ESA and Personal Independence Payments [Nadine Dorries in the Chair] 14:30:00 Angela Crawley (Lanark and Hamilton East) (SNP) I beg to move, That this House has considered employment and support allowance and personal independence payments. It is a pleasure to serve under your chairship, Ms Dorries. First, I wish all my constituents a happy St Andrew’s day. It is a privilege to bring the difficulties of many of my constituents to the House for consideration, and those of the people across the UK who have experience of trying to access support when they need it most through either employment and support allowance or personal independence payments. Since I became an MP, a large percentage of the constituency casework that I or my staff have dealt with has been a result of ESA and PIP issues. Owing to the very nature of the benefit that they are trying to access, these people are vulnerable. Many are experiencing serious illness for the first time in their lives and are facing a huge process of adjustment. That is hugely stressful, and this process is hugely stressful for those individuals, who often feel dehumanised and part of a process. The assessment procedure only serves to make things worse. Of the ESA and PIP cases that my office has dealt with—I will discuss one particular case in detail today—many have involved complaints about the assessment process. These assessments are often inhumane, needlessly stressful and unfair to claimants. Many other cases have required intervention following unsuccessful personal independence payment claims, the vast majority of which have been overturned on appeal. My constituency is sadly not an anomaly when it comes to appeals figures. The latest statistics on appeals against PIP decisions show that 65% of appeal decisions found in favour of the claimants. Not only does that highlight a deeply flawed system, but it clearly shows that a number of people who are subjected to these highly stressful and often prolonged, protracted processes to get the support that they need are ultimately entitled to that support. The statistic of 65% of appeals overturned evidences that, and unless the Government can tell me statistics to the contrary, I am going to assume that their system is not working. It suggests that the system needs to be radically reformed. The high appeal and overturn rate is unacceptable—and unsuccessful on the Government’s part, if they are trying to drive down the number of illegitimate claimants—particularly when it impacts so negatively on the claimants who require this support the most. If you will indulge me, Ms Dorries, I want to turn to the case of my constituent, Donna. I have the permission of my constituent to raise this issue, and they have asked me to do so in order to illustrate the impact of the benefits system on their life and to highlight the serious inequality they face. Donna, who lives in Carluke, is a mother of two children. She has a supportive husband. She established a café called the Hope Café, which is a mental health charity, and she is an advocate and a champion for supporting those with mental health problems. I commend Donna on her bravery in opening up to me so fully about her experiences with the Department for Work and Pensions. She has given me permission to share her story in full, because she hopes that it will illuminate the effect of malpractice and the effect that the assessments had on her life. Donna became seriously ill with severe depression and anxiety 10 months ago. She told me that her mental illness made her believe that her two young children, aged eight and 10, would be better off without her in their lives. She told me that her mental illness made her believe that she was useless and worthless and had no skills worth sharing with the world. It made her think that her close friends and family were ashamed of her for being weak. That is the mindset of someone in the grip of depression, and it is incredibly difficult to break out of. Months later, thankfully, she is recovering, and as her background is working in mental health, she is keen to use her personal story to highlight the flaws in the benefits system and hopefully improve the process for others. Donna went through the application process for both personal independence payment and employment and support allowance, which she found, in her own words, extremely harrowing. She first contacted my office to ask whether we could intervene to support her, as she was required to attend capability assessments for ESA and PIP. Donna, being logical and thinking that this would be an end in itself, asked whether she could endure one assessment. We are aware that this is not how the process works. Instead, Donna underwent an employment support work capability assessment and was asked back for a further personal independence assessment. On both occasions, she endured the lengthy assessment procedures, because these are classed as two separate benefits and the assessments are carried out by two separate providers. She found both assessments incredibly difficult. She told me that the questions she was asked made her re-live the worst days of her life, and she felt that if she had not got the award, it would have been overwhelming. At points, it made her want to give up. Let me make the point clear: people experiencing severe depression already feel worthless. Being rejected for financial support gives concrete evidence for what they believe, in their minds, to be fact. For many people, it is the last straw. Donna told me that she was not surprised that, as a result, the suicide rates that she deals with every day are increasing. Donna told me that her illness affected not only her, but her whole family; however, she has been lucky to have great support from her family and friends. Many others are not so lucky. For many people, where would they be without family support? At the point of rejection from the benefits system, who are they supposed to turn to? Donna’s case highlights the fact that no consideration is given to the detrimental effect of the system on the already overwhelmed mental state of a person going through the assessment process. The reason they are in that position in the first place is often because of circumstances beyond their control. Consideration must be given to each individual applicant and their circumstances. The recent film “I, Daniel Blake” by Ken Loach highlights both the hard-hitting, honest and gritty reality and the brutality of this Government’s policies. Donna also brought up the fact that assumptions are made about claimants based on the observations of the health care professionals. She asked for a copy of her medical assessment report and was disgusted that comments were noted about her appearance, personal grooming and whether claimants are tired or sweating. The comments were as follows: “Looks tired…looks thin…underweight, clothing loose, dark circles under eyes ... unkempt, untidy … unwell … troubled … sweating … pale … facial expression showed no emotion but was tearful … restless … fidgety… difficulty coping due to anxiety … seemed agitated … poor rapport, poor eye contact … withdrawn … self-harm thoughts identified … no delusion … no obsessive ideas … unable to complete five rounds of ‘serial sevens’ … unable to calculate correct change when asked a sum … unable to spell ‘world’ backwards … unable to remember three objects first time … had insights into their illness.” I ask the Minister: is this the kind of system that the Government have set out to achieve? Is this a system that offers fairness, dignity and respect? Where, ultimately, is the humanity in that process? Although many of those factors may be indicative of illness, many are circumstantial and subjective, given the particular illness that someone may or may not be assessing. For example, how would Donna’s entitlement have been affected if she had been immaculately dressed, had been having a good day or did not exhibit some of the behaviours outlined in that prescriptive list? It has taken Donna 10 months to feel better. For seven of those months she has been awarded personal independence payment, and for the past four months she has been receiving employment support allowance. Access to those benefits has been vital to her recovery. Donna wishes to return to work when she can, and she can manage her own health. She knows her limitations, yet at this stage, due to her recovery, she faces the prospect of losing those benefits, which help her to sustain her family at this already difficult time. She is all too aware that if the support is removed too soon—which could mean pushing her back to full-time work—while she is at a vital stage in her recovery, she could end up right back at the beginning again. Like physical illnesses, mental illnesses take a long time to heal, and there is no consideration of that in this process. Donna suggested that it would be helpful to her health to have a phased return to work—as a professional in this area, she knows only too well about recovering from depression—whereby she could still claim benefit and return to work slowly to build up her strength. Permitted work was explained to Donna, but as she knows only too well from her professional experience and from talking to others, as soon as a claimant lets the Department for Work and Pensions know that they are able to work for a few hours, they are ultimately called for reassessment and asked to go back to work full time. Donna told me that she would like to do a few hours a week volunteering, to get back herself back on her feet, but the criteria apply even to voluntary work. There is no middle ground. Donna’s case illustrates that the work capability assessment is not fit for purpose. Sadly, that chimes with the calls from mental health organisations across the country, including Citizens Advice, the Disability Benefits Consortium, Mind and the Scottish Association for Mental Health. They have highlighted that the tick-box method of the work