Motion of Regret
Moved by
That this House regrets that the Social Security (Disability Living Allowance, Attendance Allowance and Carer’s Allowance) (Amendment) Regulations 2013, laid before the House on 4 March, will result in the loss of Motability provision for many disabled people; and that this House considers that transitional arrangements should be put in place urgently. (SI 2013/389)
My Lords, the House will be aware that this Motion of Regret refers to the Social Security (Disability Living Allowance, Attendance Allowance and Carer’s Allowance) (Amendment) Regulations 2013. My three particular concerns, referred to in earlier debates, relate to: first, the way in which the changes in regulations will impact on the support which disabled people need to ensure mobility; secondly, the role of Atos Healthcare in assessing those who will be reassessed for PIP as a consequence of the changes; and, thirdly, the 20/50 metre criteria used for enhanced personal independence payment.
On the latter question, I begin at least with a welcome for the Government’s decision to consult, over the summer, on the 20/50 metre criteria for enhanced PIP. I hope that the Minister will be able to assure the House that this will be a genuine consultation and not simply a paper exercise, going through the motions, to avoid judicial review. In a Written Answer on 13 February, the Minister said:
“Once PIP legislation is in place, any consequence of a failure to meet the entitlement conditions for the enhanced mobility component would not result in a judicial review as long as the legislation was applied fairly to the claimant. We have robust dispute resolution procedures in place to ensure that this is the case”.—[Official Report, 13/2/13; col. WA 157.]
Presumably, the new consultation is a recognition that the earlier announcement was not based on fairness. If this really is to be a genuine consultation this time, and the new regulations applied fairly to each claimant, the Government will need to assure us that they will publish the responses to their consultation and explain the reason for their eventual decision. Will the Minister outline the procedure that will be followed? Until the consultation has been undertaken, how will current claims be assessed? Which rules will apply? What will happen to those claimants if the consultation determines that the rules have to be changed?
There are two other two issues which I want to explore: the impact on disabled people’s mobility and the role of Atos Healthcare. On February 25 last, with the support of my noble friend Lady Grey-Thompson, who has been unable to join us this evening because of pressing family commitments but who wishes to be associated with these remarks, I moved an amendment in Committee to the Welfare Benefits Up-rating Bill. My amendment was a plea to the Government to think about providing a transitional arrangement—perhaps at least a two or three-year period of grace—for those who already have vehicles and who risk losing them. Prior to that amendment, on 17 January, 24 January and 13 February, and in a series of Written Questions, I pressed the Government about the impact of their proposals on disabled people.
Subsequently, on 30 April, the Minister for Disabled People and Member of Parliament for Wirral West, Esther McVey, met my noble friend Lady Grey-Thompson and me, along with Jane Young, who has done a great deal of work in ensuring that this issue does not slip from sight. The Minister told us that the DWP would be announcing its own transitional arrangements this month. Can the Minister tell us what has happened to them? Since our meeting, Ms Young has been told that the department’s transitional arrangements would be reworked into joint transitional arrangements with Motability. Can the Minister can tell us whether that is so? How will that assist those who use their higher-rate mobility component on an alternative means of independent mobility other than the Motability scheme? I hope the Minister will be able to tell us.
During those discussions we made the point, which I reiterate tonight, that this is not a trivial issue. According to the noble Lord, Lord Sterling, who does such admirable work chairing Motability, there are 620,000 Motability vehicles on the road, which he says is probably the largest fleet of such vehicles in the world. That figure simply refers to Motability vehicles, not to the significantly larger number of people who rely on other forms of transport to ensure a degree of independent living. The Government have been unable to tell us, throughout these debates, how many people will have their vehicles sequestrated or repatriated and how many people who currently receive help with transport will lose access to that help. My noble and learned friend Lord Hardie has also been attempting to extract information about the numbers of people. Members of your Lordships’ House will have seen his recent Written Questions about this. I suspect that obtaining that information has been rather like drawing teeth.
I for one do not believe that Parliament has any business enacting government policies without knowing what the full effect will be of their proposals. For Parliament to be asked to walk blindfolded into decisions will undoubtedly result in some Motability users having their specially adapted vehicles repossessed. That is simply unconscionable and deeply irresponsible.
Although I am appreciative of the time that Esther McVey spent with my noble friend and me, I freely admit that I am still no wiser about the number of people who will lose their vehicles or be affected by these changes. The detail of the Government’s proposals is still inadequate; we simply do not know. The inadequate consultations match that. The transitional arrangements which are to be put in place by both Government and Motability are simply in the ether. We do not know what they are. It is for that reason that I tabled this Motion of Regret this evening and to ensure that the noble Lord, Lord Freud, who has spent a lot time on these questions, has the opportunity to come to your Lordships’ House to explain in more detail and answer some of these questions.
On 17 January I asked:
“Can the Minister confirm the Government's own prediction, made earlier this month, that 27% fewer working-age people will be eligible for the Motability scheme once PIP is fully rolled out? Disability organisations say that the new proposal means that 42% fewer disabled people of working age will be eligible—an average of 200 people in every constituency”.—[Official Report, 17/1/13; col. 818.]
I received no reply on that day but on 13 February the Minister told us:
“Yes, my Lords, there is some churn”.— [Official Report, 13/2/13; col. 742.]
He also said:
“My Lords, we know how many people will get the higher mobility component, a figure that will clearly be fewer under PIP than under DLA. I have provided those figures but, just for the record, the figure of roughly 1 million people on the DLA component in a steady state will reduce to roughly 600,000”.—[Official Report, 13/2/13; col. 741.]
How does that translate into repossessed vehicles and into the loss of Motability support?
