Grand Committee
Thursday, 25 June 2009.
Welfare Reform Bill
Committee (6th Day)
Clause 7: Abolition of income support
Amendment 83
Moved by
83: Clause 7, page 13, line 34, at end insert—
“( ) No category of person may have its eligibility for income support removed without a thorough examination of the proposals by the Social Security Advisory Council.”
We had a substantial discussion about the possibility of the removal of eligibility for income support at our last meeting. Several of us made it very clear that we had received letters from women—mostly carers—who were concerned lest their income support be removed and not replaced by anything else. We had some assurances from the Minister, who made it quite clear that he understood these worries. Indeed, he committed that there would be no removal of eligibility except after an affirmative resolution. We are very grateful for that. On the other hand, there are a lot of very concerned people out there. A lot of people are worried that they may lose their entitlement to income support, and income support is all that they have to exist on, particularly if they are carers.
In particular, I brought to the Committee’s notice a letter that I had received from a woman who was the carer for a disabled child. Quite clearly she was concerned that she would have her income support removed and not replaced by anything else unless she committed herself to waged work or work-related activity. It therefore seemed worth pursuing this amendment, the text of which was suggested by the TUC. As I said last time, the TUC is also very concerned about this because the clause gives the impression that there would be a substantial investigation by people concerned with social security, hence the requirement in the amendment that it be removed only following examination of the proposal to do so by the Social Security Advisory Committee. That would give further assurances to the people who have written to me, and to others who are so concerned that the income support that they have relied on may disappear without anything taking its place unless they commit themselves to work-related activity or some sort of waged employment. For those reasons, I think it is worth pursuing. I beg to move.
As the noble Baroness, Lady Turner said, we had a substantial debate on this in the last sitting of the Grand Committee, but it is no bad thing that she has moved her amendment. I am a huge fan of the Social Security Advisory Committee and very much admire its reports, which I draw on a lot when I speak. This is a good safeguard but I hope the Minister will tell us that we will get a report from the advisory committee anyway, under either the affirmative order or the negative procedure. It should be affirmative because he has promised us that it will be, as long as it is not brought in within six months of the passing of the Bill. The advisory committee does not look at any proposal of under six months, does it? I think that is right, but perhaps the Minister could confirm it. We very much need the advisory committee’s wise words; the noble Baroness is quite right.
I add my support. In some of the letters that I have seen sent to lone parents, the last thing that seems to have been of concern is whether they were able to do waged work. The letters emphatically state that they will lose their benefits unless they present themselves for work. For many single parents and many other women it is not that easy because they do not have easy access to good transport and they do not have the time to do it. When they will be free is very unpredictable. I very much hope that this amendment will be included.
The Committee will realise, if it remembers what I said on the last group of amendments, that I am sympathetic to the noble Baroness, Lady Turner, on this one. However, I am not so sure that just putting the amendment into the Bill will be enough to satisfy those people from whom she has received correspondence.
I note from page 23 of the Peers’ information pack that, after the Bill gets cracking, 13 groups of people will remain on income support until they are migrated. As I understand the matter—the Minister will correct me if I am wrong—that is to be by statutory instrument for each group, so we will be able to look exactly at how the modified JSA affects individual groups under, presumably, some sort of period; I cannot imagine that it will all be done rapidly. A lot of thought will have to be given to those on income support who are entitled to statutory sick pay, for example, or—the noble Baroness, Lady Turner, would be interested in this—people involved in trade disputes. Each will have a slightly different formulation.
I cannot yet discover something; perhaps the Minister will help us. Page 23 states:
“With the exception of sick and disabled claimants and possibly those in receipt of statutory sick pay DWP plans to move them all onto the modified form of jobseeker’s allowance”.
The question behind the amendment is really whether the modified formulation of JSA will be appropriate to each and every one of the 13 groups. That is what the Minister needs to answer.
I thank my noble friend Lady Turner for her amendment, which gives me another opportunity to provide some reassurance—I hope—on issues on which, I acknowledge from what she and other noble Lords have said, they have had a lot of correspondence. On the issue about reference and engagement of the SSAC, I hope that I can specifically satisfy her on why it is not necessary for the provision to be in the form that she proposes.
The amendment is aimed at ensuring that we cannot remove entitlement to income support from any category of person without the SSAC’s thorough examination of the proposals. Throughout the process, we have always maintained that abolishing income support is the next logical step in streamlining and simplifying the benefit system. It builds on much of the work we have already done and will move us to a system based on two main benefits for people of working age—employment and support allowance and jobseeker’s allowance. However, we have also maintained that the process cannot be rushed; I say that in response to the noble Lord, Lord Skelmersdale. Step-by-step change is the only way we can ensure safe delivery and minimise disruption for our customers. Income support will be abolished only when there are no longer any groups for which it is needed, because alternative provision will have been made using either the new powers in Clause 3 or other available powers.
Although we have not made any final decisions yet, at this stage we do not expect to move everyone off income support at the same time. We have made it clear in previous debates that we will need to look carefully at the position of certain groups, particularly carers, which is why we need the flexibility that the clause provides.
On that basis, the removal of entitlement to income support for most groups is likely to be achieved through regulations made under Section 124 of the Social Security Contributions and Benefits Act 1992. As a result, they will be subject to scrutiny by the advisory committee as part of its statutory duty to examine any regulations under Acts of Parliament governing social security.
It is true that when the clause is commenced, there may be some groups who have not yet moved off income support, although we will have set out where they will be moving to. As a result, the committee may not have the formal role suggested by the amendment when they are moved off it. However, in practice, we will continue to talk to the SSAC on issues such as this. There are voluntary arrangements currently in place that allow us to provide the committee with information on new legislation that would not normally fall within its remit. This includes new primary powers and the regulations made within six months of the commencement of those powers—the noble Baroness, Lady Thomas, quite correctly referred to that. These arrangements are certainly something that we would pursue in respect of the clause.
Furthermore, as I said earlier, we have accepted the recommendations of the Delegated Powers Committee, which concluded that Clause 7 should be subject to affirmative procedures, and will be tabling an amendment on Report to do just that.
I reiterate that income support is not abolished in the Bill; the Bill provides a mechanism to abolish income support by order. One of the main reasons for that approach is that there is no firm timetable because of the need for flexibility to ensure that all groups are properly provided for. The Bill provides for income support to be abolished when there are no longer any groups who need it, but not before. To reiterate, no firm decision has yet been taken on the timetable.
I hope that that is a reassurance to my noble friend and other noble Lords who have spoken that the SSAC will inevitably be involved in the detail as these matters move forward.
I do not want to repeat what I said at the end of our previous sitting in Grand Committee, but I feel honour bound to ask the Government to think very carefully before they decide finally to use an affirmative instrument to do away with income support. After all, these groups will no longer be on income support; there will be no income support customers for whom income support will be abolished. I therefore repeat my comment last Monday that it seems a very strange use of parliamentary time to use the affirmative procedure in those circumstances.
In Committee in another place, we said that we would give full consideration to the comments of the Delegated Powers Committee, and it recommended that the affirmative procedure should be used for Clause 7.
It would be a wonderful world if the Government of the day, especially this Government, accepted everything that all your Lordships’ Committees had to say, but that just ain't so.
I thought I had put on the record already, and again today, that we have accepted that recommendation that it should be done by affirmative procedure. Perhaps I am missing the noble Lord’s point.
I do not understand it either, because if it was a negative instrument I, my noble friend Lord Kirkwood, or someone else would table a Take Note Motion at the very least, so it would be debated somewhere—either on the Floor of the House or here—in any case. Making it an affirmative instrument is not wasting the time of the House at all.
I thank very much everyone who has contributed to this debate. I listened to what my noble friend said with considerable interest. I think he went quite some way to deal with the concerns expressed by all of us about the letters we have had from women who are very worried that they will not get any benefit at all if they do not sign up for a work-related or other kind of commitment. I made a careful note when he said that no groups will be excluded or lose their entitlement before they have any other entitlement. In other words, individuals will not be simply left without anything. That is very important. People are concerned that if they do not sign up they will lose any benefit. It is important to have on the record that it is not the intention that groups of any kind should be left without an income, irrespective of what they may have in the way of caring or other commitments and so on.
In those circumstances, I will withdraw the amendment and read with great interest what has been said by all contributors to the debate, including my noble friend. In the mean time, I beg leave to withdraw the amendment.
Amendment 83 withdrawn.
Clause 7 agreed.
Schedule 2 : Abolition of income support: consequential amendments
Amendment 84
Moved by
84: Schedule 2, page 68, line 32, leave out paragraph 9
Amendment 84 agreed.
Schedule 2, as amended, agreed.
Clause 8 : Power to direct claimant to undertake specific work-related activity
Amendments 85 to 93 not moved.
Clause 8 agreed.
Amendment 94
Moved by
94: After Clause 8, insert the following new Clause—
“Entitlement to tailored employment and career support
(1) All new employment and support allowance (ESA) claimants and existing incapacity benefit claimants who are migrated to ESA, who have a diagnosed mental health problem which impacts on their ability to undertake work, shall be entitled to an assessment carried out under, or linked to, the Access to Work scheme to determine what reasonable adjustments may improve the likelihood of retention should they find employment; and this assessment must be carried out before the claimant may be compelled to undertake any compulsory work-related activity.
(2) The assessment to be carried out under subsection (1) shall include evidence-gathering from agencies responsible for a person’s employment support and for the provision of health services here appropriate and must include at least one interview with the claimant.
(3) Any reasonable adjustments, recommended by the assessment, shall be funded through the Access to Work scheme and shall be available to any employer wishing to employ the claimant.
(4) Available funding for reasonable adjustments shall be communicated to employers by a claimant’s employment adviser and shall be transferable to a new employer in the event that the claimant moves jobs or employers.
(5) The assessment shall be reviewed regularly when the claimant moves jobs or employers (or both) to identify any changes to the adjustments required by the claimant.”
The amendment is suggested by the Mental Health Coalition, a group of interested organisations consisting of Mind, Rethink, the Royal College of Psychiatrists and the Sainsbury Centre for Mental Health, groups that I am sure that noble Lords will recognise. I agreed to table the amendment as it did not get much of an airing in another place. I am glad that the noble Baroness, Lady Thomas, and the noble Lord, Lord Ramsbotham, have added their names to that of my noble friend Lord Taylor and my own.
The amendment would work by giving all ESA claimants an entitlement to an assessment carried out by, or linked to, Access to Work funding, to determine what adjustments might reasonably be made to improve the likelihood of a pension should they find employment. A claimant would not be compelled to undertake compulsory work-related activity until this assessment had taken place. The amendment would ensure that reasonable adjustments recommended in the assessment are to be funded through Access to Work, and are to be available to any employer.
Access to Work is of course administered by Jobcentre Plus and aims to assist people with a disability or health condition who are in paid employment or about to start a job by providing practical support and help to meet additional costs associated with overcoming work-related obstacles resulting from their disability or health condition. Dame Carol Black’s review of employment, which the Minister and I were discussing in part last night, called for tailored support for people out of work, in both finding employment and keeping it. The scheme proposed in the amendment should be seen in this context, as a complement to existing schemes, very much in tune with the individual nature of the action plans that we have been developing.
Evidence gathered by the organisation that developed the amendment suggests that Access to Work does not yet work effectively for people with mental health problems. Too few people with mental health problems are taking advantage of the scheme, and employers do not have sufficient support and understanding.
In 2007-08, just 180 claims to Access to Work were made for mental health adjustments out of an overall total of just under 30,000. This seems, to me at least, to be a painfully low figure. The conclusion that one comes to is that if we can create greater flexibility in the timing of Access to Work assessments so that people can receive an estimate of the support they can expect to receive, take-up would improve and one hopes that employer discrimination would be reduced. Individual assessments before interview would help make people with mental health problems more attractive to employers. These adjustments should follow the person through their career to ensure that barriers are not perpetuated for people with mental health problems as they progress through that career. We must presume that it will be a powerful counterbalance to the fears of an employer of costs involved in adjustments and potential time off if a person is able to explain how much help Access to Work is likely to provide to the firm they are trying to work for.
I shall be very interested to hear the views of other noble Lords on this matter, not least the Minister, because I feel that we have an opportunity to address an area where we know there to be a weakness in the system; namely, helping those with diagnosed mental health problems to get into and retain employment. I beg to move.
We strongly support this amendment. As the noble Lord, Lord Skelmersdale, said, it brings us to a discussion about an entitlement to an assessment under the admirable Access to Work scheme for those with a diagnosed mental health problem which impacts—as the amendment says—on their ability to undertake work.
Last year the funding of Access to Work was doubled but there is no evidence yet to suggest that it is working particularly well in the mental health field, as the noble Lord has just said, or for people with learning difficulties, although I accept that the latter category of people are not specified in this amendment. What is clear is that far too few employers understand what Access to Work is all about. If there is some understanding about help for those with mobility problems, there is even less understanding about help for those with mental health problems. The amendment would ensure that all ESA claimants in the employment group would be entitled to an assessment with a view to determining the necessary adjustments needed under the Access to Work fund to enable them eventually to find and then keep a job, which is a very practical way of helping both claimants and prospective employers. As Mind has said, Access to Work does not support individuals to “sell” themselves to prospective employers at present as it is not perceived to be part of an individual’s “capital”. Often, the slow bureaucracy puts people at a severe disadvantage.
Another very important voice in this whole debate is the committee we have just been talking about—the Social Security Advisory Committee—which says that the engagement of small and medium-sized enterprise employers with the whole issue of the reasonable adaptations that need to be made to overcome barriers for disabled people has not been considered in enough depth. In particular, it stresses that the needs of those with fluctuating mental health conditions should be considered more fully. I shall come back to that in a moment. The committee makes the point that engagement with employers is important, as is the education and training provided to personal advisers in providing services to claimants in this position. As I have said before, that has been something of a leitmotiv through this whole Grand Committee.
Coming back to the mental health issue, two groups of people with severe mental health problems have been brought to my attention in the past few days, about whom there is great concern. There is a letter in today’s Guardian about it. These are mostly people with schizophrenia and those who are bipolar. These are serious but fluctuating conditions with a wide range of characteristics. It is quite possible that claimants who suffer from either condition will be in the employment rather than in the support group, and will therefore be expected to be on the journey into work by undertaking work-related activity. I could have raised this issue under a Clause 8 stand part debate, but I hope that noble Lords will agree that it is relevant enough to this amendment to raise it here.
Others in this Grand Committee know far more about schizophrenia than I do, but I have taken some instruction from my noble friend Lord Alderdice, who is a psychiatrist. He said that when people who have this condition are becoming ill they are not likely to be self-aware and there is a strong likelihood that they could be sanctioned for not undertaking work-related activity. Those who work in the field are extremely concerned about this possibility and, although it is not strictly relevant to the amendment, I hope the noble Baroness will address this concern.
As the Guardian letter says:
“We need a system in which people suffering fluctuating conditions are able to move in and out of work without fear of punishment or loss of income. It will require flexibility in a properly funded system, government support for employers, an integration of non-coercive support, therapy and care for people with mental illness. Instead of the Bill contributing to the problem of mental illness in Britain, it could become part of the solution”.
The last sentence is important because it demonstrates that the kind of support outlined in part in the amendment is what people are calling for, and not that those with fluctuating mental health conditions should be exempt from seeking work. One scheme which is having some success in the pathfinder project is the condition management programme and I wonder whether there are any plans to expand it under the Bill.
An offer for paid-for adjustments through the Access to Work fund would make prospective employees with a history of mental health problems much more attractive to employers. What could this mean in practice? It could mean providing in the short term a potential employee with a personal mentor or a job coach, or, in the longer term, a counsellor or support worker, or even a travel companion to and from work.
The more I look at the amendment, the more important I believe it to be. Making the Access to Work scheme fully portable and likely to be available before a person has left the jobcentre would also be a very positive step. I look forward to the rest of the debate and to the Minister’s reply.
I declare an interest as an adviser to the Sainsbury Centre for Mental Health. I was, therefore, very much involved in all the work leading up to the amendment, not in the drafting but certainly in the posing.
I have mentioned many times, in connection not only with this Bill but other Bills that are going through the House at this time, the fact that I find it extraordinary that no assessment has been made of the impact of any of these Bills on any other Bills. At the moment, those of us who are involved in the apprenticeships Bill are also involved in the assessment of those with mental health and learning difficulties to ensure that they get education. Why should these not have come together? The Committee will not be surprised that I, as a former Chief Inspector of Prisons, find it extraordinary that the needs of prisoners with mental health problems are not addressed either in the Coroners and Justice Bill from the Ministry of Justice or in the Policing and Crime Bill from the Home Office, when both are concerned with diverting people with mental health problems away from prison and into places where they should be properly treated. In other words, we go round and round trying to find a place to inject.
