Emergency debate (Standing Order No. 24)
I beg to move,
That this House has considered changes to Personal Independence Payment Regulations.
Thank you, Mr Speaker, for granting this vital debate on the new personal independence payment regulations. Although I welcome the opportunity to debate this issue, it is highly regrettable that the Government have had to be dragged to the House to be held to account for this nasty piece of secondary legislation.
As the House will know, the Government have ignored two urgent questions on this matter, an early-day motion signed by 179 Members calling for these punitive regulations to be annulled, and a 38 Degrees petition, signed by more than 185,000 people, asking them not to make the changes. When pushed at business questions on Thursday, the Leader of the House said there would be a debate, but could not say when. Only late last night did it become clear that the debate has now been hastily scheduled for 19 April. What particular kind of arrogance or disregard for democracy are the Government revealing? This does not bode well for their accountability to this place in the future negotiations.
For the record, we should note that today’s debate does not allow for a substantive vote on the regulations. As the Government have failed to allow a debate before the EDM praying-against period comes to an end on 3 April, the regulations will not be automatically revoked, should the House vote against them on 19 April. I would be grateful to the Minister for Disabled People, Health and Work if she explained why, given that we have risen early twice this week, the Government have been incapable of finding time for such a debate before the Easter recess. The Government are hoping that because they have delayed the debate, the objection to the regulations will be kicked into the long grass, but it will not be.
On behalf of many of my constituents, I thank my hon. Friend for securing this debate. Does she agree that the very least we owe to people who find themselves, through no fault of their own, in the most difficult of circumstances is to tell them whether we have voted for decisions made in Parliament that are having an appalling impact on their incomes?
My hon. Friend makes an excellent point. That is what we have been trying to do since the emergency regulations were laid before Parliament.
Let us remind ourselves how the emergency regulations were introduced and what they have changed. The regulations, which were laid before the House on 23 February and came into force two weeks ago, amended the legislation under which disabled people or people with a chronic condition are assessed for eligibility for personal independence payments. The new regulations followed two upper tribunal rulings. The first judgment on 28 November 2016 held that needing support to take medication and monitor a health condition should be scored in the same way as needing support to manage therapy, such as dialysis, undertaken at home. The second, also on 28 November, ruled that people who find it difficult to leave their house because of severe psychological distress should receive the enhanced rate of support under the mobility component of PIP.
In a letter to me last week, the Secretary of State for Work and Pensions said that he became aware of the rulings on 8 December. Two and a half months later, the Government laid their emergency legislation before Parliament. I am sure that the irony of something taking two and a half months in an “emergency” has not been lost on you, Mr Speaker. During those two and a half months, not only were the Government unable to bring the regulations before the House, but they also bypassed their own Social Security Advisory Committee. They have ignored SSAC’s recommendations on wider engagement, testing or piloting changes, and the analysis of impacts.
I note what the hon. Lady says about legal cases, but is not the point that those legal cases broadened the provisions, and that the regulations will simply restore the policy to what it has been and should be, which is one of targeting support at those who need it most?
I will come on to that in a moment, because I think Members have unfortunately been hoodwinked, and I will absolutely expose what the Government have said.
This move undermines and subverts not just our democracy, but independent tribunal judgments. It is unprecedented, and we should be concerned about future actions that the Government may take in relation to court cases that they lose. It is also highly unusual for such a fundamental change to be introduced by a statutory instrument under the negative procedure, bypassing debate and scrutiny in this House.
It is clear to me, from the huge number of cases that I have dealt with, that the entire PIP system is fundamentally flawed. It results in the most appalling decisions and causes distress to thousands of disabled people and their families. Does my hon. Friend agree that there should be an independent review of how PIP assessments are carried out, given the obvious failings in the system?
My hon. Friend is absolutely right. There are long-term issues with the PIP assessment process as a whole. I will address that later. It is interesting that the Government let out yesterday that they will make an announcement, following a recent review, tomorrow, just as we rise for recess.
On Monday, the other place debated and passed a regret motion tabled by my noble Friend Baroness Sherlock, asking the Government to reconsider the regulations urgently, but the elected House of Commons has been denied that opportunity during the vital praying-against period. As I have said, that is very worrying behaviour by the Government.
The Minister for Disabled People, Health and Work claims that the changes restore PIP to its original policy intentions, but that does not hold water. During the PIP consultation in 2012, Ministers were quoted on numerous occasions saying that mental health conditions would be given parity with physical health conditions as part of the PIP assessment. For example, Esther McVey said that the PIP
“assessment is being designed to consider…physical, sensory, mental, intellectual and cognitive impairments.”—[Official Report, 26 November 2012; Vol. 554, c. 147W.]
The Samaritans produced a report earlier this year that points to a significant association between socioeconomic disadvantage and suicidal behaviour. The report cites Gunnell and Chang, who wrote:
“Those who are already vulnerable, such as individuals who are supported by social welfare or who have preexisting mental health problems are at greatest risk.”Is not it shocking that the Government have not looked at the risk of suicide among those who will be denied financial support for their mental health needs?
I totally agree with my hon. Friend. My hon. Friend the Member for Bishop Auckland (Helen Goodman) has given a very moving account of how one of her constituents was affected and, unfortunately, took their own life last week.
Does my hon. Friend agree that the Government seem to be in a place where the NHS is catching up with the need to treat mental health conditions properly, but other public services, whether they be the Department for Work and Pensions or the Prison Service, are simply stuck in the past, and that this must change?
My hon. Friend is absolutely right. The situation makes an absolute mockery of the claim that there is parity of esteem. She rightly mentions what the NHS is trying to do, but sadly there are still issues with treatment for mental health conditions.
I will make some progress, and then I will come back to the hon. Gentleman.
The Government’s response to the PIP consultation reiterated that psychological distress would be included in the PIP assessment, as did the Government’s argument in the 2015 upper tribunal case of HL v. the Secretary of State for Work and Pensions. Ministers have also said that people with mental health disorders who suffer psychological distress would not lose out on PIP. However, the new guidelines for PIP assessors, issued on 16 March, state:
“Descriptors c, d and f under new mobility activity 1 are amended”,
“effects of psychological distress are not relevant”.
The assessment cannot take into account the psychological distress that someone experiences. They cannot score the 12 points needed to get the enhanced PIP mobility rate, so instead of £57 a week, they will be able to get only £22 a week.
In recent months, I have had 44 PIP cases in my constituency, with dozens going to appeal. Eight have already gone to appeal, and in every single one of those cases, the decision has been overturned. Does my hon. Friend agree that that is a massive and inexcusable waste of time, money and resources?
Absolutely. It is very important to note the association between ill health and disability in former industrial areas, and as my hon. Friend rightly says, the impact of assessments that cannot be done right first time. Why is that? Why have the Government not been able to get assessments right first time?
Will the hon. Lady give way?
If the hon. Gentleman will give me just two minutes, I will make a little bit more progress and come back to him.
Someone who experiences psychological distress because of a mental health condition can score a maximum of 10 points under “planning and following a journey”, unless they also have a cognitive, sensory or physical impairment. That falls short of the 12 points needed to qualify for the higher rate of the mobility component. In the 2016 case of MH v. the Secretary of State for Work and Pensions, the upper tribunal ruled that psychological distress by itself cannot satisfy descriptors under activity two unless the psychological distress causes a change in someone’s physical condition. It is therefore the regulations, not the tribunal rulings, that undermine the intention of the primary legislation by restricting the number of people whose mobility is severely limited by their mental health condition who are able to qualify for the enhanced mobility rate of PIP.
I thank the hon. Lady for giving way. It is very important that we get the regulations right, but does the shadow Minister accept that more people with mental health conditions qualify for support under PIP than under the old disability living allowance regulations?