Let us be clear. One third of disabled people live in poverty. Some claimants will lose as much as £150 per month if they fail to meet the newly tightened criteria, an annual loss of around £1,800. Their situation will be unbelievably bleak. On the other side of the coin, Oxford Economics estimates that the mobility provided for disabled people contributes to our nation’s economy by the equivalent of £1.3 billion every year, as I pointed out in an earlier debate after being referred to the document by the noble Baroness, Lady Hollis.
The Disability Benefits Consortium, which represents more than 50 disability rights groups, reminds us that it is not just about the positive contribution made by disabled people. Motability vehicles are,
“their means of independence and participation, the lifeline that enables them to get to work, to GP appointments, to the shops or to take their kids to school”.
We simply do not know what is going to happen to people, some of whom have had very expensive adaptations to their vehicles, and who will be left without an adequate method of getting around. We especially do not know what the effect will be on people living in places where public transport is not easily available or accessible. As my noble friend Lady Grey-Thompson told the House in February:
“The short timescale between notifying someone of their car being removed and it being taken away could make life extremely difficult. Without some further protection, it could lead to chaos for many disabled people”.
She continued:
“At the briefing that was held on the PIP regulations on 22 January 2013 with the Minister, the noble Lord, Lord Freud, and the Minister in another place, Esther McVey, it was my understanding that the timescale for someone having to return their car if they were no longer eligible for PIP could be relatively short, perhaps just a matter of a few weeks”.—[Official Report, 25/2/13; col. 937.]
Can we now have further clarity on the timescale? I should be grateful if the Minister would remind the House how much public money is provided to Motability each year and tell us what discussions the Government have had with Motability about transitional arrangements and a package of support.
I was surprised to see that when Norman Baker MP, Parliamentary Under-Secretary for the Department for Transport, was recently questioned by the House of Commons Transport Select Committee, he admitted that his department had,
“not particularly been involved … in any Motability discussions”,
with DWP and that his department should have done more to consider the impact on tens of thousands of disabled people who are set to lose their right to use the Motability car scheme. So much for joined-up government. Norman Baker also said that the department would,
“try to make sure that there are alternatives available through public transport and … that they are as accessible as possible”.
He obviously had little experience of how inaccessible this country is for sick and disabled people, something which the Mayor of London accepts, stating that,
“the reality is that even with complete Mayoral commitment a fully accessible service will take many years to achieve”.
That is why, when referring to the mobility component changes from DLA to PIP, Boris Johnson’s formal response to the DLA reform consultation states:
“The Mayor does not support this change”.
To understand why he and many of us do not support these changes, Mr Baker and the Minister should read my noble friend Lady Grey-Thompson’s account of how she has literally had to crawl on and off trains, or how Kaliya Franklin was left in a tradesman’s office and forgotten about at a main London train station while waiting for help.
For people faced with losing their adapted cars and being forced to rely on public transport, the prospects will indeed be bleak and are made even worse by the lack of clarity about how the policy will be implemented. There has been speculation that users may be allowed to keep their cars for one extra month in order to give them time to find a replacement, and perhaps provided with some financial support to help them make adaptations to their replacement vehicle. Clearly, even if people come out of the process with between £500 and £1,000, that is not the same as still having their vehicle. What figure does the Minister put on the assistance that will be given? Can he tell us how many vehicles will be offered for sale—something he referred to at the briefing that was held in an upstairs committee room? It seems extraordinary to me that disabled people could have their own vehicles offered to them for sale. At what average price does he anticipate that they will be sold? How does he expect disabled people to find the funds for these purchases or for new vehicles and modifications?
I turn to my third point. I would like to hear the Minister’s reaction to a story published last week by Disability News Service and written by John Pring—I have given the Minister prior notice of my raising this. It reflects serious concerns over the Atos Healthcare tender document and how it was awarded the contract to assess disabled people for personal independence payment in London and the south of England. Disability News Service suggests that Atos has broken a series of firm pledges that enabled it to win a £184 million disability assessment contract. The story comes as the DWP is rolling out the assessments for PIP across the UK and it surely raises worrying questions about the transparency and management of contracts won by tender and involving millions of pounds of public money.
The tender document stated that Atos had “contractually agreed” with 22 subcontractors for them to provide a network of 750 assessment sites across that area. This has fallen to just eight subcontractors since the contract was signed—22 down to eight. Atos stated:
“Each partner has contractually agreed to providing accommodation to the required specification”—
DWP’s specification. It also said:
“We conducted an evaluation process, including site visits, to select the PIP consultation locations of the highest quality. This has allowed us to identify sufficient, suitable accommodation, ready for go live and available for the length of the contract”.
Atos estimated that its “hyper-local” service would mean that no claimant had to travel more than 60 minutes by public transport to attend an assessment. Atos has now refused to say how many of the 750 assessment sites are left, while a DWP spokeswoman said last week:
“We do not have that information. We really don’t know. We are not sure”.
This is another example of not knowing how policies are going to work out. Perhaps the Minister can tell us tonight.
Why does it matter? It matters because the changes will mean that many disabled people with significant mobility and care needs will face longer journeys—possibly up to 90 minutes by public transport—to reach their assessments, rather than the maximum of 60 minutes promised by Atos when it bid successfully for the contract.
Can the Minister confirm that the award of the two PIP contracts are, together, worth nearly £391 million to Atos over the next four years and say what discussions he is having with it about the failure to honour the tendering commitments? Has he also raised with Atos the earlier complaints made last October by disabled people’s organisations that it had used misleading information about its links with those organisations to help to win two of the contracts?
The article quotes my noble friend Lady Grey-Thompson as remarking:
“There were many assurances given during the debates on PIP … People believed that a significant number of assessment centres would be available, and the geographical location would make travelling much easier. If the number of assessment centres is radically different to the number that were in the tender document then that should be openly explained”.