This month the Sainsbury Centre has published a document called Measuring What Matters, which will not have reached everyone yet because I got it only yesterday. It is about measuring the size of the problem which is included in the amendment, together with a guide as to what that assessment might be. Rather than be just a guide, it is based on pilots that have been conducted in 17 sites around the country over the past two years. The pilots were to find out the size and shape of the problem and how getting people with mental health problems into employment was being tackled. I shall not bore the Committee, even if there was time, with all the details, but some of the measures in the report—which I commend—are very significant. When talking about participation in the pilot, which included the Department for Work and Pensions and the Department of Health, it said:
“In general, the level of engagement of commissioners in the project was poor … The engagement of employment service providers, particularly those from the independent sector, was far more encouraging … Local ‘champions’ were invaluable in facilitating adoption of the framework”,
because they were the people who were,
“capable of winning over the ‘hearts and minds’ of busy clinicians and key managers”,
and:
“There was no doubt that those sites which invested most fully in the project gained the most benefits”.
If we are talking about helping people into work and maintaining that work, we are actually talking about what the noble Baroness, Lady Thomas, was just now: the individual placement and support model, which has been in action since 1994. It remains the best model to be followed. It is absolutely what it says: individual placement and support. The point is that all these people are individuals with individual problems. You cannot predict them; you cannot put them into great groups. Each one has to be handled separately. The message to each and every group of commissioners and providers around the country is that they must be prepared to deal with these people.
The interesting facts and figures show that:
“In most sites, two-fifths of incapacity benefit claimants were out of work because of ‘mental health and behavioural disorders’, while only one-fifth of people of working age in contact with specialist mental health services were in paid employment”.
“Only one-fifth” out of the whole lot is something for which we should take no credit.
The Minister and others should take the amendment very seriously. Its importance is that it comes from people who have been doing this work on the ground with these people over many years but particularly for the past two years. None of us in this House really has the benefit of them. We meet them, we hear them and we are briefed by them, but we have not actually been doing the work. In my experience, there is no substitute for those who have actually done it, which is why I so strongly support this amendment.
I am very grateful to the noble Lord, Lord Skelmersdale, for tabling this amendment. My only regret is that I did not table an amendment to the amendment to include people with fluctuating medical conditions. They suffer from the same difficulties, and it would be enormously helpful, if the amendment comes back on Report, if we could add them.
The Minister will have had a letter this week, I hope, from a lady called Sarah Smith, who describes how she has tried and tried to work but eventually had to give up. She has been rejected by Atos Healthcare twice and has appealed. This is no way to treat people who are trying to work. They need support and assistance, so I support the noble Lord, Lord Skelmersdale.
I support the amendment very strongly. In some ways, it is one of the most important amendments of the whole lot in terms of the Government’s own objective of getting 1 million people off employment support allowance within, I think, 10 years, particularly when 40 per cent of people on the employment support allowance have mental health problems.
Although I have not done the work of individual placement and support, I have spoken to a number of people who have, and we have introduced those sorts of workers across my own mental health trust in east London in all our community mental health teams. They are working to help people through the applications and interview process, to help employers, and to help the individual to hang on to a job as best they can once they are in it. This is the hard end of mental health, but the Access to Work programme has tremendous potential to contribute fundamentally and significantly to the Government’s objective.
Obviously I should not encourage money to be diverted from physical disability to mental health, issues so I am not suggesting that, but ultimately one wishes more money to come into this wonderful programme so that far more people with mental health problems could be included. I hope that the Minister will take seriously the comments already made well by other noble Lords. If the Government want to achieve their objective, they need to take the amendment seriously.
I add my support, particularly due to the considerable invisibility of mental health issues among minorities because of the unwillingness of people to admit to having mental health issues. It is a taboo and not expected. If there is a tailor-made programme developed in conversation with particular women or men, they may be able and willing to find out what is wrong with them, to seek the appropriate treatment and go on to work. That would be an enormously helpful step.
I apologise to the Committee for my late arrival; I am swapping between Chambers today.
I support the amendment. The wording of the noble Lord, Lord Skelmersdale, really encompasses some of the core problems that we have been trying to address throughout the Bill, particularly on people with mental health problems. It is a mechanism that would enable us to tackle this in a way that would reassure many of us that the problem is being taken seriously. The rest has been said eloquently by others.
We have had an extremely wide-ranging and well informed debate from the noble Lords, Lord Skelmersdale and Lord Ramsbotham, the noble Baronesses, Lady Thomas, Lady Meacher, Lady Afshar and Lady Murphy, and the noble Countess, Lady Mar. I understand the aims of this laudable amendment, and the Government do indeed take it seriously. However, we have a number of difficulties associated with it.
The amendment seeks to ensure that everyone with a diagnosed mental health condition should be assessed before they carry out any work-related activity, so that any reasonable adjustments are made once someone finds work. This is unnecessary, in the sense that we already cover this ground; I will obviously go on to expand on that. It duplicates existing provision, is impractical and would introduce extra bureaucracy and quite serious cost.
It is unnecessary because we already assess an individual’s needs and have provision in place to ensure that they are met. We do this in a number of ways. The noble Baroness, Lady Afshar, talked about the importance of keeping flexibility in the system and keeping that relationship personal. Within the employment and support allowance, as part of the work capability assessment, we carry out a work-focused health-related assessment. This assessment explores the impact of a claimant’s health condition and their barriers to work. This assessment is carried out in a face-to-face interview with the claimant by a health professional, and the outcome is then passed on to the personal adviser.
In addition to this, work-focused interviews are designed especially to discuss positive steps towards work. In many cases, this will involve a discussion around the need for particular adjustments to be made should an individual move into a job. Support through Pathways to Work provides help to move closer to the labour market, and to look for work.
Clause 8 will give a personal adviser the power to direct a customer to a work-related activity in prescribed circumstances. This direction must be reasonable, having regard to a person’s circumstances. This will of course include the customer’s health condition. An additional assessment, therefore, is not necessary given that Clause 8 will cover these areas.
Access to Work already provides an assessment for anyone who may require in-work support once they have a job offer or a job interview.
When does the Access to Work fund get mentioned to the claimant? At what point would that be mentioned?
It should be mentioned in a work-focused interview.
That is when it should be mentioned, yes.
The noble Baroness has used the word “should” twice. The question is: exactly what happens?
Yes, that is the process.
Crucially, this assessment identifies the specific support required to undertake a particular role. Given this, we believe the amendment is impractical because it is impossible to determine what reasonable adjustment someone might need until you know what job they are going to do. The amendment would have us carry out assessments before someone even begins a work-related activity. For many people, an initial work-related activity might stabilise their home life through their attendance, for instance, at debt management classes or confidence-building sessions.
While these first steps may be crucial in an individual’s return to work path, they would tell us little about what work the claimant would want to do in the future. Without knowing exactly what type of work the claimant would like to do, we would not be able to work out what reasonable adjustments would be appropriate. The right adjustments would be different between different types of job—for example, between an administrative job, a sales job or a manufacturing job. What is reasonable will depend on the employer; for instance, what is reasonable for a huge multinational will be different from what is reasonable for a small business.
The amendment would add extra bureaucracy as it might mean an additional assessment on top of the ones that I have described. It is right that we ask customers to come to a medical assessment and to come to interviews to help them think about ways of getting back to work, but the amendment would add another meeting and another person to speak to. This could be confusing, especially when the assessments and the interviews we are already carrying out perform many of the same functions.
It would add extra costs. Access to Work currently reaches around 28,000 people each year and we accept that it should reach more people, a point made very clearly by the noble Lord, Lord Skelmersdale, in his opening remarks. This is why we have announced that we are doubling the funding by 2013-14, which the noble Baroness, Lady Thomas, acknowledged. However, the additional cost of the amendment would be around three-quarters of a billion pounds and, as discussed earlier, much of it would duplicate existing provision or serve no practical purpose.
We do not think that it is right that the Government should have to fund all the costs of reasonable adjustments. The Disability Discrimination Act enshrined the principle that the employer should bear those costs which are reasonable, and we believe that this remains right. Access to Work should pick up the costs that the employer would have difficulty in meeting or which are not reasonable.
As I have said, we believe the amendment is unnecessary and has a cost problem.
We all know the problem is that employers do not want to take on people with mental health problems and will not take them on if the Government are not able to provide the support that an employer would not normally provide for an employee. They want someone to be there when the employee is feeling challenged or stressed; someone who the manager can phone up and say, “Look, we are really having difficulties here, can we have a discussion?” All kinds of things might be necessary if an employer is going to manage an employee with a mental health problem.
The noble Baroness rightly says that employers must take on reasonable responsibilities, but where people have fluctuating mental health problems it is very difficult. We all talk about stigma on the part of employers. I am not sure that I fully accept that. There are real problems that the rest of society must recognise and bear.
I very much take that point. The Access to Work scheme is not always well known to employers. Nor are they always aware that there is back-up support, which could obviously colour the way in which they view a potential employee. We are running two pilots in Hammersmith and Islington in conjunction with MIND to determine how we can extend the Access to Work scheme to make it more sensitive to the needs of people with fluctuating conditions, and to ascertain when people need practical support such as an extra support person or other material support. MIND is working with the Government on that. We are not by any means saying that the scheme is a panacea. However, we are saying that it needs to be promoted more widely and that employers need to know more about it. It has been described as the Government’s best kept secret. That is no good. Its funding has been doubled so it needs to be out there, working for people. A number of questions—
The noble Baroness has explained why we should not believe what we have been saying. However, there is a disconnect between what she has outlined and comments from people on the ground who say that, despite the strong steer from policy and research to set up evidence-based, supported employment services, very few places in the United Kingdom can say with any authority that they are actually doing it, or that it is working. That is coming from people on the ground. As I say, there is a disconnect between what people would like to happen, and like to think is happening, and what is actually happening, and that is what worries us.
Indeed, and if I have more information on that specific point I will write to the noble Lord. The information I have concerns making both customer and employer more aware of the scheme, ensuring that the scheme is promoted and developing partnerships through which it is promoted. That work needs to be more effective. A dialogue is being conducted with UNISON, Remploy and Unite to ascertain how to make their members more aware of Access to Work. We believe that Access to Work is a very good scheme and that it is not being promoted as effectively as we would wish. However, I shall certainly get back to the noble Lord on the point he made.
The noble Baroness, Lady Thomas, discussed discrimination against people with fluctuating conditions. Work capability assessments are not done on a snapshot basis. They take into account the person’s functional ability over time and assess whether he or she can carry out an activity most of the time. They also take into account the effects of symptoms such as pain and fatigue, and any relevant side-effects of medication, on an individual’s ability to carry out tasks.
Will the noble Baroness explain how someone is assessed over a period? Are they followed around during the day to see how they are feeling?
Before the noble Baroness answers that question, may I reinforce it by asking whether the number of appeals has gone up since the Atos scheme was introduced? I have asked this before in this Grand Committee and I do not recall receiving an answer, nor have I read such an answer. However, in response to that question, we discovered that the system is currently in a review period, whatever that may mean, and whatever may come out of it.
We believe that it is too soon to make that assessment because the scheme came in only in October, so far as appeals—
There must be some sort of guide; I should have thought that with something as important as this, the department would start asking questions about every three months and not wait for an annual figure.
In answer to the noble Countess, Lady Mar, an individual or customer is asked whether they can do an activity most of the time—we will obviously not follow them about during the day—and they are assessed on that basis. If they cannot, that will be taken as not being able to do that activity.
I remind the noble Baroness of the letter that I read out to the noble Lord, Lord McKenzie, at our previous sitting. Since I read it out, I have had numerous e-mails from people with all sorts of conditions—not just ME—who have been roughly treated by Atos. I am extremely unhappy about it.
While I am on my feet, I ask the noble Baroness whether she will arrange for us to have another meeting with Atos to find out exactly what it is up to; we are getting not just one or two but numerous very bad reports about the way in which Atos is treating claimants.
Yes, we take that very seriously; I am sure that a meeting can be arranged.
The noble Baroness, Lady Thomas, referred to the letter in the Guardian, which I have not seen, and talked about schizophrenia and being bipolar—they are mentioned the letter. She asked whether that would be in the support group. The work capability assessment assesses function, not diagnosis. It is important that we look at people genuinely as individuals, not simply by diagnosis. Again, that involves talking to every individual and trying to have a tailor-made scheme for them.
The noble Baroness, Lady Thomas, talked about condition management programmes. They are already available on a national basis to all incapacity benefit and ESA customers. I agree that they are a valuable part of the Pathways to Work programme.
Will they be expanded under the Bill?
I understand that the Government’s view is that they do not need to be because they are already widely available nationally.
The noble Lord, Lord Ramsbotham, talked about what he saw as the inefficiencies in the Government’s approach across the board to mental health. We agree that joining up services and policy is extremely important. We work closely with colleagues in DCSF, the Department of Health, Communities and Local Government and the Treasury, as well as the devolved Administrations. That is our response to the question why there is not more joined-up government.
The noble Lord, Lord Ramsbotham, talked about the IPS model. We agree that individual placement and support has the potential to be valuable to people with severe and enduring mental health conditions. The recent review of mental health led by Rachel Perkins, which was announced by the then Secretary of State, has within its remit looking at how models such as IPS can improve our provision. So we are looking at that as a result of the Perkins review.
I apologise for coming in late and missing some of the opening speeches. For me, the amendment gets it the wrong way around. Can my noble friend tell us, or perhaps write, which fund, if any, the personal adviser could use to attach to somebody who is on or has migrated to ESA, so to speak, a dowry that they can take with them into employment situations which can then be drawn down in a particular circumstance?
I do not think that the amendment would work. There is no way that you can tell what reasonable adjustment may or may not be needed for somebody who has a physical disability in a particular job, with particular stresses, colleagues and so on. However, if we knew, through their adviser, that that person had a dowry, so to speak, that could be drawn down when the need arose, that would cut the costs down to something more like £100 million rather than the £500 million that my noble friend was talking about. That would be much more flexible and would not require an unsuitable pre-assessment without knowing the conditions of employment.
Will such a pot of money, such as £1,000 or £2,000—analogous to somebody who is blind getting extra equipment to be able to hold down a job with BT, which Access to Work currently funds—which can be drawn down to meet circumstances, which change over time, be available? After all, the ESA is itself a ticket into such need.
I would be happy to write to the noble Baroness on that. As I originally said, our assessment of the cost of the amendment is serious money: £750 million.
I am grateful to all noble Lords, including the Minister, who have spoken in this exploratory debate. I said “including the Minister”, because she started off by applauding the amendment and then knocked it flat on three grounds. Such is politics.
I was grateful to the noble Baroness, Lady Thomas, who pointed out that far too few employers understand the needs of people, even when they want minor changes to activities in the workplace. Pace the noble Baroness, Lady Hollis, these may be physical changes—a slight adaptation to a piece of machinery, or whatever—or more psychological changes, such as working practices.
The noble Baroness, Lady Thomas, spoke in particular of bipolar disorder and schizophrenia sufferers. I referred on the first or second day in Committee—my memory fails me—to a correspondent who had a compulsive hand-washing bipolar effect. I am very conscious of that, and I am sure that we will go back to it. Incidentally, I have a feeling that I gave that letter to the Minister, and have not yet had a response to it, but I suppose that it is in the pipeline somewhere. Clearly, the system must help people to find work. That is what the entire Bill is about. In a nutshell, it is about helping people to help themselves to end up in employment.
The noble Lord, Lord Ramsbotham, an adviser to the Sainsbury group, talked about the opposite of joined-up government, and I could not agree with him more. It just so happens that, as he mentioned, we have three, if not four, Bills going through at the same time. However, it can often be over a matter of several years. Individual noble Lords with particular interests have to look at each particular one to try and get some sort of similarity across the board, which the Government seem totally incapable of doing for themselves. That is a great shame. He was talking about what happened on the ground and joined-up local policies, although he did not quite put it like that. The situations can be quite different. As I am sure he will admit, it is very much a postcode lottery. However, he is right to mention an ideal situation in a particular part of the country. The noble Baroness, Lady Meacher, made much the same sort of point.
As I said, the Minister talked about it being a laudable amendment, and then said that everyone should be assessed and that the matter was already covered. Yes, if I had stopped at “assessment” in the fourth line and left out the rest, she would have had no complaint whatsoever. The thing that really worries her is the rear end of subsection (1) in the proposed new clause, which states that,
“this assessment must be carried out before the claimant may be compelled to undertake any compulsory work-related activity”.
On reflection, she is right; that is not the moment when the assessment is needed. However, an assessment is needed when the individuals we are talking about are close to the workplace, because they do not carry a potential pot of money—the dowry of the noble Baroness, Lady Hollis—with them when they apply for jobs. That is the real basis of the amendment.
I take the points of all noble Lords who have spoken. I will certainly come back to the matter again in a different formulation once I have taken advice on what it would be. It is clear that there is something rotten in the state of Denmark. With those words, I beg leave to withdraw the amendment.
Amendment 94 withdrawn.
Clause 9 : Claimants dependent on drugs etc.