No, I certainly do not agree with that at all. I will come on to this in a moment, but the mental health charity Mind has produced data, based on the Government’s own statistics, that show that 55% of DLA claimants with a mental health condition will receive either nothing or a reduced amount when they transfer to PIP. I am afraid this is another fallacy from the Government.
The hon. Lady might have suggested that Government Members are being hoodwinked, but I am sure that she was not suggesting that the Minister plays with anything other than a straight bat. The fact is that over a quarter of those on PIP receive the highest level of support, which is much more than the 15% of DLA working-age claimants who did so. Are the regulations not doing exactly what was originally intended: targeting resources at those who need them most?
I am sorry, but I do not see the hon. Gentleman’s logic. [Interruption.] Well, it does not make sense. I will come on to that in a bit more detail, because we must dispel the fallacies that the Government have come out with in the past few weeks.
Will my hon. Friend give way?
Order. Before the hon. Gentleman intervenes, I point out that there are 10 other Members who wish to make speeches in the debate, including the Minister who will wind up. The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) is being very generous, not only with her own time, but with time that would otherwise be available to others. I know she will want to tailor her contribution accordingly.
I advise my hon. Friend not to put much credence in planted Whips’ questions from Tory Back Benchers. Another element of concern relates to people whose mental health condition worsens when they have a failed assessment. In some cases, they end up going into hospital, which is another cost for the NHS.
I could not agree more with my hon. Friend. That is such a relevant point, which, again, has not been factored into the Government’s silo approach.
The third justification the Government have used for bringing in the new regulations is that PIP is much more generous to people with mental health conditions—we have just been talking about that. The mental health charity Mind completely refutes that. Its data, based on Department for Work and Pensions statistics, reveal that 55% of people with mental health conditions previously supported by DLA get either reduced or no awards when they transfer to PIP. Indeed, the Government’s own data, when appropriately weighted, show that only 12% of people with a mental health disorder and another condition are on the enhanced mobility award.
These new regulations are nothing more than a shameful cut. Once again, this Government are trying to balance the books on the backs of the sick and disabled. The Government’s own analysis estimates that the new regulations will affect more than 160,000 people by 2023, the majority of whom will have mental health conditions. Many of these will be newer applicants, but the regulations will also affect those who are being reassessed, who will not be eligible for the full support to which they would have been entitled under the rulings of tribunals—an effective cut of £3.7 billion.
PIP helps disabled people to fund their living costs and, in particular, the additional costs that they face because of their condition. The disability charity Scope has estimated that these additional costs amount to approximately £550 a month, and are the key reason why disabled people are twice as likely to live in poverty as non-disabled people. For someone who might not be able to leave their home on their own, PIP would help with extra heating costs, or might pay for someone to assist them when they have to travel to medical appointments, for example. PIP is a vital source of income to prevent real hardship, yet to the shame of this Government, people are being denied this support.
Will my hon. Friend give way?
Yes, but for the last time.
Does my hon. Friend agree that the ability to receive PIP funding can often be part of someone’s rehabilitation, helping them from their homes back into the workplace?
Absolutely, and I know that my hon. Friend has first-hand experience of that in a professional capacity.
I have been contacted by so many people telling me their stories of living with a severe mental health problem and how it affects them, including men and women from the armed and emergency services, so I would like to share Bob’s story. Bob started off in the police service in Liverpool, and then went into the Prison Service. After 20 years or so, he said he started to experience the need to escape from the cells and inmates by locking himself in the rest room for a few minutes. Over the years, this graduated to cluster headaches and then full-blown anxiety and panic attacks.
After a period of sick leave, Bob left the service, but the attacks continued and he eventually sought psychiatric treatment; he was then declared disabled by virtue of his debilitating anxiety attacks. The degree of disability fluctuated, but it was so severe at times that he would literally run from a shopping centre into his car, just to feel safe. Bob said that he wanted to work, but when he went for a job interview, he had an attack in the car, and by the time he got home, he could barely function at all: he was hyperventilating and completely unable to move. It is people such as Bob who will be denied support through these new regulations.
These changes to PIP have come on top of significant cuts to our social security system, with support for disabled people being particularly targeted. Scope has estimated that the Welfare Reform Act 2012 alone will have meant nearly £30 billion in cuts to support for 3.7 million disabled people. Next week, as we have heard, another £30 a week will be cut from disabled people who are found not fit for work in the employment and support allowance work-related activity group, and for those on universal credit’s limited capability for work component.
The disabled community are tired of this Government’s rhetoric; they want and need to be treated with dignity, not plunged further into poverty, yet plenty of new evidence shows that that is exactly what has happened since 2010. Will the Minister publish a cumulative impact assessment of all tax and social security changes, showing the impacts that they have had, and will continue to have, on disabled people?
For some time now, there has been growing concern about the way in which PIP is working. Wider systemic issues with PIP mean that 65% of those who appeal to a tribunal succeed. Over a quarter of all PIP assessments are challenged and referred for mandatory reconsideration, with the majority of the decisions being changed. Why can we not get these assessments right first time? More than 750 people a week are losing their Motability cars because of changes to entitlement when they move on to PIP. This is so counterproductive, because it makes it nigh-on impossible for so many disabled people to work, let alone live independently.
We should never forget that nine out of 10 disabilities are acquired; this could happen to any one of us. That is what our social security system is for—to provide support to any one of us in our time of need. Labour will stand with disabled people, who have already borne the brunt of seven years of austerity, in fighting this injustice. I do not believe that, given the choice, the British public would chose cuts in corporation tax over preventing disabled people from being pushed into destitution or worse.
It is exactly a week since the horrendous attack in Westminster, when four people, including our colleague PC Keith Palmer, were murdered, and 50 were injured. The following day, the Prime Minister rightly said that she was looking
“at what further support can be made available for victims in a wider sense, because there will be people who were not physically injured in the attack…but…for whom there may be other scars. It is important to provide that support.”—[Official Report, 23 March 2017; Vol. 623, c. 942.]
However, because of the new regulations, support for people suffering psychological distress is being restricted. Warm words need to be backed up by action. Let there be no more cuts in support for disabled people. Enough is enough.
Order. May I very politely suggest to the House that, although we will not at this stage have a formal time limit on Back-Bench speeches, if each Back-Bench contributor feels able to confine himself or herself to five or six minutes or thereabouts, everyone will get in? We will start with the sage from Swindon: Mr Justin Tomlinson.
It is a pleasure to speak in this debate. Having spent 14 very happy months as the Minister responsible for these matters, I want to pass on some of the observations that I made during that time.
Let me make it absolutely clear that stakeholders and charities recognise that PIP is a better benefit than DLA. It is not perfect—much more work is still to be done to deliver further improvements—but the statistics show why it is better. Under DLA, only 16.5% of all claimants access the highest rate of benefit; under PIP, the figure is over 25%. PIP is better, in particular, at identifying those with hidden impairments, including mental health conditions. Under DLA, only 22% of claimants with mental health conditions access the higher rate of benefit, whereas the figure is about 66% under PIP. Improvements under this benefit mean that the Government have spent an additional £3 billion a year—about 6% of such spending—supporting those with long-term health conditions and disabilities.
In all the debates about this matter that I have attended, people have understandably said that a 65% success rate on appeal must mean that the quality of the assessments is not good enough. We must establish what is going wrong. Most successful appeals succeed because of additional evidence that has been submitted late, and that is one of the things that we need to improve.
If the system is so good, why do people need to come and see us? In my office, we have almost a 100% success rate when it comes to securing what people are entitled to without any intervention from any of us.
When a claimant comes to speak to any of us, as their Member of Parliament, presumably we talk to them about the respects in which they feel the decision was not right. When claimants receive a letter that says that they will not receive the benefit for which they were hoping, that letter spells out why that is, which normally triggers an assumption by claimants that their particular challenge has not been considered. A claimant will then submit additional late evidence, the claim will be looked at again and a different decision may be reached, but that does not mean that the original decision was wrong on the basis of the facts that were originally presented.
