Report (4th Day) (Continued)
51: Clause 80, page 58, line 30, leave out “6” and insert “3”
My Lords, never have I minded less about changing my original speech so extensively, because the Government have conceded on the qualifying period for PIP being brought back to three months from six months. I am grateful to the Minister for listening to the concerns expressed by many disabled people and the organisations that support them about the hardship that such a long qualifying period could cause. The reasons for changing the time back to three months are compelling, particularly in relation to those who have sudden onset conditions or a serious accident, and there is now no need to rehearse the arguments yet again. I beg to move.
My Lords, I, too, shall be brief because, as the noble Baroness, Lady Thomas, has said, the Minister has flagged his acceptance of the amendments in this group.
The debate in Committee led by the noble Baroness, Lady Thomas, centred in particular on the importance of keeping a qualifying period for PIP at three months, but obviously the concept of increasing the prospective period from six to nine months to align PIP with the definition of “long-term disability” in the Equality Act has been helpful to the process. However, the arguments for a three-month qualifying period are strong, and it is commendable that the Government have accepted the case. We have not heard them today but those arguments concerned conditions of a long-term nature having a sudden onset, conditions which are not diagnosable immediately after the onset of symptoms, and conditions which have an immediate devastating impact.
I have just one question for the Minister on the required period condition. This has been touched on before but is not the subject of an amendment today. On the basis of what is before us as an amendment, to be eligible for PIP it has to be determined whether, as respects every time in the previous three months,
“it is likely that if the relevant ability had been assessed at that time that ability would have been determined to be limited or … severely limited by the person’s physical or mental condition”.
The issue is how this requirement is to be interpreted for those with fluctuating conditions. At a recent meeting to consider how things should work for those on the autistic spectrum, we were assured that, although the wording was a bit clumsy, it covered the situation. It would be helpful if the Minister could confirm that or, as we are at one on this issue, commit to tidying it up at Third Reading.
However, all in all, the Government are to be commended for doing the right thing on this, as indeed is the noble Baroness, Lady Thomas, for having led the charge and continued to press the matter.
My Lords, I tried to rise to speak earlier because my name is added to this group of amendments tabled by my noble friend Lady Thomas, and I am very pleased that I have been able to support them. We have had a lot of responses from people whom we respect and whose advice we find very useful, including Macmillan and CLIC Sargent, and I thank them for the time that they have given.
When we looked at this issue in Committee, I think it was generally agreed that an overall 12-month required period condition was right, but there was a lot of concern that the six-month period in question here was too long. Bluntly, we were trying to balance two factors: payments being made sooner against the potential for more assessments to ensure that ongoing payments were correct. That is why we ended up with periods of six months plus six months. However, we have been listening to the arguments and have been persuaded that the balance should shift. There was a clear consensus that a three-month qualifying period and a nine-month prospective test offered the fairest solution, and that is why we are able to support the amendments.
On the point raise by the noble Lord, Lord McKenzie, I think it is easier if I write to him, as this is a fairly technical matter. On that basis I am very happy to support the amendment tabled by my noble friend.
Amendment 51 agreed.
Amendment 51A not moved.
52: Clause 80, page 58, line 34, leave out “6” and insert “9”
Amendment 52 agreed.
Amendment 52A not moved.
Amendments 53 and 54
53: Clause 80, page 58, line 46, leave out “6 months” means the 6” and insert “3 months” means the 3”
54: Clause 80, page 59, line 1, leave out “6 months” means the 6” and insert “9 months” means the 9”
Amendments 53 and 54 agreed.
Clause 81 : Terminal illness
Amendments 54A and 54B not moved.
Clause 82 : Persons of pensionable age
54C: Clause 82, page 59, line 34, at end insert “other than by virtue of an award made before the person reaches the relevant age”
My Lords, this amendment would ensure that those who are awarded either the daily living component and/or the mobility component before pensionable age can continue to receive it after they reach pensionable age. Currently the Bill states that persons of pensionable age are entitled to neither award.
The matter was fully debated in Committee, when the argument was fully rehearsed, so I do not intend to speak to it at great length this evening. The noble Baroness, Lady Grey-Thompson, said in moving the same amendment in Committee—on 16 November at column 303 of Hansard—how the Disability Alliance and other charities were being approached regularly by disabled people worried about what the current proposals would mean when they reach pension age. She maintained that the amendment would clarify the position and put many minds at rest. She also drew the committee’s attention to the fact that the Dilnot commission highlighted the pivotal role that DLA plays in preventing high-level needs from escalating. Receiving DLA helps disabled people manage their health and prevents avoidable NHS costs or people entering residential care prematurely, or at all, with potential savings in the long run.
The noble Baroness understood that the Government intended to provide in regulations for those who received DLA before pension age to retain it after they reached pension age, but she said her concern was not allayed by the Minister for Disabled People stating in the Commons that the Government wanted the matter to be addressed in regulations to allow for flexibility. Such flexibility, she said, could easily include altering the entitlement in the future and denying support to disabled people reaching pensionable age. It would offer a significant boost in confidence for many disabled people, she said, to receive the reassurance in the Bill that their support will not be withdrawn when they reach pension age.
The Minister made it clear that the Government intended to make regulations for PIP that will allow people who have reached the upper age limit to continue to receive PIP. He said:
“Our priority is to support those individuals with established, long-term health conditions or impairments that would put them at a financial disadvantage over a long period … The intention behind this amendment is to ensure ongoing support throughout later life for individuals whose abilities are limited earlier in life, recognising that they may have had less opportunity to earn and save for later life. I can assure noble Lords that this is also our intention and that it can be achieved without amendment to the Bill, but instead through regulations. As it currently stands, the amendment would potentially widen the scope of personal independence payment and undermine our intention of creating a more affordable and sustainable benefit”.—[Official Report, 16/11/2011; cols. GC 304-05.]