Amendment 95
Moved by
95: Clause 9, page 14, line 20, leave out “, or have a propensity to misuse,”
We move on to the amendments to Clause 9, which raise significant issues. I mention, simply for the record, that Amendment 96 is purely consequential on Amendment 95. I shall also speak to Amendments 97, 98, 105, 106, 113 and 114, which are in my name. If noble Lords will forgive me, I will address clause stand part before my individual amendments. I am grateful, by the way, to the Royal College of Psychiatrists, DrugScope, Release, the BMA and the National Association of Probation Officers, which have provided valuable briefing for the debate.
I am sure that we all share the same objectives, and the Government, in proposing Clause 9, are no exception. We want a reduction in the number of people whose lives are blighted by their dependence on drugs. We want the system to address any difficulties experienced by that group due to their illiteracy, lack of numeracy, and often non-existent accommodation and fractured relationships. Eventually, efforts directed at those problems will pave the way for people addicted to drugs to find their way into work. There is no short cut. The point that I—and, I believe, others—wish to make is that Clause 9, based as it is on coercion and compulsion, will not work.
Perhaps the best evidence for that assertion is the fact that the Government recently abandoned a similar regime for offenders on community sentences. In pilot areas, claimants face sanctions for failing to comply with a court order under those sentences. The Government have concluded that that approach has been an expensive failure, resulting in only a 1.8 per cent improvement in compliance and costing £5.60 in public funds for every £1 saved. I am sure that those figures are familiar to the Minister. The conclusion is that sanctions could deepen poverty, entrench marginalisation, increase crime and put extra pressure on the finances of families supporting people with drug problems; they have a difficult job on their hands. I would be grateful for the Minister’s comments on the Government’s experience of the programme that I have referred to.
Another key point is that there is no additional investment proposed for the treatment envisaged by Clause 9. The impact statement for the Bill states that additional costs are likely to be incurred by the Department of Health from the extra places in drug treatment. I understand that the DWP assumes that these resources will become available through what it terms “reprioritisation”. As the chairman of a mental health trust, I suggest that this is more than a little optimistic, particularly in the coming decade when we will all be cutting back on the services that we deliver. Believe me, the primary care trusts do not give any kind of priority to people with drug addictions. We find it very hard to persuade them to give us money to set up even those limited services that we provide.
The probation service probably has a better understanding of this needy group than anyone else. It currently supervises over 240,000 people, at least two-thirds of whom are drug-dependent; 84 per cent of whom have literacy problems and the literacy level of an 11 year-old or lower; and the vast majority of whom are unemployable. NAPO makes the point that many other drug users have escaped the notice of the criminal justice system, meaning that potentially tens of thousands of people could be subject to the sanctions regime. Apart from anything else, there will not be the resources in place to deal with the number of people involved. All these comments apply to drug-dependent people. The number of claimants caught up in the sanctions system could multiply many times over if those with a propensity to drug misuse were to be included.
That brings me to Amendment 95. The point here is that the Government propose to impose requirements on claimants for jobseeker’s allowance not only if they are dependent on a drug, but if they have a propensity to misuse any drug. The second proviso is that the dependency or propensity is a factor affecting their prospects of obtaining or remaining in work. The term “propensity to misuse”, as I understand it, lacks a precise meaning and is amenable to a very wide interpretation. It could, for example, be argued that the use of any illegal drug is a form of misuse, or certainly a propensity to misuse. How is a personal adviser to judge whether a claimant has a propensity to misuse a drug? Even more difficult will be the judgment of whether the propensity is affecting their prospects of getting and holding a job.
Apart from the insurmountable problems for the personal advisers who have to make these judgments, their subjective judgments would leave large numbers of claimants very vulnerable to benefit sanctions and the fear of them. Do the Government really want to do that? When you consider the number of unemployed people who take drugs—mainly cannabis—from time to time, or perhaps quite regularly, the risk of widespread destitution if these sanctions really were followed through could be considerable, particularly while unemployment remains very high. I know and have known people who, if I am perfectly honest, use or have used cannabis, in particular, very regularly, and yet they hold down a perfectly good job. It is not as straightforward as “drugs—cannot work; no drugs—can work”. It is not like that and therefore these judgments will be extremely difficult to make. I do not believe that rational and fair decisions could ever be made on the basis of Clause 9(1) as it stands.
Amendment 97 tackles head-on the fact that drug use is unlawful in this country, as in most others, and yet the DWP in this Bill recognises that people who misuse drugs are not villains for using those drugs and should not be treated as such. This is very interesting to me. If they commit crimes, that is a different matter. Rather, they should be treated as people with a mental health problem, who need medical or psychological treatment. In that respect, I wholeheartedly support the intentions of the DWP in this clause. It is relevant to note that the head of the UN Office on Drugs and Crime, in his report that came out only yesterday, admitted for the very first time that drug use should be treated more as an illness than a crime. This is of momentous importance across the world. For years, the UN has demanded criminalisation. Finally, we have a statement that says that it has got it wrong.
Drug users live in a world where they can be charged at any time simply for possessing and using drugs. This is why Amendment 97 is so important. It seeks to ensure that the questioning of jobseeker’s allowance claimants about whether they are dependent on, or have a propensity to misuse, a drug is done in a fair and reasonable way. That does not sound revolutionary. It also requires that such interviews are conducted at a time and place which is appropriate, and seeks to ensure that claimants have the support they are likely to need if they are to disclose the use of drugs. Very importantly, the amendment also seeks to have detailed in regulations the qualifications and competencies of persons who will be able to impose a requirement to answer questions and to conduct interviews.
The Bill does not outline at what point the requirement to answer questions is engaged. It could potentially be imposed on all claimants; in fact, it might be argued that it should. I do not want any of it, but why ask one claimant rather than another? Unlike the other provisions contained within Schedule 3, there is no requirement of reasonable suspicion. Perhaps the Minister can explain why not. A coerced declaration of drug use in these circumstances would constitute a potential breach of Article 8 of the European Convention on Human Rights. It will be reliant upon the threat of benefit sanctions and therefore the disclosure would not be freely given.
Given the criminalising context, people with drug problems are understandably fearful of statutory agencies and may feel shame about their drug use and its consequences. Such disclosure requires a level of trust between the worker and the claimant. It would be grossly unfair to impose a benefits sanction on someone for failing to disclose a drug problem in an inappropriate and unsupportive environment. It is essential that such interviews are conducted by staff with the skill and experience to handle disclosures sensitively and that appropriate support is available. I hope the Minister can give the Committee some assurances on these matters.
Amendment 98 seeks to remove from the Bill the power of the Secretary of State for Work and Pensions to require someone to take part in one or more drug tests for the purposes of ascertaining whether there is, or has been, a drug in the person’s body. Drug testing should not be incorporated into the benefits system. A positive drug test does not distinguish between problematic and recreational use and is a potential breach of Article 8—the right to privacy—of the ECHR. Article 8 provides a right to refuse treatment. Compulsory testing is certainly an infringement of civil liberties and involves important moral and ethical considerations. Further, a test will not help to establish whether any drug use is a factor in gaining work or employment or whether the person will benefit from drug treatment.
There are technical arguments, too. Drug testing is not entirely reliable. For example, someone using over-the-counter painkillers containing codeine could test positive for opiates. There are others of which I am sure the Minister is aware.
Finally on Amendment 98, intrusive drug tests without the consent of the claimant will affect the relationship with the treatment service. I have not been able to find out who will undertake the drug testing under the Bill as it stands and I would be grateful if the noble Lord could clarify that point. Who will be undertaking the drug testing? More particularly, does he accept that such testing does not belong in a Welfare Reform Bill?
Turning briefly to Amendments 105 and 113, as the Bill stands a JSA or ESA claimant must submit to treatment by or under the direction of a person having the necessary qualifications or experience. The BMA is extremely concerned about these clauses. The amendments would require instead that the JSA claimant, under Amendment 105, and the ESA claimant, under Amendment 113, must attend an initial assessment for treatment by or under the direction of a person having the necessary qualifications or experience. Thus treatment itself would not be compulsory if the amendments were accepted by the Government.
I discussed these amendments with Dr Crawford, our leading consultant psychiatrist on substance misuse in the East London NHS Foundation Trust. Her comments are worth quoting. She said:
“Addiction is a disease that is chronic and relapsing; hence there may still be reoffending. But there are many other health and social benefits of a good therapeutic intervention. If someone is not yet able to manage with the demands of the treatment system, often due to their chaotic and abusive past, then removing the low level of benefits income will lead to further community harm. People cannot always stop their substance misuse, even if they want to”.
Dr Crawford takes the view, which I share, that linking drug treatment to the maintenance of benefits is unethical. However, she would welcome a boost to the benefits and employment system to engage better with this particularly socially excluded group.
The requirement to attend an initial assessment for treatment would be ethical, and begins to engage drug users with potentially helpful therapeutic services. They could discover opportunities to tackle their addiction and other problems, of which they may not have been aware. I know that those who do not want Clause 9 at all might challenge even that. I have had discussions with Dr Crawford and I think she feels that real efforts to draw some of these very excluded individuals towards a treatment regime could be very helpful, but she is very worried about the sense of coercion and the fear that these people have in the context of the criminalisation of drug use. That is the big problem with the whole of Clause 9. It is set in a context that is the fault not of the DWP but of the UN, if I may say so, but our Government have pursued the UN line, which simply makes this whole thing completely unacceptable.
I hope the Minister will recognise that the views that are expressed here are rooted in years of direct experience of working with people who misuse drugs. I very much agree with the noble Lord, Lord Ramsbotham, that we need to listen to the people who actually work on the ground with these things. We are simply the deliverers of the message. The great challenges are to engage this group of patients and to keep them engaged to enable them to deal with their three huge challenges: drug misuse, illiteracy and a chaotic lifestyle. Compulsion, and compulsory treatment, has no place in this journey.
Noble Lords will be pleased to hear that I come to my last pair of amendments, Amendments 106 and 114, which can be dealt with together and briefly. They would ensure that no JSA or ESA claimant would be referred for treatment, even on the voluntary basis set out in our previous amendments, unless the appropriate practitioner had determined that the person is susceptible to treatment and consents to it. Amendment 106 refers to JSA claimants, and Amendment 114 refers to ESA claimants.
The arguments of the drugs and human rights organisation Release merit inclusion on the record and deserve the Minister’s serious attention. It rightly argues that forced treatment as a condition of benefit introduces a worrying new aspect to UK law. Once this precedent has been set, it could be extended to claimants needing to lose weight or give up smoking, for example. There are concerns that there has been no assessment of the effectiveness of current regimes. The only study of the effectiveness of drug testing and treatment orders was conducted in 2003 by the Home Office, which found that 80 per cent of offenders who had been subject to a DTO had been reconvicted within two years of the start of the order.
Release points out that no research has been carried out on drug rehabilitation requirements, despite the fact that recent figures showed an investment of £398 million for 2007-08. The application of further compulsion without any evidence that it will be effective gives rise to serious ethical questions. Those with direct clinical experience of these issues say that treatment for problem drug users will work only when it is appropriate and timely for the individual concerned. Even then, relapse is frequent. It is far from clear how the DWP would deal with relapse in this context. Release takes the view, based on its experience of problem drug users, that many would end up simply not engaging with the benefit system at all, living in even greater poverty and exclusion, and increasing criminal activity to make ends meet.
I hope that I have adequately represented the views of the many organisations and individuals who share my concern that the coercive regime for problem drug users that is set out in Clause 9 will be dangerous and counterproductive. I beg to move.
I will not speak to all these amendments. Indeed, my noble friend Lady Meacher has covered them all with such skill, competence and depth that there is not much more to be added. However, I would like to say one or two words to the Committee about the context in which the amendments are being conditioned.
Winston Churchill once said in the House—on 20 July 1910, to be precise—that the way in which it treats its crime and criminals is the true test of the civilisation of any country. I am not sure that this approach to drug users is a very civilised one. It is much more in line with the very unfortunate term used by the previous Prime Minister, who declared war on drugs immediately before he declared war on terrorism. The word “war” is totally inappropriate to both those subjects. If you approach this with a war mind, you start turning your head to punitive measures, as opposed to what I understood the purpose of this Bill to be all about.
Again, in that context, it has always concerned me—again, I hope noble Lords will forgive me if I go back to prisons—that one of the curious things about this country is that no one knows the cost of imprisonment. The country knows how much money is given by the Treasury to the Ministry of Justice and by the Ministry of Justice to individual prisons, but it does not know how much it would cost to do all the things that it says it wants to do with and for every prisoner.
The same is absolutely true of probation. The country does not know how much it would cost to do all that it says it wants to do with and for the 250,000 who are under probation supervision. The other day, it was exposed that one young, barely trained probation officer has to look after 127 people. In preparing for the Bill, the Probation Service has briefed people on its fear that a drug user who is denied benefits will turn to crime as his only way of surviving. Is that a sensible way ahead?
I have to ask, in the context of all that is proposed in the Bill, whether people have worked out how much it will cost to do all the things that the Government say they want to do. I do not deny that some of those things are very good and sensible, and all that, but have the Government costed that? Have they also costed the impact on the other organisations that are involved and made certain that everything is there? Are there enough drug treatment counsellors around the country for all these people to go to? The strict answer is no, they are not there, which is one reason why a lot of people are not going to treatment.
You would hope that a prisoner who had been introduced to drug treatment in prison would be picked up by a drug treatment person the moment they left prison and would carry on from the moment they left off so that they do not lose what they have started. That does not happen. People are not there; there are not enough of them. It is therefore illogical to launch something that requires a support agency without making certain that all the support mechanisms are there.
I am very interested in what my noble friend said about the United Nations at last recognising that this is an illness. Of course criminal activities are associated with it, but they are perpetrated by the criminals who are making illegal money out of making the drugs available. The result of their activities is that people become ill. The illness is exactly the same as that of gambling and so on, which must be treated properly otherwise the whole experience will get worse.
I go back to my great concern that we are approaching the whole drug scene in the spirit of declaring war. The orchestrators of the war are newspapers such as the Daily Mirror, which encourage punitive approaches. The punitive approach is a dangerous and wrong way of dealing with this and is totally out of kilter with the aim of the Bill.
We have already spent many hours on this Bill and are only now coming to one of the most controversial parts, the clause relating to treatment of benefit claimants whose drug habit is considered to make them unemployable. I shall not mention alcohol addiction at this stage; we can leave that for another day.
I think it makes good sense to have almost all the amendments to the clause grouped and to have a clause stand part debate, so that we can debate this as a whole at this point. We welcome the noble Lord, Lord Rea, to our deliberations. I shall start by speaking generally and then turn to the first amendment in this group.
We on these Benches support the voluntary approach to those on benefits whose drug habit keeps them away from the labour market, as do many of the groups that advise us and are working in the field. In other words, we believe that drug users should be strongly encouraged, rather than coerced, to undergo treatment. The reason is simply that coercion does not work, as the noble Baroness, Lady Meacher, said. If a person in that position knows that they are going to be coerced into treatment, the likelihood is that they will disappear from the radar and will quite possibly end up in the criminal justice system or living on the streets in an effort to feed their habit, a point strongly made by the noble Lord, Lord Ramsbotham.
Nor do we believe that there should be compulsory drug testing in the context of the benefit system, which cannot distinguish between recreational use and addictive use, and is a snapshot only. Nor do we believe that there should be extensive information-sharing between Jobcentre Plus and third parties such as the police.
Many powerful voices have been raised against this part, including those of DrugScope, Release and the Joint Committee on Human Rights. One that has probably not been heard loudly enough—this is the third time that I shall cite it today—is that of the Government’s advisers, the Social Security Advisory Committee. They state:
“We find the proposals in relation to those citizens who suffer from addiction to crack cocaine and opiates to be unconvincing, simplistic, and to present a number of issues that demand much more thought before they are taken further … It is our understanding that all the evidence points to drug rehabilitation programmes being most effective when the client actively wishes to engage in treatment. Taken together, coercion and the removing of income have the potential to make a bad situation worse. Even briefly removing some of the income of a family struggling to cope with the consequences of drug use is likely to force the family into deeper poverty and place children at greater risk”.
During the evidence-taking session in another place, my honourable friend Paul Rowen MP asked the then Minister for Employment and Welfare Reform, Tony McNulty, whether there had been any evaluation of existing voluntary schemes for drug users before the decision was made to move to compulsion. The answer was that the Government were very aware of the success of the voluntary processes in place and want to move in that direction. Why are they not putting more resources into the voluntary processes? The rest of his answer is less than clear, but I think that he was trying to say that having a sanction available might encourage more drug users to undertake treatment—presumably voluntary at this stage.
My honourable friend then asked how many extra resources would be available for the increased number wanting treatment. There was no direct answer to that, but we learn in the Peers’ information pack that this whole part of the Bill is to be piloted. We also learned how dire the situation is for drug treatment in Scotland, with a year-long waiting list, and that the situation in Wales is not good either. Perhaps the Minister will address that issue in his reply.