capability assessment fails to identify claimants suffering from debilitating mental health problems, and it certainly fails to take their needs into consideration. I mentioned figures for personal independence payments earlier. Similarly, the latest figures show that 59% of initial ESA decisions were overturned on appeal. The Government have made one small concession on ESA by scrapping the retesting of chronically ill and disabled claimants—so one small part of the system now relies on common sense over bureaucracy—but that has simply fixed one part of an altogether broken system. Although exemptions from repeated assessments for chronically ill claimants and those with long-term illnesses are welcome, it is extremely disappointing that the Department for Work and Pensions and the Secretary of State have not considered that for PIP claimants. I hope the Minister will take heed of the problems I have discussed with the work capability assessment and consider the effects that the process can have on the mental wellbeing of claimants. I respect the hard-working staff at the Department for Work and Pensions who ultimately are asked to administer this Government’s policy. My constituents and people up and down the UK deserve a social security system that is designed to offer people dignity, respect and fairness. It is time that the Government stepped up to their responsibility. We are all citizens, we are all human and we all deserve respect. Let me add that when the responsibility for personal independence payments is devolved to Scotland—I am sure the Minister will come to this point—we will look to design the system appropriately. As she will be aware, it takes time to get the system right, because ultimately we are talking about the most vulnerable people in society. They deserve a social security system that gives them fairness, dignity and respect. I am sure we can all agree on that. Nadine Dorries (in the Chair) I now call Mr Shannon—you are on the list, Mr Shannon. Did you put in to speak? 14:43:00 Jim Shannon (Strangford) (DUP) I did indeed, Ms Dorries. Absolutely. I am more than happy to be called—I am just surprised to be called right away. Nadine Dorries (in the Chair) You are first on the list today; I know it is unusual. Jim Shannon The first shall be last and the last shall be first. Whenever it happens, it is always good to be called. Thank you very much, Ms Dorries—I actually thought that the hon. Member for North Swindon (Justin Tomlinson) might have been asked, so I was looking at him, but no doubt he will participate at some stage. I thank the hon. Member for Lanark and Hamilton East (Angela Crawley) for setting the scene well. We are back to discuss this matter again in Westminster Hall, and it would be remiss of me not to give a Northern Ireland perspective on where we are. I am grateful that the Minister is in her place and all of us in the House appreciate it when she responds. I will give my opinion today—and others will give examples—of where the system is falling down. I have to highlight those key issues because my staff and I deal with them every day of the week. We see people across the table from us with angst and anxiety and all the associated issues of stress, and we say, “How can we help them and do things better?” I will speak about some of those things today. I have recently spoken about the changes to the employment and support allowance work-related activity group and what that means for people. The biggest issue is that the Government need to understand the difference between “ill” and “unable to work”. That, in a nutshell, is what the debate is about—the interpretation by the Department for Work and Pensions of what it means to be ill and what it means to those people who sit across the table from me every day and tell me they cannot work. The hon. Member for Lanark and Hamilton East referred to people being pasty, sweaty and anxious, and my staff and I see those things every day of the week. In the last month, we have seen in my office a former ward sister, a former construction business owner and a social worker, all of whom are now on ESA. Let me be clear: I do not believe for a second that those people are choosing not to work out of laziness. Who would want to go from earning £500 a week down to £75? People do not, but that is what happens. The inference from the Government in this whole policy is insulting—I say that with respect—and more importantly, is based on a false premise that cannot be allowed to stand. I have to challenge that in the House, respectfully and kindly, and say it to the Minister and Government directly. As hon. Members know, I do not criticise—I do not feel that that is necessarily what I do—but I need to highlight the issues and ask nicely for genuine compassion and understanding. The rationale seems to apply to PIP applicants as well. PIP is supposed to be for the help that people need to work. Apparently, the PIP assessment is intended to provide “a more holistic assessment of the impact of a health condition…on an individual’s ability to participate” in everyday life. It covers sensory impairments, development needs, cognitive impairments and mental conditions, as well as physical disabilities. Those five categories cover everything—medically, physically, healthwise——that there can be. The assessment looks at the extent to which the individual is capable of undertaking various activities. For some activities, someone can score points to help to meet the threshold for PIP if they can undertake that activity only by using an “aid or appliance”. That could include such things as artificial limbs, colostomy bags, walking sticks and non-specialist aids such as electric tin openers and long-handled sponges. I want to highlight two cases, one of which involves a young lady who has ulcerative colitis. My age is such that I can probably remember the day she was born. I have got to know her very well over the years due to her diagnosis with this unseen disease, and how it has affected her and other people in my constituency. She worked in the civil service but was granted medical retirement before 30 because her employer could no longer facilitate her working. A Government employer could not accommodate her ability to work one day and not the next, as her illness dictated. I understand the reasons why the Government and the civil service had to take a decision and say, “Look, we are going to have to terminate your employment.” However, that is where the problem started, and I cannot understand how they expect someone else to employ her when they let her go. It should be understood why this lady is no longer able to work and why her employer, the civil service—she was Government-employed—had to let her go. Why is this young lady in this conflicted position? She is asked, in respect of PIPs, “What job can you do? Where can we find you some work?” Let us be honest: that wee lassie would love to work if only she had the opportunity, but she cannot because of her disability. She is on ESA and is dealing with the stress of the proposed changes. We should never underestimate the impact of the stress of this position. I stress that as strongly as I can, because I see that all the time. She rang to make an appointment for her PIP form to be filled out. How will she be assessed? That is the question I am asking. She is currently on the higher-rate DLA—deservedly so, by the way. Will that be taken away from her? Ministers would say no, but the experience we have had so far in my office is raising fear in our mind and the minds of constituents. I see that all the time. The young lady’s condition has not improved one iota since her last DLA application. If anything, I would suggest that it has worsened, and there is real concern that the PIP changes will not help. The stress makes her even more ill. It is a vicious cycle that is repeated over and over again. The PIP is for people who need help for hygienic purposes and for safety issues, but the problem is that that is not being translated into the new proposals. I genuinely hold the Minister in the highest esteem. From her response, we need to understand how the system works and how it can help the people on whose behalf we are here to make a plea, so that we can take away the stress and hassle. On 11 March, it was announced that the number of points awarded in the PIP assessment would be halved for aids and appliances for “dressing and undressing” and “managing toilet needs”. Why would the Government reduce the points for things that are needed? I cannot understand that. As a result, 290,000 claimants will no longer receive the daily living component, and a further 80,000 will receive the standard, rather than the enhanced, daily living component. Budget 2016 estimated additional savings of £1.3 billion a year by 2019-20. That is great but where does it leave my constituent, who needs help during the night? Nadine Dorries (in the Chair) Order. Mr Shannon, lots of people wish to speak. Would you try to keep your speech to about nine minutes so everybody has an equal amount of time? Thank you. Jim Shannon I did not realise that. I will try to go at my Northern Ireland speed, which is very fast. The young lady I was talking about needs her sheets changed at night, and often replaced entirely, as well as someone to come in and take care of her during her bad periods. Her DLA paid for a carer to help her. Will PIP do the same? The answer should certainly be yes, but the points system is not set up for illnesses such as ulcerative colitis and Crohn’s disease. The Crohn’s and Colitis UK website contains a link to a PDF offering help and advice on the PIP for sufferers. The PDF is 70 pages long—that is how complex the system is and how much help people need to fill out the application. If that does not put off someone who is seriously ill, I do not know what would. Is this what was intended by the Government’s welfare reform? Did they intend to make it so complex and intricate