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Work Capability Assessment Consultation

Volume 832: debated on Tuesday 5 September 2023


My Lords, with the leave of the House, I will repeat a Statement given in the other place by my right honourable friend the Secretary of State for Work and Pensions. The Statement is as follows:

“With permission, I would like to make a Statement on our proposed changes to the work capability assessment, which aim to ensure that no one who can work is permanently written out of this country’s strong labour market story. It is a story that has seen nearly 4 million more people in work compared to 2010; 2 million more disabled people in work than in 2013; and record numbers of people on payrolls. But, although it is the case that the number of people overall who are economically inactive has fallen strongly from its pandemic peak, there remain over 2.5 million people who are inactive because of long-term sickness and disability.

Yet we know that one in five people on incapacity benefits who are currently not expected to prepare for work want to work in the future, if the right job and support were available, and the proportion of people going through a work capability assessment who are being given the highest level of award and deemed to have no work-related requirements at all has risen from 21% in 2011 to 65% last year. This situation is excluding significant numbers of people from receiving employment support to help them to move closer to work opportunities. It is holding back the labour market and economy but, perhaps most important of all, it is holding back human potential. I want to ensure that everyone who can benefits from all the opportunities that work brings—not just the financial security but all the physical and mental health benefits too.

No one who can work should be left behind. That is why, earlier this year, we announced an extra £2 billion-worth of investment to help disabled people and those with health conditions move into work. That includes bringing in our new universal support employment programme, which will assist disabled people and those with health conditions to connect with vacancies, and will provide support and training to help them start and stay in a role. Through our individual placement and support in the primary care programme, we are investing £58 million to help more than 25,000 people to start and stay in work. We are modernising mental health services in England, providing wellness and clinical apps, piloting cutting-edge digital therapies and digitising the NHS talking therapies programme. We have also published fundamental reforms to the health and disability benefits system through our health and disability White Paper. That will see the end of the work capability assessment and a new personalised, tailored approach to employment support to help everyone reach their full potential.

The scale of our reforms means that they will take time to implement, but there are changes we can make more quickly that will also make a difference. So before the White Paper reforms come in, I want to make sure that the work capability assessment—the way in which we assess how someone’s health limits their ability to work and therefore what support they need—is delivering the right outcomes and supporting those most in need. Today my department is launching a consultation on measures to ensure that those who can work are given the right support and opportunities to move off benefits and towards the jobs market.

As I have said, we know that many people who are on out-of-work benefits due to a health condition want to work and, assisted by modern working practices, they could do so while managing their condition effectively. We have seen a huge shift in the world of work in the last few years—a huge change that has accelerated since the pandemic. This has opened up more opportunities for disabled people and those with health conditions to start, stay in and succeed in work.

The rise in flexible and home working has brought new opportunities for disabled people to manage their conditions in a more familiar and accessible environment. More widely, there have been improvements in the approach that many employers take to workplace accessibility and reasonable adjustments for staff. A better understanding of mental health conditions and neuro- diversity has helped employers to identify opportunities to adapt job roles and the way disabled people and people with health conditions work.

The consultation that I am publishing today is about updating the work capability assessment so that the way it works keeps up with the way people work. The activities and descriptors within the work capability assessment, which help to decide whether people have any work preparation requirements to improve their chances of gaining work, have not been comprehensively reviewed since 2011. It is right that we look afresh at how we can update them, given the huge changes we have seen in the world of work. For instance, the work capability assessment does not reflect how someone with a disability or health condition might be able to work from home—yet we know many disabled people do just that.

Our plans include taking account of the fact that people with mobility problems, or who suffer anxiety within the workplace, have better access to employment opportunities due to the rise in flexible and home working. We are consulting on whether changes should be made to four of the activities and descriptors that determine whether someone can work, or prepare to work, to reflect changes in working practices and better employment support. This includes looking at changing, removing or reducing the points for descriptors relating to mobilising, continence, social engagement and getting about. We are not consulting on changes to the remaining descriptors, which will remain unaltered. These changes will not affect people who are nearing the end of life or receiving cancer treatment, nor will they affect the majority of activities for those with severe disablement—for example, if a person has severe learning disabilities or is unable to transfer from one seat to another.

