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Work Capability Assessment Consultation

Volume 737: debated on Tuesday 5 September 2023

With your permission, Madam Deputy Speaker, I will make a statement on our proposed changes to the work capability assessment, which aim to ensure that no one who can work is permanently written out of this country’s strong labour market story. It is a story that has seen nearly 4 million more people in work compared with 2010, 2 million more disabled people in work than in 2013 and record numbers of people on payrolls. But although the overall number of people who are economically inactive has fallen strongly from its pandemic peak, there remain over 2.5 million people who are inactive because of long-term sickness and disability. Yet we know that one in five people on incapacity benefits who are currently not expected to prepare for work want to work in the future if the right job and support were available, and the proportion of people going through a work capability assessment who are being given the highest level of award and deemed to have no work-related requirements at all has risen from 21% in 2011 to 65% last year.

This situation is excluding significant numbers of people from receiving employment support to help them to move closer to work opportunities. It is holding back the labour market and the economy, but perhaps most important of all, it is holding back human potential. I want to ensure that everybody who can do so benefits from all the opportunities that work brings—not just the financial security, but all the physical and mental health benefits too. No one who can work should be left behind. That is why, earlier this year, we announced an extra £2 billion-worth of investment to help disabled people and those with health conditions to move into work. That includes bringing in our new universal support employment programme, which will assist disabled people and those with health conditions to connect with vacancies and provide support and training to help them to start and stay in a role.

Through our individual placement and support in primary care programme, we are investing £58 million to help more than 25,000 people to start and stay in work. We are modernising mental health services in England, providing wellness and clinical apps, piloting cutting-edge digital therapies and digitising the NHS talking therapies programme. We have also published fundamental reforms to the health and disability benefits system through our health and disability White Paper. That will see the end of the work capability assessment and a new personalised tailored approach to employment support to help everyone to reach their full potential.

The scale of our reforms means that it will take time to implement them, but there are changes we can make more quickly that will also make a difference. So before the White Paper comes in, I want to make sure that the work capability assessment—the way we assess how someone’s health limits their ability to work, and therefore the support they need—is delivering the right outcomes and supporting those most in need. Today my Department is launching a consultation on measures to ensure that those who can work are given the right support and opportunities to move off benefits and towards the job market. As I have said, we know that many people who are on out-of-work benefits due to a health condition want to work and, assisted by modern working practices, could do so while managing their condition effectively.

We have seen a huge shift in the world of work over the last few years, a huge change that has accelerated since the pandemic. This has opened up more opportunities for disabled people and those with health conditions to start, stay and succeed in work. The rise in flexible working and homeworking has brought new opportunities for disabled people to manage their conditions in a more familiar and accessible environment. More widely, there have been improvements in the approach many employers take to workplace accessibility and reasonable adjustments for staff. And a better understanding of mental health conditions and neurodiversity has helped employers to identify opportunities to adapt job roles and the way disabled people and people with health conditions work.

The consultation I am publishing is about updating the work capability assessment so that it keeps up with the way people work today. The activities and descriptors within the work capability assessment, which help to decide whether people have any work preparation requirements to improve their chances of getting work, have not been comprehensively reviewed since 2011, so it is right that we look afresh at how we can update them given the huge changes we have seen in the world of work.

For instance, the work capability assessment does not reflect how someone with a disability or health condition might be able to work from home, yet many disabled people do just that. Our plans include taking account of the fact that people with mobility problems, or who suffer anxiety within the workplace, have better access to employment opportunities due to the rise in flexible working and homeworking.

We are consulting on whether changes should be made to four of the activities and descriptors that determine whether someone can work, or prepare to work, to reflect changes in working practices and better employment support. This includes looking at changing, removing or reducing the points for descriptors relating to mobilising, continence, social engagement and getting about. We are not consulting on changes to the remaining descriptors, which will remain unaltered. These changes will not affect people who are nearing the end of life or receiving cancer treatment, nor will they affect the majority of activities for those with severe disablement, such as if a person has severe learning disabilities or is unable to transfer from one seat to another.

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

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

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

I commend this statement to the House.

