[Sir Gary Streeter in the Chair]
[Relevant documents: e-petition 593296, End reviews of PIP and ESA awards for people with lifelong illnesses, and e-petition 549906, Review the Personal Independence Payment (PIP) application process.]
I remind Members to observe social distancing. Before I call the Member to move the motion, I will make a short statement about the sub judice resolution.
I have been advised that the Government have applied to appeal the findings of the High Court on the lawfulness of the UK disability survey. Those proceedings are therefore live before the courts, under the terms of the House’s sub judice resolution. However, Mr Speaker has exercised discretion to allow reference to the issues concerned, given their national importance. Nevertheless, Members should remember that those matters are still before the courts, and they are encouraged not to discuss those legal proceedings in any detail.
I beg to move,
That this House has considered disability benefits assessments and the Government’s health and disability green paper.
It is a pleasure to be here under your stewardship, Sir Gary.
I thank all right hon. and hon. Members who have come along today to debate this important issue, which affects many of our constituents. I thank all organisations that have supported disabled people and provided briefings for this important debate, including Z2K, Sense, Marie Curie, Mencap, the Royal National Institute of Blind People, the Multiple Sclerosis Society, the Cystic Fibrosis Trust, Rethink Mental Illness, the Young Women’s Trust, Scope and the Charities Aid Foundation.
I also say a special thanks to Citizens Advice Wandsworth, the South West London Law Centres and the Wandsworth food bank, which have supported people in my constituency. I pay tribute to the tens of thousands of disabled people who have been victims of the cruel and callous assessments for the employment and support allowance and the personal independence payment.
In the short time I have been an MP, I have raised the question of social security for disabled people on many occasions. The system should act as a safety net that is there to support each and every citizen in need, as envisaged by the Beveridge report of 1942, which was about strengthening the social contract for those facing hardship in our society by removing the five social ills. However, there is an ever-growing link between poverty and disability, and social security is no longer seen as a basic right.
Disabled people are usually in receipt of employment and support allowance, universal credit, disability living allowance or PIP. As is the case for ESA, disabled people claiming universal credit must undergo the work capability assessment in order to be found to have limited capability for work. PIP is designed to meet some of the extra costs of living with a disability. Since its introduction, however, almost half of those who were previously on DLA and were reassessed for PIP have either completely lost their award, or had it reduced.
I congratulate my hon. Friend on securing this debate. We have all had constituents come to see us who have been through an assessment and been denied, and we know the distress and pain that causes them. The latest figures show that 67% of appeals to the tribunal against a PIP assessment, 65% of appeals against a DLA assessment and 54% against an ESA assessment have been successful. Does she share my view that if those were the rates for the overturning of Crown court decisions—people who were found guilty, and then found innocent—there would be an uproar? Does she agree that the Government, and all of us, need to look at why, in so many of the cases that go to the tribunal, the original decision turns out to be wrong?
I thank my right hon. Friend for his intervention. He is absolutely spot on; it is so important that these decisions are got right first time around. I will come on to that issue later in my speech.
The overwhelming body of evidence shows that the assessment frameworks for both ESA and PIP are not fit for purpose. They use a series of points-based, functional descriptors and a tick-box approach. PIP looks at an individual’s ability to carry out a series of everyday activities relating to daily living and mobility, and the WCA is supposed to test someone’s capability for work, based on various activities. Its main flaw is its failure to include real-world factors, and it takes no consideration of how carrying out work could affect a particular person’s health. For example, I heard from one person who was asked to touch their toes, no matter how much pain they were in or how such an activity relates to their doing work.
For more than a decade, there has been a growing mistrust of assessors as a result of the errors in reports, and many people do not feel that they are being treated fairly. Research by Demos revealed that WCA assessors assume that people are not telling the truth or are exaggerating their condition, and many people report being treated as if they are making a fraudulent application.
I thank my hon. Friend for giving way and for bringing this important issue to the House. Like other Members, for years I have been receiving heartbreaking stories from constituents in Hampstead and Kilburn about the degrading tribunal process that they are forced to sit through just to access the disability benefits that they desperately need. One constituent told me that she had been to a tribunal on four occasions. She won each time, but while she was waiting for each decision she lost all her other benefits. That included her specially adapted car, leaving her trapped at home. Does my hon. Friend agree that the Green Paper lacks ambition on this issue, and that it is fundamentally unfair that anyone in that situation should lose their social security benefits?
I thank my hon. Friend for her intervention. She is absolutely spot on. The knock-on effect of someone being turned down for the support they are entitled to leads to their losing other forms of support, as was the case with her constituent who lost their Motability vehicle.
Assessors often do not have an adequate understanding of the specific disability, impairment or health condition that is being assessed. Although it is accepted that no one can be an expert in all these conditions, it is essential that all assessors receive appropriate disability awareness training and have access to condition or impairment-specific expertise and tools. The charity Scope has rightly called for the categorisation of assessors into groups for specialisms such as mental health, learning difficulties and so on.
I thank my hon. Friend for giving way; she is making a powerful case, as she often does on issues relating to disability. I wonder whether she could comment on another aspect of the system that is broken, namely the backlog on work capability assessments. I challenged Ministers—not the Minister of State, Department for Work and Pensions, the hon. Member for Norwich North (Chloe Smith), who will be responding to the debate—about that in November, and I was told that they were working flat out to resolve the problem. In December, there were still 335,500 cases, which are waiting an average of 150 days to be dealt with. I have constituents who are £128 to £340 a month short because of this, and that is having a crippling impact on their family budgets. Does she agree?
I absolutely and wholeheartedly agree with my hon. Friend’s comments. I really hope that when the Minister responds to the debate, she will set out how the Government intend to tackle this backlog so that disabled people receive the vital support they need at the right time and do not experience such severe delays.
As I was saying, how can it be right that someone who had been assessed by a physiotherapist for their mental health condition was awarded zero points, despite providing evidence from their psychiatrist and their doctor about their condition? At an appeal tribunal, they won and were awarded 45 points, but it should never have got to that stage. I know that many of my hon. Friends who are here today have constituents who have experienced exactly the same thing.
Evidence is an essential part of the assessment process, and it is vital that assessors engage with it. They should make best use of all pre-existing evidence from experts, including healthcare professionals. At present, anyone who undergoes an assessment is not provided with a copy of their assessment report, and that should be an automatic part of the assessment process. Who knows? That could lead to better decisions being made.
I congratulate my hon. Friend not just on securing the debate, but on everything that she has done on disability issues since she came to the House. Does she agree that we need to support calls for an independent public inquiry into the deaths of claimants, including those who have gone through the work capability and PIP assessment process? We do not know the causes or the scale of those deaths. Surely that work needs to be undertaken as quickly as possible.
My hon. Friend is absolutely right. I commend her for her impeccable work on the rights of disabled people and tackling inequality. I will come on to the point that she raises, because she is absolutely right. We have long supported the call for an independent public inquiry into these deaths, because it is a scandal that that has not been addressed to date.
People should have a choice about how assessments are carried out, be it face to face or by audio. The process has to be accessible and inclusive. The Disability Benefits Consortium rightly calls for the establishment of an independent regulator of social security assessment, with the power to compel evidence from the Department for Work and Pensions and properly hold the Government to account.