We are also consulting on changes to the provision for claimants who would otherwise be capable of work preparation activity but are excluded from work preparation requirements on the basis of substantial risk, most commonly on mental health grounds. The original intention for substantial risk was for it to be advised only in exceptional circumstances. It was intended to provide a safety net for the most vulnerable. However, the application of risk has gone beyond the original intent. We are therefore consulting on how we might change how substantial risk applies, so that people are able to access the support they need to move closer to work and a more fulfilling life. We are also considering the tailored and appropriate support that will be needed for this group, safely helping them move closer to work.

These proposals will help people move into, or closer to, the labour market, and to fulfil their potential. We are consulting over the next eight weeks to seek the views of disabled people, employers, charities and others about our proposed changes. If the proposals were taken forward following consultation, the earliest we could implement any change would be from 2025, given the need to make changes to regulations and ensure appropriate training for health assessors.

These plans are part of our wider approach to ensuring that we have a welfare system that encourages and supports people into work, while providing a vital safety net for those who need it most—a welfare system that focuses on what people can do, not on what they cannot, and that reflects the modern changes to the world of work. It is time to share the opportunities of work far more fairly. It is time for work to be truly available to all those who can benefit from it. It is time to get Britain working. I commend this Statement to the House.”

My Lords, I thank the Minister for repeating the Statement and for advance sight of it. The way we support sick and disabled people in this country is of huge importance, both to the millions directly affected and their families and to our country as a whole, and it says something about who we are as a nation. Labour believes passionately that everyone who can should be able to access a decent job, with all the financial and other benefits that brings. That is why we have been so concerned at the Government’s failure to address the disability employment gap over such a long time. Nobody should be shut out of the workplace when, with the right help and support, they could be working.

We are now in a position where an astonishing 2.6 million people are out of work as a result of long- term sickness—the highest number ever, and up almost half a million since the pandemic. This is a serious problem for individuals and a challenge for our country. The Government have been warned for many years now that benefit assessments are not fit for purpose and, crucially, that unless we have a proper plan to support sick and disabled people, even more people will end up stuck out of work when they do not need or want to be.

So what can be done? Our approach has been to set out some serious plans in this area: to transform back-to-work help by personalising employment support and tackling the huge backlogs in our NHS and social care; by offering an “into work guarantee” so that people can try work without worrying about losing their benefits—something that has had widespread support both from the voluntary sector and within Parliament; to make sure that employment support meets local needs by devolving appropriately to local areas; and to make sure that, when disabled people get a job, they get the support they need when they need it, not several months down the line.

By contrast, this consultation is rather small in scope. The Statement seems to suggest that the Government have decided that the main problem is that too many people who undergo a work capability assessment are classed in the higher rate, and therefore the only way to solve that is to change the criteria. We will look at the outcome of this consultation carefully but let me ask a few questions of the Minister now.

Is the sole intention of this exercise to reduce the number of people who are classed as having limited capability for work and work-related activity? If so, by how many? Is there a target? The Statement says that the current situation

“is excluding significant numbers of people from receiving employment support”.

Will the Minister tell the House whether DWP could choose to offer employment support now to people who are deemed LCWRA?

If in future more of these millions of people were classed as simply having limited capability for work, rather than in the higher area, would that make any other difference to them, as opposed to just getting employment support? Might it affect how much money they were given to live on while they were waiting to get a job? Can the Minister tell us how these proposals will address the total inadequacy of decision-making, which causes untold stress and wastes millions of pounds?

The Minister pointed out that the Government have longer-term plans. The Health and Disability White Paper outlined plans to abolish the work capability assessment altogether and replace it with a single assessment, which will be the PIP—the personal independence payment assessment. I do not want to be mean, but PIP is hardly a model of good practice: 80% of PIP decisions get overturned at tribunal, and only 2% are down to new evidence. In any case, these plans are way in the future, beyond this Parliament. If the proposals contained in this consultation will not come in until 2025, when will we possibly see the plans that will not even be considered until after the next election? Will the Minister give us some idea of when, if his Government were returned to power—I accept that it is an “if”—they would expect to see those plans come to fruition?