Many questions need to be asked about this whole policy if it is to go ahead. When my honourable friend Paul Rowen MP asked Sharon White, director of Welfare to Work, whether the DWP had done an audit of the skills of staff at Jobcentre Plus to deal with the whole drugs issue and whether additional training was needed, she said that personal advisers were already pretty good at recognising the signs of those who were drug users. That sounded vague. If there is a suspicion that drug use is the main barrier to work, she said that the adviser would refer that person to a specialised medical officer. She indicated that there would be additional training for Jobcentre Plus staff, but only in the pilot areas, although how long that training would be for was not addressed.
Sharon White’s replies were less than convincing to the next question, which was about whether compulsory drug treatment, as well as the sharing of information, was consistent with a person’s right to refuse treatment under the NHS Constitution. She said that the DWP was “looking at” what could be mandated in terms of all possible health interventions in the Bill. There we have it—there is no clarity at all about whether drug treatment can be mandated in the Bill. That brings me to the report of the Joint Committee on Human Rights on this section of the Bill, which unequivocally supports the position that I outlined at the beginning—that treatment recommended for drug users should be voluntary, that there should be no compulsory drug testing, and no information-sharing with third parties.
Finally, I turn to the first amendment in the group. “Propensity to misuse” seems a curious phrase to have enshrined in law. It lacks a precise meaning, as the noble Baroness, Lady Meacher, said, and is amenable to wide interpretation. It could be taken to apply to someone who might cross the border occasionally between using heroin or crack cocaine in a recreational sense, perhaps taking the odd day or two off work, and somebody who is a regular user of those two dangerous drugs but manages to stay in work. Or does it mean someone who might become addicted and therefore incapable of work if they carry on using a drug on a regular basis? If the words are not clear, they should be left out of the Bill.
We support the amendment and all the others in the group.
I add my voice to the views expressed, not least because the ascribed identity that makes criminals out of those who use drugs occasionally has several problems. The first is that, without being slanderous, it would include almost all the students I have ever taught, so it would make the labour market a tight place for anybody to get into. Secondly, once people have admitted to being drug users, they are admitting to being criminals. The moment that those criminals are put into prison, they find a university of drug dealing, because it becomes the only paid employment that they can aspire to. It seems about the worst thing that we can do.
I beg the Committee’s pardon; I must declare an interest as a member of the UK Drug Policy Commission. One finding of the commission was that, once people have been labelled drug users, they are far more difficult to place in employment than even people with mental disability. By ascribing the identity of “criminal” and asking people to declare themselves to be criminal, we are creating potential criminals, because that is the only way out. Also, we are barring their way to employment. Surely that is not the intention of the Bill.
My noble friend Lord Dubs has asked me to talk to the stand part debate because he cannot be here this afternoon. It was tabled at the suggestion of the Joint Committee on Human Rights, of which he is of course a member. The usual reason for tabling a stand part debate in Committee is to be able to cover the topic in general. In fact, those who spoke to the amendments did just that for all the amendments in the group. Everything that I am going to say has probably already been said. When we get to Schedule 3 stand part, practically everything will have been discussed, so that will take very little time at all.
My interest in this part of the Bill comes from my experience of 25 years as a general practitioner in an inner-city practice. Our list included an above-average proportion of problem drug users who we treated in collaboration with the University College Hospital drug clinic. I grew to know and understand a little of the subculture of the drug-abusing community. One relevant feature is that deception is developed to a fine art; users are very parsimonious with the truth. Another feature is that they are deeply suspicious of authority. They tend not to trust establishment institutions and work much better with an informal approach. I am also a vice-chairman of the All-Party Parliamentary Group on Drug Misuse and a member of the group on harm reduction, in which drug treatment issues are frequently discussed.
I welcome the benign intention of this legislation to assist drug users on welfare benefits to free themselves from their habit and to return to employment. However, for a number of reasons, some of which have already been put forward by other noble Lords who have spoken, I doubt whether the Bill will have that effect, certainly in its present form. In fact, it is quite likely to be counterproductive. By imposing a requirement to answer questions, the legislation will be seen as authoritative, authoritarian and coercive. As possession and use of controlled drugs is unlawful, users will be required to admit to being offenders. I know that the Bill states that information obtained by the Department for Work and Pensions during an interview cannot be used as evidence in any prosecution, but that is not likely to convince users.
We have discussed the ambiguous word “propensity” but, to me, it suggests that, even among non-users, past drug use is also being inquired into. This may mean that, in order to avoid being questioned, users are likely to forego benefits—which they need and to which they are entitled—rather than admit to drug use or past drug use, or else they will lie about their drug use. This has also been covered in outline but it is important to recognise that the average problem drug user—probably the majority—often has a chaotic lifestyle, with serious social and housing problems, poor nutrition and general health, and may be involved in acquisitive crime to sustain his habit. If they receive reduced welfare benefits, all these problems will be exacerbated. Crime, in particular, will obviously increase as they seek to maintain their income.
Another deterrent to users revealing their drug history is the provision in Schedule 3 for regulations authorising the supply of information held by the probation service, police or other such person as may be prescribed. It is an astonishingly wide provision. As has been mentioned, several other amendments address this issue, which we will come to. These provisions would seem to allow information to be shared with or obtained from any person, body or agency, including social and health workers, with whom clients share confidential information. This is of particular concern to a sizeable number of HIV-positive drug users, who have a vital need to keep in touch with treatment services. They justifiably fear that if their drug or HIV status is revealed they will suffer discrimination in employment and the social stigma that is, sadly, still widely prevalent. The fear is that they will drop out of treatment, which will of course have serious public health implications.
The list of organisations that share some or all of these criticisms of the Bill is long and tedious. Some have already been mentioned, including the main drug addiction NGOs, DrugScope and Release, the Royal College of Psychiatrists, the Royal College of Nursing, the BMS, the Joint Committee on Human Rights, the National AIDS Trust and Liberty, among others. My noble friend has doubtless seen their extensive briefing on this clause and schedule, in which their critique is more fully developed than I can manage here without taking far too much time. I hope that my noble friend can address their concerns. I suggest that he should agree to amend this clause to remove its coercive nature, while retaining its intention to offer drug users who are on jobseeker’s allowance or ESA confidential and voluntary—I repeat, confidential and voluntary—treatment and rehabilitation programmes. These should include social support and help with housing. This is likely to be much more effective with this difficult group of people than the authoritarian approach of the Bill.
I hope that I will later have an opportunity to quote from a statement on the Bill from the Royal College of Psychiatrists. I feel that this whole clause, which enables Schedule 3 to take effect, should be taken back and completely redrafted in the way that I have said, to take out the coercive nature and bring forward a way of approaching these people that is more likely to be effective.
I am very eager to support my noble friend’s amendment. I know next to nothing about drug addiction. The noble Lord will be pleased to hear that I am not going to speak at length about it. The alarm bells were set ringing when the noble Baroness, Lady Meacher, mentioned precedents. I think immediately of CBT and graded exercises for ME sufferers. If one group is forced to take treatments, it is possible that another one will be. I would just ring the alarm bells.
I have found the quote from the evidence of Royal College of Psychiatrists:
“The College faculty of Addictions has expressed considerable disquiet at the conditionality provisions while welcoming the attempt to assist drug users with their addiction. The issues affecting people with people with addictions will not improve treatment compliance or the chances that people will obtain and remain in work. On the contrary,”—
as I explained earlier—
“they may drive people deeper into poverty and marginalisation. Being coercive in nature the provisions have the potential to undermine the therapeutic relationship between clinician and client”.
I wonder if my noble friend Lord Rea will allow me to be his friendly neighbourhood psychiatrist. I must confess that whenever I am inundated by hundreds of briefing notes, a little bit of me feels that they must be wrong. There is a little corner of me that is deeply sceptical and wants to go back and read the Bill in detail. I have therefore gone back to read Clause 9 and, in particular, Schedule 3. I am deeply shocked at what appear to be profoundly unethical provisions that are, as many noble Lords have said, completely counterproductive. I speak as someone who has managed drug misuse and alcohol services and worked across a whole range of services in this area. Of course, people are sent from the courts, particularly young people, with a condition that they shall attend for treatment or at least an assessment, with the possibility of engaging them in treatment. That happens when they have committed a criminal offence.
We have long recognised that. There used to be provisions in Victorian times for compulsory treatment of drug or alcohol misusers who had no mental disorder as a consequence, but since 1959 we have been absolutely clear, including in the 1983 Act and the 2007 Act, that that cannot be the case because it is a waste of time and counter-productive.
We have here a set of provisions that cut across all previous legislation where we have debated how people should be cared for and treated appropriately and how they should be encouraged. Some forms of coercion are good and collaborative. You can work with somebody, encouraging them with carrots and sticks in a little way, but this sort of stick goes far beyond what is proper and what is likely to produce a beneficial effect.
We know that people who are truly misusing drugs to the point where it interferes with their ability to work—there are many such—will not engage with this. The only study that I know on this was undertaken in New York on long-term serious drug users on this sort of exchange coercion plan to get benefits, and it simply did not work for people who were using drugs like this. I know of no other international evidence. If the Minister does, I hope he will tell us.
It seems completely improper to demand that people should go for an assessment, which I assume would have to be a specialist drug-misuse psychologist assessment, with the aim that they should then be coerced into treatment. That they should be forced to give a urine sample when they are not suspected of or arrested for a potential criminal offence again seems extraordinary. This is not a situation where somebody is driving and they kill somebody else and therefore you want to know whether their urine has alcohol in it. It is a completely separate matter. Remember, the urine sample is taken for a drink-driving offence only when you have got to the station, after the breathalyser has already found you wanting. There are very few circumstances in which we would normally coerce people in this fashion. I find this unethical, unworkable and counterproductive. Although I support all the amendments, the only one that I really like is the proposal of the noble Lords, Lord Dubs and Lord Rea, to get shot of Clause 9.
Where do I go from here? I want the ideas behind Clause 9 to work. I suspect that we all do. The real question is whether this is the right way to get addicts off their drugs. I shall deal with this in a fairly seriatim way. Amendments 95 and 96, which would remove from the Bill the element of propensity to use drugs, raise a pertinent question. Our position on providing benefits to those people who take drugs is clear. They must make an effort to combat their habit or risk the loss of benefit. I go along with the clause that far.
As I have said twice already, it really should not be acceptable for the state to subsidise substance abuse with no questions asked. This is not a Hobson's choice, as some have made it out to be. The aim is not to harry and hound drug addicts off benefits altogether.
We should not treat Clause 9 in isolation. It should be seen in the context of the rest of Part 1. I said at Second Reading that with rights, in this case to JSA, go responsibilities. Indeed, the whole premise of the Bill is based on that precept. For a long time now we have had the responsibility of actively seeking work. Now we move that responsibility on to attend a progress-to-work interview and agree an action plan. For drug users, the action plan is to help them in the long run to kick the habit, and other barriers to work, and to reintegrate them into the workplace. There cannot be any noble Lord in this Committee who seriously thinks otherwise, nor any who would prefer to see drug addicts left to their addiction, with all the catastrophe that that entails, especially if the modern world believes—I very much took to heart this comment from the noble Baroness, Lady Meacher—that to be a drug user is an illness rather than a crime. I agree with her that that is an extremely important development.
Surely the ideal that we are all groping towards is to wean addicts off their drugs and rehabilitate them so that they can participate fully in society and the world of work. Where we differ—the Government clearly differ from those in the Committee who have spoken—is how that is to be achieved. The method that the Government have chosen is to put responsibility into the hands of Jobcentre Plus staff. They will be moved to the front line of rescuing drug addicts from the depredations of dependency and will be responsible for setting them on the path back to work. I hope that the noble Baroness, Lady Murphy, is wrong and that nobody is going to be asked to give a urine sample in a jobcentre. That is for other professionals further down the line.
If the noble Lord looks carefully at Schedule 3 he will find—I am not sure that I can find it immediately—that it is possible for the jobcentre to direct somebody to provide a urine sample if there is any suspicion that they are taking drugs and not turning up for an assessment. I am desperately trying to find it. No doubt if I am wrong the Minister will put me right, but I believe that that is the case. I read Schedule 3 quite carefully again this morning and it is surprising who is going to be doing this.
I am not quite as quick as some Members of the Committee at finding bits of Bills, I have to confess, but the schedule says:
“Regulations may make provision for or in connection with imposing on a person who … is subject to a requirement imposed under paragraph 2, and … fails to comply with it”—
which we all know about—
“without it being shown, within a prescribed period, that the person had good cause for the failure … a requirement to take part in one or more relevant tests for the purpose of ascertaining whether there is or has been any drug in the person’s body”.
That does not say that the jobcentre is going to do this, but perhaps this is not the time to go into an argument on a specific. I am sure that the Minister will be able to settle it anyway.
However, the noble Baroness has a point. I was saying that the method that the Government have chosen is to put responsibility into the hands of Jobcentre Plus staff. They will be moved to the front line of rescuing drug addicts from the depredations of dependency and will be responsible for setting them on the path back to work. That sounds like a tall order. The noble Baroness, Lady Meacher, and the rest of the Committee are quite right to raise these concerns with the Minister.
We come back to the vexed question of training. Jobcentre Plus staff are to be expected to recognise symptoms, diagnose addiction and prescribe the right course of action to take. Indeed, they will need to do more than that. They will need to be able to identify a person’s “propensity”, as the Bill says, to misuse drugs. How will they do that?
The noble Baroness, Lady Meacher, referred to the suggestion that was provided in another place by Ann McKechin when this clause was debated there. She said that staff will be “provided with guidance”. Wow. Gosh. How impressive. That is very interesting. Perhaps the Minister might be able to expand on what sort of guidance will be offered. Will it be on top of the three days of training provided to staff to equip them for everything else, or will it be written guidance with a checklist that staff may use to cross off the symptoms that they see and therefore enable them to make a diagnosis? A neo-Atos, perhaps. In either case, or should there be a different suggestion, will that be adequate? That is the basis of the problem that the Committee faces.
I know from my experience as a Minister in Northern Ireland that jobcentre staff are a committed lot and have exposure to and experience of dealing with what one might call the full range of the human condition. I do not doubt that many, if not the majority, have plenty of personal experience of dealing with claimants who have problems with drugs. I am not, therefore, suggesting in my innocence that jobcentre staff do not know what they are doing. However, I fear that too many responsibilities are being placed on the shoulders of too few people. The issue of training is therefore crucial. We have not heard a detailed enough plan from the Government to provide it. I will be very interested in joining in any meeting that members of the Committee have with the Minister and/or officials to discuss exactly what training is being designed and whether it is practical—or perhaps I should say practicable.
I should like to interrupt the noble Lord on that point. Schedule 3 says that an approved person would be permitted to take a sample of urine, but “approved person” means,
“a person having the necessary qualifications or experience who is approved by the Secretary of State for the purposes of this paragraph”.
The status of that person is not clear at all.
No, and I am sure that we will discover from the Minister’s answer to the debate whether that is a job adviser or anyone else within the jobcentre. I rather doubt it, but we will discover, won’t we?
The specific matter of propensity raised in these amendments begs the question: what is propensity? The question has already been asked. How can it ever be satisfactorily or consistently determined? Does it include the capacity and willingness to get overly merry at a Wednesday night football match and subsequently turn up a little red-eyed for work or work experience on a Thursday morning? Presumably that could be construed as a factor affecting one’s prospects of obtaining or remaining in work. Should it be? Perhaps it should. I offer no comment, merely the observation that is a wide and potentially unachievable proposal. I shall be interested to hear the Minister’s explanation of “propensity”. Perhaps he might think about the wording of the clause before we consider it again on Report, which from this debate we most assuredly will.
I offer that advice, which I am sure the Minister will welcome, naturally, because I believe that, overall, Clause 9 is important and needs to work. The numbers that have been floated about from the Peers’ information pack—I expect that the Minister will provide us with the most up-to-date statistics—suggest that there are around 350,000 drug users on benefits. If the scheme is a triumph and these people are persuaded to try to beat their habit in the way proposed, are the resources available to see that this can happen? That point was made by the noble Lord, Lord Ramsbotham, with which I fully agree. What is the Government's plan for implementation?
As I said at the beginning, I really do believe that Clause 9 needs to work. That is why training keeps popping up. If the staff are not able to do the work expected of them, the system will never get off the ground, and that would be to everyone’s detriment.
In this group there is a series of amendments on data sharing. I would like to comment on that.
It is the next group.
In that case I will not comment.
This has been an extensive debate and clearly a very informed one. I recognise the strength of feeling that has been expressed around the Committee today by people who have a detailed knowledge and understanding of the issues that we are seeking to address here.
I start with the noble Baroness, Lady Meacher, who said that we share the same objectives. That is probably the same for every person who has spoken this afternoon. I will try to deal with each question that was posed to me in some detail. If noble Lords will permit me, I will speak at some length because it is important, particularly given the tenor of the debate, that I put as much on the record as I possibly can and deal with each point raised.