Assessments are carried out by private contractors including Atos, Capita and Maximus. Last November, DWP announced that it would spend £2 billion on disability assessment contracts with private profit-making companies over the next five years. Given the millions already spent, it is clear that these private companies are not providing the best value for money. Labour has long called for all assessments to be brought back in house. That would provide for better scrutiny, accountability and value for money for the taxpayer. Does the Minister agree, and will she take action to address that?
Post assessment, the aim must be to get the decision right first time, but time and again, that has not happened. By the end of 2020 in Battersea, one in five disabled people in receipt of PIP had had their awards reduced, and one in three had their awards completely stopped. Citizens Advice Wandsworth shared the experience of someone who was assessed for both ESA and PIP within three days of each other. In their WCA, they were found to have limited capability for work as they could not walk 50 metres. However, they were awarded zero points for mobility in their PIP assessment, which concluded that they could walk 200 metres. This resulted in them losing their Motability car, so they could no longer drive to work, and they now have to claim universal credit. Surely that is not how the system should work.
With the introduction of mandatory reconsiderations, there has been a marginal improvement, but in 62% of MRs in 2021, the result was to go ahead with the initial decision. Many disabled people feel that the MR process is yet another barrier to their right to pursue an appeal to the independent tribunal. Since 2010, some 587,816 disabled people have been forced to appeal to a tribunal for their ESA. In 2020-21, 76% of PIP appeals and 74% of ESA appeals were successful and decisions were overturned at tribunal.
In the past, disabled people have had to wait long periods of time before their cases have been heard at tribunal. Given the impact of the pandemic on backlogs, as my hon. Friend the Member for Sheffield Central (Paul Blomfield) mentioned, can the Minister update us on the current waiting time and tell us the plan for addressing the backlog?
Poor decisions have come at a huge cost to the taxpayer. Between 2017 and 2019, the Government spent £120 million fighting PIP and ESA claims, and the consequences of this failing system are devastating. We all remember the case from 2017 involving Stephen Smith. He was 63 when he was found fit for work, despite having been diagnosed with numerous health conditions. After he failed his WCA, he was forced to live on just £67 a week. He died soon after, weighing just six stone. Only last month, we heard of a disabled man who was in hospital in 2019, as he was severely ill and very vulnerable to infection. The DWP refused to allow him to submit an electronic claim, forcing him to attend a jobcentre in person. He died in April 2020.
In 2019, the Government revealed that 5,690 people had died within six months of being found fit for work under the WCA in the last decade. There is no stronger indictment of a failing system than more than 5,000 people dying just months after being denied vital social security. Labour has been proud to support calls for an independent public inquiry into these deaths, because we need justice for each and every one of them.
The Department’s treatment of disabled treatment has resulted in unimaginable suffering for tens of thousands of disabled people and their loved ones. Rather than enabling disabled people to live more independently, successive Tory Governments have created a hostile environment. The long-awaited Green Paper was a missed opportunity to reshape social security and support for disabled people. I am sure there is agreement across the House that the current system is complex and simplification is needed, but the merger of payments and assessments for PIP and ESA is not the answer. They are two fundamentally different assessments requiring different information. One is means-tested income replacement, and the other is not. There is no doubt that any move towards that could lead to absurd decisions and have catastrophic consequences.
Worryingly, the Green Paper did not address the levels of social security. Cuts to universal credit, with the removal of disability premiums worth £180 a month and the removal of the work related activity component in 2017, have left some severely disabled people destitute. Last month, two severely disabled men won a legal challenge over the DWP’s failure to protect them from the cliff-edge loss of income of £60 a month following their move from legacy benefits to universal credit.
Since 2010, more than 1 million disabled people have faced sanctions. As a result, many have had to go without, skip meals, miss appointments and so forth. It has had a devastating impact. All the evidence points to the fact that sanctions against disabled people do not work, and there needs to be a permanent end to all sanctions. The Government must move towards a more holistic employment model for disabled people.
We need the right kind of social security system—one that respects the values of the Beveridge report. We need a system that we are proud of, as we are all proud of our NHS. In the past 12 years, we have watched the system diminish and demonise disabled people; that is a fact. Changing the narrative is vital to dismantling the hostile environment that has been created for them. We need to rebuild a social security system that is fair, compassionate and there for us all in our time of need. To do so, we need to ensure that the system provides people with an adequate level of income and a change of culture in the Department.
Will the Minister confirm that before she introduces her White Paper, she will engage with and consult disabled people and disabled people’s organisations? We must avoid what happened with the national disability strategy, which was ruled unlawful last month because it failed to carry out such engagement. Will she also commit to creating an inclusive, accessible application process and assessment framework that is built on compassion and genuinely co-produced with disabled people and their organisations? Finally, will the White Paper address the inadequate levels of social security and commit to considering minimum income levels for disabled people? We need urgent action to transform the social security system from one that penalises and sanctions ill and disabled people to one that supports and empowers them to live independently.
It is a privilege to speak in this debate. I greatly credit the hon. Member for Battersea (Marsha De Cordova) for calling this debate on such an important topic.
I welcome many of the comments in the Green Paper because they echo my experience as a constituency MP in Watford and, I am sure, the experiences of many others around the House. One of the key parts of the paper is on the need for greater flexibility and removing the rigidity in the system, especially around assessments. I have worked in this space for many years. Twenty years ago I was writing about the digital divide and working with charities on online accessibility, and I saw at first hand the impact of barriers. When barriers are removed, enabling people to live a fulfilled life and to fulfil their ambitions—and especially when people with disabilities are given opportunities to live their lives fully—it makes a difference not just to them, but to society. That is at the heart of what I read in this Green Paper; it is about an ambition to ensure that we look after people in the right way, and do not base assessments on how good they are at filling out a form.
A challenge that I have seen over many years when it comes to the state interacting with individuals is that it comes down to a lot of check boxes and form filling. If someone is very good at that, they can get through, but if they cannot get through, they are stuck. I see in the Green Paper—I hope that the Government will take this forward in the White Paper—the idea of putting a person at the heart of the process, and, irrespective of their disability, enabling them to live a full life.
In my constituency of Watford, I am particularly proud of the number of amazing organisations that work with charities, and the charities that work with people with disabilities. A few weeks ago, I was pleased to invite the Minister to Watford Workshop, where she saw people working in a fantastic space—very much a normal working environment—in which they have full-time jobs, and are supported and encouraged to live full lives. I hope that she will reflect on that in her comments later, but I think what she saw were happy people, living normal lives, getting on, and having the opportunity to meet others.
There are organisations in my constituency such as the Electric Umbrella, which uses music and creativity to engage with people. I have even—perhaps embarrassingly —played “Wonderwall” on the guitar there, during a royal visit. I will tell that story on another occasion, when we have more time. Watford Mencap and DRUM— Disability Recreation Unity Movement—do amazing work, and Playskill and the Bobath Centre do incredible work to support local organisations and people.
Shopmobility is based in the Intu centre, which is one of the big shopping malls in Watford. I spent two sessions volunteering there. The people who came there feeling that there was a bit of stigma about needing to use an electric vehicle to get around the shopping centre were put at ease. They were able to see that getting extra support is not something to be embarrassed or feel stigma about; it enables them to live full lives.
Time is short, so I will wrap up by saying that I hope that when the White Paper is produced, the Government listen to Members across the Benches and to constituents, and put in place the changes needed to ensure that the system supports everyone.