I thank the Secretary of State for early sight of his statement.

I know from talking to disabled people in my constituency and across the country that work can bring dignity and self-respect through the choice, control and autonomy from having money in their pocket and making the contribution they want to make in life. Work is the reason for my political party, and supporting working people is why Labour Members get up in the morning. That belief is shared by the British public, including hundreds of thousands of people who currently feel shut out of the workplace and trapped on benefits when they could work if they had the right help and support.

On this Government’s watch, a staggering 2.6 million people are now out of work as a result of long-term sickness. That is the highest number ever, up almost half a million since the pandemic alone. This is a serious challenge for millions of our constituents and for the economy, and it deserves a serious response, but that is not what we have seen today.

Labour has been warning for years that benefit assessments are not fit for purpose and, crucially, that unless we have a proper plan to support sick and disabled people who can work, even more will end up trapped in a degrading benefit system, costing them and the taxpayer far more. Labour has already set out plans to transform the back-to-work help that is available by personalising employment support and tackling the huge backlogs in our NHS and social care. Our “into work guarantee” will let people try work without fear of losing their benefits. Our plan is backed by the Centre for Social Justice, the Social Security Advisory Committee and disabled people’s organisations. Why not the Secretary of State?

We will ensure that employment support meets specific local needs through proper devolution to local areas and, when disabled people get a job, we will make sure they get the support they need to keep them there as soon as they need it, rather than having to wait for months on end.

We will study the consultation carefully, but I see nothing in the statement that matches Labour’s vision or scale of ambition. It does not even deal with the glaring problems in the current system. Eighty per cent of personal independence payment decisions are overturned at tribunal, of which only 2% are because new evidence has become available. How will the proposals make any difference to the totally inadequate decision making that causes untold stress to disabled people and wastes millions of pounds of taxpayers’ money?

The backlog of Access to Work assessments has trebled to 25,000 since the pandemic. How will the proposals help to bring that down? Where is the plan to help slash waiting lists for help with anxiety and depression, which we know is a major problem, or to get the carers that families need to look after sick and disabled relatives so that they themselves can work?

This is not a serious plan. It is tinkering at the edges of a failing system. If you run your NHS into the ground for 13 years and let waiting lists for physical and mental health soar, if you fail to reform social care to help people care for their loved ones and if your sole aim is to try to score political points rather than reforming the system to get sick and disabled people who can work the help they really need, you end up with the mess we have today: a system that is failing sick and disabled people, failing taxpayers and failing our country as a whole. Britain deserves far better than this.

I thank the hon. Lady for her remarks. It is gratifying that she agrees with much of the premise I set out. She recognises the importance of work and that 2.5 million people, or thereabouts, are on long-term sick and disability benefits—we are all equally concerned that the number is growing. She also argues that the work capability assessment, in its current form, is not fit for its required purpose, which is exactly why we are coming forward with these reforms. She refers to the PIP assessment requirements, which are not relevant to the work capability assessments that we are discussing and that are subject to the current consultation.

We clearly have a plan. The hon. Lady has been in her position for a very short period, and I respect and understand that. I invite her to look closely at the announcements that were made—the £2 billion-worth of support at the last fiscal statement, including our White Paper reforms in exactly the area where she is seeking progress; the universal support; and the WorkWell programme. She mentioned working with local providers, and there is a huge drive on that. As for mental health, we are consulting on occupational health across businesses to make sure that we get in right at the start where people may otherwise end up on a long-term health journey. We are also working closely with the NHS on getting employment advisers involved, for example, in talking therapies, which we know are so effective in addressing mental health concerns.

I strongly support the initiative to help more people who are long-term sick and disabled into work where they wish to do that. My query is: why on earth is it going to take so long? We need to be doing this now, to ease our workplace shortages and to give those people earlier support and hope. Will my right hon. Friend please work with his officials to speed it all up?

I share my right hon. Friend’s keenness to see these proposals—whatever may or may not emerge—come forward as soon as possible. They will require a lot of work on IT systems and changes to systems. The providers will have to incorporate the changes that may or not come forward as a result of this consultation. Let me reassure him that, given the benefits there will be to many people who will otherwise not benefit from work, I am as anxious as he is to make sure that we move forward at speed.