I entirely agree with her. I would like to know whether the Minister has been in touch with the NHS foundation trusts cited in the article to which I have referred. Cambridge University Hospitals NHS Foundation Trust is quoted as saying:
“We never got that involved at all. They put our name in the tender document, although they shouldn’t have done. I think they emailed us, but we said, ‘No, we are not interested’.”
North Essex Partnership NHS Foundation Trust, also mentioned in the tender document, said:
“The trust never had an agreement or contract with Atos. We had exploratory discussions as part of a consortium ... which did not go any further”.
Norfolk Community Health and Care NHS Trust said that it became aware that it had been mentioned in the tender only some time after the document was submitted to the Government. A trust spokeswoman said:
“We cannot be responsible for what they have put in, but it wasn’t with our agreement”.
There are similar comments from Norfolk and Norwich University Hospitals NHS Foundation Trust, Mid Essex Hospital Services NHS Trust, and University Hospitals Bristol NHS Foundation Trust, which said that,
“no formal agreements of any sort were reached before discussions were terminated by mutual agreement”.
An Atos spokeswoman was quoted in the article as saying that DWP was,
“fully aware throughout of the fact that contracts were not in place between Atos and its selected suppliers”.
Perhaps the Minister can confirm whether that is true and on what basis the DWP’s spokeswoman was able to tell Disability News Service:
“We have no reason to doubt that Atos and their partners are able to deliver [the contract] successfully”.
At the very minimum, this must reinforce the doubts that so many of us have about Atos and the new arrangements which the Government are putting in hand. Perhaps the central question is why the Government are content to spend taxpayers’ money paying a company that fails to honour its contract to the detriment of disabled people. Do they accept that, by failing to hold Atos to account, they will encourage it to behave in ways that it believes its paymaster will approve rather than providing an objective service to disabled people?
This latest saga also underlines how many health authorities Atos proposed to use. As these are organs of the publicly funded National Health Service, why could the Government not have appointed them to carry out this work, cutting out the Atos middleman and giving much better value for money to the taxpayer? Perhaps some of the money that they saved could be used to prevent the sequestration of disabled people’s specially adapted Motability vehicles in these hard times which we are constantly told drive the Government’s policies.
I hope that some of these well founded concerns—about the lack of clarity about the scale of the impact on disabled people; about the criteria that will be used for assessments; about the arrangements being put in place by Atos to carry out assessments; and about the absence of transitional arrangements—will be properly addressed and that, when these policies are implemented, no one, especially Ministers, will be able to say they had no idea that these would be the regressive consequences of the ill starred measures which the Government have promoted. I beg to move.
My Lords, I am extremely grateful to the noble Lord, Lord Alton, for giving us this opportunity to raise again the issue of PIP and the higher rate mobility component. This, of course, is the gateway to the Motability scheme which enables so many disabled people—including myself—to get about. I declare that interest.
I shall say a word about PIP in general, but turning to these regulations, I am pleased that Motability has stated that it aims to avoid recovering vehicles from hospital in-patients affected by this change. If the car has been adapted to suit the claimant’s condition, then it could be very expensive for a Motability car to be recovered and for the claimant to apply again when he or she comes out of hospital, and another Motability car has to be adapted in due course. Presumably the payment of the higher rate mobility component of DLA will continue to be paid if a person is in hospital for more than four weeks. Perhaps the Minister could tell me if that is the case.
Turning to other matters, I am very glad that the DWP is reopening the consultation which it failed to do on the final version of the PIP criteria. Even though the amending regulations should make the position clear, none of us who has taken part in these discussions has any confidence that the assessors will properly take the criteria in the amending regulations into account—even though they are mandatory. I hope that the new consultation will not be an empty exercise and that the DWP will take on board what disabled people say and change the original criteria if the consultation makes it clear that this should happen.
One matter which I am very disturbed about is the figure of 600,000 claimants that the Government say will disappear from their books once PIP is introduced. Where did the DWP get this figure from? Is it saying that these people are not disabled enough, or that they are now receiving DLA fraudulently? How closely is it in touch with the Department of Health, which might be able to enlighten it about improvements in treatments for many disabled people, meaning that they are likely to live longer with their disabilities?
The mantra we hear constantly is that PIP is to be targeted at those who need it most. However, although that sounds good and right, it is actually pretty meaningless because DLA and PIP are not to be means-tested. So one is left with a subjective judgment by a DWP decision-maker—heavily influenced by the assessor. Without targets, how will the decision-maker judge one person against another? Outside the Chamber, the noble Lord, Lord Alton, said they would need the judgment of Solomon. Instead, they have the judgment of Atos. I know which I prefer.
Tonight we heard more from the noble Lord about the Atos contracts, so I shall not repeat those facts, which are very disturbing. In general, I supported the move to PIP, because of the inadequacy of the DLA form, but there are too many question marks over the whole process for me to have any confidence in it any more.
I want to make three brief points, but first declare an interest. Two members of my extended family have Motability cars and they are their lifeline. I shall make a point about statistics, one about appeals and finally a point about isolation. I shall try to be quick because we are pressed for time.
On statistics, as I recall when we were doing the Welfare Reform Bill, we were told that something like 600,000 of those getting the higher rate DLA mobility component would drop and about 200,000 of those on a lower rate would go up, leaving a net loss of 400,000 people on DLA mob. As understand it from our debates at the time, something like 27% of those people converted their DLA higher rate mob into a car. Therefore it means we are talking about the loss of potentially 180,000 Motability cars from disabled people who are dependent upon them. These are cars which in many cases have been extremely expensively adapted to them and therefore are of relatively little use for people following after, because they have been customised. This leaves the disabled person without any ability to afford alternative transport, because they too cannot afford those adaptations done by Motability. So on my first point about statistics, I think we are dealing with about 180,000 cars. If the Minister can correct me on this, I should be pleased to know, but it is a huge number.
