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Improving Lives: Green Paper

Volume 776: debated on Monday 31 October 2016


My Lords, with the leave of the House, I will now repeat a Statement made by my right honourable friend the Secretary of State for Work and Pensions in another place.

“This Government are determined to build a country that works for everyone. That means an economy that serves the interests of ordinary working people. It means a society where everyone has an opportunity to go as far as their talents can take them, regardless of their background. As part of that, it means creating a country where a disability does not dictate the path a person is able to take in life.

Under successive Governments, we have made good progress in improving the lives of disabled people. Laws have been changed, old attitudes have been challenged and understanding has improved. More disabled people are in work; 500,000 more than just three years ago. That is encouraging but we need to build on that progress and do more to help disabled people reach their full potential.

It is clear that for many disabled people the barriers to entering work are still too high, and that people in work who get ill too often fall out of work, lose contact, lose confidence and do not return to work. The impact extends far beyond the individual. Families suffer, the health service faces extra strain and employers lose valuable skills. Most of all, it is a human tragedy. Potential is left unfulfilled and lives are lessened. Of course, the health and welfare systems must support those who will never be able to work, too. They should offer the opportunity of work for all those who can, provide help for those who could and care for those who cannot. It is the help for those who could that, through this Green Paper, we will transform.

First, on the welfare system, in 2010 we inherited a broken system with few incentives to move from welfare to work. Too many of our fellow citizens were simply taken off the books and forgotten about. Since then, we have brought control and the right values back to the system. I want to recognise my right honourable friend, the Member for Chingford and Woodford Green, for his passion and conviction over the last six years to make that a reality. We have ensured that work always pays, through reforms such as universal credit, while ensuring a strong safety net for those who cannot work. Spending on disabled people will be higher every year of this Parliament than in 2010, but we need to continue to review and reform the system based on what we know works.

One of those areas is the level of personalised and tailored support someone gets when they fall out of work. In the last 12 months, half of all people who attended a work capability assessment were deemed too ill to work, or even prepare for work, at that time. They then routinely receive no employment support at all. It is not surprising then that each month only 1% of people eligible for employment and support allowance after an assessment leave. This benefit was meant to help people back into work; the statistics show that it is not living up to that original aim.

We will build on the success of universal credit and provide more personalised employment support by consulting on further reform of the work capability assessment. We will also introduce a new personal support package for disabled people, providing better-tailored support, including a new “health and work conversation” between someone on ESA and their work coach, focusing on what they can do, rather than what they cannot. We will recruit around 200 community partners into jobcentres, to bring in expertise from the voluntary sector, and we will give young people with limited capability for work the opportunity to get valuable work experience with employers. These are practical steps and support that the welfare system will provide for disabled people.

Turning to the health sector, this Green Paper marks a new era in joint working between the welfare and health systems, between the Department for Work and Pensions and the Department of Health. This is about recognising that work and meaningful activity can promote good health, so we will work with Health Education England, Public Health England and others to make the benefits of work an ingrained part of the training and health workforce approach. We will also review statutory sick pay and GP fit notes to support workers back into their jobs faster and for longer. It is also about transforming the way services join up. We will be consulting on how best to do this, as well as boosting existing joint services. For example, we are more than doubling the number of employment advisers placed in talking therapies services. It is right that we focus on services such as these, as mental health conditions, together with musculoskeletal conditions, are behind many people falling out of work.

However, this is not a challenge for government alone, so, finally, I want to turn to the role of employers. Employers have so much potential power to bring about change, not just in their recruitment strategies, but in how they support their employees. We need all businesses—small or large, local, national or global—to use that power to deliver change. The fact is that as well as being good for health, it makes good business sense: sick pay for workers who get ill costs business £9 billion a year.

Businesses are leaders in innovation and transformation. We need to harness that positive power of business to promote disability awareness, so we will create a Disability Confident business leaders’ group to increase employer engagement in looking after the health and well-being of their employees and opening up opportunities to them. Now is the moment for every business to take a proper look at the relationship between work and health and what it means for their business and productivity.

Over the coming months, we will be talking with disabled people and those who have health conditions. We will be talking to carers, families, professionals, and a range of organisations that are so important to getting this right, and which, like us, want to see further change. Together, through this Green Paper and building on our work since 2010, we intend to deliver just that: to improve the way the welfare system responds to real people with health conditions; to see employers step up and play their part; to see work as a health outcome; and to see a culture of high ambition and high expectations for the disabled people of this country”.

My Lords, that concludes the Statement.

My Lords, I start by thanking the Minister for repeating the Statement, although it is a Statement that is, frankly, thinner than we would have hoped.