The big difference between the SNP and the Conservative and Labour parties is that we do not approach this from the point of view that people are somehow on the make and on the take; we do not assume that when somebody comes for an assessment they are somehow trying to cheat the Government. That is why it is important that the Select Committee on Work and Pensions noted in its recent report the concerns that disabled people are still experiencing psychological distress as a result of undergoing these health assessments.

Let me show just how perverse some of those assessments are. One of the first constituency cases I dealt with as an MP involved someone literally being asked at an assessment whether they still had autism. That gives us an idea of how fundamentally flawed this whole process is. Has the Secretary of State read the Institute for Public Policy Research report that came out today? It makes a specific recommendation to:

“Limit conditionality to facilitate person-centred support on universal credit.”

It says:

“People with health conditions, single parents and parents of young children on universal credit should be exempt from requirements or financial penalties under any circumstances.”

Has he seen that?

Will the Secretary of State also agree to look again at the Access to Work scheme? Far too often, the Government’s own Committee has received evidence that shows that Access to Work simply is not working. I come back to my fundamental point: will the Government change their philosophy—this deep suspicion that somehow claimants are on the make and on the take? All they actually need is support from their Government.

I respect the hon. Gentleman; having appeared before the Select Committee, I know how seriously he takes the matters that he has raised. However, I cannot accept being described as bearing down on those who are

“on the make and on the take”.

If he can find any example of myself or my Ministers making those assertions, I would like to see it. In the absence of that, I hope that he will be big enough to withdraw those comments.

The hon. Gentleman does not like the assessments, but we hear nothing about alternatives or what the SNP’s plan is to replace assessments. If there are inherent problems with assessments, presumably the logic is that he is not going to assess anybody at all. So we do not know what his plan is. He refers to conditionality, so let me make a point about that. There are those whose health and disability situation is such that I passionately recognise that they should not be expected to undergo any work to look for work or to carry out work itself. As a compassionate society, we should be there to support those people, and we will continue to do so. But where somebody can work, there is a contract between the state and the individual: if people are to be supported and they can work, it is right that they should be expected to do so. In those circumstances, the conditionality should apply.

The hon. Gentleman made specific reference to Access to Work. That programme provides up to about £65,000 for each individual involved to bring forward adaptations to the workplace to accommodate that individual into employment. It is a huge commitment on the part of this Government, and I can inform him that the latest figure I have is that 88% of those applications are being processed within 10 days.

It is greatly welcome that we are trying to get the assessment to give people the outcome they deserve, but it is intriguing to make what sounds like a fundamental change to an assessment that we are going to try to scrap in a few years’ time. Will the Secretary of State set out how many of the 2.5 million people he cited as being in this situation he thinks would not be in the same group after these changes? How many of them will have a chance to be reassessed before we scrap the assessment entirely?

I dealt in my statement with my hon. Friend’s question about why we are doing this, given that we will be getting rid of the WCA in due course: I said that there is no reason why we cannot bring forward these benefits earlier, even though we are going to be removing the WCA altogether. As for the numbers impacted, we know that about one in five people on those benefits do want to work, given the right support. Until the consultation is concluded and we know the exact nature of the policy changes that we may or may not be making at that point, we will not be able to assess the numbers exactly.

This will lead to a lot of fear among disabled people. I appreciate the tone that the Secretary of State has taken, but the record of the past 13 years has been one of excluding the most vulnerable disabled people from more support than they need. We know that disabled people are a group who are living in huge poverty. We also know that some of them have died, not just through suicide, but because of the lack of safeguarding in the Department and how it operates. So I urge him to ensure that the safeguarding system within the Department ensures that people are protected. I agree with the SNP spokesperson about Access to Work; we are talking about 4 million disabled people able to work and 35,000 being provided with it through Access to Work.