Before assessing individual amendments I would like to explain the intention behind Clause 9, to reassure noble Lords who wish to oppose its inclusion in the Bill. Clause 9 facilitates the introduction of Schedule 3, which amends the Jobseekers Act 1995 and the Welfare Reform Act 2007. New provisions, which apply to people who are dependent on drugs or have a propensity to misuse them—I will come back that issue, which several noble Lords probed—are inserted into both. The provisions may also be extended to alcohol, which the noble Baroness, Lady Thomas, referred to.
The provisions apply to claimants of employment and support allowance—ESA—or jobseeker’s allowance whose drug problem is affecting their ability to find work. The new provisions are broadly the same for both benefits. For JSA, they apply only to claimants who are required to meet the job-seeking conditions. For ESA, they only apply to those who are capable of undertaking work-related activity.
Long-term drug use has a devastating impact on individuals, families and wider society. There are around 400,000 problem drug users in Great Britain, defined as those who are dependent on, or have a propensity to misuse, heroin or crack cocaine. Around 350,000 are on benefit. Many more are in prison because drug use has led them into criminal activity. The crime and health costs of drug use are a huge burden to society: around £18 billion a year for class A drugs alone.
We know that many problem drug users on benefit are not in treatment. They should not continue to get benefits without being expected to tackle their problems; the noble Lord, Lord Skelmersdale, touched on this issue of rights and responsibilities. Clause 9 and Schedule 3 therefore introduce a new programme of integrated and personalised support which will initially be directed at heroin and crack users. It will aim to help them overcome their problems and get them ready for work.
I thank noble Lords for tabling this large group of amendments. Two of them aim to reduce the scope of the provisions. The remainder deal with the requirements that can be placed on certain claimants under Clause 9 and Schedule 3. Working through them each in turn, Amendments 95 and 96 amend Clause 9 so that the provisions only apply to claimants who have a drug dependency, and not to those who have a “propensity to misuse” drugs. It might be helpful if I give some explanation of what we understand by the term “propensity to misuse”. It is not a clinical diagnostic term. It refers to a person who, although they may not be physically or psychologically dependent on a certain drug, would be showing evidence of a repeated tendency to use it. So we are not talking about a suspicion of drug use, or people who have experimented once or twice. It would be usage that appeared excessive, impaired the person’s functioning and limited their involvement in a range of activities, perhaps including work. I am sure that noble Lords would agree that we should not exclude this group from the new programme of integrated support that Clause 9 and Schedule 3 would introduce.
Other legislation, which also aims to get drug users into treatment and support, covers both those who are drug dependent and those who have a propensity to misuse. The Criminal Justice Act 2003 allows a court to impose a drug rehabilitation requirement where an offender is dependent on, or has a propensity to misuse, drugs. Similarly, the Drugs Act 2005 provides that when a person tests positive for heroin or crack on arrest, or when charged with an offence, they can be required to attend a drugs assessment to determine whether they are drug dependent or have a propensity to misuse. Again, this applies in relation to drug dependency and propensity to misuse. Where it is established that benefit claimants have a propensity to misuse drugs, Schedule 3 will apply only where that propensity is a factor affecting their prospects of getting or holding down a job.
Amendment 97 would amend the provisions that deal with the requirement for a JSA claimant to answer questions about drug use. It is intended to extend powers so that regulations could impose certain requirements on these interviews. The powers in Schedule 3 are already broad enough to enable regulations to include the types of requirements sought by this amendment, and consideration will be given to safeguards that should be included to ensure that interviews are conducted fairly and appropriately.
We are aware that stakeholders are concerned whether Jobcentre Plus staff will ask these questions in a way that is sensitive and supportive, and whether claimants will feel able to discuss such matters in the surroundings of a jobcentre. Stakeholders are also concerned that failure to answer these questions without good cause might lead to a benefit sanction.
I reassure noble Lords that the questions will be fair and that staff will be trained to handle interviews with drug users in a sensitive and supportive manner. We want to encourage claimants to disclose their drug problem so that we can provide them with the support and help that they need. The role of the personal adviser will be to ask questions about drug use so that they can judge whether there are reasonable grounds—the noble Baroness, Lady Meacher, mentioned this—for suspecting that a person is a problem drug user. Where there are such grounds, the claimant will be required to attend a substance-related assessment, but advisers will make no medical judgments; clearly such issues need to be left to drug treatment professionals. The areas covered by the questions will be set out in regulations. The department has already provided noble Lords with the memorandum on extended delegated powers, which sets out what these questions might be.
We should recognise that Jobcentre Plus staff discuss daily with claimants sensitive issues such as finances, housing and medical matters, and although the provisions in the Bill will be new to them, dealing with drug users is not. Many claimants who are drug users struggle to meet the conditions for claiming JSA, such as signing on and searching for jobs. They face sanctions if they do not meet these requirements, and many of them quite voluntarily divulge that they have a drug problem.
I also reassure noble Lords that personal advisers will receive training—a constant theme of our deliberations—to raise awareness of drug misuse and how it affects people. This will be delivered in conjunction with the National Treatment Agency for Substance Misuse and local drug action teams.
Jobcentre advisers are already building up greater experience of drug issues. Since 27 April, they have been asking claimants about problem drug use with a view to referring them, on a voluntary basis, to a discussion with a local drug treatment provider. They are being supported in this by local drugs co-ordinators who are based in each district. This experience will be invaluable for the pilots set out in the Bill. I stress that we are talking here about piloting these proposals and assessing them afterwards. Sunset provisions are, in effect, in place. We can learn how we can encourage claimants to divulge drug problems, and how we can reassure them that it is safe to disclose drug problems to benefits staff.
Amendments 98 and 107 seek to remove the powers to impose a requirement for certain JSA and ESA claimants to undergo drug tests. Where there are reasonable grounds for suspecting that a claimant may be dependent on or have a propensity to misuse drugs, and that this is affecting their chances of getting and holding down a job, they may be required to attend a substance-related assessment. As has been noted, this assessment will be undertaken by an approved person, who will be a drug treatment professional. It will consider whether a claimant is dependent on or has a propensity to misuse drugs, and if so whether they require and may be susceptible to treatment. If the assessment identifies a claimant as such a drug user, they will be referred to the new drug and employment support programme: hence the assessment is the gateway to accessing specialised support. It is therefore important that people who need support are identified and attend. A person who fails without good cause to attend a substance-related assessment may be required to undergo one or more drug tests. We consider this approach to be justified. A claimant can be referred for an assessment only where there are reasonable grounds for suspecting that they are a problem drug user.
Have the Government explored with the health professions whether they would be willing to undertake tests on a compulsory basis, because that is quite contrary to normal medical practice?
There has of course been engagement with the Department of Health in developing the proposals, but I shall try to get a more detailed response for the noble Baroness before I finish.
I can reassure noble Lords that a positive test result will not be used in isolation to decide that a claimant is a problem drug user, and it would never on its own lead to a requirement to comply with a rehabilitation plan. If the test result is positive, they will be directed to attend a further appointment for assessment. If a person fails to take part in a drug test without good cause, they may be subject to a benefit sanction, but they will have a right to appeal against that.
The remaining amendments focus on the rehabilitation plan, which is a key component of the new drugs programme. The rehabilitation plan will be a single document which will integrate treatment plans with the other steps that a claimant needs to take to move towards gaining work. It will be drawn up between the employment support provider and the claimant.
Not all drug users will be required to follow a rehabilitation plan. It will apply only where a claimant has a dependency on, or a propensity to misuse drugs; this is a factor affecting their ability to obtain or remain in work; and their condition requires and is susceptible to treatment. However, where those criteria are met they will be required to agree a rehabilitation plan and do their best to make progress against it. If they fail to do so without good cause they may be subject to benefit sanction.
Clearly, the assumption behind all this is that drug users are economically rational, change their behaviour in response to financial sanctions, and so on. One wishes; I hope. I sent a note on this to the noble Baroness, Lady Meacher. I absolutely support what my noble friend is trying to do, which is to use the hook of this to try to turn lives around. We would normally have, for any person with dependants who is exposed to sanctions, a hardship regime, so that they can be sanctioned to only, say, 10 or 20 per cent of their benefit and they continue to get the rest. That is never normally applied to single people, and I suspect that most drug users will be single people—certainly not in sustained relationships.
Given that my noble friend has accepted that we are talking about illness—I am sure that the Department of Health will support him on this—conventionally, in social security policy, anyone with an illness is entitled to hardship finance as opposed to having their benefit completely wiped out. Can my noble friend help me? Will someone who, without good cause—because good cause assumes a rationality that, almost by definition, someone with a mental health problem does not possess—none the less, by virtue of that illness comes within the category of vulnerability, of dependency, be therefore exposed only to a limited sanction rather than a wipeout of the complete benefit?
My fear is that the measure would open up the drug dependent category to a whole lot of people who may “have a propensity” but are not drug dependent. The more I hear what is being said, the more I worry about the average student who leaves university with a great big debt and therefore soon becomes dependent on help from the state. Such students may have a propensity to use drugs and may continue to do so when they cannot find any work. They lead chaotic lives. Much as we try to timetable them, they just do not turn up. Students who are seen as potential employees, and who wish to become employees, suddenly become categorised as drug users because they are dependent on benefit. That will close all doors to them on their path to independence. I hope that the measure can be changed to enable this large category of bright young people to get over a hump and into the labour market.
The whole thrust of this is to try to help people move closer to the labour market, particularly those who have been excluded from it for a long time through their dependency. The measure has three components: drug dependency; propensity to misuse drugs; and the impact of that. Whether someone is susceptible to treatment and whether their dependency impacts on their ability to obtain work is the third leg that would need to be satisfied before these provisions would bite. I doubt whether they would extend to the whole range of students to whom the noble Baroness refers, but there are three components.
I revert to the point made by the noble Baroness, Lady Meacher, on engagement with the medical profession on drug testing. We are discussing with the Department of Health and the Home Office how to establish and conduct the pilots. We would engage with the medical profession through that mechanism. Off the top of my head, I cannot tell the Committee how detailed that engagement has been to date, but I understand the thrust of the noble Baroness’s point.
What would be the difference if the compulsory testing and urine sample provisions were left out? Why would it make any difference to these proposals?
The noble Baroness raises a very interesting point. As I said a moment ago, a positive test would not of itself drive an automatic conclusion that a rehabilitation plan is needed; it would simply be further evidence to support the questions that were raised initially about whether an assessment should be undertaken. But at the end of the day, if an individual will not engage with a drugs test or an assessment, these provisions cannot operate and the individual would remain on whatever benefit they are currently on—employment and support allowance or jobseeker’s allowance. As I said earlier, they could miss out, given the sanctions regime that applies to that course, as there is no strong mechanism to help them engage with the support that is available. The whole thrust of this is to try to get people through the door of treatment establishments. In a moment we shall discuss coercion. I think that the noble Baroness, Lady Murphy, referred to co-operative coercion. Why is that such a bad thing? Surely we would all wish to offer people the opportunity of treatment. It does not preclude a voluntary approach; there is no reason why that should not sit alongside.
I suppose that is why one of the amendments suggests or recommends that if there is to be any element of compulsion it should involve attending an assessment. That does not cut right across all the provisions for medical treatment, which must have the consent of the individual. You do not have compulsory treatment; you give consent. If the element of compulsion concerned the assessment, the Government would avoid a lot of the major concerns that I think will arise in the medical profession, certainly judging from the BMA response.
Perhaps I can come on to the issue of what is required and compulsory in a moment. I hope that I can provide some reassurance to noble Lords on that.
Amendments 105 and 113 remove the possibility of including in a rehabilitation plan a requirement for a JSA or ESA claimant to attend an institution for treatment. Instead, they allow a rehabilitation plan to require a claimant simply to attend an initial assessment for drug treatment. Removing the ability to require a claimant to attend an institution for treatment and replacing this with a requirement to attend an initial assessment for treatment is a significant change and is intended to soften the edges of a mandatory approach. In practice, though, it would just duplicate the substance-related assessment that a claimant will have already attended under these proposals.
We are aware that some stakeholders have voiced concerns, as we have been told forcefully this afternoon, that we are forcing claimants to undergo medical treatment, and claim that any form of coercion into treatment, such as a benefit sanction, will not work. Let me be absolutely clear. We are not forcing people into treatment. It will be possible under paragraphs 6(4) and 6(5) only for a rehabilitation plan to include a requirement that the claimant must attend an institution or treatment centre, as a resident or non-resident, for treatment under the direction of a professional. The nature of that treatment cannot be specified, so there is no requirement for the claimant to submit to any particular type of medical treatment at the institution. If the treatment is residential, the location is entered on the plan. If it is non-residential, the location and intervals are recorded, but that is all.
The employment support provider does not need to know the details of the treatment that the claimant is undergoing. The claimant needs only to agree attendance at a treatment centre. If the claimant fails to attend the centre for treatment, they may face the possibility of a benefit sanction and remaining on mainstream provision. But, as with any form of medical treatment, the patient will have the right to be involved in discussions and decisions about any treatment they receive at the institution, and to agree to or refuse medical treatment that is offered.
As a further safeguard, the Government intend to include in regulations an express provision that a person cannot be required to submit to invasive forms of treatment, such as a course of methadone, unless they have consented. The Government will also make provision in regulations for the content of rehabilitation plans to be agreed with claimants.
In relation to coercion, during the Green Paper consultation many groups told us that most drug users want to get treatment and get off drugs. We are probably agreed on that proposition. Some groups told us that an element of coercion is not a bad thing. For example, Turning Point, while expressing some reservations about some aspects of the scheme, nevertheless said:
“Turning Point welcomes any programme which attempts to engage more people in need into the treatment arena. We also recognise that some of those clients may be reached through an element of coercion, and that this may engage some with treatment who would not alone have had the momentum or support to enable them to stabilise their substance misuse”.
Some comparison can also be drawn from evidence from a study in the US. I am not sure if that is the same study that the noble Baroness, Lady Murphy, referred to; I have some more detail that I will come on to in a moment. It found that making benefit receipt conditional on treatment participation appeared to increase treatment participation rates.
Amendments 106 and 114 seek to ensure that, for treatment to form part of the rehabilitation plan, a drug treatment practitioner must have determined that the person is susceptible to, and consents to, treatment. The amendments are unnecessary. With regard to the susceptibility to treatment, a drug treatment provider, like any other medical practitioner, should not recommend treatment unless it has determined that a person would be susceptible to it. In any case, as I mentioned earlier, the substance-related assessment will have already determined that the person’s drug problem is susceptible to treatment.
On the consent point, I have explained that the rehabilitation plan cannot include a requirement for the claimant to submit to any particular type of medical treatment; it can require the claimant to attend a treatment centre for treatment only under the direction of a professional.
Amendments 111 and 112 seek to remove the ability to impose a rehabilitation plan on an ESA claimant, thus making it a voluntary matter rather than a requirement. If a rehabilitation plan were voluntary, as recommended by these amendments, we doubt that many would opt to have one. Inevitably, those who are most in need of support and would gain the most benefit from having a plan would fail to take it up. A rehabilitation plan is not just about a requirement to submit to treatment; it is the gateway to the new drug and employment programme. Claimants will be provided with other support to overcome barriers to work; the noble Lord, Lord Ramsbotham, probed this question. This will include action to address barriers to work such as housing, debt and employment skills. It will also cover soft skills such as building self-esteem and confidence.
The amendments apply only to the ESA, but if the intention is to apply it to the JSA too, by choosing not to have a rehabilitation plan, the claimant could continue to be subject to the mainstream job-seeking conditions. These are, as I said a moment ago, inappropriate for many problem drug users. Under current rules, many repeatedly fail to meet them by not signing on or by failing to show that they are actively seeking work, and as a result they face regular benefit sanctions. The intention is that when a rehabilitation plan is in place, these conditions will be lifted and replaced with a more appropriate set of conditions for drug users. This is a key benefit which many claimants would lose if they could opt out of a rehabilitation plan.
Any requirements in connection with rehabilitation plans will be introduced by regulations. These regulations will be subject to the affirmative procedure, so before they can come into force they will have to be approved in draft by both Houses and there will be an opportunity to consider and debate them. They will also include safeguards to ensure that the requirements are proportionate to our aims and compatible with the European Convention on Human Rights.
Finally, Amendment 115 seeks to restrict the ability to impose a sanction in the event of a failure by an ESA claimant to comply with a requirement to submit to treatment under a rehabilitation plan. Under powers in paragraph 7 of the two new schedules, regulations may make provision for a benefit sanction to be applied where a person has failed to comply with any of the requirements contained in paragraphs 1, 2, 3, or 6.
The amendment attempts to restrict the ability to impose a sanction where a claimant has failed to comply with a requirement to submit to treatment as part of a rehabilitation plan. Under the amendment, a sanction could be imposed only where the treatment had been recommended by a person with the necessary qualifications and experience and where the claimant has consented to the treatment.