We support the ambition to halve the disability employment gap, the clear pathway to its attainment, and the proposition that we have debated on endless occasions that there should be work for those who can, support for those who could and care for those who cannot. That has characterised labour market approaches from several Governments over recent times. I found on my shelf a booklet entitled Improving Health and Work: Changing Lives, from 2008, at about the time the Minister was an adviser to the then Labour Government. We have a shared ambition and recognition of those issues. The challenge is to convert the intent into policy and the policy into action that can be delivered. That needs resourcing. I do not think the Minister said much about the cost of his proposals; it would be good if he could give us an indication.

There was a suggestion that too many people were taken off the books, as I think was the expression, in 2010, but that does not give proper credit to the work undertaken at that time. There was a gradual realisation of the importance of the Waddell and Burton thesis, which characterised much of the work of the Labour Government, the coalition Government and this Government.

So far as the welfare measures are concerned, we have not seen the detail, but we can see the innate merit of a personalised support package for disabled people. As for community partners, can we know the basis on which they are likely to be allocated across jobcentres? I think the figure was 200 of them; I guess they would be spread fairly thinly across those centres. The Minister said there is to be a consultation on further reforms to the WCA. Can we hear a little more about the thrust of this consultation and what it will entail?

So far as health is concerned, we had a revolution announced—a new era: there will be some joint working between the Department of Health and the DWP. Of course, that is to be welcomed. The idea of ingraining the concepts of work and health in training is something that again we can see the merits of and would support. We certainly would need to understand the basis of any review of SSP and the fit note, which has had a patchy existence since it was changed from the sick note, but the underlying concept that it should focus on what can be done, rather than on what cannot, is right and something we would support.

The Minister asserted that universal credit always makes work pay. Would he care to write to us on that proposition with the evidence, taking account of the work of the Resolution Foundation and its recent pronouncements on it, and the cuts to the work allowance? Universal credit started life with a very clear ambition to do exactly what the Minister said. Successive cuts to the programme have certainly impaired that ambition and that outcome. We should be clear on the basis of the Government’s assertion that work will always pay.

Finally, the Disability Confident business leaders’ group seems a worthwhile development. We need to understand how it would be funded and the extent to which individuals would engage.

We see in the Statement a good deal of consultation, further work and quite proper engagement with a range of people, particularly disabled people themselves and their carers, but that is a long way from having a clear, funded policy to make a real difference to the lives of the people we are talking about today.

My Lords, I, too, thank the Minister for repeating the Statement. We on these Benches are pleased to finally see this Green Paper. It has been delayed time and again and many of us were wondering whether it would ever see the light of day.

Reducing the disability employment gap is a worthy aim. There are many people with disabilities whose skills and talents are not utilised. Working with employers to ensure that they recognise the benefits to their businesses of employing disabled people is vital for both the health and well-being of those disabled people who are able to work, and for our economy as a whole.

The move to reform the work capability assessment is an overdue step in the right direction. However, at its heart the structure of the WCA remains fatally flawed. This is in part because of a failure to assess what types of jobs may be available to claimants, and whether they can find such jobs within their skill set and in their local area. I therefore ask the Minister whether, in reforming the system, he will look to create a process that assesses not just whether a claimant is fit to look for a job but whether the jobs available are fit for the claimant.

I also impress upon the Minister the importance of conducting a fundamental overhaul of the system. Tweaking at the edges is unhelpful. Sick and disabled people have little confidence in the WCA, rendering it unworkable. This is particularly important given the incredible mental pressure that the lack of trust in the system puts on claimants, many of whom already suffer from mental ill health. I suggest the Minister seeks to restore confidence as a priority.

On the Government’s plans for helping those disabled people who can work back into work, we welcome the creation of a business leaders group. However, will the Minister look at rewarding the best practice of businesses that are good employers of people with disabilities? For example, Liberal Democrats have proposed that those employers who meet a strengthened version of the two-tick system for mindful employers of employees with mental health conditions are able speedily to access funding, such as Access to Work. It is important that those employers who have a good track record are given a facilitated route to employing more people who may need additional support.

Finally, will the Minister explain why a proper analysis of the failings of personal independence payments is not included in the Green Paper? This has affected people’s ability to lead independent working lives. Will the Government look again at the demands of many in this House, not least my noble friend Lady Thomas of Winchester, on the 50-metre rule and its inappropriateness in assessing mobility? The impact of disability varies greatly between rural and urban areas, and PIP as a supposedly personalised benefit should assess these barriers.