I am keen to find a way in which assessors can automatically access claimants’ medical records, with their consent. Many people have to fill in a 50-page form in which they must specify their challenges, and they sometimes under-egg those challenges.
I know that the hon. Gentleman has been a Work and Pensions Minister, but he is just wrong. In my experience of constituency cases, the assessors do not consider some of the evidence, even when people take it along with them. When I have intervened and asked why that is, the cases have been overturned. I am sorry, but the system is not working.
I am not wrong. I said that the vast majority of successful appeals were due to the late submission of additional evidence. That is a fact.
I will give way once more, but I am conscious of the time.
People in my constituency are taking deckchairs to their citizens advice bureau at 5 or 6 in the morning in order to queue outside. Is not that yet another addition to their stress and the pressure they face, and should it not be made clearer that people can have the assessments that they need?
I am trying to explain what we can do to help to improve the situation, because there are cases in which there are mistakes—1.5 million people are going through the PIP process. However, we know that the PIP process is far better than that for DLA because we are spending £3 billion more, and because of the success rate in getting those with the biggest challenges on to the highest rate of benefit—the proof is in the pudding.
This debate has arisen because a legal judgment has suggested that there are certain areas in which additional money should be spent. As I argued when we considered this during proceedings on an urgent question, if we are to spend money to make further improvements, that needs to be done in a co-ordinated manner, not an ad-hoc way.
Let me set out how this would work. We have lots of impressive charities with great policy teams, and they lobby on the basis of the experiences of their users. Individual MPs also raise concerns and suggestions for improvement through debates in the Chamber and Westminster Hall, and by tabling parliamentary questions, and the policy teams then work through them. There have already been significant changes, such as the much-needed and very welcome changes for terminally ill claimants, and the fact that waiting times rightly improved after a very difficult start when PIP was first rolled out. Rightly, this transfer of 1.5 million people from DLA to PIP is now being done at a speed that will not compromise waiting times as people go through the process. If this takes longer, it takes longer, and that means that we do not make the mistakes of the initial roll-out. The quality of the assessments is also improving month on month. There are still lots more areas in which issues will arise, but I spent a lot of time meeting charities, particularly smaller ones representing people with less common conditions. They would then spend time helping to train the assessors and rewriting the manual so that those conditions would be picked up in the assessment, so learning from such experiences forms part of the process.
The timings of when people should come back for reassessment have been looked at for the first time. Under the old DLA system, 70% of claimants were on a lifetime award. The problem with that was that one in three claimants’ conditions would change significantly within 12 months, meaning that they should have been on a different benefit. The vast majority of those claimants’ conditions were getting worse, not better, so they would have been entitled to a higher rate of benefit, but many people simply did not phone up and ask to present themselves for reassessment, so they missed out on the benefits they should have received.
Under the PIP assessment, if someone has entered on a lower rate of benefit and the assessor can see that their condition is likely to get worse, meaning that they will need to access a higher rate of benefit, an estimate is automatically made of when that might happen, which triggers a reassessment. That process means that those who are most in need will get money in the best possible time.
I do not always agree with the Government on welfare, but I do believe that the assessments have been improving. My concern is that the situation surrounding the 50-page application form, with which people are struggling, is not improving. People’s access to assessments—they can be put in taxis for up to an hour—is also a growing problem.
My hon. Friend was one of the greatest advocates of change, and I had many constructive and challenging meetings with him as he brought forward suggestions. The point is that we have to look at this in a co-ordinated manner. Further improvements can be made to the initial application form and the way in which some of the descriptors are applied. The Government are also considering allowing assessments to be recorded automatically so that they can then be used in an appeal. That would benefit both the assessors and the claimants, who have been asking for this.
I broadly agree with what I am hearing—PIP is a work in progress and the process needs to get better—and I could give 100 stories of my experience of sitting through the PIP process to show where it is going wrong.
I agree that gradual change is a great thing, but the courts have given us a loud and clear message that we have got it wrong on mental health. In this age where we are desperately trying to change society’s views of mental health and parity of esteem, we have to listen to the courts—they have given us a judgment for a reason.
I understand that point, and there might well need to be further improvements in that particular area, but they have to be made in a co-ordinated manner, not an ad hoc way. PIP is not about a condition; it is about the challenges that individuals face in their everyday lives.
I will not give way because other people wish to speak.
If additional money is to be spent, it should go into the court system to speed up the appeals process, which would be helpful. There is a particular problem for those who could lose their Motability car before their appeal is heard. As I said, there should also be automatic access to medical records, which should be shared between ESA and PIP assessments when possible. Those assessments are often similar, so that would make the claimant’s life a lot easier.
We need to do more to signpost additional help. The Government are spending £11.4 billion more to support people with mental health conditions. The biggest challenge is often identifying people with such conditions so that they can be given support, but PIP is good at identifying them. We should be offering them additional support and saying, “If you would like them, these are the sorts of services that are available in this local area that you can take advantage of.”
I urge the Minister to continue to improve the situation and to work with the policy teams. I spoke to people from Macmillan yesterday, and they are grateful that they are able to continue to access senior Ministers to discuss suggestions. We have some brilliant stakeholders and really knowledgeable charities and policy teams. Let them help to shape where these further improvements will happen.
It is a relief that we are having this debate on the Floor of the House, and I thank you for granting it, Mr Speaker, following the application of the hon. Member for Oldham East and Saddleworth (Debbie Abrahams). It is a shame that the House has had to drag a Minister to the Dispatch Box so that the Government can be held to account on this matter after weeks of their refusing to debate it. As we have heard, 179 Members from eight different parties signed an early-day motion to annul the statutory instrument that implements the changes. The truth is that the Government have been shying away from accountability for the regulations from the start. They initially refused to comply with the upper tribunal ruling by bringing forward these changes in the first place, and then they did not even have the decency, nor the courtesy, to refer a draft of the regulations to their own Social Security Advisory Committee. If the Government are so confident that the regulations will hold up to any kind of scrutiny, why have they avoided due process by trying to sneak the changes in through the back door?
My party and other Opposition colleagues will not allow the Government to take these unfair backwards steps. Sense estimates that the changes will affect 150,000 people. Those people will lose out on PIP, which supports the extra cost of living with a disability, while the Government save £3.7 billion. That smacks of hypocrisy, given that the “Work, health and disability” Green Paper said that the Government would not seek to make any further cuts to the social security budget. Is that the real reason why they did not want the regulations to be scrutinised?
Given the Government’s attitude to PIP and the assessments, it seems fitting that they will sneak out the second independent review of personal independence payments tomorrow—the day the House rises for Easter recess. What are they so scared of that they have scheduled the release of the report so that they can face no immediate scrutiny? During the passage of the Welfare Reform Act 2012, which established the new personal independence payment system, Ministers were clear that PIP was an important step to achieve the parity of esteem between physical and mental health that we want. Ministers even talked about the descriptors for the mobility component taking into account someone’s ability to plan and follow a journey. They said that PIP was designed to assess the barriers that individuals face, not to make judgments based on the type of impairment. Personal independence payments are supposed to support people with the additional costs of disability.
We have heard about the court ruling that the regulations seek to undermine. The court ruled that people who find it hard to leave the house because of anxiety, panic attacks and other mental health problems should be able to receive the higher rate of PIP.
These changes run the risk of again increasing the stigma of mental health, because they say to people with anxiety that causes them to stay inside that that is not really serious. Is that not completely in conflict with the principle of equal treatment for mental and physical health?
I completely agree with the right hon. Gentleman. We should not be treating one disability differently from another.
