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Work, Health and Disability

Volume 632: debated on Thursday 30 November 2017

With permission, Madam Deputy Speaker, I would like to make a statement on the Command Paper being published today by my Department and the Department of Health.

Good work promotes good health. It enables people to be economically independent, and gives them more choices and opportunities to fulfil other ambitions in life. A country that works for everyone needs to ensure that all who can work or undertake meaningful activity have the chance to do so, and that the right care and support is in place to enable all to thrive in work throughout their lives. Our labour market is in its strongest position for years, with the United Kingdom’s employment rate at a near historic high of 75% and around 600,000 more disabled people in work than four years ago. Despite this, only around half of disabled people are in work, but many disabled people and people with health conditions can and want to work. That means that too many people are missing the opportunity to develop their talents and connect with the world of work, and the range of positive impacts that come from doing so, including good health and social outcomes. That is why it is important that we act now.

With around one in six working-age adults reporting a disability, it is clear that health and disability issues affect the working lives of millions of people. The majority of long-term health conditions are acquired in adulthood, and inclusive workplaces are imperative in an ageing population. That is why in our manifesto, the Government pledged to see 1 million more disabled people in work over the next 10 years. That is as much about preventing people from falling out of work as it is about supporting them into work, and it requires a comprehensive and wide-ranging programme of action.

Last year, we published “Improving Lives: The Work, Health and Disability Green Paper”, which set out the Government’s new and ambitious approach to the issue and marked the start of a new era in joint working between the welfare and health systems. Our 15-week consultation on the next 10 years of reform sought input from disabled people and those with health conditions, their families, employers and a range of stakeholders. The consultation was supported by 166 accessible events, and received around 6,000 responses. Today, we are publishing “Improving Lives: the Future of Work, Health and Disability”, setting out our responses to the Green Paper consultation, as well as the next steps we will take to deliver our vision.

Changes in the nature of work, and more flexible working models, benefit a wider range of people, and new advances in technology offer more opportunities than ever before. For example, accessible hardware and software, and developments in apps and wearable technology, make it easier for employers to offer flexibility and adaptations to their staff. Small businesses and large employers alike are already implementing these solutions for their employees, and it is for Government to help set the direction and stimulate good ideas.

We know that the barriers to moving into work and staying in work are different for each person, depending on the nature of their health condition or disability, their aspirations and their individual circumstances. We need to work directly with people who experience these barriers to identify solutions that will work. We want to build an approach that is responsive and caters for every scenario, with the individual at its heart.

The change needed is not one that the Government can deliver on their own. Across the country, there are striking examples of what can be achieved when employers, charities and healthcare professionals work together locally, but Government can help create the conditions for success.

In the workplace, employers should have the confidence to recruit and retain disabled people and those with health conditions, and to create healthy and inclusive workplaces where all employees can thrive and progress. The best employers have already realised the business benefits of hiring disabled people, and while there are many examples of good practice, we want to go further.

This Command Paper responds to what we heard in the consultation and to the findings of “Thriving at work: The Stevenson/Farmer review of mental health and employers”. We will improve advice and support for employers of all sizes, working in partnership with them, together with disabled people and other stake- holders, to bring together information and advice that meet businesses’ needs. We will also make significant enhancements to the Access to Work scheme, including by increasing the capacity of its mental health support service.

To support a key recommendation of the Stevenson/Farmer review, we will establish a voluntary framework approach for large employers to report on mental health and disability within their workforce. We are also preparing a consultation on changes to statutory sick pay, and we will run a cross-Government programme of analysis and research to examine the incentives and expectations that influence employers’ decisions in this area. We will report back on the preliminary work next year.

We will build on the key role that the welfare system plays in supporting disabled people and those with health conditions to enter work where possible, by developing a more personalised and tailored approach to employment support. We will continue to learn, for example, through voluntary trials to help us build an effective offer of support that meets the needs of those in the support group. We will also continue to improve the assessment process, while building our evidence base, including by working with external stakeholders to take forward reform of the work capability assessment.