Secondly, there are appeals. At the moment, between 40% and 50% of all appeals on DLA are successful. One reason is that there is often a considerable time between the DLA assessment and the appeal, by which point someone may have got worse or, possibly, better and, as a result, the evidence is contested. The problem is the length of time taken to hear the appeal. If it takes six months to hear an appeal against Atos, you lose your car after one month, you win your appeal, but then you have to wait for a new car with all the expensive adaptations while 180,000 cars are effectively on the scrapheap, that seems a foolish and unwise use of money.
How can we overcome that? We have to link the transitional arrangement under which you can hold on to your car to the end of the appeals procedure. That could be three months; it could be six months. I am sure that the Minister will say, “That would encourage everyone to appeal”. Possibly, but we could at least have a decision-maker review in the first place, which would winnow out some and get that information looped back to the person appealing. If the Minister so chose, that would lead to an acceleration of the appeals process, which in all decency would be a good thing in any case. It would allow for better quality judgments, because the appeal would be heard much closer to the original decision and would therefore be based on the same evidence, which is not what is happening at the moment. That would be good for both the department and the disabled person.
Can the Minister give us an assurance that we can link the length of time it takes to have an appeal to the transitional time during which you can hold on to your vehicle? Otherwise, it is really absurd. I know that the Minister can find a way around this if he chooses.
The third point is about isolation. What comes out clearly time and again is that if you take away the Motability car, you turn a disabled person from being independent to being dependent on other people. More than that, you lock the person on whom he depends—I say “he”, and it is therefore likely to be his wife—into a shared isolation with him. She has to be permanently his runaround carer as well as his home carer, because he has no capacity to have any independent life apart from her support. That locks them into a shadowy dance into isolation, which is disastrous for them both.
Those are my three points: the number of cars that we are talking about, which I judge to be about 180,000; the problem of the length of time to hear appeals, which mean that more cars will be lost which then have to be restored—unless the Minister can calibrate and bring together the two; and, thirdly, the need to ensure that we do not send disabled people and their carers into isolation. That is particularly marked in rural areas. There, disabled people have few options. They cannot afford taxis, they do not have buses, they cannot walk those distances, and they cannot run scooters because the distances are too far. Without their Motability car, they are locked into their home as well as their isolation, as are their partners. For those three reasons, I very much hope that the Minister can give us more satisfactory reasons this evening than we have had so far.
My Lords, I declare an interest as honorary president of Capability Scotland and share noble Lords’ concern about the changes to the regulatory regime. In that regard, I refer noble Lords to my observations of 13 February at cols. 737-78, which I shall not repeat. The present regulations, among other things, affect claimants who have entered into a Motability agreement and are thereafter hospitalised. The noble Baroness, Lady Thomas of Winchester, derived some comfort from the assurance that Motability will not recover those vehicles if a patient is hospitalised, but if one reads paragraph 7.10 of the Explanatory Notes, one sees that that is not what the Government have said. They say that the Motability scheme has stated that it would aim to avoid recovering vehicles from hospital in-patients affected by that change.
That is not the absolute assurance that hospital patients will not lose their vehicles. Without such an assurance, the reality is that if a person is in hospital for a particularly long period, the payments made by the department to Motability on behalf of the patients will not be made and the vehicle—the car, motorised scooter or motorised wheelchair—may well be recovered. Indeed, the Explanatory Notes recognise that if it has to be recovered, Motability will give some allowance, depending on the condition of the vehicle when it is recovered.
These are concerns, because the present system means that payments direct to Motability continue to be made after the hospitalisation of a claimant. That is recognised as an exception to the rule that social security benefits are affected after hospitalisation. In my view there is a good reason for that, because these payments are payments of a capital nature to enable people to have the necessary facilities to give them the independence that they need. They are different from revenue paid direct to the person for their maintenance.
Regulations 10 and 11 remove this exemption for no good reason. It is no answer to say that it is intended to bring Motability users into line with other recipients of DLA or PIP. As I have sought to explain, they are in a different position to the other claimants. Moreover, the consequences of this change are draconian. There is a real risk of the repossession of necessary equipment, resulting in the inability of such claimants to lead independent lives after they leave hospital until they are able to renegotiate other Motability contracts. The noble Baroness, Lady Hollis, explained the complexities of that. There will be a delay in obtaining necessary equipment, during which period these people will not be able to live the independent lives that they have enjoyed previously. Can the Minister advise the House what timescale is involved between the order and delivery of a purpose-built powered wheelchair, scooter or modified vehicle?
I also ask the Minister what is the urgency in promoting this change, particularly in view of the announcement by the DWP on 17 June, already mentioned, of a further consultation on the mobility component of PIP? Would it not make sense to have an integrated approach and to leave these changes to form part of the consultation process? Has there been any consultation with interested parties or the public at large about this significant change? If the Government are not willing to await the outcome of the consultation, can the Minister tell the House how many people will be affected by this proposed change?
The loss of a wheelchair or car may have greater implications in different parts of the country. I have been anxious to assess the whole issue of Motability payments and their geographical distribution because I suspect that the impact of the loss of a vehicle might have greater impact in rural areas than in cities where there are probably better—although not ideal—transport facilities for wheelchair users. On 4 June, I tabled four Questions for Written Answer about the Motability scheme and received a reply dated 13 June. I refer noble Lords to Hansard cols. WA 255-56. I commend the Minister and his officials for the speed of the reply but it did not answer all my questions. My Questions HL594 and HL595 sought data for three years—2010, 2011 and 2012—but the answer provided data only for the last year, preventing me from undertaking any effective analysis.
Moreover, in relation to Questions HL596 and HL597 seeking information about participants in the Motability scheme, the Minister replied:
“The Department does not hold information on the numbers of Motability customers in each local authority district or area of Great Britain”. [Official Report, 13/6/13; col. WA 256.]