I congratulate my hon. Friend the Member for Battersea (Marsha De Cordova) on securing this important debate.
The Green Paper’s commitment to reforming assessments is welcome. Every MP knows of awful problems with them. At the start of the Parliament, the Select Committee on Work and Pensions agreed on an inquiry on the issue. That was put on hold while face-to-face assessments were suspended, but we are now taking evidence. We want disabled people to be at the heart of the inquiry, so we have launched a survey of personal experiences of assessments, to which we have so far had more than 3,500 responses. The survey is on the Committee’s website, including in an easy-read version, and we would welcome further responses.
A key problem is that disabled people just do not trust DWP, and the Department keeps making things worse. As my hon. Friend the Member for Battersea mentioned, last week the Department lost the judicial review brought by disabled people regarding the national disability strategy consultation. The Department’s defence in court was that it had not set out to consult disabled people properly and therefore was not guilty of not having done so. As you have reminded us, Sir Gary, the Department is now, absurdly, appealing against that defeat. The Green Paper consultation was launched after the summer recess began. Calls from disabled people’s organisations to extend the deadline were rejected. The Department also rejected the call of its own social security advisory committee for a protocol for engaging with disabled people to try to overcome the problems.
In September 2020, the Department received from the National Centre for Social Research a report that it had commissioned on the uses of health and disability benefits. Some 120 people were interviewed for that research and were told, in a letter approved by the Department, that the resulting report would be published.
The Government have a protocol on social research, adopted in 2015, which requires the publication of all such research within 12 weeks of receipt. The Secretary of State confirmed to the Select Committee that the protocol applied to that research, but told us that, nevertheless, she was not going to publish it. The Committee agreed, unanimously, that it should be published. We asked the Department again and made it clear that if it was not published, we would use our powers to order NatCen to provide us with a copy.
I am pleased that NatCen has complied with our order; the Committee now has that report. We will meet tomorrow morning, and my view is that we should publish it. Ministers seem to think that their interests are best served by hiding and covering up, but every botched attempt means that disabled people trust them even less. I hope that this Minister will usher in a new openness.
Our inquiry has already heard, extensively, about problems with assessors who lack basic understanding, assessment reports that seem to relate to a different person, and forms that cannot be read by the assistive technology that blind people use. The Department has been very slow to make sensible changes. In 2018, the previous Work and Pensions Committee produced—unanimously, on a cross-party basis—a series of recommendations. Some of those that were accepted have still not been implemented. Dr Paul Litchfield, the former independent assessor of the work capability assessment, told us in December:
“Then you look at things seven years down the road and as far as I can see things have not been taken forward.”
We have already heard many sensible points in our inquiry, and I very much hope that the Department will accept and implement the recommendations that will be made in our report later this year.
It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Battersea (Marsha De Cordova) for securing this important debate.
One of my constituents in North East Fife is a young man with post-traumatic stress disorder, anxiety and autism, who has been refused PIP. Due to those disabilities, he has been struggling to gather the evidence needed to make an appeal. He is overwhelmed by the requirements placed on him, and is already struggling with simple tasks. In his own words, he would rather die than put himself through this process again. That is clearly a broken system. The disability Green Paper acknowledges that
“some people continue to find assessments difficult and stressful”,
but that does not begin to fully describe the distress felt by my constituent, and clearly by so many others.
The Green Paper is, however, a step in the right direction. I welcome, for example, proposals for the audio recording of assessments by default. That has long been called for by disability rights groups. In the context of immense distrust in the system, people need to know that what they have told their assessor has been accurately recorded. However, as it stands, the Green Paper does not commit the DWP to a timeline by which that will be implemented. It also does not commit to making it easier for people to access the written reports made about them. Transparency is vital if trust is to be restored to the system. I invite the Minister to address that in her response.
The Green Paper still presents missed opportunities. It acknowledges that it is vital for work coaches to have an understanding of the medical problems that their clients experience, but does not say the same of healthcare professionals involved in the assessment process. Why would we not want assessors to understand what they are assessing? It would increase trust in the process if claimants felt they had been understood. It would increase the number of decisions that are right first time, and would decrease the amount of taxpayers’ money spent on mandatory reconsiderations and appeals. To me, that is simply a win-win, and I hope that the Minister agrees.
The Green Paper also fails to address DWP’s approach to new illnesses, or to illnesses that are less understood due to the relapsing and remitting nature of their symptoms. That includes diseases such as myalgic encephalomyelitis, multiple sclerosis and now, of course, long covid. Long covid is currently a diagnosis of exclusion—has an individual had a positive covid test, and are they experiencing symptoms that cannot otherwise be explained? There are some 150 possible symptoms, of which the most prevalent is fatigue, but they can present in any combination in different people. It is not yet recognised as an occupational disease, and there is no coherent strategy from the DWP for supporting sufferers.
I ask the Minister to consider a few key points. The first is evidence of diagnosis. Diagnosis relies on a positive test, but those who continue to suffer symptoms from covid caught in the first wave will have never had a test result. How can they prove their illness? The second is guidance for businesses. The Green Paper sets out that the Government’s intention is to stop disabled people from falling out of work, but if we are to prevent long covid sufferers from falling out of work, action has to be taken now. The third relates to the broader point about relapsing-remitting diseases in which fatigue is a primary symptom. The Government must give proper guidance to assessors and work coaches about how best to assist people with those illnesses.
There is one final missing element in the Green Paper: it does not consider the adequacy of social security payments. Put simply, it is more expensive to be disabled or to be the parent of a disabled child. PIP might be a start, for those who can get it, but research released before the pandemic showed that even after receiving that payment, disabled adults face average extra costs of nearly £600 per month. PIP is not enough. The system is failing disabled people. I ask the Minister to commit to reforms that place disabled people at the heart of the social security system, and to urgently address the specific issues raised today.
It is a pleasure to serve under your chairship, Sir Gary. I pay tribute to my hon. Friend the Member for Battersea (Marsha De Cordova) for securing this really important debate and for her powerful opening words.
In June last year, I held a virtual roundtable with disabled constituents and organisations from Vauxhall, which the Minister’s predecessor attended. At that meeting, my disabled constituents powerfully relayed a range of experiences of navigating the benefit system. Their testimony has certainly stayed with me. Listening to them speak, it was clear to me that the system is not fit for purpose and that disabled people simply do not trust the DWP to understand their lived experience. They spoke of a welfare system that was too focused on what disabled people cannot do, and not on what they can do. They said that the system was accusatory and uncompassionate, and the application process too difficult to navigate. They made it clear that they did not feel that the assessments were based on their needs; instead, the assessments felt like exams that had the power to alter their life.
At that meeting, the Minister’s predecessor said that he understood the need for change, but when I followed up in writing to pass on a number of suggestions from my Vauxhall constituents, I received no response. Warm words are not enough; disabled people need action. Ministers need to grasp how important these problems are for disabled people, and how complicated it is for them to navigate the benefit system.
Shamefully, disability is often a barrier to economic empowerment, because so many parts of our society remain fundamentally inaccessible. The result is that 42% of families that need disability benefits are in poverty. Many of them belong to the poorest and most vulnerable groups in our society. However, the PIP statistics from October 2020 for my constituency of Vauxhall show that 26% of claimants had their welfare entitlement reduced, and a further 32% had their applications dismissed altogether. At a time of hardship and pandemic, when so many disabled people have faced difficulties and have had to go without essential care and support, those numbers are staggering. They represent disabled people being abandoned by the DWP when they needed assistance the most. They also symbolise a benefit system that is broken.