Health and care professionals are vital to supporting disabled people and those with health conditions to achieve their employment potential. We will work with and support health professionals with the tools and techniques they need to have supportive conversations with patients about work and health. We are doubling the number of work and health champions and investing about £39 million to more than double the number of employment advisers in improving access to psychological therapies services. We will also conduct large-scale randomised controlled trials delivering employment support in a health setting in the west midlands and the Sheffield city region, beginning by March 2018.

Alongside this Command Paper, I am also announcing the next steps for the Fit for Work service. Established in December 2014, it offers general health and work advice to employees, employers and GPs through a phone line, a webchat service and a website. Since 2015 it has also provided occupational health assessments for employees at risk of long-term sickness absence, with advice on how they can be supported to return to work and remain in employment.

However, referrals of cases to the service by employers and GPs have been much lower than expected. For instance, there have been only 650 referrals a month in England and Wales, compared with the 34,000 forecast, and 100 a month in Scotland, compared with the estimated 4,200. By contrast, use of the advice line, webchats and Fit for Work website has exceeded expectations. I am therefore ending the contracts for the provision of the assessments service in England and Wales and in Scotland, while ensuring continued access to the Fit for Work online and phone services, which will continue to offer general health and work advice as well as support on sickness absence.

The Government are also announcing the appointment of an expert working group on occupational health to champion and drive a programme of work, taking an in-depth look at the sector.

To inform policy development, we have commissioned research to better understand current market supply and the delivery of occupational health provision. This research will look at local partnership models to integrate health and wider support, and it will report in 2019. We will also take account of the lessons from the Fit for Work service as we move forward.

The Government are laying the foundations for a 10-year programme of change. Everyone has their own part to play to achieve this ambitious vision of a society in which all disabled people and people with long-term health conditions are able to go as far as their talents will take them. I commend this statement to the House.

Let me begin by giving apologies from the shadow Secretary of State, who is unable to be here today.

It is welcome that the Government have finally brought this statement before the House. We have waited years since the Work and Health programme was first proposed, with the Green Paper published a year ago and the consultation closing in February. The programme was initially supposed to be launched this autumn.

During the long wait, the Government have dropped the ambition to halve the disability employment gap by 2020. Sadly, today’s statement reflects only the weaker ambition set out in their recent manifesto, reducing the number of disabled people they hope to support into work by up to half a million compared with their previous aims. We should not be surprised by this disappointment, as throughout the Government’s seven wasted years of austerity, it is disabled people who, time and time again, have borne the brunt of their cuts.

The Work and Health programme is no different in this regard, with only £130 million a year set aside for its funding—a fraction of the billions spent on its predecessor, the Work programme. Indeed, the Local Government Association predicts that, with the current levels of funding, the programme can support only 110,000 claimants annually. The Joseph Rowntree Foundation is, unfortunately, more pessimistic, estimating that around 65,000 will be supported under these plans.

That is the reason for the Government’s strategy suddenly needing 10 years. They had promised to halve the disability employment gap by 2020; now it seems they promise to not halve it by 2027. The Government handing themselves an extended deadline to meet a weaker target will be very familiar to anyone who watched the Budget last week.

No doubt due to the Government’s new, relaxed approach, today’s announcement offers little in the way of commitments. It is, sadly, an attempt to kick the issue back into the long grass, with vague statements on pilots, a commitment from the Government to carry on doing what they are currently doing, and some minuscule sums for investment in training. This does not go nearly far enough.

There is a wealth of evidence about what support is necessary to deliver labour market outcomes for disabled people. Why do the Government need to do another round of pilots? We know, for example, that Access to Work is popular among those who use it, focused on the vital issue of retention for those in work, and effective in its results. Yet Inclusion London reports that, instead of expanding the scheme, the direction of travel from the Government has been to reduce the value of Access to Work packages. Will the Secretary of State commit now to expanding the funding for the programme as part of the wider Work and Health initiative, rather than simply saying that the Government will look at enhancements? The evidence has been available for years.