That reply echoes his statement on 13 February at cols. 741-42.
I have some difficulty with these statements. As I understand the system, if a claimant elects to use the Motability scheme, payments on his or her behalf are made by the department directly to Motability. If my understanding is correct, the department must know how much it is paying to Motability and on whose behalf payments are being made. This information will identify the local authority, district or area of each claimant on whose behalf payments are made. I have written to the Minister seeking a full answer to my Questions and I look forward to receiving that in due course.
If it is truly the case that payments are made by the department to Motability without it knowing the identity of the beneficiaries, it is a matter of concern that the department cannot account for these payments. Such a failure may be of interest to the Comptroller and Auditor-General, the Public Accounts Commission and perhaps even the Treasury. Until the department provides the House with the information about such payments, I invite the Minister to amend these regulations by deleting this particular change.
My Lords, I am grateful for the opportunity to speak in this debate and to congratulate the noble Lord, Lord Alton, on bringing it forward. I should declare an interest as president of Mencap in Wales and a number of other disability organisations. The matter that we are discussing is of immense concern to countless thousands of disabled people who are dependent on the vehicles they get for their mobility. This is true generally; it is a particular problem in rural areas, to which I will come in a moment. Perhaps I might pick up the points as they have been made in turn.
First, on consultation, may we please have an assurance from the Minister that all relevant disability organisations will have a full opportunity not just to submit evidence but to engage in meaningful two-way discussion on this matter, and that the process will not be truncated and time-limited?
Secondly, on the more than 600,000 Motability vehicles, the Government must know how many people stand to lose their adapted vehicles, so why will they not come clean with the statistics? As the noble and learned Lord, Lord Hardie, mentioned a moment ago, they must know those statistics. I congratulate him on the Questions that he has tabled and the statistics that he has obtained, which bring this matter into sharp focus.
Thirdly, I draw the attention of this House to the disproportionate geographical impact. I obviously have concern with Wales. With 5% of the population, it has 7.4% of the total casework and 8.4% of the higher rate caseload. This is for an amalgam of historic industrial reasons, which we will not go into now. Those people stand to lose, and many are in areas with the lowest incomes per head in these islands—places such as Blaenau Gwent and Merthyr Tydfil, where I used to live, and where almost 13% of the population have a dependency on the mobility component. In my next-door area of Anglesey, which has one of the lowest GVAs per head of anywhere in the United Kingdom, at just 55% of the UK average, there is a caseload of 7.2%. That is in a rural area where they do not have alternative means of transport and taking away vehicles will deprive disabled people of the ability to get around.
The changes we are talking about will compound the disability and poverty suffered by these people. It will be made infinitely worse if they cannot have their mobility. They will be very badly impacted by these changes.
My Lords, I declare a tangential interest as a recipient of DLA since its inception, although being no longer of working age I am unaffected by the introduction of PIP. I will not repeat many of the excellent points that other noble Lords have made.
In a recent document, Motability set out the ways in which it is trying to ameliorate the changes and lessen the punitive impact of reclaiming customers’ vehicles. It states that the price to individual customers wishing to buy their current car will be in the order of £8,000 to £12,000. In the current climate, when disabled people have been repeatedly hit by cuts, how will many be able to afford that kind of outlay? Will the loan sharks be out in force to make yet another killing from people desperate not to lose their employment?
The Minister for Disabled People’s answer to those people facing the loss of their employment because of the introduction of PIP has been the Access to Work scheme. What work has been done to see if this could in fact be a more expensive alternative? For example, the chief executive of my local disability organisation needed to use Access to Work while he could not drive a car. The daily cost of the journey both ways was £80—£400 per week. On top of that, he has the cost of taxis for shopping, getting to the doctor, et cetera. Compare that to £55.25 high-rate mobility element of DLA, which provides him with a transport for all these activities.
Finally, the Care Bill is currently making its passage through this House. One of its main planks emphasises prevention as an essential element in minimising the cost of social care. It has been the disability living allowance which has been one of the most effective provisions in helping the less severely disabled people maintain their independence and reduce their costs for social care, as the noble Baroness, Lady Hollis, has so ably said.
Are we faced yet again with another glaring example of the Government's silo mentality, making austerity cuts which ultimately result only in much higher costs to the public purse?
My Lords, I thank my noble friend Lord Alton of Liverpool for tabling this regret Motion. He has spoken so clearly and fully on the worrying situation that the Regulations 2013 may result in the loss of mobility for many disabled people.
The mobility scheme has been a great assistance to many disabled people who would not have otherwise been able to afford a car or an electric wheelchair. This scheme is headed by Her Majesty the Queen. It has given mobility and independence to many people. Can the Minister tell me whether it is really a possibility that many people will lose their cars and the ability to run them?
I would add a few words about the vital need for a car if one lives in a rural area, as I do—even more so if one is disabled. A car enables a disabled person independence to take part in everyday life, getting to a job if they can work, taking children to school, shopping, going to the doctor, and just getting around. Making people mobile is so important. There is very limited public transport, if any, in some rural areas. I cannot understand that the Government are going backwards in penalising disabled people.
Before the mobility scheme existed there were small three-wheeler cars which were maintained by the Government. They were not ideal as a disabled person could not take a passenger, but they were better than nothing. I cannot think the Government could be so cruel to take mobility away from people whose lives are changed when they have it and are isolated if they do not.
My Lords, I should begin by acknowledging all the work done by the noble Lord, Lord Alton, in bringing to the attention of the House, not just today but repeatedly, the concerns of people who are in receipt of mobility payments and who are worried about the effect of these changes and the way they are being implemented.