that many people will give up and live in sub-standard conditions, rather than get the help they need to live with their illness? We should be concerned about people retreating inwards, their lack of confidence and the problems they face. Ms Dorries, you have given me a time limit. I just have two more paragraphs to get through very quickly. I wholeheartedly believe that the new system is failing people. I had a doctor on the phone to say that his patient’s decision was made without the assessor taking the time to request any information about the patient from the surgery. The doctor said, “Jim, if he doesn’t get this help he will have to go to a nursing home at 46 years of age.” The care packages that health trusts put in place are not sufficient to handle people who are not able to pay privately for the additional support they require. On their behalf, I again ask the Minister, most sincerely, kindly and humbly: please look at this benefit, remember why it was set up and understand that, for many, it is the difference between having support to live and simply being able to exist. Do not continue to push these ill people, many of whom suffer from mental health problems due to the stress and strain of long-term illness. In this House, MPs are called to protect and help the vulnerable, but that is not what this new ESA and PIP system does. 14:54:00 Justin Tomlinson (North Swindon) (Con) It is a pleasure to serve under your chairmanship, which seems almost a daily occurrence this week, Ms Dorries, given the Bill Committee I am also serving on. I pay tribute to the hon. Member for Lanark and Hamilton East (Angela Crawley). This is an important debate and a topic that regularly comes up, particularly in this room, which shows the importance of Westminster Hall. We are fortunate that we have a Minister who is very engaged and proactive when it comes to listening—particularly when the system is not quite working as it is intended to—and when it comes to acting and working with experienced charities, policymakers and all sorts to bring us all together. What we all want, regardless of which side of the House we sit on, is a fair system that supports the most vulnerable in society. It is a pleasure to follow the hon. Member for Strangford (Jim Shannon), who, during my time as a Minister, was really proactive and constructive on this issue. I had many good meetings with him to discuss specific issues and lessons we could learn from Northern Ireland, and to share best practice. Two issues have been raised: PIP and ESA. I gently remind Scottish National party Members that Scotland could take responsibility, certainly for PIP. During my time as a Minister, I had a good relationship with my counterpart in the Scottish Parliament. He was aware that Scotland could take on that responsibility as and when it was ready. Some 1.8 million people have already gone through the PIP process, which is considerably better than the old DLA system, and that is widely accepted by the vast majority of charities who represent people who have been through the system. Under DLA, only 16% of claimants got the highest rate of the benefit. Under PIP, it is 23.5%. It is far better at identifying hidden impairments and fluctuating health conditions. For example—this has been highlighted in the two previous speeches—under DLA, only 22% of those who had a mental health condition accessed the daily living component, yet under PIP, 66% did. For the higher rate of mobility, it was 9% under DLA; it is 24% under PIP. The new system is far better and more streamlined. The assessors are there to help people to fill in the forms. The fundamental problem with DLA was that it was, in effect, self-diagnosis. People would fill in a very long, complicated form. A lot of people did themselves an injustice by not highlighting all the issues they faced, often because they took them for granted. For example, they might think, “I can’t sleep at night. That’s just the way it is”, but they did not then highlight that in their forms. The forms were complicated, so people would not necessarily know which were the right bits to put down. Even worse, 70% of claimants on DLA had an indefinite award. It is very attractive for MPs to say, “We don’t want anybody ever to go through an assessment”, but the reality was that, under DLA, 70% did not. That sounds great, yet one in three claimants’ condition changes so significantly within 12 months that they should be on a different benefit. The vast majority of people who go through the system have a deteriorating condition, so if their condition has changed, it has probably changed for the worse and it is highly likely that they would therefore go from the lower rate to the higher rate of benefit. That was the single difference that contributed to why, under DLA, only 16% of claimants got the highest rate, and 23.5% get it under PIP. There were people who, for 10 or 20 years or more, were on a benefit below that which they were entitled to. They were unaware that they could have had an opportunity to go up. It is right, therefore, that we assess people to ensure that they are given the correct benefit. Now, common sense kicks in. If someone is on the highest rate of benefit, they have a deteriorating condition. Unless there is some miracle cure, they are likely only to be reassessed at the end of the 10-year period, and it would probably be very light touch. In effect, someone would phone and ask, “Has there been a miracle cure?” The answer would probably be no, and they might ask, “Can you provide the GP’s evidence that there has not been a miracle cure? That’s fine. You will go through.” It is those who are on the cusp of going from the lower benefit to the higher benefit who will have another assessment. The system is programmed to say, “This person nearly meets the highest rate of benefit. I suspect they will need it in nine months’ time.” It will automatically trigger a reminder to people that there is a reassessment, so they are not left languishing. I urge hon. Members to be careful in trying to stop people having an opportunity for an assessment. In cash terms, in 2010, DLA delivered £12.7 billion of benefit support. The combined DLA and PIP is now at £16.6 billion. When the scheme was first launched, the time until assessment was terrible. We had lots of debates here on that. I was not the Minister then, but I was warned when I first went into the role that we would have almost weekly debates. Some people were waiting up to a year for their assessment. That was unacceptable. For nearly 18 months now, it has been in a settled state, taking about seven weeks for an assessment and 13 weeks for the whole process, end to end, which is well below the initial target of about 16 weeks. Again, charities and those with a huge amount of experience accept that the system is working well. The forms have been streamlined. They are still longer than we might like, but it is always a balancing act because, if we do not capture all the information, people could miss out on the benefit they need. I repeat that the assessors are there to help the claimant. The Government set the amount of money and the points that are required, but the assessors are there to ensure that the form is completed. I have sat through assessments, and I have seen two different extremes. I saw the assessment of a practising nurse, and the assessment was super-quick. They used lots of very long words of which I had no understanding, and they were able to breeze through. At the other extreme, I saw an individual for whom English was not his first language. He had a mental health condition and was socially isolated. If he had self-diagnosed under DLA, he would not have qualified, but the assessor spent one hour and 10 minutes teasing out and piecing together the jigsaw to make sure that all the challenges he faced in his everyday life were accurately reflected. He would have ended up getting a higher benefit than he would have received under DLA. I urge those who criticise the assessments to go and view one, which can be arranged. They will have their eyes opened, because too many people claim knowledge based on a film that is there to make money, rather than based on the real world. Frankly, that is an insult to the huge amount of hard work that these trained professionals do to help some of the most vulnerable people. The facts are there to compare DLA with PIP. Debbie Abrahams (Oldham East and Saddleworth) (Lab) Rather than commenting on the film, which is a dramatic portrayal, will the hon. Gentleman comment on the “Dispatches” programme? That was not fictional; it was an actual portrayal of the assessment process that people go through. Nadine Dorries (in the Chair) Mr Tomlinson, the same applies to you as applied to Mr Shannon. Justin Tomlinson I will not be long. I am glad that the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) intervened. I have a feeling that she will not let me intervene on her later, so I can link this in nicely. The “Dispatches” programme showed an isolated incident that was totally unacceptable. The individual was moved, and rightly so. That is why we have external inspectors. Remember that we are talking about 1.8 million people, and I urge her to take up my invitation to go and view an assessment. Hearsay is not the right way to hold Governments to account. This is so important that people in positions of responsibility need to invest some time in going to see what is actually happening. Debbie Abrahams That is patronising. Justin Tomlinson It is not patronising. This is an important subject. There have been further improvements, including the removal of the 28-day rule for terminally ill people. That cross-party campaign has made a huge difference to those who are terminally ill, and it is a welcome measure. There is ongoing training, and I would like to see automatic recordings of all assessments, which would help the appeals process. That requires a change in the contract, which