He also made clear the Government’s intention of replicating, under PIP, the one-year linking rule which operates under the DLA regime, which allows individuals over 65 to renew an award within one year of their previous award, without losing DLA entitlement.
The matter seems quite straightforward. The assurance that those who have DLA when they reach pension age can keep it is provided in current legislation. The Government propose to remove this insurance in the Bill before us. They say that they will maintain the guarantee in regulations, but we all know that regulations can be changed much more easily than primary legislation. What possible motive can the Government have for removing from the Bill the guarantee to pensioners? One cannot blame people for asking the question or for being suspicious of the answer.
If the Government intend to give the assurance in regulations, what skin would it be off the Minister's nose to give it in the Bill? In circumstances where he needs all the confidence-building measures he can devise to take disabled people with him through the legislation, this would be an obvious and cost-free concession. The Minister referred to an earlier amendment as being the priciest yet. Surely this is the cheapest. If the wording needs to be fine-tuned in order to avoid widening the scope of PIP, I would be entirely amenable to working with him to find the appropriate wording before Third Reading. I beg to move.
My Lords, I, too, put my name to the amendment. I declare an interest as someone who was awarded mobility allowance for life and was then moved to DLA at its inception. I have continued to receive this past pension age. I strongly support the amendment, which would put in the Bill the assurance that awards of PIP will be retained after retirement age, as is the case with DLA. When the amendment was discussed in Grand Committee the Minister tried to sound reassuring, but unfortunately the Government are not trusted.
We know that all Governments prefer to use regulations, which give them more scope and power. However, to quote Sir Bert Massie, the chair of the much lamented Disability Rights Commission, the difference between now and 1992, when the DLA was introduced, is that this Government are playing with false cards. If the Government are sincere in their assurance that PIP will be retained after retirement age, why will they not behave transparently and place the commitment in the Bill? Clause 82 only grants a power. The amendment of the noble Lord, Lord Low, imposes a duty. There is a massive difference.
Sir Bert fears, as I do, that the Government are planning to use the payment of post-retirement PIP awards as part of the Dilnot package for social care. On the argument about cutting the DLA mobility component for people in residential care, they will discover what they regard as double provision, and PIP will be lost to pensioners. In his response in Grand Committee, the Minister almost said as much when he stated:
“By setting out these provisions in regulations we can ensure that the legislation can be adapted in response to any future changes in the social care system which might affect pensioners”.—[Official Report, 16/11/11; col. GC 305.]
Given the demands of responding to the Dilnot commission report, would your Lordships trust the Government not to use the flexibility of regulations to devote the entire PIP budget for over-retirement age to social care?
DLA is an essential contribution to so much more than our social needs. Throughout the passage of the Bill I have tried to convey the enormous complexity of disability and the very wide range of extra costs with which we are faced. DLA gives the lie to the false dichotomy that the Minister always draws between benefit recipients and taxpayers. My DLA has enabled me to be mobile and be employed. It has enabled me to be a taxpayer all my life. As I have aged, my mobility needs have become considerably more expensive. I could not have contemplated buying that “nice bit of kit”, as the policemen outside the Peers’ entrance term the considerably adapted car that I can drive from my electric chair, without the assurance that my DLA is for life. Future PIP recipients should have the same reassurance and I ask noble Lords to support the amendment.
My Lords, I will speak briefly in support of the amendment. The case has been very clearly made. The amendment is seeking the assurance of something written in primary legislation rather than the comfort that was given that this could be dealt with in regulations.
Perhaps I may take the opportunity to clarify a part of the debate we had in Committee. The Minister said:
“Turning to the current rules, broadly speaking, current DLA provisions have a one-year linking rule. This allows individuals over 65 to renew an award within one year of their previous award without losing DLA entitlement. Similarly, we intend to allow a linking period for PIP. This will support those individuals who reach the upper age limit and have a break in their claim through temporary improvement, provided the individual makes a claim within a defined period and continues to fulfil the eligibility criteria for PIP”.
I understand all of that. The next sentence says:
“As with DLA, there will be restrictions on new and existing claims for those over the age of 65”.—[Official Report, 16/11/11; col. GC 305.]
Can the Minister expand on what particular restrictions on existing claims for those over the age of 65 he is intending to implement?
My Lords, I should like to take the opportunity to set out our position in relation to people who are approaching 65 and over the age of 65 and, I hope, give a degree of reassurance as to what we are aiming to do and, if people could accept our firm stated intention, explain why that would be a better and more flexible way of proceeding. I hope that some of the things I said in Grand Committee and what was in our policy briefing document in May will have reassured the noble Baroness, Lady Wilkins, at least to some extent, although I am not absolutely confident of that, given the slightly questioning tenor of her remarks.
People in receipt of DLA who are aged 65 or over when PIP is introduced will not be reassessed for the new benefit from 2013. These reforms will initially be focused on people of working age. This will enable us to ensure that learning from the reassessment of working-age recipients is properly considered before any further changes are developed and implemented.
I understand that the purpose of this amendment is to ensure that financial support continues into pension age for individuals who may have had less opportunity to work and save during their working life due to their condition. I can reassure noble Lords that this is also our objective and can be achieved without amendment to the Bill, but instead through regulations, much as the detail for DLA pensioners is provided for in regulations. We intend to make regulations for the personal independence payment that will allow people who have reached the upper age limit to continue to receive it for as long as they continue to meet the entitlement conditions. Our priority is to support those individuals with established, long-term health conditions or impairments that would put them at a financial disadvantage over a long period. As we indicated in our entitlement thresholds and consultation document, we expect to consult formally on a range of issues to help inform the regulations. This is such an area and we expect to begin consultation in the spring.