Paragraphs 6(4) and 6(5) already provide that the rehabilitation plan may include a requirement that the claimant must attend an institution or treatment centre, as a resident or non-resident, for treatment,
“under the direction of a person having the necessary qualifications or experience”,
so any treatment that is recommended will have been recommended by a qualified person. The noble Baroness, Lady Thomas, drew a distinction between necessary qualifications and experience. I am not sure that I can draw a clearer picture than that, but the paragraph covers people who are knowledgeable and experienced and have a range of particular qualifications to be able to engage in this exercise. As I said, any treatment that is recommended will have to be recommended by a qualified person. This is the only requirement for treatment that can be included in a rehabilitation plan.
I have also already explained that there is no requirement for the claimant to submit to any particular type of medical treatment at the institution. It follows that no sanction can be imposed merely as the result of a failure to take up a particular type of medical treatment. Claimants will be expected to turn up to an institution for treatment and to be willing to participate in some form of treatment programme. If the claimant fails to attend the centre for treatment or to agree to any form of treatment at all—for example, if they are unwilling to take up even the offer of counselling—they may face a benefit sanction and remain on mainstream provision.
Sanctions in this area will be a last resort. As always, a claimant will be given an opportunity to show good cause for any failure to attend an institution or treatment centre for treatment, but we do not intend Jobcentre Plus to impose a sanction for missing just the odd treatment appointment. The key thing is that the claimant agrees a rehabilitation plan and does their best to make progress against it.
I am sure the department will have made this calculation. Of the 350,000 serious drug users, what is the department’s estimate of how many go into a rehabilitation or treatment programme, as the Minister describes?
The short answer is that it depends very much on what flows from the pilots. Until we have established and evaluated the pilots, it will be difficult to be precise about that.
Will it be a third or two-thirds? The department will have made some assumptions, I presume.
I think it will, and those assumptions are on the way. Up to 10,000 people will engage through the pilots. That is the estimate.
What is that information based on? I am trying to work this out. The department will have made some estimate of the likely outcome of this programme. In other words, will a third or two-thirds of drug users go into it? The department is faced with the possibility of sanctioning the residual number. Does the Minister have that information to hand, or could he share it with us in a letter? For any such programme I am sure that my noble friend will have calculated that X per cent will engage. You can then start to work out some of the costs and whether you should put down a form of dowry to get people into the programme and other such matters, but you need the base number. Of the 350,000, does my noble friend expect 200,000 or 20,000 to respond positively? I would be happy for the Minister to write in reply because I did not forewarn him of this.
I well understand the point that my noble friend is probing. It would be better for me to write and circulate the reply to every Member of the Committee who has participated today, rather than giving a few figures that have been not quite plucked from the air, but plucked from the Bench behind me.
The welfare state has historically combined rights with responsibilities. In return for benefit payments and extra support, customers who are able to do so should be expected to do their best to find work. Where there is a requirement to carry out a responsibility, there must be a penalty to encourage compliance. As I said previously, the new provisions on drugs will be piloted for two years and subject to evaluation. There are also sunset provisions. Within two and a half years of the regulations coming into force the Secretary of State will be required to report to Parliament on the pilots. A statutory instrument will also be needed to continue the arrangements or repeal them if they are not to continue. This would be done via the affirmative process.
There are several points that I still need to address. The noble Baroness, Lady Murphy, and the noble Lord, Lord Skelmersdale, asked about drug tests. To be very clear, these will not be carried out in jobcentres. The noble Lord, Lord Ramsbotham, used, I think, the phrase, “declaring war on drug users”; I think that was the tenor of his approach. I genuinely will not accept it as a characterisation of our approach. This is about supporting people but recognising a degree of coercion to get to the starting point of a treatment centre. In the context, it is not unreasonable. In relation to the use of benefit sanctions, these are not new. Many drug users and their families are already experiencing them. Their chaotic lives mean that they fail to sign on or show that they are available for and actively seeking work. If, through these provisions, we can get them into a different category or programme, we can, I hope, support them in moving closer to work and away from the dependency that is destroying their lives and those of their families.
The noble Baroness, Lady Meacher, asked whether Jobcentre Plus staff will identify problem drug users. Let me be very clear: personal advisers will not make assessments of a person’s drug use; they will simply decide who to refer for an assessment. That is all. To do so they will need to be satisfied, as I said earlier, that there are reasonable grounds for suspecting that a person is a problem drug user.
The noble Baroness sought to draw a parallel with the community order pilots. I suggest that they are not the same. These pilots use the benefit system to enforce community sentences. We are using the benefit system to enforce decisions made by personal advisers or agreements made with employment providers. It is entirely consistent with what we do within the current benefit system.
The noble Baroness, Lady Meacher, and the noble Lord, Lord Ramsbotham, asked about resources. Certainly, because of record levels of investment in treatment for drug misuse in England, there has been a big expansion in capacity and dramatic reductions in waiting time. I have figures that 93 per cent of drug users are receiving treatment within three weeks of being assessed. The Department of Health and the DWP have looked closely at the likely numbers being referred to treatment from jobcentres, and we will confirm those broad assumptions in writing.
We do not think that capacity will be an issue. However, we will monitor the situation closely. Local drug jobcentre co-ordinators funded by the Department of Health and in post from this April will be keeping an eye on any potential pinch points and drawing them to the attention of the local drug partnership. The national treatment agency will be monitoring data on waiting times.
The noble Lord, Lord Ramsbotham, with his deep experience of what happens in the Prison Service, referred to the drug abuse situation there. Under the Fresh Start initiative, Jobcentre Plus already works with prison services to speed up the receipt of benefit for prison leavers; this really is joined up. Advisers from Jobcentre Plus visit prisons to advise prisoners about benefit claims and finding work. Advisers will encourage those with drug problems to declare drug use so that they benefit from the new programme and, if appropriate, receive a treatment allowance rather than face the full JSA job-seeking conditions. The supply of information about prisoners will additionally help to identify those ex-prisoners who claim benefit and need help and support to overcome their drug problems.
I am grateful to the Minister for that comment. One of the things that has always concerned me about prisoners and benefits is that they receive an allowance when they leave prison. One would have hoped that that was the first payment of their benefit, so that they could carry on from there. I have never understood why they come out of prison with their release allowance and then have to start the process of going to benefits, which inevitably leaves a gap. This is nothing particularly to do with the Bill but, in connection with how they are treated, it really could be investigated with advantage in view of the problems that it creates—particularly for women prisoners.
The noble Lord raises an interesting point on which I do not have detailed notes. We will certainly have a look at it. There are provisions in later clauses to do with advance payments of benefit to get out of the cycle where people have to rely on crisis loans until the benefit comes into payment. However, we will take that away and have a look at it.
The noble Baroness, Lady Thomas, was probing what “propensity” means and the process of trying to identify whether someone was a problem drug user. A drug test will be required only if a person has failed to attend a substance-related assessment. To be referred for an assessment, the personal adviser must already have had reasonable ground to suspect that they are dependent on drugs, or that they have a propensity to misuse them.
The noble Baronesses, Lady Meacher and Lady Thomas, referred to the position in Scotland and Wales. The provisions in Paragraph 9 in Schedule 3 extend to England, Scotland and Wales and will deliver a commitment made in the Government’s 2008 Drugs Strategy for England. As with social security matters, however, there is, of course, a reserve to this Parliament and the legislation extends to the whole of Great Britain. Health matters are devolved to Scotland and Wales and criminal justice matters are devolved to Scotland. We clearly need some joint working on that, and officials are working with both the Welsh and Scottish Governments’ officials to establish how the new regime might be piloted in Wales and Scotland, taking into account the availability of drug treatment and other factors.
The noble Baroness, Lady Thomas—I think I have covered this point already—asked what types of treatment claimants are being mandated into. I emphasise that claimants are not being mandated into treatment. They may be required to agree to and follow a rehabilitation plan, which may include a requirement that the claimant must attend an institutional treatment centre as a resident or non-resident for treatment by or under the direction of a professional, but they are not being mandated into treatment. That deals also with the point raised by the noble Baroness, Lady Murphy.
Returning to the evidence around coercion, which the noble Baroness, Lady Murphy, pressed me on, the evidence from the USA to which I referred has shown that making benefit receipt conditional on treatment appears to increase treatment participation rates. There is a study entitled “Termination of Supplemental Security Income Benefits for Drug Addiction and Alcoholism” by JA Swartz, A Lurigio and J Baumohl which I am happy to let the noble Baroness and any other noble Lords have if they are interested in a more detailed reference.
I want to press the Minister on his previous remarks when he talked about medical treatment. There is a phrase in the Mental Health Act, and in other medical Acts, to the effect that medical treatment includes all treatment, habilitation and rehabilitation, and I am surprised that they appear to be separated in this Bill. It seems to imply that rehabilitation is not medical treatment when in fact medical treatment includes rehabilitation.
I am not sure whether we are focusing on semantics here. So far as any treatment issue is concerned, obviously the rehabilitation plan involves only the requirement to attend a particular centre or institution. The other components of the plan would depend upon the individualised or personalised circumstances of the claimant. For example, they may be to do with housing advice, debt counselling and so on, which would not traditionally be recognised as medical services and as coming within the restrictions to which the noble Baroness is referring. I am not sure whether I am covering the point to which she refers.
Certainly requiring the attendance of an individual at a day centre, for example, comes under compulsory treatment.
I should like to take the point away.
It may be a technical point, but it is a very important one. If attending a rehabilitation programme is going to have a different meaning in the Bill, then that should be made very clear.
We need to get clarity on this issue. I shall make sure it is followed up and write to noble Lords. I understand the point that has been made.
I hope that I have dealt with all of the points raised. I am sorry it has been such an extensive response but, given the nature of the debate, I thought it would be helpful to all if I put as much on the record as I can. I am conscious that the voluntary approach is the way in which the noble Baroness, Lady Thomas, would like this to move forward. That view was echoed by every other noble Lord who spoke, with the possible exception of the noble Lord, Lord Skelmersdale. The noble Lord, Lord Rea, with his 25 years as a general practitioner, has a great deal of experience and expressed doubts about whether this would have the desired effect or whether it would drive people into poverty. He made an important point about people being suspicious of authority. I acknowledge that, but if we cannot engage as an authority, how are we going to help these people and move them forward in the challenges that they face in their lives?
The noble Baroness, Lady Afshar, said that we were creating criminals. With respect, that is not what we are doing with these provisions. If people are users and dependent on drugs, we will recognise that and help them through a process so that they can get treatment and support, and we hope in due course get off that dependency and into employment. The process that we are focusing on here is not about criminalising people. I accept the point that the rest of the criminal justice structure might do that, but that is perhaps a wider issue for a debate outside our deliberations here.
I hope that that has dealt with the point that noble Lords wish to cover; I would be happy to try again if not. Correspondingly, I wonder whether the various noble Lords who tabled the whole raft of amendments might feel able not to press them.
I thank every noble Lord who has spoken in this debate. It has been very productive and there is clear consensus of concern about Clause 9 as drafted. I suggest that we have a meeting with the Minister about the training institute, but also about a number of concerns that remain unresolved here. I shall mention just a few of them, so that he can think about them before we meet, if we do.
The Minister did not explain how the personal adviser can measure at all the question of propensity. I think that there will be a major problem with medical staff. I cannot imagine medical staff getting involved in what I think they would see as compulsory treatment, as the noble Baroness, Lady Murphy, made clear. That question remains up in the air. Frankly, compulsory treatment is compulsory treatment even if the specifics of that treatment are not spelt out by the personal adviser. If you have to attend some form of treatment, that is compulsory.
There are human rights issues, there are certainly ethical issues and there are certainly issues cutting across the Mental Health Act. One cannot get away from the fact that compulsory attendance at a residential place of treatment is compulsory treatment of some sort. As I heard it, the Turning Point view appears to go along with the idea of compulsory attendance for an assessment, rather along the lines of one of our amendments. I heard nothing in that quotation about Turning Point supporting compulsory treatment. I cannot believe that it would.
Resources will be an issue. That is another matter that the Minister needs to consider further.
Before the noble Baroness leaves that point, I am not sure whether the Minister answered the point about the NHS Constitution and whether any of this cuts across that.
I meant to. I have a note that refers to it. We will liaise on these issues with the Department of Health. Perhaps I can pick that up when we discuss the next amendment, if it has not come through by the time we have concluded this one.
To conclude, we would all be interested to see the US evidence, but the consultant psychiatrist in the East London foundation trust agrees that a few people might be drawn in by compulsory treatment. The problem is that the down side, the negative consequences, for the very much larger number completely outweighs the possible benefit to a few. That psychiatrist—she is a very good consultant psychiatrist—said that that would be incredibly unhelpful. She works with drug users all the time, she has given her life to it, and she said, “Please, this is just not going to help us in this very difficult task of drawing these people in and keeping them engaged to a point where perhaps they can resolve their many difficulties and therefore return to work”. I think that one should take the views of a practitioner like that, along with the noble Lord, Lord Rea, very seriously. Those people really understand the incredible difficulties of dealing with these issues.
I am very disappointed by the Minister’s reply. I hoped that he would be willing to take the amendment away and think about redrafting Clause 9 so that it could be a positive rather than, in my view, a very negative contribution.
I am very happy to set up meetings after the end of the Committee stage to continue to address her points. I am sure that we can facilitate that.
I thank the Minister very much for that offer. I beg leave to withdraw the amendment.
Amendment 95 withdrawn.
Amendment 96 not moved.
Debate on whether Clause 9 should stand part of the Bill.
We have covered half the issues to which Clause 9 gives rise, and we still have another batch to go through. I am a little sorry that my noble friend has not talked about the right to privacy under Article 8 in the Human Rights Act when requiring people to answer questions about their drug and alcohol use and to undergo tests with police and probation officers. The Government are supposed to put safeguards into place so that this does not affect a person’s private life and contravene Article 8, but perhaps we can go into this later.
Yes, I think we can. Another batch of amendments is coming up that focuses on this.
In that case, I do not oppose the clause at this stage.
Clause 9 agreed.
Schedule 3 : Claimants dependent on drugs etc.
Amendments 97and 98 not moved.
Because the debate on Amendment 99 will also be quite long, the usual channels have suggested that we take a break for 10 minutes. Unless any noble Lord objects, the Committee will adjourn for 10 minutes.
Sitting suspended.
I do not see the proposer of Amendment 99 here present.
If the Deputy Chairman of Committees will allow me, it is within the realms of possibility for any Member of the Committee to move an amendment in somebody else’s name at any point, especially if they were intending to speak to it. I intend to speak to the amendment and will, if necessary, move it.
Amendment 99
Moved by
99: Schedule 3, page 72, line 38, at end insert—
“( ) No information disclosed by a person in compliance with a requirement imposed by regulations under paragraphs 1 to 3 may be adduced in civil proceedings or in any other circumstances disclosed to third parties without the person’s consent, or in any circumstances where this may be detrimental to the person’s interests.”
The noble Baroness, Lady Meacher, would have raised the issue of data sharing. I recognise that this is a tricky matter. There is, as ever, a tension between protecting the individual’s privacy and ensuring that enough information is flowing to allow the system to work. Redaction, which is exercising the press and another place at this time, exemplifies that. It is heartening, given the Government’s ambiguous relationship with the sharing of information on citizens, that Schedule 3 does at least acknowledge limitation on the use to which this information may be put.
Schedule 3(4), on page 72, notes that some of the information elicited from participants might well constitute evidence that a criminal offence has been committed. That point was made by the noble Baroness, Lady Afshar, a little earlier. She was worried that evidence might be used to lead to a conviction of the drug addicts that we were talking about in the previous amendment. That is unsurprising, as we are talking about people who may be taking illegal drugs, but the Bill, as I understand it, specifically prohibits this. No information can flow from the social security office to any part of the court system, including the police. I hope that I have got that right.
An exploratory interview about their lifestyles, necessary to form an individual action plan, may uncover more. Although I have been taking a harder line on the conditions that should be placed on drug takers than some noble Lords might like, I stand firmly by my position. I too see the logic of the provisions. No one would volunteer to get help with their addiction and get back onto the work programme if there was a risk that they could be prosecuted. It would be quite counterproductive for these purposes. Dogma ought to be set aside in favour of pragmatism. I will probably come back to this point; I reserve the right to do just that. I beg to move.
I apologise for not being back in time. I take it that the noble Lord has moved Amendments 103, 104, 109 and 110. Is that correct?
At this stage only one amendment can be moved at a time.
I spoke to them as a group but I moved only the first one.
That is what I meant. I will speak to Amendments 99, 103, 104, 109 and 110. Schedule 3 provides for information to be provided by the police, probation service or others. These are all of concern, but I am particularly concerned about the involvement of a doctor. These persons would be required to give information to JSA and ESA officers. These clauses also provide for information obtained by these officers to be passed on to others. These clauses appear to have been written in a vacuum. Again, they take absolutely no account of the fact that drug use is a criminal offence.