This debate this evening has made very clear just how important Motability cars and other mobility schemes are to so many disabled people. I was very moved by the account just given by the noble Baroness, Lady Masham, who explained so well the consequences for so many people; of how important it has been to have access to these cars and the fears that would accompany their departure.
The scheme, as Motability itself puts it, gives disabled people,
“the freedom to get to work or college, meet up with friends, enjoy a day trip out with their families, attend a medical appointment, or go shopping; to enjoy the independence that so many of us take for granted.”.
Yes, quite so. One of the things that we have struggled to get to tonight is the game of numbers—a point made by the noble Lord, Lord Alton, the noble Baroness, Lady Thomas, my noble friend Lady Hollis and others. It has proved very difficult to get a clear picture of just how many people will be affected by these changes since the Government have so far been unable to give us precise figures for those who might lose their cars or adapted vehicles. My noble friend Lady Hollis offered up 180,000. In the absence of anything from the Government, I suggest we all adopt that figure tonight. If the Minister will not accept that, please could he give us his own figure?
In past debates, the Minister has contended that because the decision to lease a vehicle is an individual one and the contract between the individual and Motability is a private one, it is not a matter for the Government. In response to that, first, the noble and learned Lord, Lord Hardie, made the very interesting point that if direct payments are made, the Government must know that information. Even if they do not, irrespective of the fact that a number of people will choose no longer to lease a vehicle, a number will automatically lose theirs simply by virtue of the fact that they will no longer be entitled to the enhanced rate when they transfer to PIP. The Government surely must have at least an estimate of what those numbers will be. Could they please share those numbers with us? Could the Minister tell us his best estimate tonight?
Secondly, if the Government intend to press ahead in the way they have announced, those affected will clearly need to make plans about how to manage the effects of the changes. What are the Government doing to publicise the changes and inform people who will be affected? The noble Lord, Lord Alton, and my noble friend Lady Hollis asked what transitional arrangements would be put in place for people losing their cars. The Government have told the House previously that they were in discussions with Motability but could not then give further detail. The noble Lord, Lord Freud, has said previously that he had sympathy with the concerns of the noble Lord, Lord Alton, and he was keen to find a way of supporting people during the transitional period. In the debate on 13 February, the noble Lord, Lord Freud, said in response to my noble friend Lord McKenzie of Luton:
“We are actively exploring what extra support we can give to disabled people to ensure that they can still get to work. We are looking at whether we can use access to work as that particular vehicle. We want to ensure that mobility support remains in place during any transition between the Motability scheme and access to work”.—[Official Report, 13/2/13; col. 740.]
What is the position on Access to Work, an issue also raised by my noble friend Lady Wilkins? Will it be possible to use Access to Work for this? What will happen with transitions? Will the sums of money available be enough to deal with the kinds of things described by my noble friend? Where have the Minister’s conversations got to? Also, where have his discussions with Motability reached? Will he provide more information as to what transitional measures might be put in place? In particular, what opportunities will be given to claimants to either buy or continue to lease adapted vehicles, and at what price? Will he clarify the position of in-patients in hospitals? That point was raised by the noble and learned Lord, Lord Hardie, the noble Baroness, Lady Thomas, and others.
This would also be a good time for the Minister to give the House some more information about the new consultation on PIP criteria and how that will link in with the inception of this new scheme—a point made by many noble Lords, understandably. It might help if the House understood more of the Government’s thinking on questions such as the 20/50 rule and the issues on which other campaigners have been pushing the Government to consult. How will this affect people in receipt of the higher rate of DLA who use Motability cars? What advice would he give them at this stage, looking ahead and trying to plan?
There is then the question of geography, raised by the noble Lord, Lord Wigley, and that of people in rural areas, raised by my noble friend Lady Hollis and the noble Baroness, Lady Masham. Have the Government done any assessment of the variable impact around the country? Can we even have a sense of impact by region, or the difference between urban and rural impact? I am sure that the Government would not have made a change on this scale without having considered that. Will the Minister share that with us?
Finally, at the risk of running slightly wide of the Motion, has the Minister given any thought to the context in which these changes are taking place? We know that support for disabled people wanting to move into work has been in trouble. The Work Programme is struggling generally and is clearly failing to help disabled people into work. The latest report from the Employment Related Services Association suggests that the numbers of people on ESA getting a job start as a result of referral to the Work Programme are terribly low: just 6% of referrals in the ESA flow payment group had a job start, 5% of those in the ESA volunteers group, and just 2% of referrals in the ESA ex-IB group. Given that, will the Minister take this opportunity to give the House some reassurance that the Government are concentrating in a cohesive and integrated way on the kind of support needed to help disabled people into work and to support them when they are there?
My Lords, I have some difficulty in framing this answer because the debate was very wide but the regulations we are discussing are actually extremely narrow. What we are actually discussing is bringing the treatment of patients in hospital into line between those who receive Motability and those who stop receiving it after a certain period. There was an exemption for the Motability element and we are just bringing the two into line. I acknowledge that there has been a very wide debate on the whole area but we are talking about something that is actually much narrower. I hope noble Lords will understand as I try to juggle the two. I will try to deal with some of the wider issues but I will deal with the actual issue first.
I will set a little bit of context by saying that even in these hard economic times this Government continue to spend around £50 billion a year on disabled people and services to enable those who face the greatest barriers to participate fully in society. That figure compares well internationally. We spend almost double the OECD average as a percentage of GDP—2.4% against the OECD average of 1.3%. Only two out of the 34 OECD countries spend more. Through the reforms of DLA and the introduction of PIP, we will make sure that the billions we spend provide more targeted support to those who need it most. Three million people will continue to get DLA or PIP and half a million will actually get more under the new system.