It is also our intention that the rules for people over the age of 65 should be broadly similar to those that currently apply to DLA. For example, DLA provisions allow a one-year linking rule which lets those aged 65 or over renew an award within one year of their previous award expiring without losing DLA entitlement or having to satisfy a qualifying period. This provision is intended to allow for those on a fixed-term award to renew their award on a new claim or to reclaim where their condition previously improved and subsequently deteriorated.
I turn to the link question raised by the noble Lord, Lord McKenzie. Under DLA, claimants over the age of 65 cannot move up or down the mobility component rates or move to the lowest rate care component. In the main, these rules match up with attendance allowance and that is an example of the kind of restrictions currently in DLA, which we will look to and consult on maintaining in PIP. Our commitment is to maintain support for those individuals who have relied on DLA or PIP for their working lives into retirement. People who develop care needs during retirement as part of the natural ageing process, for example, and who are not receiving PIP, will be able to claim attendance allowance.
The effects of this amendment are important. It could allow an individual aged over 65 who had previously, at any point in the past, received PIP to make a new claim for the benefit. This could have the effect of allowing people over 65 to receive PIP if they have previously been awarded it, even if there was a very long break in the claim—a break of decades. We would not want that to be the case.
Under the powers we have in Clause 82, we can ensure that the regulations can be flexible to respond to future changes. The changes in the social care system were raised as an example by the noble Baroness, Lady Wilkins. Clearly, if there is a rebuild of the entire support system, that is one thing that we might want to take account of. It could, of course, go both ways: it might affect pensioners.
In terms of developing the rules and how we implement them, I would like to assure the House that we will continue to work closely with the PIP implementation development group to ensure that policy design and delivery in respect of people aged 65 and over are informed by disabled people and their representatives. We intend to consult fully on our proposals during the spring as part of that commitment to involve disabled people. Given these assurances on our approach, I urge the noble Lord to withdraw the amendment.
My Lords, I declared my interest as a DLA recipient when I first entered the debate on PIP before dinner. However, in view of the particular relevance of this amendment to my own situation, I ought to have made it clear, like the noble Baroness, Lady Wilkins, that I have received DLA from its inception and continue to receive it now that I am past pension age.
Obviously, at this time of night, I am not going to press the amendment and will seek leave to withdraw it. However, I have to confess that I am not entirely convinced by the Minister’s answer. The strongest point he made was that, in the way it is drafted, the amendment could override linking rules and enable somebody who had received DLA a considerable length of time before he reached pension age successfully to resuscitate a claim to PIP after he reached pension age. That would not be our intention and, as I said in moving the amendment, if we could resolve that and any other matters of mis-wording to which the Minister could draw my attention by Third Reading, I would be very happy to have discussions with him and his officials.
Perhaps I may make the position clear. The difference between us is that we would not want this in the Bill but the substance of what we are trying to do matches what the noble Lord is looking for. I am not in a position to offer anything further for Third Reading. I am, however, very willing to see him personally—and any groups he wants as well—to discuss this matter when we move into the spring period to make sure that we get it absolutely right. We are anyway having full consultation, but I am absolutely prepared to commit to looking at this so that the detailed regulations are acceptable.
The trouble is that by the spring consultation the Bill will be done and dusted and we will have missed the opportunity. However, on the basis that the Minister is happy to meet us to discuss this matter further and perhaps bottom it more than we are able to do at this time of night, I beg leave to withdraw the amendment.
Amendment 54C withdrawn.
54D: After Clause 83, insert the following new Clause—
In section 70 of the Social Security Contributions and Benefits Act 1992 (invalid care allowance), for subsection (2) substitute—“(2) In this section, “severely disabled person” means a person in respect of whom there is payable either—
(a) an attendance allowance;(b) a disability living allowance by virtue of entitlement to the care component at the middle or higher rate; or(c) a personal independence payment by virtue of entitlement to a rate of the daily living component which will be prescribed in regulations, or such other payment out of public funds on account of his need for attendance as may be prescribed.””
My Lords, the amendments would place the new arrangements announced by the Minister in Committee in the Bill to reflect existing provision for carer’s allowance passporting in primary legislation. In the discussions around the Bill, Peers, including the Minister, have demonstrated their understanding and appreciation of the huge contribution made by the 6.4 million carers in the UK, often at considerable personal sacrifice.
Despite its rather low level, carer’s allowance is a vital benefit which provides an essential independent income for families providing care. As a result, it is crucial that the prominence of carer’s allowance is maintained, as now, in primary legislation, preserving the strength and importance of these crucial rights for carers. Amendment 54D would establish this crucial link between carer’s allowance and personal independence payment in the Bill but allow the Government to prescribe the rates in regulations. However, the clear preference of Carers UK and other charities—I agree with them—is for the maintenance of the strength of existing rights by also setting out the rates in primary legislation.
Amendment 54E would establish the passporting link and that both rates of the daily living component would act as gateways, fully reflecting existing provision for disability living allowance and the details announced by the Minister in December. I remind the House that in December the Minister said:
“It has always been our intention that personal independence payment will provide a gateway through to receipt of carer’s allowance in the way that DLA currently does”.
The briefing paper went on to say:
“It is our intention that both rates of the daily living component will be used as a criterion in connection with entitlement to carer’s allowance”.