I listen to the hon. Lady’s remarks with great respect; having appeared before her at the Select Committee, I know how serious she is about the issues she raises and how strongly she promotes her ideas and concerns. She mentioned the lack of support available for the people in the situation we are describing, which is precisely why I want to start providing more support to them by making these reforms. Let me make an important point in an area where I am in agreement with her: we need to do this in the right way. We need to listen carefully to those who will be affected by any changes we may bring forward, which is why we have a full eight-week consultations. My Ministers and I will be engaging closely with the various stakeholders, disabled people and so on. We will of course welcome her comments as part of that process.

When I was a Minister, whenever I went on a visit I would ask young disabled people what they would do if they were the Minister. They said that they would always want to have the same career opportunities as their friends. I therefore welcome any moves to make more personalised and tailored support available, to build on our record disability employment. However, we lose more than 300,000 people a year from the workplace and the majority of long-term health conditions and disabilities develop during the working age. So during this consultation I urge the Secretary of State to work with employers to see what more support and advice they need to make sure that people do not ever have to even enter the WCA system.

I thank my hon. Friend for that typically sensible and astute intervention. May I personally thank him for the advice and input he has given over the preceding months, particularly in this area? He is right that we should be proud of our record of assisting disabled people into work—2 million more in work since 2013. Equally, he is right about addressing the hundreds of thousands of people with these kinds of difficulties and challenges who are leaving businesses and the workforce every year. I recognise that it is essential to get help to those people as early as possible, before they progress too far along that health journey. That is why we are already consulting on occupational health, so that we can make sure that is rolled out more effectively across large and medium-sized businesses.

In his statement, the Secretary of State mentioned that four descriptors would be reviewed, but there were no plans for any other changes. He certainly did not mention adding any descriptors. At yesterday’s Westminster Hall petition debate on disability assessment, one of the key issues discussed was remitting and relapsing conditions, particularly fatigue. Will the Secretary of State commit to looking at fatigue, and either adding it as a descriptor or telling us what he is going to do about it instead?

Nothing in the consultation excludes bringing forward exactly the point that the hon. Lady makes. I hope she will do just that, and encourage others to do so as well.

The Secretary of State is quite right to refer to the 2 million additional people with disabilities who have come into work since 2010. He will recall that the first Disability Confident event, held in 2013, was in Gloucester. His Department worked closely with charities and employers to ensure that more opportunities happened. I have met many people who benefited from that programme, so I support him in the principle. Can he confirm that he will engage closely with charities and organisation such as Seetec Pluss, which has a lot of experience in helping to bring people with disabilities back into the workplace?

I thank my hon. Friend for all the passion and intelligence he brings to these issues. I can confirm that our door will be open to Seetec Pluss. In fact, I will go further and make sure that our officials reach out to my hon. Friend to ensure that that happens.

In a key paragraph of his statement, the Secretary of State appears to envisage that he will either remove or reduce the descriptors giving access to benefits for people who have problems with mobility or are incontinent. Will he explain what he means by that? Will he also tackle problems on the other side of the world of work, including rogue employers exploiting people through low-paid part-time or temporary jobs? One in nine workers are in poverty as a result. Is it not time that he took on the employers rather than the poorest in our society?

That sentiment of taking on the employers is probably not conducive to having an economy that is generating the jobs that have occurred under this Government. As to the descriptors—indeed, the activities—that the hon. Gentleman refers to, there is a plethora of information out there about exactly what those mean. If he has trouble finding that, I would be very happy to have my Department point him in the right direction.

The Secretary of State rightly points to the tripling of the number of people receiving the highest award after a work capability assessment. Does he share my concern that a false assumption is growing not only that those people cannot work, but that they should not work, which therefore writes them off? Do we not have a serious moral obligation to remove all sorts of barriers that come between those individuals and the workplace? His approach is exactly right in trying to target those obstacles that most get in the way of people enjoying the agency and autonomy that activity in the workplace brings.

I thank my hon. Friend for the advice and support he has given me when we have discussed these issues over the last few months. I know he is extremely knowledgeable in this area. He is absolutely right that we do not want people to be trapped, to use that expression, on benefits. We want to help people to move into the labour market and work. That is better for the economy and the labour market, but most importantly it is better for the physical and mental health of the individual concerned, as shown by all the evidence.