While I am on figures, to answer the question from the noble Lord, Lord Alton, about the money flow to Motability, £1.6 billion went through to it in terms of transfer of benefit. My noble friend Lady Thomas asked what happens to the transfer. Clearly we recognise that some people will lose out but we have sought to ensure that those who lose out are those whose disabilities have the least impact on their participation in society. On our sampling of this, many people—more than half a million—will be winners under PIP.
The UK has a proud history in furthering the rights of disabled people and we want to ensure that all people are treated fairly. The provisions under debate, which also apply to claimants of PIP, are a case in hand. They ensure that everyone receiving the mobility component of DLA or PIP in the future will be subject to the same payment rules, whether or not they have a Motability vehicle. The history of this was that when the mobility component of DLA stopped being paid to hospital in-patients in 1996, transitional provisions were built in, including a measure which allowed for payments to continue in order to cover the costs of the lease on a Motability vehicle. These arrangements represented a reasonable adjustment at the time for those in-patients who were committed to a mobility contract when the rules changed. However, noble Lords must understand that any lease held by someone in 1996 will have now long expired and these arrangements are past their sell-by date for the users affected at the time.
In response to the question from the noble and learned Lord, Lord Hardie, about consultation, we clearly signalled our intention to implement this change in our consultation on the detailed design of our reforms to DLA. In that consultation we made clear that this change was not intended to penalise Motability users but to introduce fairness between how we treat those who chose to take out a lease with Motability—some 600,000 people—and the vast, or substantial, majority who do not, which is 1.1 million people.
We received some support for our proposals. Unsurprisingly, some concerns were expressed as well. There were requests from some of the respondents to the consultation that the mobility component of both DLA and PIP should be paid continuously for all recipients while in hospital. I am sure that noble Lords would agree that to continue paying a benefit intended to meet the additional costs of disability indefinitely when they are already being met by the NHS would be a waste of financial resource, regardless of the financial climate. Adult in-patients will continue to receive their DLA for 28 days, which compares with an OECD estimate of the average hospital stay of between seven and eight days, and benefit payments will continue for 84 days for children.
The consultation told us that we needed to strike a better balance between attaining equal treatment for all DLA recipients in hospital in the future while recognising the particular concerns of those who currently have a Motability vehicle. In particular, concerns were expressed about existing Motability users who could not have planned for these new arrangements at the time they took out their lease. We have therefore introduced transitional protection for those people who had a Motability vehicle and were in hospital when the new rules came in. This will allow customers who were in hospital on 8 April to run out their current lease. However, in contrast to the previous provisions, we have set a backstop so that the protection will end after three years. I think noble Lords will agree that this is an extremely generous transitional protection period.
Therefore, the provisions apply only to people newly entering hospital and remaining there in excess of 28 days if an adult or 84 days if a child. I appreciate that where a Motability vehicle is recovered, this may have an impact on the user’s family—a concern that was also raised by some people in the consultation. However, I stress that a Motability vehicle is meant to be for the use of the disabled person, not to meet any mobility or transport requirements for family members or visitors to hospital. To quote from the Motability scheme’s own terms and conditions:
“The car is used by, or for the benefit of, the disabled person”.
Motability provides additional clarity in the terms and conditions:
“This does not mean that the disabled person needs to be in the car for every journey. In practice, this means other named drivers in the household can use the car for shopping and other routine activities, as long as the disabled customer will benefit”.
I leave noble Lords to decide whether the use of a vehicle by others when someone is in hospital is of a sufficiently direct and immediate benefit to the disabled person. In our view it is not, there being insufficient material benefit to the disabled person, particularly in meeting their own limitations in mobilising, as exemplified by the examples Motability uses.
I also understand that some users are concerned about when Motability would recover their vehicle and whether they would lose money as a result. I assure noble Lords that we have worked closely with Motability on this issue. It has confirmed that where payment of the mobility component stops, it will allow a further protection period of up to 28 days in which to recover the vehicle. Motability has also said that when a vehicle is returned any advance payment outstanding will be returned on a pro rata basis. Once these protections end, Motability will discuss with scheme users the return of the vehicle and, on a case by case basis, whether it may be more appropriate to defer the return of the vehicle. Clearly, if someone is expected to be discharged shortly or the vehicle is heavily adapted, that will be fully considered in any discussions. However, let me be clear: that will be an independent decision by Motability.
I will give noble Lords some figures around the scale of the issue—the numbers that the noble and learned Lord, Lord Hardie, requested. We estimate that there were around 1,500 in-patients with Motability vehicles when the new rules came in on 8 April. As I mentioned earlier, these people will be allowed to run their lease down, but will be subject to a backstop of three years’ protection. In the future, we estimate that there may be around 800 new in-patients a year who have a Motability vehicle, remain in hospital beyond 28 days or 84 days and will be subject to the new rules. These people will benefit from up to an additional 56 days a year of vehicle use and in all cases the return of the vehicle will be subject to one-on-one discussions with Motability, which may include retaining the vehicle for an additional period.
I will now try to pick up some of the broader points that were raised on the general position and the introduction of PIP. As I have mentioned, clearly some Motability customers will not receive the enhanced rate of the Motability component of PIP once DLA reassessment begins later this year, and will lose their vehicle. We cannot reliably estimate at this stage how many people will be impacted as decisions on whether somebody takes a Motability lease are claimant-led rather than led by an assessment of their need. We are, however, working closely with Motability on that, and we will aim to get a bit of a better—
The Minister knows what the figures were in the past; why can he not project them forward? I am relying on memory now, of debates we had 18 months ago, but am I not right in thinking that he told us at the time that something like 29% of those in receipt of higher rate mobility turned it into a Motability vehicle. If that figure is correct, which I believe it to be, then he can surely extrapolate that to the numbers of gross losers coming down from high rate DLA mobility, which I understand, again relying on memory, was 600,000. Therefore, 29% of 600,000 brings me to my 180,000 figure. What is wrong with that figure?