Carers UK hopes that the Minister will feel able to support the amendment, to cement in primary legislation this announcement made before Christmas and to send out the clear message that the Government do indeed value carers and that their rights and entitlements are valued correspondingly in primary legislation. Having made such a positive announcement, I can see no reason why the Government would not wish to establish these details in the Bill.
In addition to establishing the provisions announced by the Minister in the Bill, the amendment also provides the opportunity to express ongoing additional concerns about the impact of the personal independence payment reforms on carers, which were not addressed by the announcement around passporting. Carers UK and other organisations are still deeply concerned that the 20 per cent reduction in spending on these benefits as the personal independence payment is introduced will lead to the loss of carer’s allowance for a number of carers, on top of substantial numbers of disabled people losing their benefits.
Having looked at the consultation issued yesterday and other documents which I have received, I cannot see an assessment of the impact on carers of the changes. I may have missed it. We know from the statistics the impact on the relevant groups of disabled people—those in receipt of middle or higher rates of the care component of DLA, the gateways to carer’s allowance—and that these groups will be reduced by 80,000. Many, of course, will not have carers, but it is likely that some of those 80,000 will have someone currently in receipt of carer’s allowance caring for them, and when the disabled person loses his or her benefit the carer will lose eligibility for carer’s allowance.
I understand everything that has been said about the emphasis being on supporting people with greater need and that some people may receive more and that some people currently receiving the lower rate may move into the new standard rate, but concern has been expressed. So, if there has been no impact assessment, is the Minister now able to inform the House how many carers are likely to be affected by these changes? I look forward to hearing the Minister’s response to the two amendments. I beg to move.
My Lords, my name is also on this amendment and I fully support what my noble friend Lady Hollins has said. As we have heard, there are approximately 6.5 million carers. Of course, we all need to remind ourselves just how important they are and how much money they save the state in the work that they do on behalf of their families and, indeed, friends, because quite a number of carers are not necessarily directly related. Perhaps the Minister would agree that that is a very good reason for putting this proposal in the Bill. It would certainly reassure all those who, as has been said, do so much for the nation in terms of finance and for individuals with whom they have personal caring relationships.
I hope that it will be possible for the Minister to accept this amendment. Otherwise, perhaps he will give us an assurance on the questions that have been asked. That would be helpful and useful. I look forward to hearing his reply.
My Lords, I, too, speak in support of these amendments. We are talking about essential rights for carers. When carers give up work in order to care, it is crucial that they are able to access financial support, which provides them with an independent income. I hope that your Lordships will forgive me for a brief trip down memory lane about an independent income for carers. In the 1960s, an independent income for carers was at the very heart of what started the carers’ movement. That independent income was achieved in the 1970s and went on to be extended in the 1980s. I should like to acknowledge the very active part that the noble Lord, Lord Newton, who is not in his place, played in extending those rights under—perhaps I may remind your Lordships—a Conservative Government.
Given the importance of carers, which has been acknowledged time and again, it is disappointing that the Government have not brought forward an amendment to place these rights in the Bill. If the gateway for PIP payments is left to regulations, different groups of carers will have their rights to carer’s allowance set out in different ways. Those caring for disabled children will continue to receive DLA and will not be moved on to PIP, and carers looking after an older person in receipt of attendance allowance, which is also unaffected by these reforms, will continue to have their right to carer’s allowance clearly set out under the Social Security Contributions and Benefits Act. Yet those who are caring for disabled people of working age who are being moved on to PIP would have their rights set out only in secondary legislation, which would make for a confused picture.
I know that Carers UK, other Peers in your Lordships’ House and the Disability Benefits Consortium very much welcomed the Minister’s decision to bring forward their decision about both levels of PIP in December. But to give carers full confidence in their rights and clarity in the legislation, it is crucial for the decision to be written in the Bill.
My Lords, my name is also on this amendment and it is clear that we support it. The amendments are, I hope, welcomed by the Minister as an opportunity to firm up what, as the noble Baroness, Lady Hollins, has said, he said before Christmas: that carers of claimants of both rates of the daily living component will retain eligibility for the carer’s allowance, and to make that undertaking concrete by placing it in primary legislation.
The Minister and the House know well that the changes to disability benefits are causing considerable concern to disabled people and to their carers. This amendment is about providing some clarity. It cannot provide full reassurance because carers do not yet know how they will be affected by the 20 per cent proposed cuts or the exact way that the new thresholds will work. We know that half a million people will lose benefit, but we do not know how many of that half a million qualify for carer’s allowance at present. I am afraid we must assume that there will be a large number of current recipients who will no longer qualify for support.
There has not yet been any impact assessment—it is not simply that the noble Baroness, Lady Hollins, cannot find it. We hope—indeed, we expect—that there will be as part of the response to the consultation announced yesterday. However, for today, we would simply ask the noble Lord to solidify his commitment to those who qualify under the new assessment process that their carers will be able to receive carer’s allowance. At the moment, the Bill does not repeat what is there for DLA. It does not even appear to do it in regulations.
A move from warm words to an undertaking in the Bill to maintain the status of carers’ rights would be very welcome. It would be a sign that the Minister is listening to disabled people and understands their need for clarity. In Committee the Minister spoke very warmly of our 6 million carers. Along with those warm words, can we have something in legislation?
My Lords, I welcome the opportunity to place on record the value that this Government place on carers and their work. Although times are difficult, I have managed to redesign the universal credit so that we are ameliorating the £100 cliff edge, as carers do some earning, that they dislike so much. I hope that that is a token, even in these difficult times, of how much we value carers.
The second thing I would like to mention is more than a token. I was really pleased to be able to announce before Report that both elements of PIP will be a gateway for the receipt of carer’s allowance. I am grateful for the very detailed and knowledgeable debate that we had on this matter. We have had a lot of very thoughtful and clever representations from groups such as Carers UK, which we have taken very seriously indeed. I know that our announcement has been very warmly welcomed by various groups.