All in all, the Green Paper is welcome, but until the Government address these myriad other problems we will still fall well short of providing the support that people with disabilities should be able to expect.

I thank both noble Lords for their very thoughtful contributions and for their general welcome, with maybe a little complaint in one case about thinness. I take the point.

Both noble Lords made the point, in different ways, about the level of engagement going on now with this Green Paper. We make no apology for that. We need a process that fully brings on board the disabled groups, so that they have full impact. We want to take the time necessary to do that properly. The noble Baroness, Lady Bakewell, looked at the health and work relationship; it is confined to the area that it is because the process is not about PIP at this stage. There will be other times to look at PIP but it is not part of this consultation.

As the noble Lord, Lord McKenzie, pointed out, fundamental here is the Waddell and Burton report of September 2006. It was very valuable for me when I was writing my first piece of work on what to do with the benefits system. It turned on its head the traditional relationship between the benefits system and work when it said that work, particularly good work, is good for people. It is not one of the problems; it is one of the solutions. It has been really hard to move and change a system that is designed to protect people from work, which made sense when there was heavy industry. It now changes at every level.

We all feel that this is taking a long time, but there is a good reason for it. We are transforming a system that put people in a silo of disability and did not let them back into work. Transforming that requires universal credit as a fundamental base where you do not just have those different groupings; you have everyone able to do what they want, with their pay adjusted accordingly. That is the answer to the noble Lord, Lord McKenzie, about universal credit: it makes work pay.

If you make a comparison between what somebody who had been in the system would have got and what universal credit does, you come up with different figures. Once you are in the universal credit system, the reality is that you are incentivised to work. That will have a behavioural effect, which we are already seeing in the way that universal credit operates. It helps and encourages people to work more. While we do not yet have many numbers of those who are disabled in the system, there are some and they are going in. Within universal credit we will build evidence as to how best for them to do so. As noble Lords appreciate, we are building the universal credit system very carefully with a “test and learn”, and it is still one of the areas about which to learn a lot.

This is a new era, of joint working. I said it, as did the noble Lord, Lord McKenzie. It is joint working not just between the two departments, which is pretty tough, but also with employers. Getting all that to work well is one of the reasons why we are taking time over our consultation. Clearly we are looking at building on the three types. We now have three tiers of employers in the new two-tick system that was relaunched in July, with the top tier being the leaders. In response to the question from the noble Baroness, Lady Bakewell, about whether there will be the demonstration employer—and we all know individual employers who really have put huge effort into supporting people—I can say that we are setting that up with tiers where the leaders will support others.

On the question from the noble Lord, Lord McKenzie, on statutory sick pay and the fit note, that is clearly at the heart of getting the relationship between health and work and the employment system in the DWP to work better. That is why consultation in this area is so important. One of the most important things is to get the health system seeing employment as one of the therapeutic outcomes for which it is looking. We have already taken that step, and it takes us a long way. I cannot at this stage tell the noble Lord what the allocation of the community partners will be, but we will work on that.

With that, I think that I have dealt with the first level of questions and would enjoy some more.

I too thank the Minister for repeating the Statement and would like to add my word of welcome for this Green Paper. The objective of halving the disability employment gap is commendable, and a lot of work and thinking have been going on in the department about how to achieve it. I commend the Minister and the department on that, and I look forward to studying the product of that activity in the Green Paper more carefully than I have had the opportunity to do so far.

Can I just make a plea for the Minister to revisit the reduction that was made to employment and support allowance going to those in the WRAG in the most recent session of Parliament? As the Minister knows, we had long discussions about this and there would be widespread agreement, even if the Minister did not share it, that although those asking the Government to revisit that cut lost the vote, they won the argument on this one. If the Government do not revisit this cut with a view to cancelling or at least ameliorating it, they will find that they have shot themselves in the foot and prevented themselves even getting to first base in the matter of halving the disability employment gap.

This cut to employment support allowance will hinder people’s ability to look for work by undermining their ability to pay for well-being activities that help recovery and enable them to consider paid work; will make people more worried and stressed, thus impacting their mental health; will have an impact on work-related activity such as travel to appointments or volunteering opportunities; and will make it harder to attend training courses and work-focused interviews if people are already struggling to meet basic needs. That is a substantial argument, which was developed in detail by the charities that produced the report on the impact of the cut to ESA. The case was well made and the deleterious impact of the cut was demonstrated beyond any doubt. Again, I ask the Minister to revisit this if he wants to attain his objectives.

I very much regret having to say that we are not in a position to look again at that measure. The WRAG was not doing what it was designed to do. What we are now looking at in the Green Paper is how to separate the financial aspects of the benefit from the support that people require.