I have said this before, but it bears repeating that the Government cannot simply move the goalposts every time they lose a battle in court. The regulations do nothing more than pander to the old stigmas and attitudes towards mental illness. If a person needs help, he or she needs that help regardless of the nature of their disability or health condition.
In evidence to the Lords Secondary Legislation Scrutiny Committee, Disability Agenda Scotland, an alliance of Scotland’s major disability organisations, raised a number of concerns. It said:
“We disagree with the Government’s presentation of the change that this will not be a ‘cut’ for people currently receiving PIP, as it is a clear diversion from the stated aims of the legislation back in 2012 (to award the enhanced mobility component ‘if a person’s mobility is severely limited by their physical or mental condition’).”
Essentially, the Government are intent on trying to spin their way out of this outrageous, stigmatising move against those with severe mental health conditions. Disability Agenda Scotland also fears:
“Current recipients may also lose out in future despite no change to their condition, if they are reassessed under the new criteria.”
It will come as no shock that the DWP’s own evaluation of the changes shows that the Government have no idea of their long-term impact—no idea! They simply do not care and are happy to push forward a move that makes a clear distinction between people with different conditions, against the ruling of the Court.
There are clearly concerns about assessment processes for personal independence payment, and the Scottish Association for Mental Health’s report on PIP, “What’s the Problem?”, sets out those concerns. One of the main themes running through its research is a distrust of the process. One person said:
“People advise you not to shave, and turn up dishevelled—to show that mentally they are unwell! Just because you’re articulate doesn’t mean you don’t have a mental health problem.”
There is simply no consistency in the assessment process, yet the Government keep shifting the sands in a piecemeal way, which only exacerbates the problem and the impact on the lives of those who are simply trying to claim what they are entitled to.
The Government have form on pulling the safety net from under those who are desperately or life-threateningly ill. Such is the impact of sanctions on those with mental health conditions that many become destitute and dependent on food banks. The Government do not strike me as keen to ensure parity of esteem for those with mental health conditions; they seem intent on doing everything they can to make people dependent on support, rather than empowering people to live independent lives. We know that, in practice, “parity of esteem” means nothing to the Government, who have instructed private companies carrying out assessments to award the higher rate of the mobility component only to people with physical, cognitive or sensory impairments.
The Scottish Government, on the other hand, are determined to build a social security system with dignity and fairness at its heart. The process of building that system and taking over responsibility for personal independence payments is ongoing.
The hon. Lady describes the situation in Scotland, but I assure her that seats such as mine are also affected. People might call Ealing Central and Acton metropolitan, elitist or suburban, but we have had 120 such cases recently. She talks about parity of esteem, and people keep pointing out to me that that is another example of how this Government say one thing and do another.
I agree with the hon. Lady. I am sure that most of us in the Chamber will have had constituents queuing at our door with personal independence payment issues.
I hope that lessons can be learned from today’s debate. The Government should stop forcing important legislation through the back door. They should have consulted their own Social Security Advisory Committee, and they should not have had to be dragged to the Dispatch Box for an emergency debate because they simply did not give the House answers.
The Government have not even waited on the second independent review of personal independence payments before manipulating the system. The Minister needs to stop mucking people about, back away from these ill judged and ill thought out changes and call a vote on annulling the regulations. If the Government do not do so, it will show how intent they are on bulldozing through legislation without scrutiny, and in spite of an independent judicial ruling.
The bottom line is that these changes are being implemented to save the Government money, no matter the cost to our communities and those with mental health conditions. This is no way to treat our vulnerable people in society, and I ask the Government to reconsider.
Order. I please ask hon. Members now to stick to five minutes each, otherwise either a Member who wants to speak will not get in, or there will not be time for a proper ministerial response, about which hon. Members would understandably, but too late, be the first to complain.
It is a pleasure to speak in this important debate. I appreciate the concerns set out by the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), but the bigger picture is clear: the Government spend £50 billion a year to support people with disabilities and health conditions, which is an increase of £7 billion since 2010. The Government moved away from DLA to PIP on the basis that support should be given to those experiencing the greatest barriers to living independently. PIP supports people according to their overall level of need—not on the basis of a specific medical condition, but based on how their freedom to live independently is impaired. That is the right approach.
I chair the all-party group on eye health and visual impairment. Yesterday, I led a Westminster Hall debate on preventing avoidable sight loss, but of course in many cases sight loss is unavoidable. How we support those with limited ability to live independently is important. Sight loss affects nearly 2 million people in the UK, and the huge personal challenges and hurdles that people with sight loss have to overcome to live independently can never be underestimated. Through my work with the all-party group, I have seen at first hand the Government’s commitment to helping people dealing with sight loss.
Last year, the then Minister for Employment, my right hon. Friend the Member for Witham (Priti Patel), who is now the International Development Secretary, facilitated a meeting with her team about support to help blind and partially sighted people. We hope my hon. Friend the Minister for Disabled People, Health and Work will meet us soon to discuss how PIP can best support people with sight loss, and I am grateful to her and to Work and Pensions Ministers for their focus on this important issue. I am sure that she will agree that the Royal National Institute of Blind People does commendable work, and I urge people who are blind or partially sighted to contact the RNIB, which has created a toolkit for completing the PIP form effectively—both for the mobility part and the daily living component.
I wish to share with the House the personal experiences of PIP which have been collated by the RNIB and are available on its website.
I am sorry, but there just is not enough time to give way.
Research and evidence was gathered by the Thomas Pocklington Trust, Sense and the RNIB, and the key finding of the study, which reflected real-life experiences of people with sensory loss and visual impairment, is that those participants who transitioned from DLA to PIP received a “positive” financial outcome with PIP. However, I hope the Minister will reflect on the feedback on the process, which some found confusing. Assessors need always to work to deliver a positive experience at face-to-face assessments. Regardless, the evidence from this study, available on the RNIB website, shows that switching from DLA to PIP meant a more positive financial outcome, and that is welcome.
Opposition Members have accused the Government of betraying people with mental health conditions, but we are spending £11.4 billion on mental health this year alone, and more people with mental health conditions are receiving the enhanced PIP daily living and mobility rates than were previously getting the equivalent under the DLA system.
Will the hon. Lady give way?
There just is not enough time for everyone to get in. Some 66% of people getting PIP with a mental health condition get the enhanced daily living amount, which compares with 22% who were receiving the highest rate of DLA.
I will finish by focusing on this Government’s record on helping disabled people into work. Since 2013, the number of disabled people in work has increased by half a million. However, those with sight loss are at the bottom of the table, and I hope we can do more to ensure that they get—
On a point of order, Mr Speaker. The hon. Lady is making a good speech, and she makes some valuable points about PIP, but it has got nothing to do with the regulations we are talking about today.
The Chair has to make a judgment about pertinence and at this stage I am content with my own judgment. If the hon. Gentleman is not, I shall do my best to bear that burden with such stoicism and fortitude as I am able to muster.
We have heard experiences of where PIP is not working, but I wanted to share experiences of where it is working, as it is important to hear them, too. The point I was trying to make is that we have got many more people with disabilities going back into work, but I want to make sure that we campaign hard for those who have sight loss to ensure that they have those opportunities, too. Half a million more people are benefiting from opportunities to secure work. We have half a million more people who can support families and loved ones; half a million more people are supporting themselves, their communities and the economy. I thank the hon. Member for Oldham East and Saddleworth for giving us the opportunity to reflect on that and, no doubt, welcome those figures as well.
I congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on securing this debate and on the important case she made from the Dispatch Box.
I wish to challenge some of the assertions the Secretary of State has made in commenting on the changes in the regulations since they were announced. I have no doubt that his comments were made in good faith, but I think they were incorrect. In particular, the changes do not restore the original intention of the benefit. The Secretary of State suggested that the changes are not a cut, but they obviously are, and they affect a substantial number of people. The equality analysis produced by the Department tells us that of the current case load, 143,000 people would have had their mobility award reduced to zero had it been made under the new regulations, and that a further 21,000 would have had their payment reduced. This is not, therefore, a minor or insignificant cut; it is a substantial cut that will affect a large number of people.