I am encouraged to hear that the Government will propose concrete changes in a White Paper that is based on the responses to the Green Paper. However, given the many delays and disappointments that my disabled constituents have experienced at the hands of this Government, I can understand why they doubt that those changes will ever come. Will the Minister guarantee that further proposals in this area will be co-produced with disabled people who use the benefit system? Will she guarantee that the system will provide people with a stable income that is sufficient to enable them to proactively empower themselves; that it will deliver equality by offering disabled people more independence, choice and control; and, crucially, that it will treat people on social security with dignity, fairness and respect at all times? By delivering on that, the Minister could finally start to rebuild disabled people’s broken trust in this Government.
It is a pleasure to serve under your chairmanship, Sir Gary. I want to speak in this debate on behalf of my constituents in North Ayrshire and Arran, who, in common with others across the UK who go through disability benefits assessment, find the experience extremely stressful. That is significant, as we know that poverty levels are consistently higher for disabled people. The latest figures show that 32% of disabled people live in poverty; with the cost of living crisis, that figure is likely to be higher now. In my constituency, 42% of families who rely on disability benefits are living in poverty. That is shameful. There can be no doubt that there is a deep mistrust between disabled people and the DWP due to the disability assessment process, which has been described as “traumatic” and “dehumanising”.
70% of disabled people feel that their benefits assessor did not understand their condition. Under this system, there is no way to make sure that an individual is assessed by someone who understands their condition. That might help explain why, since 2018, seven out of 10 tribunals dealing with mandatory reconsiderations of benefits have overturned the decision that was reached. In the past, I have heard various Government Ministers insist that this shows that the appeal system is working for claimants; it instead shows that assessments are not being conducted properly. In addition, it shows that seven in 10 claimants are put through the unnecessary stress and trauma caused by the appeal process.
Many people are incorrectly assessed and do not appeal. I know that from experiences in my constituency. Many people simply do not appeal as they feel so broken and defeated by the system. That means that they are deprived of the level of support that they need—a disgraceful indictment of the system. What of the cost of putting right decisions that are simply wrong and cause so much distress? Millions of pounds are wasted on fixing wrong decisions; £120 million was spent by the UK Government fighting disability benefit claims for PIP and ESA between 2017 and 2019.
In Scotland, the SNP Government have brought forward a new, simplified and compassionate adult disability payment system, which focuses on dignity, fairness and respect. It has built in from the very start a fast-tracking system for those with terminal conditions, following the judgment of clinicians. Those who are unable to work due to disability must be supported. Those who are disabled but can work must have the support they need in order to work. The Scottish Government aim to halve the disability employment gap by 2038, and leave behind the stigma too often felt by those who live with a disability. I hope that the Minister will use the person-centred system rolled out by the Scottish Government as a template from which the UK Government can learn.
The UK Government must follow Scotland’s lead, because the Scottish Government have prioritised making significant changes to how disabled people in Scotland experience accessing disability assistance; the system treats everyone with fairness and respect. If the system across the UK is not fixed, then Scotland’s system will put the system in the rest of the UK to shame.
I thank my hon. Friend the Member for Battersea (Marsha De Cordova) for securing this really important debate. It was in 1987, while I was a Bar student, that I first came across these types of cases. In those days, very few cases ended up in the social security tribunal. Most people were able to get their benefits after an administrative paper review. However, a number of years ago, when the Conservative Government came in, they abolished the practice of doctors assessing whether people were eligible for benefits. That was replaced by private contractors using staff who were not medically qualified. As a result, many people ended up having to go to appeal to get their benefits. The Government should think about that, and look at it in their Green Paper.
Some years ago, the Government changed the rules regarding the disability living allowance, and converted it to PIP. Many people who used to receive DLA then had to be reconsidered for PIP. The criteria for PIP were much harsher and more stringent. As a result, many disabled people lost out. I want to concentrate on those people who have been very unwell for many years. Every few years they have to go through the reassessment process, which is an incredibly debilitating, stressful and anxious time for them. I was recently contacted by constituents who suffer from ankylosing spondylitis, an inflammatory disease that over time can cause some of the bones in the spine to fuse. They have been called back time and again to be reassessed, when everybody knows their condition is only going to get worse.
Another couple contacted me. The husband received a lifetime disability living allowance award 18 years ago. He is unable to walk and is completely dependent on others for his needs, yet he has to go through a stressful and difficult reassessment process for PIP. I would like the Minister to enlighten us. When a person is so incapacitated that a lifetime award is appropriate and it is recognised that they will not get better, why do the Government think it reasonable for that person repeatedly to endure reassessment?
Another constituent with cerebral palsy had, before PIP was introduced, received DLA since she was 16. Her illness is only going to get worse; the brain damage is irreversible and is not going to change, yet she has to get reassessed again and again. Why do the Government insist on reassessment for lifelong conditions, when they know that that is a waste of money and energy, and is very cruel? The reviews mean that people are subjected to repeated interviews with people who are not medical experts.
We have a system where people who are blind, paraplegic or have Down’s syndrome are put through reassessment, and forced to provide information about their disability; information that the Government already have and cannot possibly change. We have seen that the system that assesses them has proved to be a disaster; with lost applications and delay, it is not fit for purpose. None of that is mentioned in the Green Paper.
I urge the Minister to consider the following point. Lifetime awards, such as those we had with DLA, are a genuinely useful part of our welfare system. They are sensible responses to the reality that some people with disabilities will never get better. They ensure that they have to go to an assessment only once. I urge the Minister to consider the policies that have caused an enormous amount of suffering to our disabled citizens.
It is a pleasure to serve under your chairmanship, Sir Gary. I am grateful for the chance to speak in this important debate. I pay tribute to my hon. Friend the Member for Battersea (Marsha De Cordova), who is a trailblazer and history maker. I am grateful to her for securing this debate and giving us the opportunity to express our solidarity with people with disabilities.
I was elected to this House in April 2019 and, like many colleagues, I have spent many hours working and supporting residents in their engagement with the Department for Work and Pensions, and it has not always been easy. In fact, more often than not, many of my constituents have been pushed to the brink. I and other colleagues are exasperated by the failure to get answers and leadership from the Government. Every Member here will have stories of widespread dither and delay.
Disability campaigners have long voiced concerns about benefit assessment processes. In February 2018, a Work and Pensions Committee report found that failings in the end-to-end processes for both PIP and ESA had contributed to a lack of trust in both of those benefits, and undermined confidence among claimants, including my constituents in Newport West. The very helpful House of Commons Library report made it clear that the DWP Committee report made a series of recommendations, covering, among other things, the recording of assessments; the supply and use of evidence; the clarity of communications; guidance in relation to home assessments; and the role of companions. Can the Minister provide an update on those specific recommendations? If that cannot happen here, I would be grateful for a written update.
Like many in Newport West and, I suspect, across the country, I am concerned about the fact that the Government have failed to consult properly disabled people and the organisations that support them. Those non-governmental organisations have excellent, practical ideas for sorting out the current issues, and I ask the Minister to work with them going forward.