I understand is the intention. It is also right that assessors now encourage people to bring somebody with them into the assessment, which is particularly helpful for people who are not necessarily articulate, for whom English is not their first language or who would not have the confidence to display all their challenges. As the hon. Member for Lanark and Hamilton East said, the ESA and PIP assessments are not a million miles apart. I have too often heard of cases where someone has done one assessment one month and the other assessment the next month. In respect of the Green Paper, many organisations will lobby for some serious data sharing. In conclusion, because I have focused on PIP, I will briefly address ESA. The Green Paper is a wonderful opportunity, as the charity Scope said, because disabled people need “expert, tailored employment support”. We need to focus on what individuals can do, rather than on what they cannot do. It is important to provide tailored support, to recognise that people have fluctuating health conditions and to utilise the best parts of the universal credit system to allow for flexibility and common sense, particularly in relation to voluntary work that builds confidence to get people back into work. We need to provide ongoing support, through a specific named coach, when people go into work for the first time. I will continue to pitch, as a matter of importance, the small employer pilot, which was so successful that it should be rolled out across the rest of the country as quickly as possible. We need to unleash the opportunity for disabled apprentices. Everyone agrees it is a great thing, and we have signed it off. We now need to see it making a real difference, particularly for those with a learning disability. 15:04:00 Siobhain McDonagh (Mitcham and Morden) (Lab) I thank the hon. Member for Lanark and Hamilton East (Angela Crawley) for securing this important debate. I will focus on some of the logistical issues around PIP that could be improved at local level, drawing on the experience of the excellent Merton centre for independent living in my constituency. Merton CIL is a user-led disabled people’s organisation that delivers a range of services to disabled people across Merton. The practical experience and casework of its members has brought together a range of issues in relation to both ESA and PIP that demonstrates how disabled people are facing a significant and unfair disadvantage when accessing the benefits to which they are rightly entitled. Disabled people have been disproportionately hit by welfare reform, with the cumulative cuts to benefits and social care affecting them, on average, 19 times more than non-disabled people. Merton CIL’s experience has shown that PIP assessment centres are amazingly inaccessible. Some of my constituents in Mitcham and Morden in south-west London have been asked to travel as far as Deptford and east London to get to their assessment centre, journeys of about two hours each way, which is unacceptably difficult for many disabled people, many of whom pass their local centre en route to faraway destinations. Even the local centres in Wandsworth and Croydon are difficult to get to, because many disabled people in south-west London lack transport links. Unbelievably, some centres have no disabled parking, and others are not accessible for wheelchair users. Most have cramped and unpleasant waiting areas. All that demonstrates a lack of consideration and thought into practicalities. It is imperative that all PIP assessment centres should have an audit of accessibility and should be fit for purpose for use by disabled attendees. Research has also shown that the practice of overbooking appointments for assessment centres is commonplace and is based on the assumption that some people will not turn up, but the practice causes great distress and inconvenience to those who do. Shockingly, an assessor told Merton CIL that she had 20 assessments on her list per shift but that she expected to do only six in the time available. Many of my constituents have had to wait hours to be seen, or have had their appointments suddenly cancelled less than an hour beforehand. Many disabled people need to wait a substantial length of time even to get an appointment, and then to be kept waiting for hours on end, or to have a last-minute cancellation, after weeks of preparation and after getting someone to provide transport and to attend the appointment is completely unacceptable. Finally, and perhaps most worryingly, inaccurate assessments for both PIP and ESA are widespread, making the wrong decisions and causing a lot of pain to individuals who are entitled to those benefits. PIP works on a points system, and Merton CIL has witnessed many assessments in which people are assessed as having zero or very few points, with the result later being overturned in tribunal. For some of my constituents, their assessments were so far removed from their lived experience that they felt sure that their notes had been mixed up with someone else’s. Some of the disabled residents to whom I have spoken say that they have felt intimidated by aggressive assessors. Meanwhile, Merton CIL advocates who have attended appointments with residents have sometimes been prevented from asking questions or taking notes, in direct contravention of DWP guidelines. It is crucial that providers address that at local level by working with individual centres and staff. There is a range of other ESA-related problems, such as the practice of arranging unnecessarily frequent repeat assessments, the unfair and sudden stopping of ESA payments and the difficulty of successfully contacting the DWP to correct issues. We all know of the terrible pain and hardship that come with the appeals process, and it cannot be acceptable that two thirds of people applying for PIP and ESA are being forced to undergo a lengthy appeals process in order to access a benefit to which they are entitled. I hope the Minister will address some of the basic practical issues with the administrative process and with access to assessment centres in order to ensure that every centre is reasonably accessible by public transport and has disabled parking. People should expect to be seen when they receive an appointment. I am sorry that I will be unable to be here for the Minister’s speech, but I wish those practical issues to be addressed. 15:09:00 Corri Wilson (Ayr, Carrick and Cumnock) (SNP) I thank my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) for securing this important debate. I was recently contacted by a constituent after his DLA was stopped when he failed to attend an assessment that he knew nothing about. A missing letter resulted not only in the loss of more than £400 a month in DLA payments but, because he was no longer in receipt of DLA, he had had more than £30 a week in severe disability payments taken off his ESA. If that was not enough, he had his plus one bus pass taken away. This gentleman suffers from severe mental health issues, including dementia, depression and anxiety. He also has a heart condition that needs regular monitoring. The lack of funds and the bus pass being taken away has meant that over the past few months he has now missed at least three health appointments. His dementia means he has memory problems, obviously, and because he is no longer in receipt of DLA he has now lost his carer and is solely responsible for his own medication. When he asked about all these changes he was told that he did not have a good enough reason for missing his appointment. The decision to remove his DLA will stand, and his failure to attend the assessment means he is not eligible for PIP. His appeal will not be decided until the new year. While my office is looking into ways of helping this man, the fact remains that the Department for Work and Pensions, and by extension the Government, think it is perfectly acceptable to leave a man with dementia and a life-threatening heart condition with zero support for more than four months, just because he missed one appointment that he has no memory of being notified about. Sadly, he is not alone The Government’s ongoing transition from DLA to PIP means that thousands of disabled people are losing out. According to DWP statistics, of the more than 46,800 claimants in Scotland who have been reassessed from DLA to PIP, only 77% were successfully awarded the new benefit. Almost 11,000 people lost their award and were left at the mercy of the system. Despite the rosy picture painted by the hon. Member for North Swindon (Justin Tomlinson), the system is seriously failing people. As we have heard today, I am not the only MP with a large number of constituents who have lost access to the higher-rate mobility component. Taking away a person’s mobility vehicle makes it significantly harder for them to sustain employment or education. It reduces their options, increases their dependency on family members and adds to social isolation. As my hon. Friend the Member for Lanark and Hamilton East mentioned, the latest statistics and appeals against PIP decisions show that a staggering 65% of appeals find in favour of the claimant. Coupled with almost 60% of initial decisions on ESA assessments being overturned, a reasonable person would be left wondering about the cost-effectiveness of a system that routinely makes such bad decisions. When we add in the recent United Nations report that describes the austerity policies of this Government as amounting to “systematic violations” of the rights of disabled people, it is clear that the system is deeply flawed. The Government’s Green Paper on disability employment support is a critical opportunity to get the system right for sick and disabled people, but one cannot help but be sceptical when they insist on pressing ahead with cuts to the ESA work-related activity group. The Government claim this will incentivise disabled people into work, despite there being no actual evidence to support this. The