There is some concern about how the decision is to be enacted. That is clearly what is driving the amendments from the noble Baroness, Lady Hollins. I want to give an absolute assurance on this. We will use the powers under Clause 90 of the Bill to make the necessary change. We will bring forward, in due course, the appropriate secondary legislation to amend Section 70 of the Social Security Contributions and Benefits Act 1992 and put the position beyond doubt by making clear that people will be able to access carer’s allowance from both rates of the daily living component of the PIP. That is how we are planning to lock that position down, and it is a commitment that I make here and now to carers in this country. We have listened to the concerns from Peers and the carers’ lobby.
The noble Baroness asked how many carers would be affected. We expect to undertake an impact analysis as we get to regulations. The noble Baroness, Lady Hayter, spoke about large numbers being affected. That is a slightly brusque assumption given that carers currently on the lowest rate would not anyway be passported. We are talking about the top two rates. The assumption of a 20 per cent cut in that budget does not marry up. It is not a cut on where we are today; it is a cut on where we would be at the end of this Parliament. We have to await the impact analysis before we can know the real figures.
On the basis of the reassurances that I have provided, I hope that the noble Baroness will not press her amendments.
My Lords, I am indeed reassured to hear the Minister’s response, in particular that an impact analysis will be done as the regulations are prepared. I accept the Minister’s assurance that the passporting arrangements will be locked down. I beg leave to withdraw the amendment.
Amendment 54D withdrawn.
Amendment 54E not moved.
Clause 84 : Persons receiving certain services
54EA: Clause 84, page 60, line 15, leave out from “provide” to “that” in line 17
My Lords, I am happy finally to place in the Bill the Government’s intention to continue to enable disabled people who live in care homes to be mobile. I am equally pleased to have the noble Lord, Lord McKenzie, joining me on this amendment.
The amendments in this group put our position beyond doubt by removing from the Bill the power to make regulations to stop payment of the mobility component of PIP to people who live in residential care homes and whose costs are borne from public funds.
As noble Lords will know, we examined the evidence base, sought contributions to the debate from many disabled people and disability groups, and considered in detail the excellent report produced by the noble Lord, Lord Low, which was published in November. We established, as did the noble Lord, Lord Low, that while there was some duplication, the overall picture meant that in order to access mobility provisions within a care home environment, which we have steadfastly said we are committed to protect, the fairest outcome was to retain payability of the mobility component in those settings.
I am pleased to be able today to act upon these findings and to introduce a new, separate clause for people undergoing treatment in hospitals or similar institutions. I hope that noble Lords will feel that this reflects the fact that we do listen—sometimes, especially when people shout very loud—and that we try to get things right in this area.
I can go through each provision in turn, but I hope that noble Lords will trust my assurance that the overall effect of the amendments is that the mobility component of PIP for people in care homes will remain on the same basis as it currently is for DLA, including for those in residential schools and colleges. I commend the amendments to the House and urge noble Lords not to press theirs.
My Lords, as the Minister said, we have an amendment in this group that I do not propose to move as I accept it has been superseded by the Government’s formulation—this listening Government that we have on this issue.
It is to be welcomed that the Government have accepted the arguments that have been put forward over many months and from many quarters. As the Minister indicated, we should be particularly thankful to the noble Lord, Lord Low, for his leading on the independent—I would stress the importance of independent—review of personal mobility in state-funded residential care. The report does not just focus on the narrow issue of the availability of the mobility component of DLA—soon to be PIP—but on wider issues of the mobility needs of disabled people, the role of local authorities and care home providers, and the importance of mobility to disabled people’s rights. The clear conclusion in that review found no significant evidence of overlap in the support offered by the mobility complement of DLA and that offered by local authorities and providers. If the rights of disabled people are to be preserved, it is vital that DLA mobility and its successor under PIP are retained for people living in residential care. The report offered a very clear analysis, which I would suggest the Government, frankly, had no option but to accept. Perhaps we should leave unanswered the question of what the position today might have been if the initiative by Mencap and Leonard Cheshire had not been undertaken and the noble Lord, Lord Low, had not assembled such a knowledgeable team to produce this report.
We always give voice to the proposition that disabled people are the experts in their own affairs. It is just a pity that it took so long for their voices to be heard on this occasion, but we should welcome the fact that that has now happened.
My Lords, as Mencap has just been mentioned, I would very much like, as president of Mencap, to thank the Minister and his colleagues for accepting this situation and the Low report. I congratulate my noble friend Lord Low on his splendid research into this problem. It is wonderful to hear the Government’s change of tack. I notice that the Minister mentioned hospitals, but I was busy chatting to the noble Baroness, Lady Hollins, at that moment. Did he mention children? I was not quite sure what the position was going to be regarding children—over 16 and under 16—in regard to this mobility component. However, apart from that, we are very satisfied in Mencap. I would like to thank, both personally and on behalf of Mencap, the Minister and his colleagues for this change of heart.
My Lords, I promised the Minister earlier on that if he just waited long enough, sweetness and light would break out. The fact that the noble Lord, Lord McKenzie, and I have our names on another amendment in this group enables me to tell him that we have now reached that point.
There is more joy in heaven over one sinner that repenteth than over 99 just persons who need no repentance. For that reason, I greatly welcome the Government’s decision to drop their proposal to withdraw the mobility component from those living in residential care. I have been given some credit for bringing this about with the review that I was asked to lead by Leonard Cheshire Disability and Mencap, but I think, in all honesty, I must disclaim this. Half of that is because I had a very good team working with me, supported by an extremely able and hard-working secretariat from both organisations; and half because I think Ministers, to their considerable credit, largely came to their decision of their own accord. Perhaps I may have provided a little cover for a U-turn—if so, I am glad to have been of service.