We know the impact that covid has had over the past 18 months. Serious questions remain about how adequate the funding is and how serious the Government are about standing up and delivering for disabled people. Will the Minister focus specifically on the impact on severely disabled people, in particular those on legacy benefits, and on how their needs tie into the Government’s health and disability Green Paper?
According to Scope’s report, “The Disability Price Tag”, and the Joseph Rowntree Foundation’s annual “UK Poverty” report, being disabled puts people at higher risk of poverty: 31% of the 13 million people with disabilities in the UK live in poverty. The assessment processes do not work. Disabled people have been among the hardest hit over the past two years. There remains no strategy to properly improve the support on offer to disabled people. We have much to do. I hope that the Government start to listen and learn.
I congratulate my hon. Friend the Member for Battersea (Marsha De Cordova) on securing this debate.
I will raise two cases of my constituents’ Kafkaesque experiences of disability benefits assessment. Susan had a work-related accident in 2019. She had an initial operation that left her severely disabled, virtually housebound and in a great deal of pain, unable to walk or to use a wheelchair. After claiming the new-style employment and support allowance in January 2020, she had a telephone assessment in July, followed by a recommendation that she had a further face-to-face medical examination—but medicals were suspended at the time, due to the coronavirus pandemic. By the time she was called for a face-to-face medical, the 365 days of the new-style ESA had expired.
Now, after months and months of waiting to obtain a decision relating to her work capability assessment, no decision has been made—or, it seems, will ever be made —about Susan’s eligibility for the ESA support group. A great deal of medical evidence has been handed to the DWP, providing detail as to the extent of her disability, on which they could have and could still make a decision. The DWP could also use as evidence its own face-to-face medical of late 2019 for her PIP, the outcome of which was the award of the higher rate of the mobility component, as well as an award for care needs.
I have made representations to the DWP and, following my letter of May ’21 to the complaints team, I understand that the Centre for Health and Disability Assessments was asked to reassess its position, but it has still failed to provide recommendations on Susan’s eligibility. There remains no report on which the DWP could make a decision and, without a decision, she has been left in the iniquitous position of being denied the right of appeal. Ironically, she would have had the right if the support group had initially been refused. Based on the evidence, she would have been in a very good position to succeed in an appeal. I implore the Minister to intervene to resolve Susan’s claim.
The other case is that of Aaron Merharban, a 21-year-old young man who suffered from deafness, anxiety and epilepsy, from which he died on 15 June 2019. His family firmly believe that that was brought on by his earlier experiences of the inhumane assessment process, just two days before he was due to attend a medical for a personal independence payment.
Aaron had been receiving DLA for some time. He had qualified for that without any issues, but he was made to apply for PIP. His claim for PIP was refused, as was his subsequent appeal. His mother recounted to me that the treatment Aaron endured through that process—at the initial medical, and in particular at the subsequent tribunal of February 2019—traumatised him to the extent that he was absolutely terrified of going to the next medical he was called to. Understandably, his mother is convinced that that was a major factor in bringing on the seizure that caused his death. Devastatingly, Aaron died alone at his home. Had he been awarded PIP to help pay for the care that he needed, that situation might well have been avoided.
Heartbreaking cases such as those leave me utterly despairing about the way in which this Government treat our fellow citizens. The way in which a society looks after the most in need says all we need to know about it. If anything is clear about the system of disability benefits assessments, it is that it is an outright damning indictment of Tory Britain.
I am grateful, Sir Gary, for the opportunity to speak in the debate. I also thank my hon. Friend the Member for Battersea (Marsha De Cordova) for securing this really important debate on an issue that is very close to my heart, having worked for many years alongside people in receipt of social security benefits, offering advice and support. Like other hon. Members, I heard heartbreaking stories.
I worked alongside Citizens Advice, which continues to provide invaluable support and advice to people in my constituency of Cynon Valley, where the number of people in receipt of social security benefits is unfortunately very high indeed. We suffer high levels of deprivation and poverty. We had one of the highest rates—the third highest rate, actually—of deaths from covid. In fact, some research that I recently commissioned from the Bevan Foundation in Wales revealed that Cynon Valley has the highest rate of economic inactivity, not just in Wales but in the whole of the United Kingdom.
That is largely attributable to the industrial legacy, but the sharp reduction that occurred during the covid pandemic makes it clear that the pandemic has taken a significant toll on the health and physical and mental wellbeing of people in my constituency, so it is essential that we have an adequate, easily accessible and supportive safety net for people. Sadly, as we have heard this afternoon, the experiences of far too many people show that that is not the case.
“Dehumanising”, “stigmatising”, “degrading”, “complicated”, “drawn out”, “unfair” and “a complete lack of faith and trust in the process”—these are words that we hear time and time again to describe the social security claims process. It is essential that people’s experiences and experts’ views play a pivotal role and determine the reform of the assessment process, as others have said.
When the Government published the Green Paper, my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft), who is the shadow Minister for disabled people, said:
“Disabled people and their families deserve much more than this repeatedly delayed and piecemeal announcement.”
Campaigners have highlighted the fact that the current process is not getting assessments right, with evidence showing that almost three quarters of people do not get the right benefit decision first time around. Indeed, DWP’s own recent statistics have shown, as others have said, that 67% of PIP appeals at tribunal are overturned in the applicant’s favour. In my constituency of Cynon Valley, Citizens Advice appeals for ESA, universal credit and PIP have a 94% success rate. Clearly, something is wrong with the system.
I will also briefly refer to the outsourcing of the delivery of health and disability benefits to private companies, which is a significant cause for concern. Charities such as CAB and Disability Rights UK, as well as the Public and Commercial Services Union, have made that clear. It cannot be right that private firms, which have no prior experience in this sector and are driven by profit, deliver these services at a huge cost to the public purse.
There are genuine concerns about the proposals for part of the Government’s plan to cut costs. Disability Rights UK has expressed a clear concern about the repeated stress that the Green Paper makes on affordability. Others have mentioned the low benefit rates, which create hardship and poverty, and also the fact that the Green Paper does not address the dehumanising impact that sanctions have on people.
We look forward to the final report by the Select Committee, but I hope that the Minister will today pledge to listen—indeed, not only to listen, but to co-produce any reform that is required with disabled people and other people in receipt of health and disability benefits. We need a system that provides a proper safety net for people, supporting their independence and helping them to lead fulfilling lives, so that they can reach their full potential with dignity and respect.
I am grateful, Sir Gary, for the opportunity to speak in this debate.
I also thank the hon. Member for Battersea (Marsha De Cordova) for setting the scene so very well on a very important issue. I am sure that she will not mind my saying this, but her disability has never prevented her from bringing forward cases in this House, and I would say that for many of us she is an inspiration in the way in which she deals with her life for the benefit of all. I thank her for that and say well done to her.
As my party’s health spokesperson, it is important for me to be here; I always give a Northern Ireland perspective on how issues impact on my constituents. I do it in every debate I attend; I think that hon. Members, right hon. Members and Ministers probably expect it.
In July last year, the Department for Work and Pensions released its Green Paper on health and disability. First, may I say that I welcome the positive things that have come from the Green Paper? It has allowed the extension of special terminal illness rules, which is a much-needed step in the right direction. There was also an extension on the continued use of audio-visual assessments, which certainly makes the process more accessible for claimants as well.