real barriers to returning to employment, such as ill health, the attitudes of employers, skills barriers, reasonable adjustments and the availability of suitable jobs are not addressed by cuts in financial support. In fact, creating additional financial pressure can make people less likely to return to the labour market, as the added stress damages their already fragile health. By carrying out cuts to ESA WRAG, the Government are sending a clear signal that they do not recognise the additional barriers faced by those currently unable to seek work. People with the most complex needs often have higher costs related to work activities, as they need to spend money on transport and communication support to go to interviews, attend training courses and secure work experience. The cuts to ESA WRAG will further penalise people who are already struggling, and will not address those additional issues. Cuts to ESA should, as a minimum, be delayed until the provision suggested in the Green Paper is tested and shown to support disabled people into employment, including people with complex needs. Some 15% of the UK benefits system is being devolved to Scotland, and I am pleased that the Scottish Government are committed to ensuring that the mistakes the UK Government have made with PIP and the assessments are not repeated. The priority is the safe and secure transfer of social security powers to Scotland to ensure that everyone who relies on benefits will receive the right amount at the right time. Nobody should fall through the gaps, and everyone should be treated with respect and dignity. That is the social security system I would like to see, but on current form I think it is unlikely that that is the system that will be seen in the 85% of the system still reserved here at Westminster. 15:15:00 Patricia Gibson (North Ayrshire and Arran) (SNP) I wish to offer my thanks and congratulations to my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) on securing this debate. I am delighted to participate, although I really wish it was not necessary. I intended my contribution to be brief, but I am afraid that my efforts to help the hon. Member for North Swindon (Justin Tomlinson) will make it a wee bit longer than I thought it would be. I wish that the austerity agenda—a political choice—did not fall so heavily on the shoulders of those living with disabilities. I wish that the UK Government would put an end to the revolving-door culture of work capability assessments for those seeking to claim personal independence payments, although I think we all welcome the removal of the merry-go-round of reassessments for those with chronic conditions. I wish that those who find themselves grappling with a health condition or a disability that limits their ability to work—indeed, their ability to live as full a life as they would wish—did not feel as though they were being punished for it. I wish that those claiming personal independence payments, or seeking to claim this benefit, which is gradually replacing disability living allowance, were not confronted with such a flawed system that needs radical reform. Justin Tomlinson I am sure the hon. Lady will welcome the fact that an extra £3 billion is now being spent to support those on DLA and PIP compared with DLA alone in 2010, and the fact that 23.5% are on the highest rate compared with 16% on DLA. That is good news. Patricia Gibson The hon. Gentleman would do well to remember the fact that, according to OBR figures, although more money is being spent, that is down to the fact that demand has increased, so we should treat those figures with a little more caution. The fact that the system is flawed is demonstrated by the fact that 65% of appeal decisions found in favour of the claimants, which means that that 65% initially had their application turned down, causing untold stress and anxiety about how they would cope in future. The hon. Gentleman spoke of work capability assessments as an opportunity. Well, I am afraid that my constituents in North Ayrshire and Arran did not see this process as an opportunity. Perhaps the constituents of North Swindon found it so, but certainly in my part of the world, that was not the case. Justin Tomlinson To be clear, I said PIP assessments were an opportunity; not the work capability assessments for ESA, which need to be reformed. Patricia Gibson Surrounded by such a wealth of opportunity, it is hard to keep up. Nothing in the system that my constituents experience is seen as an opportunity. It is seen as extremely negative, intimidating and humiliating. When the hon. Gentleman talked about the assessments, perhaps I misunderstood him, but if I have I certainly am not alone. One might think that these assessments always resulted in somebody’s entitlement or benefit being increased, but I can assure him that in my constituency that is almost never the case. The hon. Gentleman, perhaps in the interests of trying to be helpful to the Chamber, talked about how we should go and see an assessment taking place. Perhaps this is just me—I have not done a survey or anything—but these assessments are not a spectator sport. We are talking about people’s lives. The people who go through them very often find them humiliating and damaging. If I were to go through one of those assessments, the last thing I would want is an audience. Perhaps I might want a member of my family, or a close friend, but I certainly would not want my MP, who would in effect be a stranger, although their name might be well known to me. I certainly would not want the occasion to become a spectator sport. We must be careful about MPs filling the galleries when people are having their lives exposed and deconstructed by strangers. This is a debate about social justice. Employment and support allowance is a form of financial support for people with life-limiting conditions whose ability to live a fully satisfying life, something we would all hope for, is effectively removed. That should be remembered during debates such as this one—and during the assessments. The hon. Member for North Swindon has informed the Chamber that the assessors are there to help, and I am sure that they think so too, but claimants feel stressed. They are confronted by assessors who are, by definition, strangers and who have little or no knowledge of their condition. We have all heard stories: for those who have not heard them, Parkinson’s UK can keep them going all day. There are stories, for example, of people with Parkinson’s being asked by the work capability assessor, “How long are you likely to have Parkinson’s for?” We know that the criteria for work capability assessment are flawed and that people whose conditions fluctuate are always at risk of what might, strangely—as it is all relative—be called a good day. Such things are not taken into account by the work capability assessment, and nor is the impact of pain and fatigue, or the degenerative nature of conditions such as Parkinson’s. As a result, too many employment and support allowance applicants are placed in the work-related activity group, instead of the much more appropriate support group, which recognises that the claimant is simply not well enough to work. I reassure the hon. Member for North Swindon that I know that the Government have reversed the need for repeated work capability assessments for the chronically ill—that is welcome, but it simply does not go far enough. It is a matter of great concern to all fair-minded people that from April 2017 people placed in the employment support work-related activity group will receive £30 a week less than someone in the same situation today. That makes the failure of the system more alarming. Flawed criteria are a particular difficulty for people with conditions such as Parkinson’s in receipt of disability living allowance—I could mention a range of conditions but time forbids it—when they are being assessed for PIP. Under DLA, if a person could walk no more than 50 metres they would be eligible for support. For PIP that distance has arbitrarily—randomly, it seems—been reduced to 20 metres. That is such a short distance that it is not a useful or helpful estimate of a person’s mobility. Given the fluctuating nature of some conditions and the failure of the process to register such fluctuations, many people are losing their Motability vehicles, on which they rely heavily. The hon. Member for North Swindon will be interested to know that recent investigations found that under DLA 82% of people with Parkinson’s received the full mobility payment, whereas under PIP that has dropped to 40%. That is a massive drop, and those people lose their vehicles within 28 days of an assessment decision being made against them. I do not see how anyone can come to this Chamber and say that that is acceptable. Those people are being isolated in their own homes and effectively punished for their illness. Their dependence on family members increases. Nadine Dorries (in the Chair) Order. Will the hon. Lady apply the restriction of nine minutes to her speech? Patricia Gibson Yes, Ms Dorries. Justin Tomlinson Will the hon. Lady give way? Patricia Gibson I am being pressed by the Chair to conclude my remarks. Everyone welcomes the Green Paper. What we do not welcome is the headlong rush to cuts before there can be proper analysis, which could be used to correct the system. We need an evidence-based and compassionate approach. Frankly, I do not see that. We should all want the same thing: we should all want to support people with disabilities into work, and to support those who cannot work. We need to make sure that we do that properly, and I urge the Minister to reflect on that and on all the suggestions made today. Natalie McGarry (Glasgow East) (Ind) rose— Nadine Dorries (in the Chair) Ms McGarry, I did not get notification that you put in a request to speak, but I could call you for a few minutes if you concluded in three or four minutes. 