It is clear that many people who happen to have a disability have immense talents and valuable skills, which employers should want to tap; they will miss out if they do not. We already offer some support—for instance, Access to Work—and we are increasing that spending. The consultation will ask employers what they need from government to help them recruit and train disabled people.

My Lords, it would be unfair to use the old joke, “This is déjà vu all over again”, because this is a welcome initiative. I have just two quick points to make. The Minister knows a great deal about this. Perhaps he will accept that trashing the past rather than learning from it is not helpful. This is not an entirely new era. In 2005, as he well knows, the Department of Health and the Department for Work and Pensions jointly appointed Professor Carol Black. All the things that came out in the report he has mentioned flowed from that initiative. While it takes a great deal of time to implement good policy, as we are all painfully aware, there has been a great deal of it; for instance, the Employers Network for Equality & Inclusion has 2,500 employers already engaged. A new business leaders’ group is not required. What is required is to build on what is there, to build on the experience of the pathways and the talking therapies, and to ensure that what we all say—and we do all say it—about joined-up policy is put into practice.

My right honourable friend in the other place, the Secretary of State, took some pleasure in quoting James Purnell from 2008 about the objectives here, illustrating that they are the same. We must acknowledge the continuity there has been in this difficult area and, in particular, give thanks to Dame Carol Black, who I have worked with now for many years and who has done an extraordinary job in trying to get these two networks together. We are building on many years of work but, like everyone else, I acknowledge that it is hard pounding—it takes a long time to get this right.

My Lords, I welcome the Statement and I completely understand that PIP is not part of this Green Paper, but the Minister’s department will have to work hard to restore people’s faith in the DWP’s consultation process because it comprehensively ignored the PIP mobility consultation, when more than 1,000 people said that we should not have what was subsequently put into law. I hope the Minister will agree to listen to the voices in the consultation process before there is legislation in this area.

I know that the noble Baroness has very strong feelings about this. At her urging, I did make significant changes to the mobility measure. We did not have a clean measure before. We now have a precise measure with the 20 metres but we have it on the basis defined—safely, securely and regularly—which is something that she wanted, and have made it a much more measurable part of the PIP process. More people are receiving the top rate of PIP than receiving it were under DLA.

I have great respect for what my noble friend is trying to do, particularly in getting people with autism into work. Will he bear in mind a couple of things? First, we have seen many schemes over a long time that are badged as work prep, with all sorts of names attached to them to get people ready for work. They are important but where they have failed in the past is in going that step further and finding the appropriate job and getting a person into that job. That applies particularly to those people on the autistic spectrum with learning disabilities or chronic mental health problems. When my noble friend is engaging with employers, I ask him to make sure that it is not just the prep they think about but the advice people with those conditions need for interviews and on how to adjust in the workplace.

Secondly, I filled in a work capability assessment form on behalf of a relative. It is not always doctors who can interpret how a particular medical condition affects somebody’s everyday life or how it will affect them in the workplace. Very often physiotherapists, social workers or support workers are better placed than the local GP to know just how an individual is impacted and how they need to be supported in a much wider range of ways than just giving a diagnosis and saying, “This is how it affects them”.

The noble Baroness is right. One of the areas of greatest concern is people who have learning difficulties and people with autism. The figures are not good. There are more than 1 million people with learning disabilities and only 6% have work. I think we are going to see a report on autism this evening showing that only 16% of people with autism are in work. Clearly, in this period of consultation we need a particular focus on people in this group to help them into the workplace.

My Lords, how is the Minister going to see that the various departments work together and not in silos so that disabled people get the help they need? For instance, there are some brilliant people in the spinal injury field but they may need help to get up in the morning and go out to work.

That is exactly the kind of focus that pulling the two systems together should start to address. As the noble Baroness says, if somebody needs a bit of help at a regular time every day to get to work, just putting that little bit of resource in is transformative for that person. That is something that the system has never really been able to do until now and one of the things that we can start to look at as we bring work and health together.

My Lords, I very much welcome the Green Paper, which is definitely the right direction for us to go in, as is having wide consultation. Has my noble friend the Minister thought about new technologies to support people with disabilities, both in the home and in the workplace as well, as part of the consultation and working with employers?

Yes, some of the technologies that one sees are remarkable. The noble Lord, Lord Low, who is not in his place at the moment, demonstrates that for the blind every time he stands up—I cannot imagine how he can do it—as did one of the members of my private office, who was also blind. There are amazing technologies to help support in that case; I know that it is also true elsewhere. We want to adopt and take on new technologies. One of the interesting and heartening things with Access to Work, where we have been a little concerned about the take-up, is that we have just introduced a digital offer there and we are encouraged by the response to it. There will be other areas where we can get a lot of benefit from going with new technologies.