The DWP was given extra time to look at evidence and make decisions, ensuring that all those eligible received what they need. These are steps in the right direction, and we need to have them in place. The hon. Member for Battersea has raised issues that I would like to discuss. First, there are accessibility issues for benefit assessments. A recent study showed that 27% of disabled adults across the UK have never used the internet. When it comes to assessments, I think we have to recognise that. One of my staff works full time helping my constituents to complete their benefit forms and says that, very often, in an audio-visual assessment, it is hard for consultants to get a real feel of how badly the claimant is suffering, making it less likely for them to make a successful claim. Perhaps the Minister can respond on that.
As of August 2021, in Northern Ireland there were 161,000 PIP claims. The overall award rate is 64%. Some 75% of DLA-reassessed claims were granted an award of PIP. and 79% of those claims were at an enhanced rate. I think there is a certain level of positivity, but there are those who do not get there and who, perhaps, as the hon. Member for North Ayrshire and Arran (Patricia Gibson) said, are overawed by the process and just give up. We need to try and reach out to those people.
The Green Paper also refers to PIP and ESA costing £8 billion in the early ’80s, rising to £31 billion in 2021 and probably £40 billion in the next five years. It states that Ministers want to take steps to make the benefits system more affordable. I am not quite sure what that means. Does that mean that they are cutting back on the number of applicants, or that people who justify receipt of the benefit do not get it? I hope the Minister can clarify that point.
One factor crucial to me is the protection of the disabled in terms of employment. The hon. Member for Battersea is a wonderful representation of how a disability should not impact what someone wants to do with their future. There are 8.4 million people in the UK who have a disability of some kind and 4.4 million are in employment. When looking at these figures it must be remembered that they scope from minimal disabilities to the most severe. Much to my dismay and that of others, employment-related suggestions are concentrated around the disabled person rather than changing the attitudes of the employer. The employer should understand what it means to have a disabled person in their workplace, and should be working to meet that goal.
It is imperative that disabled people are a priority for the Government, both in benefit assessments and in the Green Paper. They are often left behind in society and the Green Paper provides a way to reverse that. Their concerns must be listened to, not only by us, but by our constituents and by those who will be directly impacted by the Government’s Green Paper.
It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate and thank the hon. Member for Battersea (Marsha De Cordova) for introducing this important debate.
The UK Government are failing disabled people, who have been hit hardest by the pandemic and the rising cost of living crisis. Some 42% of families who rely on disability benefits are in poverty, and the Joseph Rowntree Foundation has said that 49% of all those living in poverty in the UK are either disabled people or live in a household containing a disabled person. According to the Disability Benefits Consortium, the financial situation of 78% of disabled claimants has worsened during the pandemic.
The long overdue national disability strategy was an underwhelming wish list, with few real commitments. It failed properly to take into account disabled people’s experience. Last week, the High Court found the strategy’s consultation process unlawful, due to its inadequate and inaccessible attempt at engagement with disabled people. The Green Paper was long overdue, but did little to convince disabled people’s organisations and disability charities that the UK Government have their best interests at heart. The Green Paper has failed to address benefit sanctions, the payment cap within Access to Work and the accessibility of the UK Government’s kickstart scheme and, worryingly, it considers merging benefits assessments to cut costs.
The DWP disability benefits assessment is an ineffective, deeply stressful and often traumatic process for disabled people. That would fairly sum up what many Members have said today. The assessment process often impedes rather than facilitates access to vital financial support. On average, more than 12,000 disabled people successfully overturn wrong PIP decisions every month. From 2017 to 2019, 2,500 people in my constituency appealed the outcome of their assessment and 18% had the outcome overturned. That figure was relatively low, which meant that people had to continue fighting for benefits they were entitled to by going on to a tribunal, causing more stress. Having an appropriate professional with relevant knowledge and understanding of a disabled person’s condition or impairment is vital to getting the right decision the first time around. Survey data shows that 70% of disabled people felt that their benefit assessor did not understand their condition.
Z2K, which I met this morning, has given me examples. I do not want to waste too much time, but they are important. One person said:
“I repeated several times how much pain I was in which was visible. They still asked me to do physical tests, leaving me in tears and in pain”.
“When I received the assessor’s report, I cried, because it reflected a perfectly healthy person, not someone who cannot clean their house or hold down a full-time job”.
One Scope person said:
“I find it deeply dehumanising.”
I will stop there because it is distressing to read these accounts.
The UK Government must end punitive disability assessments to build on the positive temporary changes seen during covid, such as removing conditionality and sanctions for disabled claimants, as well as the need for face-to-face assessments. Claimants must be able to choose the method of assessment best suited to them and what makes them most comfortable. Disability organisations such as Sense have called for the DWP to retain the option of offering applicants the option of telephone and video calls and non-in-person assessments.
The Green Paper’s proposals for a new approach to sanctions are at odds with the Tory Government’s new Way to Work campaign, which is sure to push many, including disabled people, on universal credit into a corner and see sanctions rise. The Government must permanently end benefits sanctions for disabled people and those who are unwell. It is particularly cruel and does nothing but hurt those most in need.
My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) outlined briefly the Scottish Government’s approach to disability assessments. I will not repeat what she said, but I stress that the whole system in Scotland in based on dignity, fairness and respect. I think that should be rolled out right across the UK.
I have a few asks of the Minister. How will she ensure the White Paper on health and disability benefits properly consults disabled people, beyond an inaccessible lifestyle questionnaire, and does not repeat the Department’s failure of engagement seen in the Green Paper and national disability strategy? Will she permanently end benefit sanctions for disabled people and those who are unwell? Will she confirm that the UK Government’s Way to Work campaign will not push disabled people on universal credit into a corner and see sanctions rise? Will she fight for the cut of £20 in universal credit uplift to be reversed and for that money to be extended to people who are on legacy benefits who did not get it? That is another court case we are waiting for a result on.
Will the Minister consider following Scotland’s lead and create a person-centred approach that removes the burden from the claimant of providing supporting information and considers a wider array of evidence outside one-off assessments? Will she take steps to ensure that assessors carrying out disability assessments have the appropriate knowledge of the claimant’s condition or disability—basic stuff—and have proper disability sensitivity training?
It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate my hon. Friend the Member for Battersea (Marsha De Cordova) on securing this important debate and thank her for all her work in this area. She powerfully put forward why the assessment system is not working and the devastating impact that has on disabled people.
Many Members have outlined serious constituent concerns. That includes those so powerfully put forward by my hon. Friend the Member for Middlesbrough (Andy McDonald), and I hope the Minister will look into the cases he raised. There are numerous concerns about the health and disability Green Paper, including, as many Members said, about the lack of proper consultation and co-production with disabled people. Having spoken to disabled people across the country, a running theme has been the tokenism with which the consultation has been undertaken. They asked me, “Why is the DWP so reluctant to engage with those who have been through the assessment process?”
As my right hon. Friend the Member for East Ham (Stephen Timms) outlined, it is deeply concerning that the Department has not taken onboard the recommendations of the independent Social Security Advisory Committee about the way it involves disabled people in the design and evaluation of policies that affect them. The committee recommended co-production with disabled people. The Green Paper’s consultation has, sadly, fallen short of that. Worse still, the DWP has not undertaken any proactive engagement with disabled people and their organisations—the experts by experience who have been through this process and would enhance this paper.