The statement instead praises the Government’s existing Disability Confident programme, yet produces no evidence of concrete results from it. Can the Minister confirm how many additional disabled people have found work as a direct result of the programme? Can he also confirm how much Government money has been spent on Disability Confident per additional person employed as a result of the programme? I suspect he cannot. Once again, we see the Government talking a good game but delivering nothing beyond warm words.

Of course, we welcome the vague nod to a reformed statutory sick pay, although the devil will surely be in the detail of that announcement. Yet another consultation will have to keep us content for the time being. The Government clearly like to listen; it is taking action that they find much more difficult. When will the Secretary of State bring forward details of the consultation, including a timeline for action?

The Government propose to publish a report on local partnership and better integration of health and wider support, but we will have to wait until 2019 for it—two years into their 10-year strategy, and only a year before the 2020 deadline for halving the disability employment gap. That simply is not good enough.

Madam Deputy Speaker, you will remember that when the Government cut £1,500 a year from disabled people by slashing the employment and support allowance, that was justified as being for the sake of an effective Work and Health programme. Today’s statement is clear evidence that they have broken that promise. I hope that Government Members will recognise that this is not what they were promised, and work with the Labour party to demand a stronger programme of support for disabled people. Should the Government be unable to deliver that, they should stand aside and let the Labour party get on with the job.

It is important that we all seek to remove barriers to work and to increase opportunities for disabled people to get into work. I think we should have a constructive debate on that shared objective, and I will take that contribution as a constructive contribution, even though it did not always sound quite like it.

May I pick up one or two points in what the hon. Member for Battersea (Marsha De Cordova) said? Let us be clear: what has actually happened over the past four years is that the number of disabled people in work has increased by 600,000. To go now from 3.5 million disabled people in work to 4.5 million people in work over the course of the decade is an ambitious objective; it will require a great deal of work. I hope there can be a constructive debate in delivering that. I welcome the Mayor of London’s remarks this morning, in the context of the Work and Health programme in London, in which he recognised what we have done and said it was time to put party politics aside on this matter. I hope that we can maintain that spirit across the board.

Let us remember what we are already delivering. The hon. Lady refers to Access to Work. Well, the budget of Access to Work—the expenditure of Access to Work—increased by 8% last year. We have in place the personal support package, helping people, where we are spending £330 million over the next four years. Let me be clear as to how we approach this. We recognise that there will be some disabled people and people with health conditions who will not be able to work, and we need to continue to support them—it is worth noting that we spend record amounts on benefits for disabled people. However, there are also very many people who want to work, and we are determined to do everything we can to support them, whether that is by using our capabilities in the welfare system and the health system or working with employers, because we want to put work at the centre of this.

Work matters. It should be at the heart of what we do in delivering a welfare system. That is exactly what this Government do across the board. I can draw a parallel with our debates last week about universal credit, which helps people into work. That is the approach that we are delivering, and I hope at some point we can have the support of the Labour party in achieving that objective.

May I first welcome this 10-year plan? I am delighted that the Secretary of State and the Department continue to focus on this area. He knows that I have campaigned for many years to improve the life chances of people with autism, but sadly still only 16% of adults with autism are in full-time employment, and only 32% in full-time or part-time employment, and that percentage has not really shifted much in a decade. I pay tribute to the Secretary of State for International Development, to whom I presented, on 21 February, when she was a Work and Pensions Minister, a cross-party petition, signed by 30,000 people, about the autism employment gap. Can he give me an assurance that he will continue to focus on the needs of people with autism and close that gap once and for all?

I thank my right hon. Friend for her question and pay tribute to the work that she does on autism, including the work that she has done for many years now as chair of the all-party autism group. Yesterday she published a very good report on the issue and we are studying its contents closely. She highlights this issue. That is the challenge: we have made progress across the board, but is there more to do? Absolutely; there is more to do. She highlights the employment gap for those with autism. That is something that we do have to address as a society.

