the claimant first time. That is an absolute given, but we rely on individuals to present evidence. Everyone is unique. Everyone involved is facing a different challenge, which is why they are applying for the benefit. In an ideal world, we would have access to all their information and no one would have to provide it, but as I have explained, that information is not available. My colleagues in the Scottish Parliament are doing some interesting work in this area, and we will look carefully at how that progresses, but we have added that extra time and are trying to be as clear as we can in the letters.
Beyond this debate, I will be interested to look more closely at the points that the hon. Member for Wrexham made about how the information that comes back to people is sometimes not clear enough. However, all claimants can request a copy of the full health professional’s report at any stage in the decision-making process. That is automatically triggered at the independent appeal stage, but it is available before that if people wish to have it.
We are also working on the online application process, to put all the information in one place. A lot of people want to be able to apply online for convenience. An added benefit will be that we can put additional help and support online, but people will still be able to claim in the traditional way if they want to.
I do not have long, but I want to address the point that was made about locations. All claimants in north Wales are offered—