Table 6 in the equality assessment is titled, “Conditions most likely affected by reversing effect of UT”—upper tribunal—“judgment on mobility activity 1”, and the list includes schizophrenia, learning disability, autism, cognitive disorder due to stroke, dementia and post-traumatic stress disorder. According to the Government, those are the people most affected.
My right hon. Friend clearly knows something about the new regulations, and I do, too. The reality is that those with psychological illness cannot now qualify for enhanced mobility payments because activity 11e attracts only a maximum of 10 points. Twelve points are needed to allow mobility payments, so this is clearly a cut and the Government should just fess up.
My hon. Friend is right.
I wish to say a little more about the precise content of the regulations. The Secretary of State told us at the beginning of the process that nobody would have their current benefit cut; I think Ministers now accept that that statement was incorrect. Regulation 2(4) states:
“In the table in Part 3 (mobility activities), in relation to activity 1 (planning and following journeys), in descriptors c, d and f, for ‘Cannot’ substitute ‘For reasons other than psychological distress, cannot’.”
The changes explicitly carve out people who cannot plan and follow a journey because of psychological distress.
The Secretary of State has said not to worry, because people with cognitive impairments can still qualify for the highest rate of the mobility component. That may well be the case, but that is a different group of people. The changes explicitly carve out people whose mobility impairment arises from psychological distress. Was that the original intention? On 7 February 2012, the right hon. Member for Basingstoke (Mrs Miller)—if I remember rightly, she was the predecessor but two of the hon. Member for North Swindon (Justin Tomlinson)—said in a written answer that
“when considering entitlement to both rates of the mobility component we will take into account ability to plan and follow a journey, in addition to physical ability to get around. Importantly, PIP is designed to assess barriers individuals face, not make a judgment based on their impairment type.”—[Official Report, 7 February 2012; Vol. 540, c. 232W.]
That is a clear statement of the original intent of this benefit. If the Secretary of State has been advised that the original intention was something different, he simply needs to check the record.
The changes in the regulations are different from the original intention. They introduce an explicit judgment based on impairment type; the original intention was to have no such distinction. The regulations introduce a distinction that was not in the benefit’s original intention. They say that someone is in if they struggle to plan and follow a journey, but if their problem is because of psychological distress, they are out. It is an explicit judgment, it is explicitly contingent, and it carves out a large group of people with mental health problems.
Does not that carve-out ultimately amount to nothing but discrimination against people suffering mental distress? Also, is it not the case that any references to spend on mental health in any other area are totally irrelevant to this issue? This rule change is about discrimination.
That is absolutely explicit in the regulations. That group is now being discriminated against, which is contrary to the original intention. The Secretary of State talked about restoring the original aim of the policy, but the change does not do that; it is different.
The Secretary of State suggests that it was never the intention to include this group of people with mental health problems, but his predecessors told the House, in terms, that it was the intention to include people irrespective of their impairment type. That was the intention of Ministers in 2012, but these regulations will thwart it. I hope that, like the other place, we will say no to these changes.
It was a privilege to serve on the Work and Pensions Committee with the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) in the last Parliament.
I wish to focus my speech on two particular areas. First, it is not the case that the Government are using the change as a cost-cutting exercise. Secondly, I will address some of the comments made by Opposition Members on mental health and physical conditions in relation to PIP.
We spend £50 billion every year on benefits—up by £7 billion since 2010—to support people with disabilities and health conditions, so, rather than being subjected to austerity cuts, these benefits have seen an increase in Government spending. That figure is 6% of all Government spending, or 2.5% of GDP. It is significantly more than countries such as France and Germany spend, and higher than the OECD average. It is more than we spend on the defence of the realm.
As I have said, this change is not, as some Members have suggested, a cost-cutting exercise. The Government have made it abundantly clear that they will seek no further savings through welfare in this Parliament. I ask my hon. Friend the Minister for Disabled People, Health and Work to reassure the House that she will continue to defend the disability budget.
The changes restore the original aim of the policy by clarifying the assessment criteria to make sure that support is targeted on those who need it the most. Nobody will receive less money than they have previously been awarded. This is not about making savings. PIP was widely consulted and voted on and debated in this House during the coalition Government.
I am sorry, but I really want to make some progress so that other Members can have their say.
More than two thirds of PIP recipients with a mental health condition receive the enhanced daily living component, compared with just 22% who used to receive the higher rate under the disability living allowance. This Government are investing more in mental health support than any other before them. The figure stands at £11.4 billion this year.
Parity between mental and physical conditions is a core principle at the heart of PIP’s design. Awards are dependent on the claimant’s overall level of need, regardless of whether the condition is mental or physical.
As well as increasing spending on disabilities, this Government are challenging attitudes towards disability through initiatives such as Disability Confident. Last year, I, along with many Members of this House, held my first Disability Confident fair, bringing together 20 local businesses and support agencies to hear at first hand the benefits of employing people with disabilities.
The hon. Gentleman says that parity of esteem applies to the way in which PIP works, but the right hon. Member for East Ham (Stephen Timms) has specifically explained how the carve-out of mental distress means that it is clearly discriminatory. Does he not agree with that?
I cannot comment on the specific case to which the right hon. Member for East Ham (Stephen Timms) referred. All I would say is that there is variation from case to case, and we can all give examples. In my experience, these changes to PIP have, overwhelmingly, been better for people with mental illness in my constituency.
I also have a number of local residents concerned about those with mental health issues having access to the higher rate mobility allowance. I think that it has had the unintended consequence—this is where I seek my hon. Friend’s advice—of young people, post-transition, not necessarily being able to still have access to their blue badge or disability or mobility access.
That is for the Minister to answer.
The Disability Confident fair brought together employers in Weaver Vale and those with disabilities and mental health issues and I encourage Members to consider doing something similar. I learned a lot about the challenges facing my constituents and the fair helped to bring employers and those with disabilities together. This Government have done a lot more to ensure that our welfare system is a strong safety net for those who need it. PIP is a more modern, dynamic and fair benefit than its predecessor, DLA, focusing vital support on those in our constituencies who need it the most.
I congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on securing the debate and reaffirm her points about how disappointing it is that the Government did not find time for a debate and a vote on these regulations before they come into force. I would say to the Government that it does not reflect well on this House and on the Government as regards public trust on our proceedings if we do not conduct these debates and votes before such significant regulations come into force.
As others have said, we know that disabled people are twice as likely to live in poverty as non-disabled people. PIP helps to level the financial playing field between disabled and non-disabled people. I represent a constituency with a significant level of poverty where 3,410 people are in receipt of PIP. We have all received representations from a range of third sector organisations about this assessment process and we have all seen, as I have in my constituency, the impact of how the assessment process works.
I want to highlight two organisations I work with. One is the Motor Neurone Disease Association, and I am pleased to be patron of its Merseyside branch. Its analysis shows that over the three years from 2013 to 2016, the proportion of people with MND who saw their award reduced as they moved from DLA to PIP was 13%. This is a condition that by its nature is both progressive and terminal. When I spoke to the MNDA this morning, I was told that the organisation wanted me to raise the quality of assessments in the debate because it believes that the poor quality of assessments has contributed to the issues mentioned today.
On that point, one thing that has struck me when I have been through PIP assessments—either mock assessments or those that I have observed with a constituent—is the generalist nature of the assessors. They are expected to be experts in mental health, physical health and mobility, and it is just not possible, in my view. I think that there needs to be triaging.
That is borne out by the experience in my local office. Disability Benefits Consortium research suggested that 71% of respondents said that assessors had not sought any evidence or information about the specific condition, and I think that that is part of the reason why 65% of those who challenge a decision are successful.