I thank the Secretary of State for advance notice of the statement.

The SNP is extremely disappointed in the statement and the Command Paper that have been produced today. We believe that the UK Government, as a priority, need to reverse the cuts they have made to these benefits and need to scrap the freeze on benefits, because they are harming people.

Mencap has released a statement that says:

“We are alarmed that the needs of hundreds of thousands of people with mild or moderate learning disabilities have been overlooked.”

The Government seem to have abandoned their pledge to halve the disability employment gap, and the gap is even worse for those people who have learning disabilities.

The Disability Benefits Consortium has said:

“We are extremely disappointed that they have chosen to focus on the design of ESA, instead of the broken Work Capability Assessment.”

Sixty-eight per cent. of those challenging their work capability assessment results are successful in that challenge. The system is discredited and broken. We want to see the UK Government committing to scrapping the work capability assessment. We want to see them committed to putting in a new system that puts fairness, dignity and respect for disabled people at the absolute heart of the system.

First, in response to the hon. Lady’s comments on behalf of the SNP, I know that the Minister for Disabled People, Health and Work, my hon. Friend the Member for Truro and Falmouth (Sarah Newton), has spoken to Scottish Government Ministers today and got a much more constructive response. It is the launch of the innovation fund for the Dundee gateway today and we look forward to working closely with the Scottish Government in a constructive manner.

We have consulted on the work capability assessment. It is not clear that there is consensus at this point as to the way in which the work capability assessment should be reformed, but we acknowledge that there are improvements that should be made. We have indeed made improvements in how the work capability assessment works; for example, those with severe long-term disabilities will not be reassessed in the way that they were previously. So we continue to make improvements on that. If we can reach consensus on the way in which the work capability assessment should be reformed, I will be happy to proceed with that.

I strongly welcome the statement that the Secretary of State has made this afternoon. I also welcome the news that the disability employment rate has risen by nearly 5% since 2014. The Government are obviously a major employer of people. What are the Government doing to ensure that the civil service leads by example in this area?

My hon. Friend makes a good point. The Government are a large employer. I am pleased to say that all Government Departments are Disability Confident employers. One of the points that we make in the Command Paper is that, as an employer, it is important that the civil service leads by example in terms of how it operates and the support that is provided to disabled people.

I thank the right hon. Gentleman for his statement and welcome the passage in which it sounds as though he will introduce significant improvements to the Access to Work programme. Does that include abolishing or raising the cap on support for deaf people that was introduced in March 2015?

We continue to review that matter. We have certainly received representations on that point, and we continue to look at the evidence.

My father was made disabled at work. When that happens to someone, it can really affect their life chances. I congratulate Microlink, a company in Chandler’s Ford that has been going for more than 23 years, which enables people with certain conditions and disabilities to get back into education or employment by helping them with the challenges that they face. Will the Secretary of State undertake to listen to such companies, which do so much to keep people in work and education and give them opportunities at every point in life?

I praise the employer in my hon. Friend’s constituency. Very good employers lead the way. There are now 5,000 employers signed up to the Disability Confident scheme, and we want to ensure that the best practice that is pursued by many employers is pursued by all employers.

The Secretary of State will be aware of evidence presented to the Select Committee about individuals’ frustration with the Minicom service and text relay operators. It is not acceptable for people to wait 45 or 50 minutes to access those services, or to be hung up on. Can he assure me that the Minicom service and text relay operators will be adequately staffed?

We are always looking at what we can do to improve the service that is provided. When the standard falls below an acceptable level, something clearly needs to be rectified.

I welcome the statement. I am sure the Secretary of State agrees that, particularly when it comes to mental health, we need to tackle the taboos that may prevent people from accessing help when they first think that there may be an issue. Will he make that a key part of his strategy, to help to keep people in work and make employers more confident about employing people who have a history of mental health issues?