15:24:00 Natalie McGarry Thank you, Ms Dorries; that was an oversight, and I am grateful for the opportunity to speak in the debate. I thank the hon. Member for Lanark and Hamilton East (Angela Crawley) for securing the debate. She made an excellent speech, in which she articulated her constituency case well. She opened the debate in good style, with a lot of information. Two weeks ago, there were two lengthy debates in the House of Commons on the Government’s punitive welfare reforms—specifically cuts to the ESA work-related activity group; 127 MPs laid down a marker and said that the Government must pause, reflect and reconsider the cuts. The Government did not oppose the motion, and some would be forgiven for thinking that it was a sign that they were listening to our concerns. It feels as if we have debates such as this one week in, week out; but if we have to keep bringing the matter back to the Chamber we will. The time for conciliatory debate that does not powerfully challenge the Government is over. It is right for constituents and Members to be angry, especially when there is no evidence that cutting ESA WRAG incentivises people into work. The people of Glasgow East—like people across Scotland and throughout the UK—listened to the Prime Minister speaking on the steps of Downing Street when she promised to fight injustice and lead a Government for the many, not the few. However, by the time the Chancellor stepped away from the Dispatch Box on Wednesday, the benefit of the doubt had evaporated. Sometimes what a person does not say is more telling—or more damning—than what they do say. The Chancellor of the Exchequer spoke at length—6,092 words—but failed to mention ESA once. He could even find the time and words to ask whether the shadow Chancellor could dance, but no words could be found for disabled people or ESA. Since the Government announcement of punishing cuts, MPs of all colours and stripes have railed against them. The matter is so important that it keeps being brought back to the Chamber, and the Minister is constantly called back to answer. I appreciate that the Minister of State is present to do that today. The case seems to be devoid of logic and compassion. Reducing ESA to the rate of jobseeker’s allowance is wrong for a number of reasons. People on ESA are already assessed as unfit for work, whereas people on jobseeker’s can actively seek work. It is therefore unsurprising that ESA recipients should need more support, for longer, than JSA recipients. Indeed, more than half of ESA WRAG recipients are on welfare support for more than two years. Such long time periods are linked to higher associated costs of illness and disability. It is extraordinarily perverse and callous to expect those with illness and disability to suffer on £73 a week for a prolonged period of two years. The hon. Member for Strangford (Jim Shannon) made that point forcefully: why would someone with a job at £500 a week want to go down to £73 a week, if they could help it? I cannot, and I never will, understand how any elected representative or Government could support proposals that serve no purpose other than picking the pockets of the sick and disabled, and putting them through the trauma of a broken and unfair PIP or ESA assessment. Where is the humanity in that? Like other hon. Members, I look forward to seeing the Green Paper; but before then it is time for the Government to rethink the assessments, and to pause the cuts to ESA WRAG. 15:28:00 Neil Gray (Airdrie and Shotts) (SNP) It is a pleasure to take part in the debate, Ms Dorries. I pay tribute to my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley) for securing the debate and for the way she set out the case, highlighting how pressing the issue is, as our postbags show. She raised a case of great concern—the experiences of her constituent Donna. The assessment notes that my hon. Friend read out struck me as closely mirroring a constituency case that I am now dealing with. A gentleman, who had been in work, suffered mental health problems and as a result of them fell out of work. He was assessed for social security support and failed. Some of the notes from the assessment that my hon. Friend quoted were very similar to his. Sadly, my constituent committed suicide. The harrowing cases that we have heard today are very concerning. I also note the contributions from other Members today. The hon. Member for Strangford (Jim Shannon) rightly asked why on earth someone who had previously had £500 a week would choose to receive £73 a week. That is not a choice that anyone would make. He also highlighted the apparent dichotomy that is at play: the Government are telling his constituent that they are unable to employ him, while expecting employers to employ people who are in a similar position. I hope that the Minister will reflect on that. I listened carefully, as I always do, to the contribution of the former Minister, the hon. Member for North Swindon (Justin Tomlinson). He gave a stout defence of the Government and of his own record in government. As always, I want to be as constructive and as consensual as possible, but I must remind him that the accounts that we have heard today and in previous debates are personal testimonies from constituents, not just hearsay. I do not know whether that was a slip of the tongue from the former Minister, but the experiences of the constituents that were highlighted today are not just hearsay. The hon. Member for Mitcham and Morden (Siobhain McDonagh) rightly highlighted the disproportionate impact that welfare cuts are having on those with disabilities. They are affected many times more than those without disabilities. That appears to fly in the face of the commitment from the previous Prime Minister, David Cameron, to protect those with disabilities in the social security system. I welcome my hon. Friend the Member for Ayr, Carrick and Cumnock (Corri Wilson) to her place as the Scottish National party’s new disability spokesperson. She highlighted another very troubling constituency case; I hope the Minister has taken heed of it and will commit to looking into it. My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) is absolutely right that this debate is centrally about social justice. She also rightly highlighted the indignity felt by our constituents when they go through these processes. If the Government are to get this right, they need to look at how people feel they are being treated. Whether the Government agree or not is irrelevant; what is important is what the people who experience the system feel, which is clearly different from what the Government feel. The hon. Member for Glasgow East (Natalie McGarry) rightly said that, when it comes to ESA WRAG, we are not going away. I will focus on ESA WRAG for the majority of my speech, because this is a further opportunity to quiz the Minister on her plans. On 17 November, a motion on ESA that I moved in a Backbench Business Committee debate with the support of eight other parties was carried by Parliament. In that debate, the Minister took an intervention from the hon. Member for Enfield, Southgate (Mr Burrowes), who supported the motion. He pressed her on potential financial mechanisms that would “fully compensate for the loss of the WRAG payments for new claimants”. The Minister replied: “Yes. Let me give my hon. Friend that reassurance.” Perhaps my interpretation of “fully compensated” is different from the Minister’s, but I understood from what she said that new ESA WRAG claimants would be getting equivalent financial support through the mechanisms outlined by the hon. Member for Enfield, Southgate: “the hardship fund, the flexible support fund and the third-party deals”.—[Official Report, 17 November 2016; Vol. 617, c. 464.] I tested that in a written question but I did not get a clear reply, so I hope that today the Minister will take the opportunity to say what she understands “fully compensated” to mean. The Chancellor appeared in the autumn statement to undermine the Minister’s apparent pledge. The Chancellor said in response to the shadow Chancellor, the right hon. Member for Hayes and Harlington (John McDonnell), that the savings of £330 million from the ESA WRAG cut would now be invested in a package of support, as opposed to direct financial help. Presumably, he meant the Green Paper package, which is currently being consulted on and which was previously budgeted as £60 million next year. That is as clear as mud to me and to the many others who are looking on and trying to understand what the Government are going to do, how much they will commit and the mechanism by which that will be implemented. The only thing that the Government have been clear about is that they want to cut ESA WRAG. They have not said what is coming in to replace it. They have really put the cart before the horse. I understand that fresh Ministers are perhaps flogging that horse to catch up, but the plans for halving the disability employment gap appear to be falling away; we do not know whether that is still a commitment. The cuts to ESA WRAG and the system to replace the Work programme should have been consulted on first. The point has been made across this Chamber today and it has repeatedly been made across the House in previous debates: the Government have it the wrong way round. It is like announcing that they are going to scrap the TV licence in April, but only now going through the process of deciding how it should be replaced, with no guarantee to the BBC of how much financial support it would receive. In fact, this will probably receive a third of the public funds, but get practical support in order to generate better outcomes. That just does not wash. It may be a policy that appeases some people, but it is clearly not the way to treat anyone. It has no evidence of being any fairer or delivering better outcomes, because we have no idea how the system is going to work. I must critique what appears to be the Government’s main motive, which is that for someone to get