My hon. Friend the Member for Vauxhall (Florence Eshalomi) talked eloquently about how she had had a roundtable with the former Minister, and powerfully said how that had stayed with her and why co-production is absolutely key to building the trust of disabled people. What possible justification does the Minister have for not doing that? The Government need to learn from last week’s court judgment, which ruled that the national disabilities strategy consultation was unlawful. As many Members have said, a defence of “not set out to consult” fails to build trust with disabled people. The DWP must ensure that future engagement is far more robust and must urgently publish a plan for consulting with disabled people on the White Paper. It should allocate enough Government time for debate, ensuring that robust discourse can take place.
The next area that many Members mentioned is the adequacy of the benefits system. Even before the pandemic, disabled people were struggling to survive. As my hon. Friend the Member for Newport West (Ruth Jones) said, the number of disabled people living in poverty has risen by over a million since 2010. According to new analysis from the New Economics Foundation, single parents, pensioners and families with one or more disabled people are more likely to be the hardest hit by the rise in energy bills.
As my hon. Friend the Member for Cynon Valley (Beth Winter) said, people are worried that this Green Paper could be the start of a cost-cutting exercise. The Government must show that it is not. My hon. Friend the Member for Bolton South East (Yasmin Qureshi) articulated the problems and unfairness when people were moved from DLA to PIP. The House of Commons Library statistics show that, of the 1.5 million disabled people who were previously in receipt of DLA and who were reassessed for PIP, nearly half have seen their entitlement reduced or disallowed completely. While the Government might attempt to claim that that is positive, the high levels of mandatory reconsiderations and appeals tell another story.
We have a system that all too often places disabled people in extreme financial hardship. We know that the DWP has data on this. The Prime Minister committed to releasing the NatCen research it commissioned on the adequacy of benefits. What is the delay? Or is this something else he forgot? I welcome the fact that the Chair of the Work and Pensions Committee, my right hon. Friend the Member for East Ham, will see that research. I really hope it can be published, but as he rightly said, it is disappointing that the Government must always be pushed into doing these things.
The other area Members focused on was employment. There is no mention of the kind of work that disabled people have. Are these good or sustainable jobs? Do people get good incomes, or are they on unstable, zero-hours contracts with poverty wages? Sadly, evidence has shown that disabled people tend to be in lower-paid and unstable work, yet there is no acknowledgment of that in the Green Paper. Why does it put forward only a consultation on disability employment and pay gap reporting? The Minister could do that tomorrow. Will she? Perhaps she can give an answer in her response.
The Green Paper talks a lot about sickness management, but there is nothing on improving statutory sick pay. We need to support people who need short periods off work for sickness, so that they can return stronger and without fear of financial hardship.
Absolutely. I completely agree with the hon. Member and I think that is really important. I was just coming on to that point.
Will the guidelines the Government are going to produce be fit for purpose? Surely the Minister should recognise now that co-producing these with disabled people and disabled people’s organisations is the best way of ensuring that they work and deliver a more diverse workplace where the talents of disabled people are fully realised.
Disabled people have said that they often struggle to access their rights in the workplace and that employers do not always follow guidance. It is hard for disabled people to challenge that, and the legal process is expensive, especially for those who are not in trade unions. Where is the support for disabled people to ensure that they can access tribunals to hold their employers to account? I ask the Minister: why not provide additional support to disabled people’s organisations and charities and to trades unions, which offer vital support?
To conclude, I thank my hon. Friend the Member for Battersea once again for securing this vital debate, and other Members for taking part. I thank the many disabled people’s organisations, charities and trade unions that work tirelessly to support disabled people. As all Opposition Members have said, co-production is key. The Minister should start listening to disabled people, who are experts by experience.
It is a pleasure to work under your chairmanship, Sir Gary. I am grateful to the hon. Member for Battersea (Marsha De Cordova) for creating this opportunity for debate on a very important subject. We all believe in a compassionate welfare system. We have heard welcome contributions from all parts of the United Kingdom, and there are many parties represented.
More than one in five people in the United Kingdom are disabled. That is more than 14 million people. As the Minister for Disabled People, it is my priority to ensure that disabled people and people with health conditions are supported to achieve their potential and participate fully in everyday life. We know that disabled people and people with health conditions face many challenges to living independently and realising their goals.
I thank the Minister for giving way. Very briefly, she will have heard about the inhumanity of the assessments system this afternoon, and she will know that Wales suffers acutely, in that we have the highest level of disability and poverty in the UK. She will also have heard about the new system being introduced in Scotland, which will bring in a humane system of assessments. Will she commit in the White Paper to considering the devolution of the administration of welfare benefits to the Welsh Government?
I do not think that is likely to be in the White Paper. The hon. Gentleman might have heard that it is not our intention to further devolve welfare to the Welsh Government. None the less, I look forward to more conversations on that with him and with colleagues in the Welsh Government. I take a great interest in devolution affairs in the Department and will be able to have those conversations, just as I do with colleagues in the Scottish Government. I note what SNP Members have said today, which I will come to shortly.
Last year we published the health and disability Green Paper—the main subject of today’s debate—and the national disability strategy, which set out a wide-ranging set of practical actions to improve the lives of disabled people and affirmed our commitment to put disabled people at the heart of policy making. Support for the British Sign Language Bill, which was debated last Friday, is the latest example of such action. The health and disability Green Paper explored what changes we can make to the system, for three reasons—so that we better enable independent living, improve employment outcomes and improve the experience of people using the DWP’s services.
Both the national strategy and the Green Paper were informed by the views of disabled people, who told us in enormous numbers about their experiences and their priorities for change. Although it is not the main subject of today’s debate, I can confirm that we are disappointed at the judgment on the UK disability survey and intend to appeal. Of course, the Chamber will be aware that the court dismissed the claimants’ claims that the Secretary of State had been subject to a duty to consult.
We remain focused on delivering the contents of the strategy, which is broad and important. Ensuring that everyone has the same opportunity for a fulfilling working life is a key part of levelling up the country, on which I am sure I agree with the Chair of the Select Committee.
As was said in the debate, the grounds on which the Government resisted that case was that they were not properly consulting people in the first place. That is surely a hopeless position for the Government to be in. They should consult people properly from the start.
We certainly do have confidence in our consultation and our listening. I will not go into further detail on the strategy because there is so much else that I want to respond to today.
We have made progress, including significant progress towards our commitment to see an additional 1 million more disabled people in work by 2027. As my hon. Friend the Member for Watford (Dean Russell) explained, supported employment is very significant within that, but there is much more still to do, and I welcome the point made by the hon. Member for Strangford (Jim Shannon) that employers also need to rise and play their part in supporting disabled people or people with ill health in the workplace.
There is also more to do to improve people’s experiences of our services and to build their trust in the system. I have heard the comments made today, and that is why our aim in the Green Paper was to improve the experience of disabled people and people with health conditions by listening, learning and improving. We want to make our services easier to access and our processes simpler where we can. We want to make improvements that will help build people’s trust and explore ways to offer more and better support for the people who need it most.
Turning to the economy, which is important for the context of this debate, the last two years have been really tough. However, because of our focus on getting people into work, we had the highest level of employment that this country had ever seen when covid hit, and we have succeeded in supporting jobs and livelihoods throughout the pandemic. The economy continues to rebound. With around 1.2 million vacancies currently available, including in many sectors vital for our recovery, we want to get people into jobs that they can do right now. The jobs market presents huge opportunities for all jobseekers. I want to ensure that those opportunities and the world of work are accessible and inclusive for disabled people and those with health conditions.