The reason that it is wrong is that we do not know that the Motability figure lines up at that same percentage into the mobility. That is the reason. As a rule of thumb, it is one way of going, but we actually do not know whether or not the kind of people who will maintain their higher rate mobility will be the ones with Motability. That is the issue.
One of the questions that the noble Baroness was particularly concerned about in this area was the heavily adapted cars, and I think she described it as the foolishness of moving a heavily adapted car back. I emphasise that only 2% of Motability cars are heavily adapted, so this is a much smaller problem; most are just standard cars.
I was a patron—or something or other—of Motability, and that is certainly not my experience. They may be standard cars but they have been adapted to make them comfortable. Even people who drove ordinary cars beforehand transferred to a Motability car in order to get the adaptations and so on which made it comfortable as well as possible for them to drive. Obviously I am in no position to argue with his 2% figure, but I suspect from my own experience that another 20%, 30% or 40% will be using a Motability car which, to some extent or other, has been personalised or tailored for their use.
My Lords, I do not think we have time to debate what heavily adapted comprises. However, the figure for cars heavily adapted for a disabled person is 2%. Clearly, we all personalise cars to some extent. I can let the noble Baroness have some more information on that to the extent that I have it, but that is the figure that I have. I confirm that the noble Lord, Lord Sterling, is looking carefully at how Motability can help to mitigate the impact for those who may be affected by the move to PIP.
Before the Minister leaves that point, will he tell us a little bit more about what he is doing to create joint transitional arrangements, if that is what they are to be, with Motability, and when they will published? When will opportunities occur for people to be consulted and to respond to the consultation?
My Lords, we are working with Motability currently on what the arrangements might be. I have no information at this stage on where we are with those discussions between the department and Motability, but clearly we are in discussions. I am not informed as to when I can update the House on that matter.
On the judicial review, as noble Lords have seen, there is a consultation on the 20 metre/50 metre issue. I can assure my noble friend Lady Thomas that this is a genuine consultation which we are entering with an open mind and we will be looking to hear the views of individuals and organisations. Once that consultation is closed, we will publish our response, including how we intend to act.
The noble Lord, Lord Alton, referred to changes to Atos’s supply chain since the tendering stage of the PIP. I assure noble Lords that the department’s decision to award the contract was not based on the mention of any particular organisation in the bids to deliver the PIP. It is usual for there to be changes between contract award and delivery. Indeed, we expect Atos’s use of supply chain sites to rise and fall in line with referral numbers. The department made a change to the reassessment timetable after Atos submitted its tender, which means that there will be significantly fewer assessments in 2013-14 than it had originally planned. However, it is important to note that Atos has kept the department informed about changes and we are confident that Atos and its partners are able to deliver successfully.
The noble Lord asked about the £391 million that the Government are said to have given Atos over three years. I do not have that information to hand but I will write to him on that matter.
I am grateful to the noble Lord. He will recall that I also asked him specifically whether the 60 minutes’ travelling distance which Atos had said would be the maximum that people would have to travel to an assessment centre will be maintained or whether it will now be extended to 90 minutes, as has been alleged. Will the total number of assessment centres be reduced from the number I cited earlier to just a handful?
I remind noble Lords that Atos tendered for four of the contract areas and received two, so it is not surprising that the 22 sites it was looking at have been reduced, given that it has a smaller number of contract areas. My information is that the 22 figure has gone down to 14. I will add to my letter any information I have on travel times estimates.
In summary, this issue is about balance and fairness—fairness to those who have a Motability vehicle and to the substantial majority of mobility component recipients who do not. However, this is fairness tempered with appropriate mechanisms to ensure that the impact on existing and future users of the scheme is minimised. Specific transitional arrangements are in place for those directly impacted when the measure was introduced and there will remain appropriate and generous provisions in the future. I commend the hospital in-patient arrangements to the House and trust that they have reassured the noble Lord, Lord Alton, and that as a consequence he will not press the Motion.
My Lords, as always, I am grateful to the Minister for the way in which he answered the questions that were put to him, although I think he would be the first to agree that a number of questions raised during the debate remain unanswered. However, he will also understand that, although the measures may be narrow, parliamentarians have to take their chances. If they can find a hook on which to hang their coat, they are obliged to do so. That is surely part of our role as scrutineers. Your Lordships will be glad to know that I do not intend to drag this out although there is no time limit. Even though this is a dinner hour debate, we could have gone on for much longer. I think those taking part in the following debate will recognise that we have been pretty disciplined in the way that we have gone about this.
The issues that we have covered range from the disproportionalilty in the way that these changes will affect rural areas and poorer areas and concerns about the statistics that have still not been shared with us. We do not know the number of people who will be impacted by these changes and the cost of the vehicles, which was a point made by the noble Baroness, Lady Wilkins. Will it cost between £8,000 and £12,000 for someone to purchase one of these vehicles—a vehicle that had been made available to them previously by an Act of Parliament? It was an Act of Parliament that laid down the criteria under which people qualified. Surely we are guilty of behaving without due concern for the effect of the changes that we have put in place.
I repeat what I said in our deliberations earlier this year. It is our duty to understand the impact of the decisions we make. The Minister has just said that we cannot reliably estimate the impact; we do not know. That is not a good position for us to be in. Decisions will affect the mobility and independence of people with disabilities. The noble Baroness, Lady Hollis, put it very well when she said that you turn a person from being independent to being dependent when you take such decisions.
Just as we found a way of encouraging the Minister to come to the House this evening, I know that I and other Members of your Lordships’ House will look for other ways of holding the Government to account to ensure that we mitigate the worst effects of these changes. On the basis of the reply that has now been given, I beg leave to withdraw the Motion.
Motion withdrawn.