It would be tedious if I were to start recycling all the water that has now flowed under the bridge by rehearsing the considerations that led both the Government and my review to come to the conclusion that it would not be appropriate to withdraw the mobility component from those living in residential care. Probably the most significant of them, as has been mentioned, was that we could not detect any evidence of the double funding that was thought to exist and the Government could not either.
The Government can be proud of the fact that on this occasion, when faced with the evidence that did not support their initial conclusion, they had the grace to acknowledge the fact and reverse that initial conclusion. This is very much to be welcomed and a matter for congratulation.
Amendment 54EA agreed.
Amendment 54F not moved.
54FA: Clause 84, page 60, line 21, leave out paragraph (b)
Amendment 54FA agreed.
Amendments 54G and 54GA not moved.
Amendments 54GB and 54GC
54GB: Clause 84, page 60, line 25, leave out from second “is” to first “a” in line 26
54GC: Clause 84, page 60, line 32, leave out paragraph (a)
Amendments 54GB and 54GC agreed.
54GD: After Clause 84, insert the following new Clause—
(1) Regulations may provide as mentioned in either or both of the following paragraphs—
(a) that no amount in respect of personal independence payment which is attributable to entitlement to the daily living component is payable in respect of a person for a period when the person meets the condition in subsection (2); and(b) that no amount in respect of personal independence payment which is attributable to entitlement to the mobility component is payable in respect of a person for a period when the person meets the condition in subsection (2).(2) The condition is that the person is undergoing medical or other treatment as an in-patient at a hospital or similar institution in circumstances in which any of the costs of the treatment, accommodation and any related services provided for the person are borne out of public funds.
(3) For the purposes of subsection (2) the question of whether any of the costs of medical or other treatment, accommodation and related services provided for a person are borne out of public funds is to be determined in accordance with the regulations.”
Amendment 54GD agreed.
Clause 85 : Prisoners and detainees
Amendment 54H moved.
Amendment 54HA not moved.
Clause 86 : Claims, awards and information
Amendments 54J and 54K not moved.
55: Clause 86, page 61, line 14, leave out subsection (3) and insert—
“( ) Regulations will prescribe what considerations must be taken into account in deciding whether a fixed term award would be appropriate.”
First, my Lords, I should make a correction for Hansard: it was the noble Baroness, Lady Hollis, who I was chatting to, not the noble Baroness, Lady Hollins. I inadvertently put an “n” into her name, and I apologise.
My Amendments 55 and 56 relate to opportunities for people in receipt of PIP to receive lifetime or indefinite awards of the benefits in much the same way as many people do who are currently entitled to DLA. As figures published by the Department for Work and Pensions in May 2010 revealed, of the 3,157,300 people in receipt of DLA some 2,239,500 received an indefinite award, and on closer inspection this is hardly surprising. If an individual’s disability, impairment or condition is lifelong, their needs will either remain the same or increase over time—they will not go away. Therefore, it seems perfectly logical and right for them to be entitled to the benefits indefinitely.
Individuals with a learning disability are examples of such people. At this point it is appropriate for me to declare an interest as president of the Royal Mencap Society and describe briefly what happened to my daughter, who died five years ago. She was born with Down’s syndrome, which in those days was defined as mongolism, in 1951. She had hip dysplasia, which was not operated on when she was young enough. Eventually her femur was too brittle and too thin for any hip operation to take place. She developed cataracts in her late 20s and had six eye operations at Kingston Hospital and Moorfields. She developed a certain degree of dementia at the age of 38. She gradually got worse and more blind until, at the age of 54, having developed epilepsy three years earlier, she had five seizures in a row, which rendered her unconscious. She lived for 10 days and eventually died. In that time she was incapable of movement and had to be hoisted everywhere. She was totally blind, and totally incapable of any form of communication because she had Alzheimer’s. In other words, her condition gradually progressed from bad to worse to worse still throughout her life.
Those are the kind of people that I am talking about: people who deteriorate as the years go by. It seems absurd that they cannot have a lifelong award, which would to a certain extent be covered, although I know that this is a different area of healthcare and social care. The point is that we are asking for, and being granted, annual health checks for people with a learning disability. People with severe learning disabilities will also be subject to those annual health tests, and if their condition worsens it can be reported so that the lifelong award would continue to apply.
I hope that the Minister will also see that this will save the Government a great deal of money. You are looking at tens of thousands of people who deserve a lifelong award—not only those with learning disabilities; there are other conditions as well, obviously. There are tens of thousands who would have to go for regular assessments. It is absurd. They should be allowed to have their lifetime awards, or at least lengthy awards, for which they could have a health check. I cannot remember the Minister’s exact words but he said something to the effect that people whose circumstances were exceptional could continue to have a lifetime award or something similar. I hope he is able to pronounce a little further on that. Having ad libbed this speech and moved away from my original script, which I cannot read anyway because of my eye condition at the moment, I hope the Minister will find room in his heart to accept this amendment. I beg to move.
My Lords, I rise briefly to support the amendments in the name of my noble friend Lord Rix. I suspect that, after days of assessing the increased cost implications of the amendments already discussed, there will be a genuine expression of relief on the Minister’s face at proposals that will almost certainly reduce overall costs and the administrative burden on the department. I have already declared my personal family interest—I have two disabled adult children—and my professional experience of working with people with severe learning disabilities and autism over 30 years.