We must always be careful when a Government say that they are targeting somebody or something, as we know that that is a codeword for cuts and a reduction in benefits. My constituents often find it an ordeal because they are going into the unexpected, and they do not know what the outcome will be.
My hon. Friend makes his point very powerfully.
The other condition I wanted to say something about is epilepsy. I am one of the honorary vice-presidents of Epilepsy Action, an organisation that has also been in touch with me today to say that that they fear that these proposals could penalise people with epilepsy who might rely on support or supervision to manage their medication and monitor their health condition. The DWP’s own case study recognises that a person with epilepsy who has a seizure might need a friend or carer to administer medicine, without which they might go into status epilepticus. We know that that can lead to brain damage or to death.
I reaffirm what my hon. Friend the Member for Oldham East and Saddleworth said from the Front Bench. We have an opportunity through this debate to raise concerns on a cross-party basis, but I urge the Government to listen to those concerns. As the hon. Member for South Cambridgeshire (Heidi Allen) said earlier, we have been sent a message by the tribunals about parity between mental and physical health. Let us say clearly that we have listened to that message and urge the Government to reconsider the regulations.
As someone who spends a great deal of time on work to improve care and support for people with mental health conditions, I will begin my remarks with a couple of contextual points before moving promptly to talking about the question of PIPs.
I am thankful that mental health has never been a higher priority for any Government. The Prime Minister has made it clear that it is a priority for her. We have the “Five Year Forward View for Mental Health” and extra funding for mental health. Campaigners, charities and professionals that I work with in the mental health sector have said to me that right now is a golden moment to improve mental health care because of this unprecedented commitment by the Government to mental health.
Will the hon. Lady give way?
I will just make a little bit of progress. I will then be happy to take interventions, if there is time.
The Secretary of State for Work and Pensions and the Minister for Disabled People share the commitment to mental health. It is shown in the recently published Green Paper on work, health and disability and, for instance, in the Stevenson and Farmer review of employment for people with mental health problems.
There is strong evidence that PIP is a better benefit for people with mental health conditions than its predecessor. My hon. Friend the Member for North Swindon (Justin Tomlinson) has already mentioned some of the statistics, so I will not reiterate them, beyond saying that it is important to note that people with mental health conditions are far more likely to receive the mobility component of PIP than its equivalent under DLA. Some 28% get the enhanced mobility component, compared with 10% getting the equivalent under DLA. That is relevant to this debate.
We should reiterate that the whole point of PIP, as the Minister has said in the Chamber before, is that the award is based on how the condition affects someone’s day-to-day life, not on their diagnosis. It is based on their needs and the consequent costs.
Does the hon. Lady agree that for the Government to suggest that mobility impairments caused by psychological issues are not relevant is an insult to anybody with a mental health condition? Does she also agree that mental health conditions should be treated no differently from physical ones?
I do not agree with the first of the hon. Gentleman’s two points. He should continue to listen to what I have to say. I agree with his second point and, if he listens to what I have to say, he may find that we are aligned on that.
I thank the Minister for being exceptionally assiduous in responding to and discussing my concerns on these matters. I have had several meetings with her in which she has emphasised her commitment to achieving the original aim of PIP, which is to support people to live full and independent lives. I have questioned her about the regulations in my role as chair of the all-party parliamentary group on mental health, and as a local Member of Parliament. For instance, we have discussed the case of a lady I met in Maidstone a few weeks ago who had been set on fire on a bus. That lady told me that she has been unable to go out of the house without being accompanied by somebody she trusts since then. Throughout the discussion about the regulations, she has been worried that the welfare system might not treat her the same as someone who has been unable to leave the house because of a physical disability. The Minister has assured me that that is not the case and that people are, and will continue to be, given payments based not on their diagnosis, but on their needs.
Will the Minister now clarify to us all that somebody suffering with severe psychological distress such as post-traumatic stress disorder, who needs to get out and about—for instance, to go to work or take their children to school—but finds it impossible to do so without significant assistance, could and would receive the enhanced rate mobility component of PIP, if their needs justified it?
Given the concern about the issue and the regulations, I also ask for the Minister’s reassurance on three counts regarding implementation. First, will she ensure that the guidance to PIP assessors is absolutely clear that people with mental health conditions can and should receive PIP awards based on their needs and costs, and that that may well be the enhanced level? Secondly, will she ensure, through the audit system that she has told me about, that this happens in practice? Thirdly, will she draw on the evidence provided by recordings of PIP assessments, the trialling of which I welcome, having pressed her and her predecessor, my hon. Friend the Member for North Swindon, who is sitting behind me, on recording PIP assessments?
Will the hon. Lady give way?
I am just wrapping up.
Finally, I look forward to my hon. Friend the Minister assuring us all that the Government’s welfare system does, and will continue to, treat people the same, whether their needs arise from mental or physical conditions.
I, too, congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on bringing this important matter before the House. I want to concentrate on a couple of the misapprehensions that have arisen in this afternoon’s debate and to clarify my understanding of the position, in the hope that the Minister will confirm it.
First, on the original policy intent, we heard from my right hon. Friend the Member for East Ham (Stephen Timms) that Ministers told us during the passage of the Welfare Reform Bill in 2011 and 2012 not only that psychological stress and other conditions would be eligible to be covered by PIP, but, specifically, that the benefit would be judged on the basis not of the condition but of the overall impact on someone’s life. If psychological stress is having a significant impact on somebody’s life, why will it be excluded in assessing them for the higher rate of PIP? That simply contradicts what we were told at the time of the Bill’s passage. What is more, the Government themselves acknowledged in 2015 in the case of HL that psychological stress was to be included. They now say that was a mistake. Frankly, it is not good enough for Governments to go around making mistakes when something as important as this is at stake for our constituents.
Secondly, the Government have said that nobody will suffer a cut to their benefits. It is not clear whether they are still saying that, but to be clear, I have two things I would like to point out to the Minister. First, on 15 March, in the course of the urgent question heard in this House, the Secretary of State acknowledged to me that some people who had had their award increased as a result of the decision in the first tribunal could see that higher award reduced back to the level of the original Department for Work and Pensions award. He was very careful with his wording: he did not say that all awards would be protected but that the original DWP award would be. Does that mean that some people will, in practice, see their awards reduced?
If that is the case, when will that happen? I ask that because the second thing the Government are doing, as well as introducing these regulations, is appealing the two tribunal decisions. My understanding is that that is specifically to catch the people who currently see their benefits on a higher level, and who would enjoy that higher level of payments because the regulations would come in too late for them to be impacted and to see their benefits reduced again. Is the Minister now telling us that if the Government are successful in those appeals, they will reduce the benefits of people who got awards before the application of these regulations back to the level of the original DWP award?
Thirdly, can the Government reconcile the three cases decided in the upper tribunal on 9 March with the decision to strip out psychological stress, in part because it is a fluctuating condition? As we heard in the decisions made on 9 March in the upper tribunal, it is not just whether something is occasional that determines whether someone should be eligible for a higher rate of PIP; it is also about the overall impact of the harm caused by that condition. As we heard from my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), there is no better example of that than someone with epilepsy. They may suffer occasional seizures, but when they do, the harm they experience could be considerable, resulting in brain damage or even death. Will the Minister therefore explain how she reconciles those decisions on 9 March with the assertion that psychological stress should not attract the highest rate of award in appropriate circumstances because it is a fluctuating condition?
Order. I advise the House I would like the Minister to have 10 minutes in which to reply, so she needs to be on her feet at four minutes past 5.
With regard to these PIP changes, the Government have done all they can to avoid parliamentary scrutiny. They have ignored the concerns repeatedly expressed by MPs and the Disability Benefits Consortium, as well as the deafening clamour of concerns out there.