an extra £29 per week on top of jobseeker’s allowance is a disincentive to work. Here is what my constituent Janice had to say when she got in touch with me this week: “Being unemployed and reliant on benefits is demeaning and depressing. Employers need to focus on what people CAN do rather than on what they can’t. There are ways to work around: many can work from home with flexible hours and would jump at that opportunity.” Does Janice strike the Minister as someone who chooses or wants to be out of work? Of course not. She is like hundreds of thousands of sick and disabled people up and down the land who desperately want to work. Cutting the money they could receive will not change their minds or incentivise them any more than what already motivates them: dignity, self-worth and getting a job that they can sustain. Cutting away that vital support will add an layer of stress and worry and, with additional work search costs, will hinder their ability to find the work that they so desperately crave. The MS Society points to research published last year by Scope’s extra costs commission, which says that living with neurological conditions such as multiple sclerosis can cost people an extra £200 a week. I plead and hope that the Minister will say what she and the Government plan to do to help people by providing additional employment support and financial support. She must realise and accept that people who are in ESA WRAG are in that category because they are currently unfit for work; they have an illness or a disability that means that they cannot currently work. ESA WRAG is often their only income and yet, from April, people on ESA WRAG who are sick or disabled will somehow be expected to sustain themselves on the same rate as jobseeker’s allowance. The Government must think again. 15:38:00 Debbie Abrahams (Oldham East and Saddleworth) (Lab) It is lovely to serve under your chairmanship again, Ms Dorries. I congratulate the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing an excellent debate. It has been really constructive and has brought to light more cases to show the Minister and the former Minister, the hon. Member for North Swindon (Justin Tomlinson), how people experience the cuts, how sick and disabled people experience the assessment process and the indignity they too often face. I wish Donna all the very best and I hope she continues to recover. It is the personal stories that bring this issue to life. I thank all hon. Members who have contributed so well today—I should have started by saying happy St Andrew’s day. It is so important to understand what people are going through and to put a human face to it. The former Minister said, “Go and observe one of these assessments.” He is right that we should all try to do that, but I am sure he is aware of observational bias. We should not take our own observations as the only form of evidence. Up and down the country, we are hearing and seeing examples of what sick and disabled people are going through every day. This is the first opportunity that I have had to discuss this issue with the Minister, and I want to focus on what the hon. Member for Airdrie and Shotts (Neil Gray) also focused on. We will not go away and this issue will not go away. We will continue to campaign on it, because it is a real injustice: £1,500 a year from the most vulnerable people, the poorest of the poor, some five million people—I will not continually repeat the statistics that we repeated in the two debates just two weeks ago. What is so disappointing is that all the evidence—from the UN committees investigating human rights concerns and breaches of the convention on the rights of persons with disabilities, from our own Equality and Human Rights Commission, from the Government’s Social Security Advisory Committee, from a whole list of well-respected charities, such as Parkinson’s UK, Scope and so on, and even from the Government’s own Back Benchers—is being completely ignored. We heard about the Backbench Business Committee debate, when the motion was carried without contest, which is almost unprecedented. The strength of feeling in this House has been expressed, yet what was so absent in the autumn statement was anything that sick or disabled people could grasp for how their lives would be made better. Their lives have been made a misery over the last six years and it will get worse. I know that the Minister is new in her post and she has said some very positive things. We have also heard very warm words from the Prime Minister, but when it comes to doing anything, the Government have put their hands in their pockets and turned away. We cannot have that. It needs to change. The Government have put forward arguments about incentivising claimants and argued that cuts will incentivise people into work, which is quite disgraceful, really. It implies that people are making a choice. As we have heard, people are not making a choice to live on £70-odd a week when they have had a decent living before. They do not choose to do that. As the fifth richest country in the world, we have an obligation to treat people with dignity and respect. It is about choices. I want to pick up on the point that other Members have made about what other discretionary funds people might be able to draw on. I was going through the Minister’s earlier speech last night, and the flexible support fund was mentioned. We need to understand some things about that fund. First of all, it was investigated recently for fraud. The former Secretary of State, the right hon. Member for Chingford and Woodford Green (Mr Duncan Smith), tried to claim that it was being supplemented by £15 million a year to cover the costs. That is not the case; it is actually £15 million from 2015 alone. That fund does not go anywhere near to matching the loss that people will experience and the in-year deductions that will be made as a result of these cuts. I will finish on a point that was raised in my constituency. We all have hundreds of different cases; my case load has gone up exponentially as people have been subjected to these increased cuts. I want to talk about John Ruane, who has a brain tumour. As a consequence, he has three to four epileptic fits a week. I was contacted by his surgeon, because John was refusing to have a life-saving operation, as he had passed his work capability assessment—how could that happen to somebody with a life-threatening condition?—and he was worried that he would be sanctioned, in the same way that we saw in “I, Daniel Blake”. John had no means of support, and it has taken us months to sort this out. He has now, finally, had his ESA reinstated, but he was scared of being sanctioned because of what had happened, and the stress that he was placed under, as well as the indignity, just is not right. That is one case; I could cite loads of others. Within the context of ESA, we cannot ignore the work capability assessment. Again, more than two years ago the Work and Pensions Committee raised the WCA as an issue in its report on ESA: “Simply ‘rebranding’ the WCA by taking on a new provider will not solve the problems: a fundamental redesign of the ESA end-to-end process is required”. Very briefly, I want mention another one of my constituents, a young woman who is going through the PIP process. She was a high-flyer, in a good career, and she is only in her 30s, but she is suffering from Lipedema, Dercum’s disease, fibromyalgia and chronic fatigue syndrome. She has pain in every part of her body, but particularly in her hands. She cannot even cook or prepare her own food. She has gone through the PIP process and she feels that it is just like a slap in the face. She needs that support to enable her to recover, and she feels that she is being thwarted at every turn. This is about choices—choices about what we do. It is about whether we as a country feel that it is right to support our most vulnerable people or to support those on the top incomes—which is what the autumn statement analysis shows that we did. We on the Opposition choose that we should protect and support the most vulnerable in our society. This is about choice, and I hope that the Government will listen and do something about it. 15:46:00 The Minister for Disabled People, Health and Work (Penny Mordaunt) I congratulate the hon. Member for Lanark and Hamilton East (Angela Crawley) on securing this debate and all hon. Members who have contributed to it. These are important services and they are at the heart of our nation’s values and its interests. Of the 2.5 million people claiming incapacity benefits, 1.3 million also claim PIP or DLA. A further million claim PIP or DLA, but not incapacity benefits. Many of these people will also access other support and state services, as well as support provided by partner organisations. What we do is vital, not only to enable someone to meet their living costs and endure, but to support their ambitions. We have that dual responsibility. In addition, I am very conscious, because of the combined areas that I look after, that I have the largest budget of any Minister in any Government Department. That is a huge responsibility to the general public, who fund it, and to those whom these services are designed to help. It is a responsibility that I take very seriously indeed. PIP and ESA are entirely different benefits, designed for different purposes, and each has its own legal criteria. ESA provides support to those who face barriers to work and looks at what work a person can do, rather than focusing on what they cannot do. Unlike ESA, PIP is non-means-tested and available to disabled people regardless of their employment status. PIP provides a contribution towards the extra personal costs arising from their disability or health condition and can be paid on top of other benefits. The PIP assessment is designed to treat all health conditions and impairments fairly, and the assessment criteria take into account the impact of all impairments, including mental