The aim of the personal advisers must surely be to develop a rapport and degree of trust with claimants. If claimants find that information has been obtained from the police or their doctor, or that information is passed on, the claimant will inevitably be afraid, will lose any element of trust in those involved, and will simply discontinue their claim. If the aim is indeed to frighten claimants off the benefit count, Clause 9 will achieve that result rather well. However, I know that the Minister will want to consider the implications of that: more crime, more destitution and higher prison and other criminal justice costs. I do not believe that the Minister wants to go down that route.
We can also consider Clause 9 from a human rights perspective. The proposals are, I understand, a clear breach of Article 8 of the European Convention on Human Rights and a potential breach of the data protection laws. To argue that the information is being obtained to prevent fraud, and for the prevention and detection of crime, is wrong in law. A fishing exercise is not a targeted approach to preventing or detecting crime.
The Bill makes clear that failure to disclose drug use will be met with benefit sanctions. There is no recognition that the DWP would be seeking evidence of a criminal activity—the use of a drug. You cannot expect claimants to confess a crime to government officials. As we know, other forms of addiction, such as to nicotine and alcohol, are not criminalised. I would not have a problem with the DWP asking questions and seeking corroboration about cigarette use, for example. At least such an information exchange would not raise the serious issues raised by Clause 9.
Until the Home Office catches up with the DWP in regarding drug use as a medical problem, the DWP cannot have information exchange with other agencies at the heart of its benefit sanctions policy. The BMA is concerned that doctors could be required to supply information to the Secretary of State or a person providing services to the Secretary of State. It points out that there is no clarity over whether the information expected from a doctor, as the prescribed person, would be confined to previous episodes of care that are directly relevant to the claimant’s drug or alcohol misuse and treatment.
I would be grateful if the Minister could clarify for us the terms under which doctors would be required to disclose potentially highly sensitive health data. Under existing law covering the provision of health data, they are supplied to the medical officer of the DWP or an officer acting directly on a doctor’s behalf. The doctor supplying the data therefore knows that they will be held under the protection that the GMC requires, as there is another doctor whose professional reputation and, indeed, registration demand such protection.
The BMA shares my concern about the provision for the onward disclosure of this information. It notes that the proposal seems to authorise the unrestricted further or onward disclosure of highly sensitive and personal information supplied for the purpose of confirming an individual’s misuse of drugs or alcohol. There is no clarity over whether the onward disclosure of information is confined to those directly involved in the claimant’s treatment. Indeed, sub-paragraphs (2) and (3) seem to contradict the Government’s stated policy objective of helping claimants on drugs or alcohol back into the workforce.
Our amendments in this group provide minimum safeguards to prevent the worst consequences of the information exchange provisions of paragraph 9 of Schedule 3. Amendment 99 ensures that for JSA claimants no information would be disclosed to third parties without the claimant’s consent or in any circumstances where it may be detrimental to the person’s interest.
Amendment 103, with respect to JSA claimants, and Amendment 109, with respect to ESA claimants, ensure that information supplied under the regulations by the claimant or others could be used only for the purposes of determining the claim. That is the amendment that I would really like to see adopted. It would be proper and appropriate and not a breach of the Human Rights Act and all the rest of it.
Amendment 104, with respect to JSA claimants, and Amendment 110, with respect to ESA claimants, delete the offending sub-paragraphs and thus prevent information obtained by the DWP being used by others—the police or the Home Office, for example—to amend or supplement their information. The approach to the whole business of information is most concerning.
These amendments also prevent such information being used by others outside the DWP for any purpose. In fact, if the other amendments were passed, these sub-paragraphs would become redundant and would need to be deleted. Others will press for Clause 9 not to stand part of the Bill, and I would consider doing that if the Government are not willing to revisit this clause and change much of it to turn it from a very dangerous piece of legislation into something that could be productive and helpful. That is the route that I would prefer. I would welcome it if the Minister would think about how this could be made to work, taking account of the serious points made by all Members of the Committee.
Perhaps I may come back to the situation. I shall not repeat what I have already said, but it is clear from it that I agree with many of the worries that the noble Baroness, Lady Meacher, has just expressed. One comment that I must make about what she has just said is that page 27 of the Peers’ information pack clearly states:
“All these will be one-way data flows. We do not intend that jobcentre Plus will pass information back to the criminal justice agencies”.
Can I take it from that that the noble Baroness is slightly skewed in her thinking and that the information will not come out of the jobcentre in any event but will always go in? That would be an important safeguard. Where does the Bill tell us that? I have not found it and it is clear that the noble Baroness, Lady Meacher, has not found it, but the Peers’ information pack clearly has.
I am not convinced of the need for Amendment 99, which would restrict the use of this information in civil trials. There may be circumstances—in proceedings for negligence against the jobcentre, for example, although I have not developed my hypothesis with any level of detail—that might require the revelation of some details. In other words, I could see occasions when information might come out in the case of a civil trial, although that would be pretty rare. Perhaps the Minister could help me there.
I note that the amendment qualifies that exclusion with the caveat that the person might consent to the release of the details to a third party. If the permission is on the claimant, that puts a totally different complexion on the whole matter. I have no doubt that concerns will be raised about the provisions that allow for the sharing of data between the jobcentre and various law enforcement agencies, but, as I said, I do not believe that this is a genuine worry. I hope that the Minister will be able to explain why.
Data security is extremely important and something on which I have to say the Government have a less than inspiring record. I expect that we will see this matter raised again at the next stage of the Bill if the Minister does not do quite such a good explanatory job as he did on the previous amendment, which was masterly. I would have thought it would be in his best interests to be as open and explicit as possible about the Government’s intentions here in Committee so that, with a bit of luck, there will be no need to return to this matter on Report. We will just have to see.
I shall speak to Amendments 100 to 102. Amendment 101 takes out all the provisions that allow the Secretary of State or a person providing services to the Secretary of State—that is, a benefits worker—to ask for drug information on a benefits claimant from the police, the probation service or other such persons as may be prescribed. It would also take out the provisions that allow that information, having been received by the Department for Work and Pensions, to be passed on to others.
I felt that the noble Lord, Lord Skelmersdale, did not realise that there was such a provision, but paragraph 5(3) of new Schedule A1 says:
“Regulations under this paragraph may, in particular, authorise information supplied to a person under the regulations … to be used for the purpose of amending or supplementing other information held by that person; and … if it is so used, to be supplied to any other person, and used for any purpose, to whom and for which that other information could be supplied or used”.
That is a little complicated in its wording, but it seems to allow this information to be passed on to quite a wide circle of other people.
Amendment 108 is almost exactly the same, but it applies to the employment and support allowance rather than the jobseeker’s allowance. If the whole paragraph cannot be taken out, Amendment 101 is more limited.
I doubt that Amendment 100 will be accepted. It would merely take out the words,
“such other person as may be prescribed”.
This could include almost anyone. Liberty commented:
“Such information is highly personal and it is worrying, given this government’s history of data loss, that such information may be provided to an unspecified number of people”.
Amendment 102 is more limited in that it excludes only health and social care workers from the provision that allows them to be approached for information, because they are the people most likely to have been given information by the client in confidence. There are three choices of level, but the people on them are all are highly critical of the blanket provision in the Bill.
If the data are a one-way flow, which we believe they are, why does the Peers’ information pack state, as the noble Lord, Lord Skelmersdale, said, to whom the information will not be passed if no information is passed back? It makes us a bit suspicious when the pack says that it will not be passed back to the criminal justice agencies. You think, “Well, why don’t they say they won’t pass information back to anyone?”. Perhaps the Minister can explain that.
Again, I repeat my worry that, by having this information on record, people who may not be in the category of drug users that is envisaged in the Bill will be labelled drug users. Employers are unwilling to go near drug users because of this attribute of criminality and all the rest of it, so this goes against what the Bill wants. It is very important to have an assurance that, if this information is given, it will not go beyond the person to whom it is given.
I am grateful for the chance to address these amendments and, I hope, to reassure noble Lords about what the provisions are intended to achieve, although I acknowledge that they may be seen to be drawn quite broadly. I thank the noble Lord, Lord Skelmersdale, and the noble Baroness, Lady Meacher, for giving us the chance to debate these amendments.
These provisions are not about frightening people off benefits. That is genuinely not what we are about here. Nothing could be further from the Government’s intention. I set out the policy intention behind the drugs provisions and the reason why Clause 9 should stand part of the Bill in an earlier debate. The new drug and employment support programme will provide integrated and personalised support for problem drug users—those dependent on heroin or crack cocaine.
Schedule 3 inserts a new section and schedule into the Jobseekers Act 1995 and the Welfare Reform Act 2007. The new provisions will allow the Secretary of State to make regulations that relate to people who claim the JSA or the ESA and who are dependent on, or have a propensity to misuse, drugs or alcohol to the extent that it affects their ability to gain and keep employment. Some of those regulations will concern the supply and use of information. Noble Lords have tabled a group of amendments on these issues, as we have heard. I will deal with each of the amendments in turn.
The Bill already ensures that the information covered by Amendment 99 cannot be used to incriminate a claimant who has provided it. It cannot be cited by the prosecution in criminal proceedings unless the defendant, or a person acting on their behalf, chooses to raise the matter. That is very clear. Jobcentre Plus will use information about a claimant’s drug use only to enable the operation of the new drug and employment programme. Information provided by a claimant in answer to a question about their drug use or the result of a drug test might therefore need to be passed on to the drug worker who carries out the substance-related assessment, or to the employment support provider. However, this information will be handled in strict confidence. Jobcentre Plus will not disclose any information connected with these provisions to third parties unless it has lawful authority under statute or common law and is satisfied that it is proportionate to do so, or is compelled by a court to do so.
There may be some instances in which information needs to be disclosed because this is in the overriding public interest; for example, where disclosure is necessary to prevent harm to a child. However, any disclosure would have to comply with the Data Protection Act 1998, and be compatible with the European Convention on Human Rights. Information provided by claimants about their drug use would be sensitive personal data, and the processing of the information would be subject to additional requirements under the Data Protection Act. If a member of staff discloses information without lawful authority they would be committing an offence under Section 123 of the Social Security Administration Act 1992, which is punishable by imprisonment.
However, we do not believe it to be appropriate to agree to a provision which routinely prevents the use of this information in connection with civil proceedings. The noble Lord, Lord Skelmersdale, was right on that. These may include family court hearings where the use of class A drugs by a parent might be a relevant matter when making a decision about the residence of a child. This amendment would also mean that information from the claimant in answer to questions about their drug use, or information disclosed in connection with a substance-related assessment or drug test, could not be referred to in an appeal against a benefit decision. That clearly would not be sensible.
On Amendments 100 and 108, paragraph 5 is intended to help Jobcentre Plus identify problem drug users so that they can be provided with the support that they need to prepare for and find work. We are aware that some problem drug users will not disclose that they have a drug problem due to stigma or embarrassment, or other reasons, but we do not want them to miss out on the support that will be available.
Regulations will allow information to be supplied to Jobcentre Plus by the police, Probation Service or other person as may be prescribed. It will be used to check and supplement information already held about a claimant’s drug use. The information already held may include the claimant’s answers to questions about their drug use, the results of a substance-related assessment, and, in a minority of cases, the results of drug testing. However, I reassure noble Lords that none of the information supplied under paragraph 5 will contain medical details, and no data will be provided from Jobcentre Plus to the criminal justice system.
The Probation Service will provide details of people who are subject to a drug rehabilitation requirement. These are issued by a court, as part of a community sentence, and require those convicted of a crime to undergo drug treatment. About 16,000 of these are issued each year. Supply of this information will enable them to be included in the programme.
Information will also be supplied about people who fail to attend for a police “required assessment”. This means they tested positive for drug use when arrested or charged with an offence and then they failed to attend an initial, or follow-up, assessment of their drug use, which is in itself a criminal offence. Details of those individuals, who number around 13,000 a year, will be provided by the drug workers who carry out these assessments. We intend to achieve this using the power to prescribe “other persons” at paragraph 5(1)(c), but these are flows into Jobcentre Plus.
Did the noble Lord say that no information would be obtained from doctors about the care of clients? If so, will he agree to include the words in Amendment 102,
“with the exception of health and social care workers, who are excluded from these provisions”?
I was just coming to that very point. Amendments 101 and 102 focus on this particular power. Amendment 101 removes it entirely, and Amendment 102 exempts health and social care workers from its scope.
Both amendments would prevent the use I have just described. We also intend to use this power to obtain information about people who have recently left prison from the Prison Service. Many prisoners are treated for drug problems while in prison, and will claim benefit on release.
It is important that we identify them at this point. In future, it may be considered appropriate to authorise other persons or bodies to supply information. Therefore, it is important that we retain flexibility in the powers of paragraph 5(1).
Regulations authorising the supply of information by prescribed persons will be subject to the affirmative parliamentary procedure, so before they can come into force they will have to be approved in draft by both Houses. Therefore, there will be an opportunity to consider and debate the regulations. Information supplied in paragraph 5 will be treated in strict confidence and will be used only to the extent that it is necessary to check the accuracy of information given by claimants about their drug use, and to enable the operation of the new drug and employment programme. The regulations will include safeguards to ensure that the use and sharing of the information is proportionate to our aims. The processing of the information will have to comply with the Data Protection Act 1998 and be compatible with the European Convention on Human Rights.
What did the Minister mean when he said that information obtained from the police or the Probation Service would be used to supplement information already obtained about the drug use of the claimant? Suppose the claimant had denied drug use and then a submission was made to the police or the probation officer to ask if they had any evidence. You could say that this would be supplementing the information from the claimant. If it became known to claimants that inquiries to the police or the Probation Service will be made if they claim benefits, I would again assume that claimants will simply run a mile from the benefits system because they will not want to have that tangle with the police and the benefits system. I would be grateful to know what the Minister’s view on that is.
It is very much to cover the circumstances that the noble Baroness identified. If somebody has come into Jobcentre Plus, been asked about drug dependency and has answered that they have none, but the flows of information from the police suggest otherwise, having that information available to Jobcentre Plus is quite important. This is particularly true for the category of people I have just described, who do not turn up for the assessment. It enables the assessment to be undertaken or mandated, and potentially opens up the gateway to the programme of support that is available. That would be the nature of the flow for somebody who has come in and lied about drug dependency. I can understand that people are concerned about it. This would be a supplementary source of information that could identify potential problems.
Shortly I will perhaps have a more precise answer to that and the question of why, if we did not have that gateway, it would preclude the question leading to the assessment. That is the thinking behind those flows. The Bill is quite clear about what that information can be used for. Paragraph 5(3) states:
“Regulations under this paragraph may, in particular, authorise information supplied to a person under the regulations—
(a) to be used for the purpose of amending or supplementing or supplementing other information held by that person”.
That is the thrust of that information.
The Minister did not continue paragraph 5(3)(b), which I think is what concerns the noble Baroness, Lady Meacher, and is beginning to concern me. It goes on:
“if it is so used, to be supplied to any other person, and used for any purpose, to whom and for which that other information could be supplied and used”.
It would be helpful if we could be told exactly what that means because it is the origin of the suspicions around this.
I am happy to deal with that point and I promise that I shall come to it shortly.
We do not intend to use the power to authorise the supply of information obtained by persons in the course of providing treatment, counselling or care to claimants. For example, the power will not be used to authorise the supply of information held by doctors or the supply of any medical details of the claimant. That is as specific as I can be on that. I hope my noble friend Lord Rea is comforted by it.
The noble Lord is always approachable and helpful, so would he agree to see before Report a group of representatives of health and social care workers to discuss whether some wording could be put into the Bill to reassure them further?
Yes. Given the discussions we have had today and the range of concerns raised, I shall be pleased to do whatever I can between now and Report to engage on all of these issues. It is important that we do that.
On Amendments 103 and 109, which concern the disclosure of information, as the Bill is drafted, paragraph 5(2) will allow regulations to provide that information obtained under paragraph 5(1) from the criminal justice system could be supplied by Jobcentre Plus to other third parties and to impose limits on the circumstances and the extent to which the information could be disclosed. These amendments would remove that ability. Instead, the new sub-paragraph would limit the use of information supplied by a claimant under paragraph 5 so that it could be used only for the purposes of determining the benefit claim. I can reassure the Committee that regulations made under the power in paragraph 5(2) can allow information to be provided to a third party only in relation to ensuring the accuracy of information given by claimants about their drug use, or where it is otherwise needed to operate the new drugs provisions. Paragraph 5(2) enables regulations to impose further limits on the circumstances in and the extent to which this information can be disclosed. The safeguards that I have already outlined will apply here too.