My Lords, as we have heard, this Green Paper is to be recommended. It will obviously need some broad support to get it through. Can my noble friend tell us what he is doing to garner broad support for these changes?

We have deliberately designed this Green Paper to ask for responses from a lot of key areas. Noble Lords may remember that when we started off on this process, it was by looking down a direct White Paper route. We have pulled back and gone for the Green Paper route, with a lot of areas for consulting. We plan to hear from and work with disabled people and people with long-term health conditions. We want to hear from employers, health and care professionals, the voluntary and community sectors and the devolved Administrations. We really want to build a consensus on what we can do and get the widest support that we possibly can for any changes.

My Lords, can I ask the Minister not to forget education, because the transition for young people from schools into work at 18 is really important? If they start working from 18, it is much more likely that they will remain in work during their lives.

The noble Baroness is absolutely right that these transitions need to be managed carefully. It is clearly not a health issue for the majority, but it is for some. Just getting into the habit of living independently is tough for youngsters. We are looking at how we can help them. However, it will be separate from this Green Paper exercise.

My Lords, thinking of young people with learning disabilities, how easy will it be under the new arrangements for them to move from one council or area of the country to another? Does the Minister agree that this has been considerably restricted over recent years, and something that they perhaps deserve under the new arrangements?

Youngsters are able to go to other areas to work. I think that the noble Lord must be referring to the restriction on 18 to 21 year-olds getting housing benefit. One of the exclusions that we have been debating with people—we announced that we would look at that strategy—was to make sure that those youngsters who move between areas for work could be exempt from that particular restriction.

My Lords, I have just come from next door, where there has been a gathering on autism. I have two interests. One is through Motability; the other is because I have a young grandson who is right at the bottom end of autism, so this is very personal. One very key factor on autism is that 60% of people said that they did not know where to go for support or advice about employing an autistic person. I see people nervous of how they should support and handle people whom they have never quite understood. Also, if I may, another factor that we have found over the years—I have had the pleasure of discussing this with noble Baronesses opposite—is that this can also deal with loneliness. If you are disabled and at home, and do not have a job, you might be left on your own for hours or days. I very much greet this Green Paper because it is the start of the right dialogue. How can one achieve on the former factor and make certain that we can help to educate workforces, before somebody comes to them, as to how to handle what they would consider a problem and we would consider a challenge?

One of the problems with autism is, clearly, that many—too many—of those people are not in the workforce. That essentially acts to exclude them from the normal economic life of the country, which in itself leads to isolation. If we want to get the volumes that we are talking about and halve the disability gap, we need some concrete policies to come out of this Green Paper and address this issue. We now have dialogue between the health systems, the DWP and employers. It should not be beyond our capability as a society to solve this problem.

My Lords, I welcome this Green Paper not just for myself but for my daughter, Sarah. My daughter has worked for many years since she left college but has been out of work for the last four months. The majority of disabled people really want to work. It is demoralising and lonely not to be working for any length of time. They do not want to be on benefits; they want to be, like all the rest of us, self-sufficient and a member of their society.

I particularly welcome two things in the Green Paper. Having listened to other noble Lords, I suggest that disability is just a word but it means a huge and wide range of issues that people in our communities have. Tailored support is therefore very important because you cannot lump everybody into the same type of support. There should be specific support—I am sorry that the noble Lord, Lord Blunkett, is not here—but that is not in here at the moment, so I urge the Minister to make sure that, while we go through the whole process with the Green Paper and White Paper et cetera, what should be delivered now is being delivered. That is really important; my daughter does not want to wait for a Bill to go through.

It is particularly important that we talk to employers earlier rather than later. When employers have disabled people working for them—when they go over that barrier—they find it a very positive experience for their businesses and for the rest of their employees, but they need a little help to understand and to be able to manage. Sarah has been for numerous jobs and every time, as soon as they know she is in a wheelchair, they do not come back to her. That is a nonsense. It only needs a little help to understand that a wheelchair is not a barrier to somebody working in a business. I urge the Minister not to stop with what is being offered now but to get on with this, because it is extremely important, not only for disabled people but for the economy as a whole.

I thank my noble friend. We will get on with it. We have the Access to Work Programme to help her daughter, Sarah. I hope she will find work. We are putting more resource into the programme right now. I can only hope that Sarah is successful, and I trust that my noble friend will keep me up to date with her progress.