I declare an interest as the chair of the all-party parliamentary group on myalgic encephalomyelitis. The Secretary of State has said that the work capability assessment is not fit for purpose, and many disabled people with invisible or fluctuating conditions would agree with him entirely. They report not being believed, their medical evidence being disregarded and leaving the assessment feeling as though they have been belittled by the assessors. The Department of Health and Social Care is undergoing a massive change in the way it deals with people with ME and other conditions like ME. Can he provide an assurance that his Department will look at how people with ME and other invisible disabilities are being considered through work capability assessments?

I can give the hon. Lady exactly that assurance when it comes to ME. I point her to the White Paper that we published in March, in which we made a clear commitment on fluctuating conditions and said that we would test and trial around those conditions, as part of the White Paper process.

I welcome the Secretary of State’s statement and thank him for his offer of more personal, tailored support for disabled people, who we must always do our best to help and support. Given that this is the 21st century and there have been huge advances in medical treatments, adaptations of buildings to help disabled people, improvements in mobility devices and a rapid rise in digital connectivity, it is staggering that the proportion of people going through a WCA who are deemed to have no work-related requirements at all has gone up from a fifth to almost two thirds in just over a decade. Why does the Secretary of State think it is like that?

It is correct that we have gone from 21% to 65% in that short space of time and I recognise that that statistic is simply unacceptable. We know that one in five people in that group wants to work, given the right support, and we need to do something about that. Quite rightly, my hon. Friend also raises the fundamental change in the way that work is conducted in the modern world. The last time the work capability assessment was reviewed for reform was 10 years ago. That is inadequate and it is now time to make appropriate changes.

There are 76,000 people in Wales with a severely limiting condition. New research this summer shows that four in 10 of them are having to skip or cut down on meals or have gone without heating. Is the Secretary of State confident that the proposed changes will remedy that?

It is a fact that people are better off, on average, being in work than being on benefits. I pay tribute to my predecessor who introduced universal credit, which makes that the case. Bringing people into work who would not otherwise be in work means that they will, on average, be better off. This Government have increased the national living wage by over 9%—it has been £10.42 since April—and have introduced cost of living support for 8 million low-income households, 6 million disabled people, pensioners and so on. In response to the hon. Gentleman, the proposed changes are another step in exactly the right direction.

In response to my hon. Friend the Member for Kettering (Mr Hollobone), the Secretary of State referred to the statistic of 65%. It strikes me that out of that 65% of people, a number of them could work, should work or want to work, because that is the best thing for them. Building on the 2 million people with disabilities who we have got back into work, is it not the case that there must be people who are trapped in that 65%? Is it not imperative for the Secretary of State and his officials to get those people into the world of work as soon as possible?

My hon. Friend has used exactly the right word: it is imperative that we get those people into the world of work. If somebody is on benefits—and we know that one in five of those people would, with the right support, like to get into work—it is our duty as a Government and as a society to do whatever we can to support them.

In 2011, this Government said that they would help 100,000 disabled people into employment through dedicated personalised support, such as Access to Work. In the 12 years since, the number of disabled people supported by Access to Work has risen from 37,000 to 38,000. Given the Department’s failure and the wider context of cuts, would disabled people not be forgiven for thinking that this is just further cuts dressed up as modernisation?

Not at all, Madam Deputy Speaker. I have set out very clearly the principled reason why we are bringing forward these measures. As the hon. Gentleman will know, when it comes to more disabled people moving into the workforce, we set a target for the 10-year period from 2017 to see a million more disabled people in employment. We broke that target in half that time, reaching 1.3 million in addition after just five years.

The number of people who are economically inactive due to long-term sickness has reached a record high of 2.55 million, which is very concerning. Given the Secretary of State’s fanfare today, what level of reduction in those figures would he measure as a success in supporting disabled people into secure and sustainable employment? What specific improvements does he envisage to the sorely inadequate Access to Work scheme to prevent the disability employment gap widening even further?