The main purpose for which we need to rely on paragraph 5(2) is to allow information from the police, drug workers or the Probation Service to be passed on to the drug treatment provider who carries out a substance-related assessment. For example, when referring a person to a substance-related assessment it might be appropriate to disclose that they had failed to attend a police-required assessment. Therefore, our intended use of the power at paragraph 5(2) is limited, but it is important that we retain flexibility to authorise the supply of information to other persons involved in operating the drug and employment programme where it is necessary to properly assess a claimant’s drug use and to enable the programme to operate effectively. If the amendment were accepted, the operation of the drug and employment programme could be hampered.
On Amendments 104 and 110, paragraph 5(3) has two functions. Under sub-paragraph (a), a recipient of information that has been provided from the police, Probation Service or other prescribed body can use that information to amend or supplement information already held by the recipient about the claimant’s drug use. The information already held would include the claimant’s answers to questions about their drug use or information obtained through the substance-related assessment or drug testing. For example, under paragraph 5(3)(a), where the claimant’s answers about drug use were inaccurate, the information could be used to amend them. The amendment would prevent this.
Paragraph 5(3)(b), which seems to be a matter of particular contention, provides that when information has been used to amend or supplement information already held about the claimant’s drug use, it can also then be disclosed to others. However, let me be clear: it can be disclosed only to people who will lawfully be allowed to receive and use the original information held about the claimant’s drug use. It can be used only for the same purpose as the original information. So with information supplied by a criminal justice agency that has been used to modify or add to the claimant’s answers about drug use, or the results of a substance-related assessment or drug testing, this provision would allow the updated information to be used and shared in the same way as the original information. The amendment would prevent this happening.
A practical example of both of the above might be as follows. A claimant denies that they use drugs, and says that they are not subject to a drug rehabilitation requirement. Information received under paragraph 5 from the Probation Service suggests otherwise. Removing paragraph 5(3) would mean that regulations could not authorise the information from them to be used to correct the claimant’s inaccurate replies. The result of this would be that the information could not form part of any reasonable grounds for suspecting that a claimant had a drug problem. This might mean they could not be referred to a substance-related assessment, even though the evidence suggests they have a drug problem.
These amendments therefore would hamper the ability to use and share the information that may be provided under paragraph 5 in order to assess whether a claimant has a drug problem. We need to use, and in certain circumstances share, information supplied by the criminal justice agencies in order to identify problem drug users, to get them on to the new programme, and to provide them with the support and help that they need to gain employment.
We are aware of the need to ensure that any information-sharing we provide for in regulations is proportionate to our aims. The affirmative parliamentary procedure will apply to the regulations so, before they come into force, they will have to be approved in draft by both Houses. The regulations will include a range of safeguards to ensure that the requirements are compatible with the European Convention on Human Rights.
I hope that those lengthy explanations about our intended use of these powers were helpful and that noble Lords are reassured that the regulations will be proportionate to our aims and compatible with the European Convention on Human Rights, and that the department will be subject to significant obligations to safeguard the confidentiality of information supplied under the regulations. Having said that, as I said a moment ago in response to my noble friend’s question, I am very happy to meet with noble Lords between now and Report to go through any of this in more detail if they think that would be helpful. Accordingly, I ask that the amendment be withdrawn.
Before the noble Baroness does that—oh! or rather before I do so—I had forgotten that we had got ourselves into a slight tangle. I am in a slight tangle because I quite understand that paragraph 5(1) refers to information going to the Secretary of State and to officers of the Secretary of State, as does paragraph 5(3)(a), but I still do not understand what prevents paragraph (3)(b) allowing information to go out from the officers of the Secretary of State to virtually anybody who is stated in the regulations.
Obviously, this is a framework Bill and the regulations would need to be much more specific. As I said a moment ago, the purpose of paragraph (3)(b) is to enable the information so supplied for the same purpose to be made available to, say, the employment support provider who is taking forward the programme and working on the rehabilitation plan, or the professional who is involved in the drug assessment process. The information could be provided to them. If it comes into Jobcentre Plus, it will come to the job adviser. But if the information that was originally provided was inaccurate or needed supplementing, this is a route to do it. If it comes into Jobcentre Plus, it could be made available to those, particularly the employment provider, who will work with the individual to get them on the rehabilitation plan.
I rather think that example does not cover any case. However, I shall look very carefully at what the Minister has said, and unless the noble Baroness, Lady Meacher, wants to add anything—
I simply ask the Minister whether he would regard it as reasonable to have something explicit in the Bill that would make clear that what we are not talking about here is information going out to the police or to anybody else out there, and that it would be limited to the operation of the return-to-work provisions themselves. That should be on the face of the Bill. Otherwise, frankly, some future Minister—whoever they may be—could include anything in the regulations.
I am certainly happy to see whether we can reconsider the drafting to address that point more specifically. I understand the issue that is being raised.
The noble Baroness yet again took the words out of my mouth. Before withdrawing the amendment, I was going to ask that the draftsman revisits paragraph 3(b). Although I am not a lawyer, I have a sneaking affinity with the drafting of Bills, and I do not think that the paragraph totally affirms the Minister’s statements on this. However, as he has very sensibly offered to take it away and look at it again, I beg leave to withdraw the amendment.
Amendment 99 withdrawn.
Amendments 100 to 115 not moved.
Schedule 3 agreed.
Clause 10 : Conditions for contributory jobseeker's allowance
Amendments 116 to 118 not moved.
Clause 10 agreed.
Clause 11 : Conditions for contributory employment and support allowance
Amendments 119 to 122 not moved.
Clause 11 agreed.
Clause 12 agreed.
Amendment 123
Moved by
123: After Clause 12, insert the following new Clause—
“Mobility component for severely disabled children under three years old
(1) Section 73 of the Social Security Contributions and Benefits Act 1992 (c. 4) (mobility component of disability living allowance) is amended as follows.
(2) After subsection (1) insert—
“(1ZA) Subject to the provisions of this Act, a person shall be entitled to the mobility component of a disability living allowance for any period in which he is under the age of 3 and throughout which—
(a) he requires heavy and large ventilation equipment;(b) he requires a powered buggy or wheelchair; or(c) he requires a pump feeding system.”.”
At the outset, I must correct what I said last Monday about the disability living allowance. In doing so, I again declare my interest.
There are two components to the DLA: mobility and care. The care component has three levels, but the mobility component has just two: a higher level and a lower level. I think I said that it had three. At present a child must be more than three years old for a claim for the lower rate of mobility allowance to be made, and five years old for the higher rate. Severely disabled children under three who use heavy equipment, for example to help with their breathing, are thus being discriminated against. Vulnerable families are being denied vital support just because their disabled child is under three. If families do not receive any mobility component of the DLA, they are also not eligible for the Motability scheme—again, I declare an interest—which enables disabled people to obtain a car, powered wheelchair or scooter by using their government-funded mobility allowances.
This problem was brought to my attention particularly by the Muscular Dystrophy Campaign—I declare an interest as a vice-president—which relates the case of Aaron, a boy from Oldham who is 19 months old and was born with a debilitating muscle disorder. He cannot walk, sit up straight or breathe unaided, and relies on a special buggy that is equipped with a ventilator to keep him alive. Children with this kind of disorder might live for at least 10 years or more.
Aaron ideally needs a specially adapted vehicle big enough for the buggy to fit into. His parents applied for mobility allowance to help them pay for one but the DWP told them that they were not eligible until he was three. His mother said: “We have a blue badge for him but we aren’t allowed mobility allowance. Without that we can’t afford the £10,000 it would cost for an adapted vehicle. I am my son’s full-time carer. My husband was made redundant last year and is looking for work. As a result Aaron is going to be housebound. We can’t take him shopping or even to the park or to see his granddad who is seriously ill. I can’t understand why they won’t help. They say the law is the law and that children under three can be carried. It’s impossible to carry my son and his equipment. It feels like he’s being discriminated against because of his age and disability”. The Minister will say that the Family Fund might help provide this equipment, but why should a family in this situation be forced to rely on a charity, admirable though it is?
The amendment is necessary because families with disabled children are more likely to live in poverty than families with non-disabled children. It costs three times as much to bring up a disabled child compared with other children, and childcare costs for disabled children are up to five times as much. Families with disabled children are both 50 per cent more likely to be in debt than other families and 50 per cent less likely to be able to afford essentials such as new clothes or things like school outings.
The campaign to give blind people higher-rate mobility DLA was successful—hooray for that. I urge the Government to look favourably on this very small group of severely disabled children and to allow them to have the lower rate of mobility allowance claimed for them. I beg to move.
My own pathway to work today has been rather lengthy, but I seize it with alacrity. This is the only point at which we will be debating Clause 12, which extends the mobility component to blind people. I notice in the Explanatory Notes that it does not change the arrangements for blind/deaf people. I met such a person yesterday at the Lincolnshire Show. He was there as a pillion rider on a trick buggy that was leaping over vans, cars and various other things. That shows the degree of imagination that is needed when dealing with people and the way in which people with even the most substantial handicaps can be helped into occupational employment. I could communicate with this very courageous young person only through his care worker tapping on the palms of his hands. It is very humiliating, as I am sure noble Lords will understand.
I thank the noble Baroness, Lady Thomas, for raising this topic in her amendment, which seeks to extend the entitlement to receive the mobility component of the DLA to certain categories of children under three. Those categories she has listed expand the existing categories in Section 73 of the 1992 Act, which states in subsection (1) that,
“a person shall be entitled to the mobility component of a disability living allowance for any period in which he is over the age of 5 and throughout which … he is suffering from physical disablement such that he is either unable to walk or virtually unable to do so”.
I would have thought that at least two of the categories at proposed new paragraphs (a) and (b) could be covered by that existing criterion. The noble Baroness clearly believes that very disabled children are currently falling outside the protection of the 1992 Act. I confess that I was not hitherto aware of the problem and so I am not in a position to offer much further comment.
However, other noble Lords and I would be in a more informed position if the Minister could provide us with figures on the number of children who might fall into these categories. By setting the age in her amendment at three years old, the noble Baroness has brought into play payments at the higher rate. However, the age level set me wondering and I asked the noble Baroness to consider whether the criteria in her amendment are realistic. Would a child under three be likely to be using motorised buggies or wheelchairs, for example? I would have thought that unlikely. Severely disabled children would surely be more than usually dependent upon their parents’ support. The point she is making is that parents of very disabled children who are not in the categories covered in the 1992 Act might need additional support. This would cost the Government money but, as it would apply to only a small number of children, can the Minister tell us how much?
If he intends to resist the amendment, I look forward to an explanation. He may say that the amendment is not necessary because this small category of disabled children is already covered under existing legislation, as I have suggested it might be, but, along with other noble Lords, I shall look carefully to see whether that assurance satisfies the noble Baroness, who apparently has identified a hole in the net.
I support the amendment of the noble Baroness, Lady Thomas. I can assure noble Lords that there are indeed increasing numbers of children with severe impairments who require the use of ventilation and feeding equipment. In fact, I am only four stone but when I bring all my junk with me—my ventilator, my ripple bed, my special chair and my medication—I need a truck to allow me to go on holiday.
Children of two and three with spinal-muscular atrophy and very severe forms of neuro-muscular impairment are now being ventilated from the age of six months. Some types of ventilating equipment are light and others are very heavy; it depends on what you require. Feeding equipment is incredibly heavy to carry around because of the bags that it has to be put in. I support the amendment because we know there are a small but increasing number of very severely impaired children who have the right to go wherever they want and to have the freedom of mobility that their brothers and sisters have. I believe that this is low cost and involves very small numbers.
I find myself in the uncomfortable position of having to resist this amendment, although the Government are not unsympathetic to the arguments put forward. The noble Lord, Lord Taylor, referred to Clause 12. I am pleased to see that we were able to make that development in the Commons. In fact, we did it twice and my noble friend will shortly be deleting the second of those.
We understand the situation that the parents of children dependent on therapeutic technologies and equipment can face, especially where the equipment is heavy and difficult to transport. The noble Baronesses, Lady Campbell and Lady Thomas, gave some practical examples of that. I should clarify the intention behind the amendment because, as it is drafted, it has the effect of extending the lower-rate mobility component of the DLA to children under the age of three. I understand the intention is to extend the higher-rate mobility component and with it access to the Motability scheme to children under the age of three.
As noble Lords will be aware, the higher-rate mobility component of DLA is, quite rightly, assessed by an inability, or virtual inability, to walk when out of doors. When deciding entitlement to the component, decision-makers have to take account of a variety of factors such as the distance someone can walk, the speed of their walking, the manner of their walking, whether walking brings on severe discomfort and whether the very act of walking could be detrimental to their health. These are the statutory requirements intended to inform a reasonable view of someone’s walking ability.
With reference to young children, I think that we can all agree that the great majority of non-disabled children will be walking by their third birthday, and most of them will have been walking much earlier than that. But very few of them will have been walking considerable distances. The majority will have required, and may continue to require, significant help from their parents and have a reliance on prams, buggies or other bulky or awkward equipment that parents regularly carry with them.
However, we recognise that therapeutic equipment used to support some disabled children can, in certain instances, prove to be bulky, heavy or awkward to carry or transport. We understand that this can place a great strain on the time, resources and finances of parents and siblings.
It is for these sorts of reasons that we already make sure that financial help is available to parents of children dependent on the equipment referenced in the amendment. For instance, there exists a range of measures, over and above the mobility component of DLA, designed to help families with disabled young children. The disability-related premiums in the income-related benefits and the additional elements for disabled children in tax credits are but two of the statutory provisions.
However, extra statutory schemes such as the Family Fund, to which the noble Baroness anticipated I would make reference, can also provide help for less well-off families with disabled children. The fund can help with travelling costs and can extend to the purchase of vehicles in exceptional cases, although all decisions are taken on a case-by-case basis.
Of course, in this difficult financial climate, we need to consider carefully the potential cost of any such change; the noble Lord, Lord Taylor, asked me specifically about this. This amendment would, of course, result in additional costs, but these are difficult to estimate. Our broad estimates put the cost at around £15 million per year. This would obviously be a significant increase in what is, unfortunately, a difficult economic situation, and is simply not affordable in the current context. On numbers, our estimates, which were quite difficult to compile, suggest that there could be around 5,000 children under the age of three who could potentially benefit from the impact of the amendment.
In summary, I am not dismissing the broad aim of the amendment. As I said earlier, we are sympathetic to the aim, which we take to be delivering greater help to the parents of severely disabled children who depend on certain therapeutic technologies or equipment to get them around out of doors. But, for the reasons outlined earlier, we believe that this amendment is not the best way of advancing that aim. With a degree of regret, I therefore ask the noble Baroness to withdraw her amendment.
I thank the Minister for that reply, and particularly thank the noble Baroness, Lady Campbell, for her speech, which was extremely interesting. It was so detailed, and she knew exactly what I was talking about. The noble Lord, Lord Taylor, has broken his duck for today, and I am glad to have given him the chance to do so.
I apologise for mixing things up. The Motability scheme would, of course, come into play only when the child is a bit older—I think it is five years old. It would then have high-rate DLA and might be able to have some sort of equipment under the Motability scheme. The lower rate would help a great deal but would not provide any equipment under that scheme.
I think that the Minister meant £15 million a year. Is that right?
Yes, £15 million a year, but that was on the assumption that the amendment was focused on the higher rate.
Perhaps he could write to me with how much it would cost if it was the lower rate, so that mobility does not come into it. It would just be a sum that families could receive as of right if they have a child, in that case. That would be very helpful, because I admit that I did conflate the two. I shall read what the Minister said with interest to see whether to come back at the next stage.
I am happy to write to the noble Baroness with the figure for the lower rate and to confirm the figure for the higher rate.
As I assume that this is the last amendment of the day—
We will try to fit the next one in. It is very brief and technical.
I was only going to say that I am glad that we have not missed our daily ration of the word “conflation”.
I beg leave to withdraw the amendment.
Amendment 123 withdrawn.
Clause 13 : Disability living allowance for blind claimants
Debate on whether Clause 13 should stand part of the Bill.
With the leave of the Committee, perhaps I can go through this extremely briefly. I will try not to use the word “conflation”. I trust that it will be in order to cover Clause 13 in brief. The Committee will already know that my noble friend Lord McKenzie of Luton signalled on Second Reading the Government's intention that this clause should not stand part of the Bill. The Committee will also know that the reason for its current inclusion is the exuberance for change in another place. Although I commend their enthusiasm, they have left us with two clauses which to all intents and purposes strive to do the same thing. In our view, Clause 12 is the more technically correct of the two and therefore, for absolute clarity, I beg to disagree to the Motion that Clause 13 stand part of the Bill.
The Government are obviously quite right to reduce the duplication in the Bill, but the noble Baroness did not say how this happened. Was it the fault of the Government Whips or was it the fault of the Speaker? It must have been one or the other.
The Bill team tell me that it was their fault. They seem to be falling on their sword.
It cannot be the Bill team. You should never blame officials.
Clause 13 disagreed.
This may be a convenient moment to adjourn the Committee until Tuesday at 3.30 pm.
The Grand Committee stands adjourned until next Tuesday, 30 June, at 3.30 pm.
Committee adjourned at 6.08 pm.