The hon. Member for Motherwell and Wishaw (Marion Fellows) mentioned the Way to Work campaign. I can reassure her that for those who are unable to take up employment due to their health conditions or personal circumstances, we tailor their requirements to their capability and situation to ensure that all that we ask of them is realistic and achievable.
We understand the pressures that people are facing with the cost of living, and we will continue to listen to people’s concerns, as we have done throughout the pandemic. That is why we are providing support of around £12 billion this year and next to help families with the cost of living.
Many important points were made during the debate about the assessment system and the benefits system. The benefits system considers the impact that a health condition or disability has on an individual’s ability to work and carry out day-to-day activities. As all hon. Members know, decisions are based on an assessment of an individual’s functional ability, not their diagnosed health conditions. Claimants are of course encouraged at the outset of their claim to provide all evidence that is relevant to their case, including medical evidence supplied by their GP or other professionals such as support workers, carers or community mental health nurses. We recognise that attending a health assessment can be a stressful experience, which is why, whenever we are able to assess somebody solely on the available paper evidence, we do so.
It is of course important that the benefits system is fair to both benefit recipients and taxpayers. We think that our health assessments are a fair and robust approach to managing the gateway to benefits, with our decisions based on evidence and objective criteria.
I want to acknowledge a point that has been made by a number of hon. Members before I give way to the hon. Lady who secured the debate. That is the point about transparency, which was raised by the hon. Member for North East Fife (Wendy Chamberlain) and others today. Transparency is a key principle in our Green Paper, and will be very important going forward.
We are talking about a Green Paper. The point of a Green Paper is to improve the system, so we should continue the debate that we are having.
We are committed to ensuring that people get a good service from our assessment providers. On training, all assessors are of course subject to ongoing quality checks and an audit process, so they all have access to specific training and guidance on a wide range of clinical conditions. To the Labour Members who want us to end the use of private providers, I simply confirm that we intend to continue to use providers.
I now turn to some of the statistics that have been used in the debate.
I am terribly sorry, but I now need to make progress to cover as many of the points that have been raised as I can.
Since October 2013, 3.2 million completed work capability assessments for ESA have taken place. Just 3% of those have gone on to complete an appeal against a fit-for-work decision, and 2% have been overturned at a tribunal hearing. Since PIP was introduced, 4.6 million initial decisions following an assessment have been made; 9% have been appealed and 5% overturned at a tribunal hearing. It is important to set that broader context around appeals and tribunals.
Although we know that most people who claim health and disability benefits have a positive experience—indeed, people themselves tell us that—we recognise that that is not always the case, and we are working hard to improve the assessment system for our claimants. We are committed to assessing people as quickly as possible, so that they get the benefits to which they are entitled. As several hon. Members have rightly said, we want to get backlogs down. Managing journey times for claimants is a priority for the Department. That is why we are using a blend of phone, video and face-to-face assessments to support customers and deliver a more efficient and user-centred service. We are increasing case manager and assessment provider health professional resource, and we are prioritising new claims.
I will briefly touch on the very sad points made by the hon. Member for Middlesbrough (Andy McDonald). He asked me to look at some specific cases; he will appreciate that there are boundaries to my powers to do so, but I can tell him that of course we want to do all we can to ensure that people get the right support as quickly as possible. We also have processes in the Department for identifying possible improvements from serious cases to prevent such things happening in the future. Of course, it is incredibly sad and tragic whenever any person dies, and I convey my condolences to his constituent’s family.
During the pandemic, we introduced a series of easements to help disabled people and people with health conditions to access our services. We made changes to ESA to help people who had covid, or had been advised to self-isolate, to access the benefit more quickly.
I will move on to some of the key points in the Green Paper and provide some updates to the House. We announced our intention to replace the current six-month eligibility rule for the special rules for terminal illness with a 12-month end-of-life approach. That is extremely important and there will be more details before the House soon on various parts of that implementation.
Our health transformation programme is integrating the services that deliver personal independence payment assessments and work capability assessments into a single service supported by a single digital platform. I note the example provided by the hon. Member for Battersea of a constituent who felt that they had had a particularly disjointed service from those two. We recognise the need to go further and rightly, therefore, consulted on several initiatives in the Green Paper to change the application and assessment process for the better, guided by the three priorities that I already mentioned.
We announced our intention to test a service that provides support for the most in need to help them to navigate the benefits system and other Government services. We will be setting out more detail in the White Paper. I note the points made by the hon. Member for Bolton South East (Yasmin Qureshi) about severe disability. We announced our plans to test a new severe disability group for those with severe and lifelong conditions. Again, in the White Paper, I will be able to provide further details of the work on that.
The Green Paper also looked at how we might separate the assessment for financial support from employment considerations, encouraging people to take up employment support, leading to better employment and independent living outcomes. Again, we will be beginning various tests of an employment and health discussion over the next couple of months regarding that.
We received more than 4,500 responses to the Green Paper proposals. We are very grateful to all those who fed in their views. Listening to disabled people is critical. We are now analysing the responses, along with the views expressed to us by people who attended one of the more than 40 consultation events that took place over that period. That included the first meeting with our newly founded ethnic minority forum, where we heard from people from ethnic minority backgrounds about their real lived experiences of the benefits system. As I say, we will be able to bring forward a great number of updates in the White Paper later this year. I continue to work closely with disabled people, disabled people’s organisations and many of the charities also mentioned today. There are several areas of work where I hope to co-produce the outcomes with them.
I reiterate my and the Government’s commitment to improving the lives of disabled people. I am proud of the progress we have made so far. We have put forward some important reforms to go further and build trust and to ensure that disabled people have every opportunity and support that is needed.
I express my warm thanks and appreciation to the hon. Members who have contributed to what I believe is a very important debate. This has to be an ongoing dialogue because, sadly, I feel slightly disappointed in the Minister’s response. We heard from my hon. Friend the Member for Vauxhall (Florence Eshalomi), the hon. Member for North East Fife (Wendy Chamberlain), my right hon. Friend the Member for East Ham (Stephen Timms), my hon. Friends the Members for Bolton South East (Yasmin Qureshi), for Newport West (Ruth Jones), for Middlesbrough (Andy McDonald), and for Cynon Valley (Beth Winter) and the hon. Member for Strangford (Jim Shannon), along with incredibly powerful interventions from my right hon. Friend the Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Hampstead and Kilburn (Tulip Siddiq), for Sheffield Central (Paul Blomfield) and for Oldham East and Saddleworth (Debbie Abrahams).
The Minister did not truly address the issue around private contractors. We have spent billions in funding private companies making profit out of poor, sad and distressing experiences for ill and disabled people and really putting profit before health. That is unacceptable and, frankly, quite disgraceful. The Minister did not address whether she would agree to an independent inquiry into the deaths of so many ill and disabled people. This is a national scandal and in any other environment an inquiry would happen, so it should be happening now for ill and disabled people, because for far too long we have been treated as an afterthought. It must end now. Finally, when the Minister brings forward her White Paper, I hope for her and her Government’s sake that they finally begin to take the lives of disabled people seriously.
Question put and agreed to.
That this House has considered disability benefits assessments and the Government’s health and disability green paper.