We need a big plan now to help sick and disabled people who want to get back to work—after all, the backlog for Access to Work payments has trebled to 25,000 since the pandemic. Where are the proposals to bring that down? Where is the plan to slash the waiting lists for those who are struggling with anxiety and depression, which is keeping them out of the workplace? Where are the plans to give help to carers to support their sick and disabled loved ones so they can get back to work?

I understand what the Minister is trying to do, but the truth is that this is tinkering around the edges of a system which is failing sick and disabled people. It is not providing the help they need and, in the meantime, our NHS and social care, on which sick and disabled people depend more than anyone, is being run into the ground. We need more than this and we need it soon.

My Lords, what a mixed message there is in this Statement. The first page of the Statement that the Minister so kindly read says how successful the Government have been in getting people back to work and in the next part it tells us how we need to get more people into work. If ever a message was mixed, that is it. It is not a good story, and the fact that it needs consultation shows that. With all this so-called success, the Statement says that the policies are, in its words, “holding back human potential” so let us have the old idea of consultation.

Flexible and home working usually require that the employee has adequate access to space and technology to safely work. This is even more the case for someone with a disability. Will the Minister say whether the Government will also commit to extra funding for the aids, adaptions and technology required to take up work- from-home opportunities?

The Minister, in rereading the Statement, is suggesting removing descriptors. Will the Government also review additional descriptors, which can impact on someone’s ability to work? At the moment, fatigue is not a descriptor. However, we know that this is a significant symptom for people with long Covid, MS and pain conditions. Sitting at a desk—we know all about sitting on the Benches here in the Lords—for long periods, even for people who do not need to leave their house, may be no less fatiguing. Will the Minister consult to make sure a safety net is kept in place?

I am concerned about the consultation on substantial risk. We know that, for many people, engagement with the DWP can create anxiety and worsen their mental health. In doing his review, will the Minister take the opportunity to get his own house in order and make employment support a positive experience and not one that has, sadly, seen so many people come to harm and even take their own lives?

Finally, in the real world, when somebody comes before someone at the Department for Work and Pensions, how consistent will the DWP be in treating them in the way they should be treated? I am worried about the balance between helping people into work and forcing people—and I do mean forcing—to give up on support for those least fortunate in society.

I begin by thanking the noble Lord, Lord Palmer, and the noble Baroness, Lady Sherlock, for their points. The way I read it is that the consultation has broadly been accepted, but I understand that a number of questions have been raised and I will do my best to answer them.

First, there is some agreement that it is very important to support disabled people and to give them every opportunity, if they are not in work, to find a way of getting into it or to prepare for it. Hopefully, there is agreement to that extent. The noble Baroness, Lady Sherlock, is absolutely right that no one should be shut out of the workplace. We are at the forefront in wanting to do more to ensure that disabled people who want to and can work are able to do so. However, some disabled people may not be able to work; we are a compassionate country and it is important to make the point that, where they are generally unable to work, the state should step in and support them, as it does at the moment.

I take issue with what the noble Baroness said about the intention and scope. We believe that it is an important measure to look at the conditionalities during this eight-week consultation, because it is important to move quickly. It is part of a whole package of measures that the Government have taken and continue to take for the disabled, which includes, as the House will be aware, the national disability strategy and the disability action plan. I will expand on that to try to be helpful. By the way, the sole intention is not to do with figures —there is no target; it is not to do with that at all; it is to look more closely at who in the disabled diaspora might be willing to work and how they can be encouraged and helped into work or preparing for work.

To pick up a point from the noble Lord, Lord Palmer, as he will know, the consultation is inviting comments on the four descriptors: mobilising, continence, getting about and coping with social engagement. As the House will know, people are referred for a WCA when they report a health condition or disability which may prevent or limit their ability to work or undertake work preparation activities. Currently, the activities do not take account of somebody’s ability to work from home, as the Statement said. We have identified some activities as the most likely to be affected by modern changes in the workplace, including working from home and better support and understanding from employers around how to overcome barriers to work for disabled people and people with health conditions. To that extent, we are moving more quickly and offering this targeted approach as part of the consultation.

On our broader support, I remind the noble Baroness that we announced £2 billion at the Spring Budget 2023 to support disabled people and people with health conditions into work, including through WorkWell and universal support. We also increased our support offer to help people move back into work when they can with additional work coach time.