I have addressed the issue of Access to Work—what a significant programme it is and the recent improvements in the processing of those particular awards. On economic inactivity, I make two points. First, compared with the EU, the OECD and the G7, economic activity overall is below the average across those different groups. Secondly, it has declined by about 360,000 since the peak that occurred during the pandemic, and that in substantial part is due to the policies of this Government.

It is very noticeable that the Secretary of State did not answer the question of the hon. Member for Wellingborough about why he believes that there has been a trebling of the number of people who are now getting the maximum verdict under the work capability assessment. I have helped many of my constituents who have had problems with their WCA, and not one of them has come to me and said that it is the WCA that is keeping them out of work. Many of them have said that it is not nuanced enough to understand the issues, and I welcome the fact that it is to be replaced. However, can the Secretary of State tell us what assessment he has made of how many people are likely to win their appeals after the changes that he has brought in, and what percentage are winning them now? At the moment, huge numbers are winning their appeals, which makes it clear that the work capability assessment is not working.

I feel duty bound to correct the hon. Gentleman. It was my hon. Friend the Member for Kettering (Mr Hollobone) who asked the question to which he referred. Of all the Members in this House, he is probably the one who promotes his constituency the most, and he should be lauded for doing so.

The bottom line is that we know that one in five, or thereabouts, of those who are receiving these benefits at the moment actually want to do some work, if they are supported in doing so. That means that we have a duty to look at the way that the WCA operates and to look at reforming it to make sure that, in every case that somebody can do some work to the benefit of themselves and the economy, we facilitate that.

I have been supporting a disabled student who has not been able to access universal credit because their work capability assessment was not completed before they started their studies. They are now at risk of dropping out of university, because they cannot work to support themselves through their course because of their disability, and they cannot access social security either. That means that they cannot improve their skills and abilities, when that might lead to an opportunity of employment in the future. What resources or flexibilities, if any, are featured in this consultation and the Department’s plans so that my constituent can carry on with their studies, and others will not face the same situation in future?

The hon. Gentleman is able to feed into the consultation and I encourage him and his constituents, as appropriate, to do so. I cannot comment on the individual case that he raises, but if he would like to get in touch with me and my private office, I would be very happy to look at the circumstances that he has raised.

I think all of us in this place would welcome an improvement to the work capability assessment. Like many others here, I have had a number of constituents who currently receive PIP payments coming through my door. They have contacted the DWP to advise officials that their situation has significantly deteriorated. They now face lengthy delays of several months before their payments are taken over by Social Security Scotland and their change in circumstances is considered. Can the Minister assure us that, in the work being undertaken and in the consultation, there will be discussion between the DWP and the Scottish Government to make sure that payment recipients in Scotland are not put at a significant disadvantage, and that the upheaval that they are currently undergoing is taken into account?

I thank the hon. Lady for her question. Just to clarify, there are no plans on the part of the Government to make any changes to the way in which PIP operates—and she did refer specifically to PIP. On the broader point, which is an important point about the interaction between my Department and the Scottish Government, I assure her that I have written today to my Scottish counterpart to open my door to whatever discussions they wish to have. The Minister for Disabled People will also be having his regular engagement with the Scottish Government next week.

I am almost tempted to say another week, another consultation. Disabled charities come to me regularly with real doubts and worries about the way disabled people are being treated. I visited Project Search in my constituency last week. It was wonderful and inspiring—they practically had to throw me out the door. It is a programme that takes in young people, often from college, with severe disabilities and learning issues and gets them into work and then continues to support them. The support that is offered once people get into work is crucial to the success of any programme the Government undertake, and how they treat these people is vital. What is the Government going to change? How are they going to change these work capability assessments to benefit the recipients, and how will they treat the people that they force into them?

I believe that my hon. Friend the Minister for Disabled People will be meeting the hon. Lady very shortly. That is in the diary, so those matters can be discussed in greater detail then. Specifically, she asks what support we will be providing. It will be exactly the kind of support to which she has just alluded. There will be universal support to help train and place individuals in work, and it will stay with those individuals for up to 12 months to make sure that they get the support to hold down that job.