There can be no doubt that these PIP changes are having a fundamental and life-limiting effect on those affected by them. The whole point of PIP is to help with the extra costs resulting from disability or long-term ill health, replacing DLA. The effect, real or accidental, is clear discrimination against those living with mental health challenges that could put vulnerable claimants at risk. That was the conclusion of the House of Lords.
The Disability Benefits Consortium is extremely concerned that these changes will restrict access for disabled people who need PIP through their facing additional costs. Clearly, the criteria are now far too strict, resulting in almost 50% of disabled people and people with long-term health conditions losing access to some or all of their support on being assessed. In addition, over 60% of PIP appeals are successful. To those who have had their support withdrawn or reduced, I would say this: go to your MP for help. The process is distressing and upsetting, but please appeal any decision that you think is unfair, because over 60% of appeals are successful. This shows on its own that the process is not working. It also shows that the system causes unnecessary distress for far too many claimants. My constituency office in Ardrossan has numerous examples of such cases leaving claimants confused, frightened, bewildered and in serious financial difficulty.
There are also particular concerns around the mobility component, with over 750 returning their Motability vehicles every week due to the withdrawal of essential support. We know from the DWP’s own analysis that 146,000 disabled people could lose financial support as they drop from the higher rate of mobility to no entitlement at all. It is also conceded by the DWP that there is difficulty in predicting these numbers, and so the final numbers losing financial support could in fact be much higher.
It is vital that the PIP assessment criteria are reviewed to ensure that there are clear definitions in place before any changes are made. The criteria are far too narrow and restrictive. They simply do not recognise the impact that many long-term conditions and disabilities have on a person’s ability to undertake daily living activities, and often fail to take account of hidden and fluctuating symptoms, including cognitive difficulties. What kind of people are suffering under this system? Those with MS and those with Parkinson’s—serious chronic conditions. Those with such conditions very often also suffer from depression and anxiety. If that is not specifically and separately diagnosed, in terms of PIP assessments, it does not exist. Those with long-term conditions and disabilities that include depression and anxiety as a common symptom will not score under the original descriptor.
These changes, on top of the arbitrary cut of £30 a week to the ESA work-related activity group which is also due to be imposed, show the complete disregard for disabled people felt by this Government. How can putting disabled people into greater hardship help to remove the barriers that will help them back to work? Where are the disability employment support programmes outlined in the Green Paper? We need to treat disabled people with dignity and respect. This Government need to listen and show some compassion and understanding, and stop trying to build an austerity programme on the backs of the poor and the disabled.
I want to start by thanking the Minister. Last Wednesday, as I was coming down the escalator, she, in a large crowd of people, was coming in the opposite direction and let us know in no uncertain terms that we should leave the building. I thank her for that.
Moving on to the debate, I thank my staff, who, like others, have a 100% success rate in the appeals that we have taken up in our office. I thank you, Mr Speaker, for facilitating this debate—or, in fact, forcing it on the Government. The Government should have facilitated it in a timely manner, and they stand condemned for failing to do so in spite of a cross-party request that they make time available. I am pleased that the original prayer that we tabled with the support of the main Opposition party has led to the successful securing of this debate under Standing Order No. 24, thanks to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams).
As Members have said, PIP helps disabled people to meet some of the costs related to their impairment or condition, and the Government have a stated intention of securing parity of esteem for physical and mental health. How does stopping people with mental health problems securing extra support through PIP for their journey—that is activity 11, I believe—help to achieve parity of esteem?
The Government claim that they are simply affirming what was originally intended in the legislation. I dispute that, and the evidence backs me up. Members have quoted what the right hon. Member for Basingstoke (Mrs Miller) said about that, particularly the phrase that
“PIP is designed to assess barriers individuals face, not make a judgment based on their impairment type.”—[Official Report, 7 February 2012; Vol. 540, c. 232W.]
Lord Freud said:
“One of the big differences between ?the personal independence payment and DLA is that the personal independence payment looks at the person’s ability to plan and execute a journey, not just at their physical capacity.”—[Official Report, House of Lords, 7 February 2011; Vol. 725, c. 9.]
Those examples alone demonstrate that the Government’s intention was to allow people with mental health problems to receive PIP to assist them if their mental health meant that they could not travel without assistance. If the Government want to change the law because of the extra costs associated with funding parity of esteem, so be it, but let us have proper scrutiny, a proper debate and a proper vote, not this piece of parliamentary jiggery-pokery.
We are most grateful to the right hon. Gentleman. I advise the Minister that she should sit down no later than 5.13 pm.
I start by thanking hon. Members, from all parts of the House, who have contributed to the debate. There are many points that I need to answer and I do not have much time, but I will do my best, and I will write to hon. Members about any outstanding points.
As hon. Members know, at the core of PIP’s design is the principle that awards should be made according to a person’s level of need, not whether their condition is of one sort or another. Those who have higher need, greater limitations on their ability to participate in society and higher costs associated with their condition will get more support.
Will the Minister give way?
I will answer the questions that have already been raised, and if I have time I will take interventions at the end.
That approach—using the social definition of disability—is important, and assessments are therefore complex. The assessor will try to understand the impact on a person’s life and how their disability or health condition affects them in their caring duties, parenting, social life and daily living.
As the House has heard many times, recent legal judgments have interpreted the assessment criteria for PIP in ways different from what the coalition Government originally intended. The upper tribunal judgments were concerned solely with the interpretation of the wording and, as my hon. Friend the Member for South Cambridgeshire (Heidi Allen) has said, not with policy. We have therefore made amendments to clarify the criteria used to decide how much benefit claimants receive. The changes restore the original aim of the policy, which was agreed by Parliament following extensive consultation, and they add essential clarity for all.
Will the Minister give way?
I will make some progress. As my right hon. Friend the Secretary of State for Work and Pensions said in the House and in his letter last week to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), it is important to be clear about what these regulations are not. They are not a policy change, they are not intended to make new savings and they will not result in any claimant seeing a reduction in the amount of PIP previously awarded by the DWP. There is no change to the budget and no change to the guidance that we give to assessors.
To answer the point raised by the hon. Member for Stretford and Urmston (Kate Green), she is right to say that between the making of the rulings and the coming into force of the regulations, a handful of people—we think about eight—will have been awarded a higher amount in the tribunal rulings. We will not claw back money from those people, but we will look at those cases and our intention is to restore them to the original benefit level. That is one reason why we have acted quickly. There will be no change in the amount of PIP paid to people who have previously been awarded a certain amount by the DWP, or in the amount paid to people who will be assessed on the same principles and the same policy in the future.
It is entirely appropriate for the Government to act to restore clarity to the law, as Governments have done before and will no doubt continue to do in the future. Indeed, Labour, when in government back in 2000, introduced a change to the rules for disability living allowance that overturned a commissioner’s decision holding that telephone conversations with someone with severe depression and chronic anxiety should count as qualifying attention for the care component of DLA. That decision was seen to have significantly widened the gateway not only to DLA, but to attendance allowance, and the then Government took a similar decision to the one we have taken to restore the original policy intent.
Let me assure the House that we want to ensure our policies are working and being delivered effectively, and we will continue to review our policies, including on PIP, regularly. I remind everyone that this Government have already introduced two formal statutory reviews of the PIP assessment, and we remain committed to publishing Paul Gray’s independent review, as set out in legislation. We remain committed to making continuous improvement in the PIP assessment and our decision making, and to improving the advice we provide to guide people through the process.
We know that feedback from claimants and stakeholders gives us valuable insight into the services we deliver. That is why we are setting up service user panels for PIP and ESA claimants, their carers and advocates, and representative groups to gather views on PIP and ESA. The panels, which will start next month and will initially run for 12 months, will ask for people’s views on their experiences of claiming, capture new ideas for improvement and test reactions to specific changes and proposals. We wish to reach as many people as possible.