health, on an individual’s ability to carry out a broad range of everyday activities. That breadth is one of the benefits of the new system in comparison with what went before, and I thank my hon. Friend the Member for North Swindon (Justin Tomlinson), who outlined some other improvements that the system makes. The title of this debate refers to two benefits, but understandably much of the debate has focused on people, and quite rightly so, as the hon. Member for Airdrie and Shotts (Neil Gray) said. In developing our policy and delivering our services, we need to remember that it is not just about those who have been featured in today’s debate. It is also about those who have not been featured and who rarely get a mention: those who are not on benefits and are not yet in crisis, but are financially fragile; those in ill health; those with multiple caring responsibilities who do not qualify for carer’s allowance; and those who, despite hardship, do not for a variety of reasons access the benefit support available to them. Our concern and our support should stretch beyond the reach of our benefits. What we take forward from the Green Paper and all we do in the interim must have help for those people in mind. ESA and PIP are massive systems, and both have rightly undergone, and will continue to undergo, continual improvements. Contrary to what the shadow Minister said, we have made many changes. Recent changes include the announcement that we will stop ESA reassessments for those with severe health conditions and disabilities. In designing the changes, I have asked that we plan ahead and see whether we could have permission to share information with local government. That could enable local authorities to stop requiring those very same people to fill in forms for locally administered schemes. In his speech, the hon. Member for Strangford (Jim Shannon) outlined some of the potential benefits of doing that when he mentioned social care and other services. With ESA, we now have clinical data to hold contractors to account. I pay tribute to the DWP’s chief medical officer and her team for the work they have done on that and on data sharing. We have trialled greater flexibility on the time given to the early stages of an application process to ensure that all the health information is available to the assessor. That is the best way to cut down on incorrect decisions being made at that early stage. Debbie Abrahams Will the Minister give way? Penny Mordaunt If the shadow Minister will forgive me, I will make some progress. We are rolling out that trial. The past presence test will no longer apply to claims for DLA, PIP, attendance allowance and carer’s allowance with regard to refugees, people with humanitarian protection status and their families. We are extending hardship payments. The ESA appeals process has been reformed, with mandatory reconsideration clearance times down from 35 days to nine. The number of weeks and the percentage of case load having to go to appeal to get the right decision are both reducing. Huge strides have been made in identifying hidden impairments, including through training of staff. The hon. Member for Lanark and Hamilton East spoke at length about the factors of appearance. Many people might look perfectly together and presentable but have deeply hidden issues. We have done a huge amount in training staff to recognise that, and more is planned. The Secretary of State has announced his focus on the use of sanctions with those with mental health conditions, and the Green Paper gives us the possibility of major reform to different parts of the system in unison. In that consultation, we want to examine how we might simplify and improve the assessment process and how we can use information better to effectively support people, such as sharing data—with claimant consent—with support organisations and other state services. The reform of the work capability assessment—which we have not been able to do to date because it requires primary legislation—is a focus of the Green Paper. We could separate out decisions on entitlement to employment support and entitlement to financial support. Neil Gray Will the Minister give way? Penny Mordaunt I will just make a little progress, because I have some announcements to make. The Green Paper also looks at statutory sick pay and other issues that would have benefited people such as Donna—if I have understood her situation—by enabling a phased return to work, which is obviously what people need. Rather than having someone continually jump through hoops, we want that support to be wrapped around the individual, whatever situation they have been landed in. Not only does that support need to be exactly what they need, when they need it and personalised—whether it is delivered by a jobcentre, a GP practice nurse or another—but their experience of the whole system has to be what they need, when they need it. Having to wait for an assessment to be carried out before someone can have a conversation about their situation and hopes is not smart. We need a joined-up, common-sense approach in all we do. We should not just start thinking about what assistive technology or equipment someone might need when they hit the employment market. We need to think about that when they are at school or college and receiving careers advice. Carol Monaghan (Glasgow North West) (SNP) Will the Minister give way? Penny Mordaunt Forgive me, but I will make some progress. That kind of quality support can be reached only through stellar local working. That is why the Green Paper consultation is more than an information-gathering exercise; it is a call to arms. We have to build new commitments and shared outcomes locally. I urge all Members to help us in the consultation process and to come along to the drop-in event in the House on Monday between 3 o’clock and 5 o’clock. It will offer information specific to Members’ constituencies, guidance on how to run an event or get involved in one, as well as bringing partners together to respond to the consultation and thinking about what needs to be done in the local area. During the consultation process, we will continue to develop those networks, facilitated by the flexible support fund, and also busting some of the myths about what local services we will commission to support those on benefits. I briefly turn to Motability, which the hon. Members for Ayr, Carrick and Cumnock (Corri Wilson) and for North Ayrshire and Arran (Patricia Gibson) particularly focused on. Members will know that a scheme has been set out—I am very grateful to Motability for doing that—to try to help with the transition from DLA to PIP. It is a challenging time for individuals. That scheme is the £175 million package that Members will be familiar with, which enables individuals to keep their car for seven weeks, allows them to buy back their old vehicle and offers a one-off payment of £2,000 to help to meet their continuing Motability needs. Motability is also helping to pay for new adaptions to non-scheme cars, with insurance thrown in. We are aware of how difficult it is—despite that mitigation and the other sources of transport subsidy that might be available—for an individual to be told that they will lose their vehicle with only a few weeks to make alternative arrangements. There are other problems too. I want to outline one that is of particular concern to me. It relates to people leaving the country for extended periods longer than 13 weeks. That is a problem for students, but it is also a problem for someone who might want to take up a career opportunity, a sabbatical or other opportunities that require travel. Our systems must be able to support someone following their dreams and ambitions. They must enable a person to thrive, so this situation should not be left to stand. We have been discussing with relevant Departments ways to enable PIP claimants to keep their vehicle pending appeal, and we are exploring options to allow those who are not in receipt of the higher Motability component to have access to the Motability scheme. I am also exploring how claimants who are out of the country for extended periods can be better supported. We have a plan and the Treasury’s blessing. This week I have written to Motability to ask for its help in delivering that plan. I anticipate that the plan will require some changes to its processes, but I know that it will do all it can to help us in this matter, as it has in the past. We have a remarkable and unique partnership with Motability, and I hope in my tenure to maximise that. I have spoken at length about the work-related activity group. Time is short but, briefly, we are looking at a range of measures to help to ensure that someone’s experience of these systems—that is fundamentally the heart of what Members have been discussing today—can be improved and that we are aware of all the issues. That includes looking at developing service user panels to create a real-time reporting mechanism on people’s experiences. We can use those panels to design our benefits systems. There are a raft of other measures that I do not have time to outline today, but they will help us to do that. I will bring forward measures shortly. The final thing I will do before I hand over to the hon. Member for Lanark and Hamilton East is reassure her that I will be there to assist when devolution transitions further powers to Holyrood. I am already talking to her colleagues there about how we can get the best outcomes for the issues she mentioned. Again, this comes down to all Members of this House—whichever part of the country we represent and whatever our political hue—working together to get the best outcomes in the systems. I hope that all Members will come to the drop-in session next Monday. Nadine Dorries (in the Chair) Six seconds. 15:59:00 Angela Crawley I thank you for that, Mrs Dorries. I thank all hon. and right hon. Members— Nadine Dorries (in the Chair) Order. Motion lapsed (Standing Order No. 10(6)).