There has clearly been a very welcome change in attitudes in respect of mental health in recent years. We need that sort of cultural shift more broadly in the recognition and understanding of disabilities or health conditions that may have held people back in the past, but can be dealt with and accommodated. Employers can take steps and put in place adaptations to enable people to continue to work, as the Command Paper argues strongly.

Will the Secretary of State start a specific job of work looking at support for people with acquired brain injuries, whether they result from concussion in sport, which might lead to chronic traumatic encephalopathy, or from other injuries sustained in, for example, a car accident? The truth of the matter is that we do not have anywhere near enough rehabilitation units around the country. Rehabilitation can get people right the way to cure and get them back into work, and it is immensely cost-effective for the Government. I urge him to meet the brand new all-party group on acquired brain injury, which I chair, and to look specifically at this job of work so that we can get those people the real-life opportunities that they need.

The hon. Gentleman raises an important point, and I know that the Minister for Disabled People, Health and Work is particularly keen to meet him in his capacity as chair of the all-party group to discuss the issue further.

I wonder whether the Minister or other Members watched the programme “Employable Me” on BBC2 the other night. When I watched it, I was struck by the courage of the disabled people who were very keen to get back into work but faced insuperable challenges, and by the enlightened employers who gave them a chance. It demonstrated the life-enhancing power of work for people who make a positive choice to work and who are supported. Will the Minister think about how difficult it is for small businesses and charities, which featured in the programme, to give the right support? Will he tell us how this welcome statement will make that go further?

I confess that I have not had the opportunity to see the programme that my hon. Friend mentioned, but she is not the first person to recommend it strongly to me. I will perhaps endeavour to watch it over the weekend. She raises an important point about small businesses. We need to help small businesses to find the best way of providing support to disabled people. That will give small businesses access to people who, as I understand the programme demonstrates, have significant ability, are very talented and could bring a lot to the labour market, but who have not had the opportunities that they should have had, partly because of attitudes, culture and so on.

I note that the statement mentioned taking forward reform of the work capability assessment. I have certainly found that to be a major issue in my constituency case load. I think of Jean Birrell, my Fullarton Park constituent, who was treated really quite poorly in the work capability assessment process. May I ask the Secretary of State when he last sat in on a work capability assessment?

I have not done so, but we have made reforms to the work capability assessment process. As I said earlier, those with severe disabilities no longer need to be reassessed in the same way. I have dealt with the matter as a constituency Member of Parliament, and I recognise the concerns that exist. I also recognise that there is not, as yet, a consensus on exactly how the work capability assessment should be reformed.

In welcoming the Secretary of State’s statement about helping more people with health conditions back into work, may I ask what is being done to enhance the Jobcentre Plus offer, specifically in relation to helping people who have mental health issues and learning disabilities with universal credit applications?

My hon. Friend makes a good point. We have 300 disability employment advisers in place. I have met them and discussed their work, and I am struck by the specialist support that they can provide. We are also putting in place 200 community partners to assist further on the matter. We are trying to ensure that Jobcentre Plus is well placed to provide the support that people need.

Are we in danger of setting a very dangerous precedent, whereby constituents who are in possession of a sick note from a health professional—whether that be a consultant, a doctor or perhaps a psychiatrist—have it overridden by the work assessors, who declare them fit for work? I had a disabled constituent visit me just two weeks ago; her disability is clear for all to see. She was asked how she did her shopping, and she said that she did it online every couple of weeks. She was told that she was therefore fit to work in an office for 37 hours a week.

Whether we are looking at ESA or PIP, the percentage of assessments that are overturned on appeal is running at about 4%. I would rather it were lower, but let us put it in context.

Today’s Command Paper is a huge step forward, and it should be welcomed. When it comes to attitudes, does my right hon. Friend agree that we need to tackle the culture, in some quarters, of failure to harness disabled people’s potential in the workplace?