I should point out that an annual or short-term assessment would almost certainly be a waste of time and money. This is true not just for people with learning disabilities, but would be true for people with other conditions such as some 69,000 with multiple sclerosis who are currently in receipt of disability living allowance and, on a smaller scale, those with motor neurone disease. After an initial assessment by experts confirming the diagnosis and the degree of severity, it is surely better to leave things as they are but to respond, on the application of carers or the individual themselves, to any deterioration in their condition. That is then the time for further examination, when it may well be found that the person may need greater support.
It is also important to recognise that annual reviews may only increase the anxiety of those undergoing them and will do nothing for their morale. I think with horror of the time—currently scheduled for 2014—when my son will be due for an assessment. I hope I will have the opportunity to go with him and that I will actually know about it. It is not that there would be any intention that I would not know, but rather because he cannot read and his supporters do not always realise the importance of involving me in certain aspects of his support. I hope to be with him when that review is done, but I also know how challenging it would be for him to be reassessed. For quite a lot of people, this constant reassessment would be costly in more ways than you can imagine. I look forward to hearing the Minister’s measured reply to these very modest and cost-saving proposals.
In quite a lot of the publicity run in some newspapers preceding today’s debates, there has been—how can I put it—synthetic outrage about the number of DLA awards that have been made for life, as though they are somehow fraudulent, negligent or erroneous, thus apparently besmirching the entitlement of the holder of that lifetime award to it as of right, as though they have somehow manipulated or cheated the system and that the previous Administration has colluded with them at the taxpayer’s expense. That publicity has been extremely ugly and extremely unfair. Whether or not the Minister feels able to accept the amendments—and I hope he does—I hope he will accept that some conditions, on which the noble Baroness, Lady Browning, spoke so eloquently and movingly and of which two other Peers in your Lordships’ House have had intimate experience, do not change except for the worse and for which a lifetime award is a decent, sensible and cost-effective way of proceeding. Could he therefore ask his press hounds to lay off those people who have had them in the past and who ought, in all decency, to go on to enjoy them in the future?
There has been a suggestion that people with disabilities adjust to their condition. It is true, if you take the meaning of those words at face value, that people do adjust to their condition. For example, in one of the case studies shown in the paper produced by the Government yesterday, there is an account of a woman with epilepsy who did not meet the PIP qualification. It said that it was dangerous for her to use a cooker but she got round it because she used a microwave and therefore does not need to use a cooker. That may be a very practical suggestion—apparently when a cooker was needed her husband did the cooking on a proper cooker—but we have, in a way, failed to address what we mean by people with a range of disabilities coping or adjusting to their disability. Yes, there is an adjustment and yes, there are practical and psychological ways in which people cope with their disability, but it only requires something that is really unsettling to someone with a lifelong disability for those very important building blocks that have been put in place at the bottom to be disturbed or taken away and for the whole thing to disintegrate and come down like a house of cards.
Therefore, while I can understand why reassessment is necessary in some cases, a judgment has to be made about identifying those for whom reassessment, with the associated costs that have been mentioned, will add to their stress. Stability, as I said earlier, is important in these cases. If their stability is unsettled, there are consequences. The Government must make some sort of judgment about this. They will not save money and it is compassionate to recognise the types of disabilities that will present themselves when there will clearly be no improvement and degeneration is more likely. Quite frankly, if in some cases people adjust to their disability, are they not to be applauded for having made that adjustment, not penalised for it?
My Lords, I first want to put absolutely on the record that we are not talking about the constant assessment of everyone. That is simply not how it is going to work. To the extent that there is concern about people being dragged in to face assessors every year, that is simply not how it is going to work.
When we talk about having another assessment for some people who have deteriorating conditions, noble Lords have to remember that they might have started on the lower rate of PIP and that in practice the assessment will move them to the higher rate at that time. DLA is an understudied phenomenon. It was studied by the previous Government in 2004-05 and it was found that £630 million was overpaid. That was not as a result of fraud; it was just that people no longer fitted the rather easier criteria of DLA that were in place when they applied, although we do not know where they fitted when they did apply. Just as worrying was the finding in that year that £190 million was underpaid. We want to make sure that the money goes to people in the right way in both ways.
My Lords, I was the Minister responsible for those reports at that time, and I have to say to him that they did not apply to people with lifetime conditions. People with lifetime conditions should get lifetime awards. Clearly, if someone deteriorates, they or their carer may apply further, but the information on DLA that the Minister referred to was either about people with fluctuating conditions or about people who had become better but had not realised that they might no longer qualify as a result, and so on. We had no argument with the need to continue to review DLA for people whose conditions may change quite rapidly over a period of time, particularly if they have been recovering from an accident, and so on. We are talking here about lifetime conditions in which it is therefore decent to give lifetime awards. I can assure the noble Lord that the statistics to which he referred do not refer to that group.
As I understand the statistics, they refer to the whole group and we clearly need a system that we can apply to everyone, within which there will be groups with lifetime conditions. Let me come back to my main point, which was my concern about the underpayments. People with lifetime conditions deteriorate, and they need to be caught at the point of deterioration in order to be paid the extra funds they need to cope with the higher level of disability or higher inability to do things.
I apologise for interrupting yet again. The point is that if, as I said, the annual health checks are taken for these people it can be reported medically. Certainly the carers can report on this. There is no question that if your son or daughter or your friend is obviously not receiving the amount they should be, it is up to you to get hold of the necessary officials and to inform them. Equally, the annual health checks should certainly—for people with a learning disability anyway, although I do not know about other disabilities —take care of any deterioration in condition.