I will set out some figures for the House. Roughly 700,000 new benefit claimants go through a work capability assessment each year and we are seeing around 450,000 determined as having limited capability for work-related activity. Hopefully, that gives some scope of the population we are working within. Clearly, if we helped just 10% of that cohort, around 45,000 more people per year would be placed in a group in which they would receive the necessary help to get into employment.

I do not think the Minister answered some of the questions I asked—maybe he omitted to do so. I asked about the timing and whether a shift away from the higher rate to the lower rate would have any implications for the amount of money somebody got, for example. Did he miss those questions?

This is unusual procedure. On the timing, I made it clear in the Statement that we will work through this consultation and receive the results. In terms of the results coming through, I mentioned 2025. I will certainly look at the other questions the noble Baroness raised and write to her, although I think there were probably just one or two.

My Lords, I apologise for not being here for the start of the Statement. In all my time in the department, now being carried on by my noble friend the Minister, there was real ambition to help those people in the work capability assessment—earlier rather than later, because the longer you leave it, the worse the condition gets.

This weekend, I was trying to tidy up my study, which is a massive job, when I came across an independent evaluation of a programme we ran at Tomorrow’s People when I was there—I declare an interest, although I am not there any more. We had a programme in a doctor’s surgery called “The Right Prescription: A Job”. When somebody was physically or mentally unwell and came to the doctor, if there was nothing he could do for them, he called them his “heartsink patients” because his heart sank when they walked in the room. He wrote “a job” with us on the prescription pad.

We had a consulting room and, initially, we worked with a cohort of 200 people. The results were pretty astounding. We ended up with 880 surgeries across the country wanting us, representing millions of patients. The Government at the time—I will not declare which—said that it was too expensive, but for an investment of £2,000 you got a return to society of £10,000. We reduced the anti-depressant prescription bill by 34% for those 200, saved the doctor 20% of his time, saved referrals to counsellors and got people into work. On average, 80% of them were there 12 months later, although it was intense.

We must look at the consultation as an opportunity for people to put forward ideas that make life better for people. If the department will have me in for 10 minutes, I will certainly come back and share that evaluation to see whether it can help, because people with mental health issues in particular need all the help we can give them.

I take this opportunity to encourage all those who are interested to give input to the consultation. To pick up on my noble friend’s point about GPs, a key principle is that the WCA considers what impact the person’s disability or health condition has on them, not the condition itself. To clarify, the department does not ask claimants’ doctors to make decisions about their patients’ capability for work. This is because the doctor diagnoses and treats a patient’s illness, whereas the WCA healthcare professional’s role is to assess the effects of the claimant’s illness on their ability to perform everyday work-related activity. It is important to make that distinction.

My Lords, my question is informed by a study published this May by a group called INvolve, which spoke to 500 UK employed adults with invisible disabilities, including visual impairment and chronic pain. Two-fifths said they were not getting the support they needed at work, particularly as businesses cut back under the current economic challenges; two-thirds said it was up to them to sort out their own support, as they were not getting help from their employer; one-quarter said they had a workload that they simply could not manage; and one- fifth said they were considering leaving their job as a result of their difficulties. The kinds of things these sick and disabled workers were seeking were flexible working hours, training for other employees to understand their situation and assistive technologies and tools.

This government action is focused entirely on people suffering from sickness and disabilities, but they are going out into a workplace where there is clearly significant discrimination. The Statement makes a lot of the move towards working from home, but quite a number of businesses have been heading in the opposite direction, trying to force staff now working from home to come back into the office. Do the Government plan measures of a similar scale to those in this Statement to crack down on discrimination in the workplace and to ensure that employers offer conditions in which the people this Statement refers to can work?

The noble Baroness makes a very good point, which allows me to emphasise the dependence on employers. The noble Baroness will know that we have reached out considerably to employers to encourage them, and we continue to encourage them to take on those who are disabled. ONS data from September 2022 to January 2023 shows that 44% of working adults work from home exclusively or at least some of the time each week. If that is translated into those who are disabled working for employers, that is quite encouraging. We encourage everyone to input into the consultation.

The noble Baroness may know that recent published data suggests that disabled people are more likely to work in the health, retail or education sectors. As of July 2023, these three industries have a combined total of 350,000 vacancies. There is a tremendous opportunity there, and we need to work through that.