My hon. Friend is absolutely right, and I come back to the point about the need for a culture shift. The Government have an important role to play in making the case for that, and I am determined that we will do so.

The timely payment of PIP is an important support for disabled people, whether they are in work or not. My constituent Margaret has had two strokes, and she had to make a 70-mile round trip for a PIP assessment with her daughter, who had taken a day off work. Her meeting was cancelled on the day she turned up, despite the fact that she had received written confirmation, and there was no record on the DWP system. Will the Secretary of State investigate the growing problem of PIP appointments being cancelled because of a lack of resources, and the impact that it has on disabled people in the highlands and elsewhere?

Clearly, what happened in that particular case was unacceptable, and we need to address those issues. When it comes to delays in payment of PIP and assessments of PIP, we have made progress in the last couple of years or so, but we need to continue to ensure that the standard is adequate.

How does the Secretary of State react to the fact that Lord Shinkwin, an applicant for the post of disability commissioner, complained last week that he believes the post is about to be downgraded or abolished? Lord Shinkwin is a magnificent example and role model of someone who has overcome a severe disability. How does the Secretary of State react to a visible defect in the Government’s failure to act on a complaint I made some years ago about a constituent working in the civil service whose career came to an end because he could not get wheelchair access to the Box in the corner of the Chamber?

I was not aware of the latter case, but the hon. Gentleman raises an important point. I agree with him that Lord Shinkwin is a great example. My understanding is that that decision is for the commissioners of the Equality and Human Rights Commission, without any ministerial interference as to whether there is a particular disability commissioner role. That is my understanding of the situation.

I thank the Secretary of State for the important work on this issue that has been done by his Department with the all-party group on disability, which I chair. A clear recommendation from our inquiry report is that a significant improvement could be made in employment if we leveraged public procurement contracts towards Disability Confident employers. Will he consider that further, and write to the all-party group with his thoughts?

First, I thank the hon. Lady for the work she does with the all-party group, and for her kind words about its engagement with my Department. She raises an interesting point about procurement. She will be aware that, when it comes to procurement issues, Departments and sectors very often have different asks, and the Cabinet Office obviously has to take a view. However, we are considering the issue, and I encourage all major companies, particularly those that have engagements with the Government, to look very carefully at what being a Disability Confident employer involves.

Will the Secretary of State update the House on the progress made for people damaged by the state when they received contaminated blood products during the contaminated blood scandal, particularly in relation to passporting benefits to them so that they do not keep having to go through regular assessments?

My constituent Jade Minto suffered mental health problems and had to give up her work, but she subsequently gained a qualification to enable her to work in the care sector and has been offered a job. That sounds like a good news story, except for the fact that she is on ESA and allowed to work only a maximum of 16 hours of week, and the DWP will not allow her to take up the position because she needs to do an internal training programme that would take her over the threshold of 16 hours a week. Will the Government look at ending this crazy situation?

I am grateful to the hon. Gentleman for raising that case. I agree that that does not in any way sound like a sensible situation. The good news I can give him is that such a situation will not happen once universal credit is brought in.

One of the major concerns of disabled people in my constituency is about the impact of universal credit. I note that in the right hon. Gentleman’s statement last week, he postponed the roll-out of universal credit in his constituency and those of the Prime Minister and the First Secretary of State. As he is in the mood to reconsider the policy, will he do the same and pause the roll-out of universal credit for the people of Barnsley East?

The previous question provided an example of how universal credit will actually be much better for disabled people. We are rolling out universal credit in a way that is safe, and we are making adjustments as and when we need to, but I am pleased to say that the date on which universal credit will be fully rolled out remains unchanged—March 2022. If it could be earlier, I would make it earlier, but that is the safest point at which we can do it. As I have said, universal credit will be an advantage for many disadvantaged people, because they will not be faced with some of the current disincentives, such as not working more than 16 hours a week.