My Lords, let me go through the approach we are planning to take in PIP. It will involve a personalised approach and, in some cases, awards will be fixed for a short period—maybe one or two years—but in others they will be much longer and we are looking at awards that could be five or 10 years. That will depend on the circumstances of the individual, the impact of their health condition or their impairment and the extent to which they are able to live independently and participate in society. In many circumstances, this can change for better or for worse during someone’s lifetime and that will be different for different people. Therefore flexibility in award durations is key and will allow decision-makers to tailor awards appropriately. Again, we will be working with disability organisations and disabled people to develop the necessary guidance to support these decisions over the next 12 months. There will be many chances to get this absolutely right in the months to come.
I must quote the noble Lord, Lord Touhig—who is not in his place—who quoted Lorna Wing, one of the founders of the National Autistic Society, who said, “When you have seen one person with autism, you have seen one person with autism”, which is a phrase that will remain with quite a few of us in the years to come. Our flexible approach should allow us to provide the support to meet the variable needs people have. We also recognise that the system needs to deal with fluctuating conditions and that is one of the things we need to really lock down in consultation in the next 12 months.
Even where awards of PIP are made for a fixed term and periodic reassessment is required, it will be proportionate. Some assessments may only involve scrutiny of paper evidence and will not require face-to-face consultation. That will particularly be the case where there is considerable supporting evidence on which to base decisions. Conditions or impairments that are lifelong or degenerative will have such supporting evidence. Clearly, we are going to provide guidance on the duration of an award, including when an ongoing award would be appropriate and with what frequency that award would be reviewed. That will be evidence-based and we are committed to coproducing it with the appropriate experts in the field. I assure noble Lords that we are keen to involve disabled people and their representatives in this process. We are determined to get it right.
I have to make the point that lifetime awards were abolished in 2001 and only in very rare circumstances would they be reviewed. At the moment in DLA, we have indefinite awards that can be reviewed at any time. On the other point raised by the noble Baroness, Lady Hollis, on the national benefit review, the only group excluded from that is the awards made to the terminally ill.
I hope that I have reassured noble Lords on the issue. There is still a lot of work to be done in this area. We will look to organisations that help us, including those with which the noble Lord, Lord Rix, is associated. However, before I ask him to withdraw his amendment, I must make clear the technicality that the Government do not consider that Amendment 56 is directly consequential on Amendment 55, so they are separate matters. I ask the noble Lord to withdraw his amendment.
Amendment 55 withdrawn.
Amendment 56 not moved.
Clause 87: Report to Parliament
56ZA: Clause 87, page 61, line 20, at end insert “—
(a) within 2 years beginning with the date on which the first regulations under that section come into force; and(b) within 4 years beginning with that date.”
My Lords, the government amendments are intended to support our plans for a sensible, achievable and measured approach to the introduction of PIP and to report on the effectiveness of the assessment. I went into detail on what we are planning earlier this evening, so I do not need to dwell on it too long.
The first amendment will allow us to test the processes in a truly live environment and gives us the ability to control where those early new claims will come from. We are looking at which sites to use and developing the detail.
The second is designed to support our programme of examining how PIP works against the assessment. In summary, as I said, I propose to put into the Bill a statutory duty to publish two reports to Parliament—the first within two years from the time that PIP starts, the second within four years of that date. I also made the commitment earlier this evening, which I repeat, that if there is a need for a third review and report because of ongoing issues identified in the second review, we undertake to do that. That is a commitment to ensure that the assessment and its processes are working. We have slightly adapted the idea of doing that annually, which is what happens under WCA, because that has led to a slightly piecemeal approach. We think that two-year reviews will be better and we have learnt from that.
These are sensible and practical amendments. They are of course inspired by noble Lords in Committee, whose arguments convinced me. I have already put it on record that I think that Committee Members did a fantastic job and went through the Bill in an organised, diligent manner with astonishing energy. I have tried to take all the good ideas possible—some of them are not, but I am really pleased to be able to take this one.
The Government consider Amendment 56ZB to be directly consequential on Amendment 56ZA, but do not consider Amendment 70 in this group to be directly consequential on Amendment 56ZA. Despite that, I beg to move.
My Lords, the Minister gave the shortest reply in Committee, interrupting my amendments, and I sat down within about three seconds of standing up. The noble Baroness, Lady Hollis—I have the name right this time—said that if the rest of the amendments could be taken at that speed, we would have got through the Committee stage much faster. I am absolutely delighted that the amendments have been modified but certainly accepted by the Government. I am very grateful.
Amendment 56ZA agreed.
56ZB: Clause 87, page 61, line 21, leave out subsection (2)
Amendment 56ZB agreed.
Clause 88 : Abolition of disability living allowance
Amendment 56ZC not moved.
Schedule 9 : Personal independence payment: amendments
Amendments 56A to 56K not moved.
56KA: Schedule 9, page 138, leave out lines 17 to 20
Amendment 56KA agreed.
Amendment 56L not moved.
56LA: Schedule 9, page 138, line 32, leave out “, but before the “and” preceding paragraph (b),”
Amendment 56LA agreed.
Amendments 56M to 56ZD not moved.
56ZDA: Schedule 9, page 141, line 20, after “84(1)” insert “or (Hospital in-patients)(1)”
Amendment 56ZDA agreed.
Amendments 56ZE to 56ZJ not moved.
Clause 91 : Transitional
Amendment 56ZK not moved.
Schedule 10 : Personal independence payment: transitional
Amendments 56ZL to 56ZY not moved.
Clause 92 : Regulations
Amendments 57 to 58ZA not moved.
Clause 93 : Interpretation of Part 4
Amendments 58A and 58B not moved.
Amendment 58BA had been withdrawn from the Marshalled List.
Consideration on Report adjourned.
House adjourned at 10.13 pm.