I am coming to the right hon. Gentleman’s point, if he will give me a moment.
We are working with charities and representative organisations to promote awareness and draw on their expertise. Following references to the panels in another place last month, we have started to see requests from claimants who are keen to participate. We are carrying out pilots to test whether there are any benefits to audio recording face-to-face assessments. The pilots, which started on 13 March, will last for six weeks and involve 400 claimants. We are trialling telephoning claimants to ensure all that the evidence they wish to be considered has been collected and submitted. That is critical to reducing the number of cases going to mandatory reconsideration and appeal, as my hon. Friend the Member for North Swindon (Justin Tomlinson) pointed out. We are giving people fuller reasons why they have not been successful to ensure that they understand those reasons exactly.
We have strengthened clinical support and clinical mentoring for the healthcare professionals who carry out assessments. Our assessors discuss with people the impacts on their life before taking a medical history. The hon. Member for North Durham (Mr Jones) raised the critical issue of ensuring that there is support throughout the assessment process, particularly for people with a mental health condition. I will not list all the things we do, but he will know that processes are in place, with special markers for such individuals. We are always interested to hear how we can improve those processes, but they are already part of the system.
Will the hon. Lady give way?
I want to respond to the points that have already been raised. I will take an intervention if I have time, if the right hon. Gentleman will bear with me.
The health and work Green Paper and Paul Gray’s second review will both look at the issue of shared health records, which hon. Members mentioned. We have also been working more closely with Motability to ensure that the issues of appeals and counterproductive bureaucracy—hon. Members also referred to those issues—are resolved, and we will report back to the House as soon as possible. I assure my hon. Friend the Member for Kensington (Victoria Borwick) that the particular focus has been on young people and students. We are looking at what further we can do, and I assure my hon. Friend the Member for Wealden (Nusrat Ghani) that we are indeed working closely with the RNIB.
Let me turn to the specifics on mental health and the regulations. Supporting people with mental illness is a priority for this Government. That is why we are spending more on mental health provision than ever before— £11.4 billion this year alone. We have introduced the first ever access and waiting standards for mental health services. These changes and investments are already making a difference. Since 2010, the number of people accessing mental health services has risen by 40%—
I am coming on to the right hon. Gentleman’s point.
The number of consultant psychiatrists in this country has risen by 5%. We are working to join up the healthcare system, the welfare system and society more widely so that we focus on the strengths of people with disabilities or health conditions and what they can do if properly supported. It is for that reason that in the summer of 2015 the health and work unit was created in the Department of Health, and why in October last year we published, “Improving Lives”, the work and health—
On a point of order, Mr Speaker. You rightly ensured that the Minister had enough time to answer questions, but none of what she is saying is about the key issue in the regulations.
The right hon. Gentleman must seek to intervene if he can and pursue other mechanisms if he cannot.
I am coming on to the regulations, but I think that the key to this whole debate is that people are questioning the parity between mental health and physical health. I point out to the House that mental health was never more prominent on any previous Government’s agenda.
If Members will allow me, I will turn to the regulations—I will not repeat the statistics that show that PIP is more favourable than DLA for those with a mental health condition. Let me tackle the issues relating to the regulations.
Several Members have concluded that if someone is suffering from psychological distress, that would not count towards their score and they would somehow be prevented from scoring the maximum on the descriptors. That is not the case. As time is tight, perhaps I could place some case studies in the Library if that is in order, Mr Speaker. As has been pointed out, if someone is suffering from autism, PTSD, depression or a similar condition, they can score 12 points on that descriptor.
Let me cover the issues on process. We have used the most appropriate parliamentary procedure. It is set out in the Welfare Reform Act 2012. In the light of the significant and urgent consequences of the judgments, the amendments were passed to the Social Security Advisory Committee on 8 March—that is, after the regulations were laid. We have welcomed the Committee’s response and the fact that it did not wish to have the regulations referred to it for public consultation. We have also responded in full to the Committee’s recommendations. In particular, we have made it clear that we are committed to continuous improvement, as we recognise that it is important, for both quality and consistency, to ensure that PIP policy is clearly articulated. We have also made it clear that we will ensure that healthcare professionals who carry out the assessments fully understand what those amendments mean. The regulations were today passed by the Joint Committee on Statutory Instruments.
In the seconds I have left, I reassure the House that the regulations simply restore the original aim of the policy, as previously debated, and that we are delivering PIP in line with its original intent. We stress again that the changes will not result in claimants seeing a reduction in the amount of PIP awarded by the Department.
Question put and agreed to.
That this House has considered changes to Personal Independence Payment Regulations.
On a point of order, Mr Speaker. In an earlier intervention on my right hon. Friend the Member for East Ham (Stephen Timms), I forgot to mention an indirect interest: my wife sits as a tribunal judge. I apologise to you, Mr Speaker, and the House.
I am extremely grateful to the hon. Gentleman. He has made the position clear and he has done so very quickly, and the House will have noted that.
On a point of order, Mr Speaker. May I apologise to you and the House for inadvertently misleading it during my Adjournment debate last Thursday on the Ratty’s Lane incinerator? I said that in 2012 Hertfordshire County Council objected to 46 of Veolia’s HGV movements a day, and that the company was now proposing 212 HGV movements a day. That figure was provided to me by Veolia on 4 March 2016, but I have since discovered that the actual number is 268 HGV movements a day. [Interruption.] Nothing Veolia tells me turns out to be the reality of the situation, but I owe it to this House to do my homework more thoroughly, so may I apologise to you again, Mr Speaker, for misleading this House and to my esteemed colleagues in this place, who indicate that they share my sense of outrage?
I am very grateful to the hon. Gentleman for his point of order. He is certainly a witty wag. I would add that, as far as Veolia is concerned, the hon. Gentleman is a formidable foe. I rather imagine the company is discovering that now, if it did not know it before.
Further to that point of order, Mr Speaker. As you will appreciate, my hon. Friend the Member for Broxbourne (Mr Walker) was put in a most unfortunate situation because he was given duff information that he used in good faith. It then turned out that the incorrect information he gave was an underestimate of the severe impact those journeys were going to have on his constituents and local community. Could you advise us, Mr Speaker, of any satisfactory way, notwithstanding my hon. Friend’s generous apology to the House, for the perpetrators of this disinformation to be called to this place to explain why they embarrassed my hon. Friend in a way that led to misleading figures being given in a debate, which had an effect on the views of other hon. Members listening to the debate?
I am very grateful to the right hon. Gentleman for that point of order. Summoning someone to the Bar of the House is rarely used as a disciplinary device and is an extremely serious matter. I would have to reflect very carefully on whether it would be appropriate in this case. Even if it were not, I think the right hon. Gentleman would agree with me, and I think other hon. Members would agree, that in the circumstances the least we all might expect is for an apology to be proffered by the company. There is no shame in making a mistake, but there certainly is in failing to recognise the fact that one has done so and failing to apologise for having done so. I will wait to see whether we receive an apology. If I receive any such apology, the right hon. Gentleman will be the first to hear of it.
Pension Schemes Bill [Lords] (Programme) (No. 3)
That the Order of 30 January 2017 (Pension Schemes Bill [Lords] (Programme)), as varied by the Order of 22 March 2017 (Pension Schemes Bill [Lords] (Programme) (No. 2)) be further varied as follows:
(1) The Order of 22 March 2017 (Pension Schemes Bill) [Lords] (Programme) (No. 2)) shall be rescinded.
(2) Paragraphs (4) and (5) of the Order of 30 January 2017 (Pension Schemes Bill [Lords] (Programme)) shall be omitted.
(3) Proceedings on Consideration shall be brought to a conclusion immediately after the conclusion of proceedings on the Motion for this Order.
(4) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion 90 minutes after the commencement of proceedings on the Motion for this Order.—(Richard Harrington.)