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Mr. Flynn : I am sure that that occurs. Of course there is abuse in any system, but the Government have had 15 years in which to put the system right. If the hon. Gentleman is suggesting that that figure is as high as 750,000, he is entirely wrong. There is a black economy, which is fuelled at the moment by the Government's stupidity
Madam Speaker : Order. I am sorry to interrupt. The hon. Member for Shoreham (Mr. Stephen) led the hon. Gentleman down the wrong path with his question. I am sure that we can return to the Government new clause.
The other reason for the increase in the potential number of people on incapacity benefit was the large number of people who were at retirement and who decided to continue on invalidity benefit, rather than claim the state pension, because of the advantage that it was not taxable. The Government have turned their back on that for a long time.
It is hard to understand how that situation justifies a Bill in which the Government are trying to take away the entitlement to benefit from people who are incapable of work. The Bill does that in a number of ways. It extends from six to 12 months the period for which short-term benefit is paid, resulting in a massive loss of income during the second six months. It abolishes the
Column 162additional benefit for which people paid contributions between 1978 and 1991, and it introduces new tests of incapacity which will deny benefit to people who, in some cases, have rightly been treated as incapable of work for many years.
The new clause shows us what is happening in the Government's mind--if "mind" is not too large and all-embracing a word for the irrational ideological trash that comes from them. The Government are a group of ideologues introducing a series of what could be regarded as Treasury support measures--measures that have nothing whatever to do with social security.
The Child Support Agency has rightly been dubbed the Treasury support agency. It is ill thought out and has caused enormous damage. People have even lost their lives, as suicides have been attributed to the nonsense and excesses of the legislation. In a parliamentary answer I was told that 90 per cent. of the money that the agency will receive is likely to end up in the Treasury, not with custodial parents.
I do not wish to detain the House too long on the new clause, but it is indicative of the spirit of the whole Bill, and of a Government who wish to get out of a financial hole that they have dug for themselves, and who are doing so at the expense of the weakest in society.
Mr. Pike : I shall make a few brief comments, one of which arises from my earlier intervention. My hon. Friend the Member for Manchester, Withington (Mr. Bradley) rightly referred to the problem of fast tracking. We have reached Report, yet we are still not really sure whether the Government will deliver because, as so often happens, we are debating a Bill that does not include the regulations that will go with it.
We are being asked to take in good faith something that was said in Committee, so I hope that the Minister will be able to say positively that the Government recognise that there is still a problem regarding fast tracking and still the need to expedite the resolution of any benefit entitlement that people who are terminally ill may have. I hope that the Minister will spell out clearly the fact that although there is no solution in the provisions before us today, one will be included in the regulations.
With regard to the new clause, the tests and the transitional arrangements, as my hon. Friend the Member for Newport, West (Mr. Flynn) said, and as we all know, the principal objective of the Bill is to save money and to reduce the number of people eligible for invalidity benefit. Even the Government have not tried to hide that fact. We all know that decisions on invalidity benefit involve deciding whether people are capable of performing their own work and if not, whether they are incapable of all work or only of certain types of work. That causes tremendous difficulty for people who have specific jobs in which they may have worked for a long time, but who have become incapable of performing that work.
A skilled engineer came to my advice bureau on Saturday. His hand had been seriously injured at work and he was no longer able to perform the work of a skilled engineer, so he has been on invalidity benefit. First, he had been found to be capable of work, although incapable of working in his own job, but then his case went for review and he has now been told that he is capable of any work. We think that the provisions for the new tests will involve that type of move regarding present entitlement to invalidity benefit.
Column 163The Minister was trying to make it look as though the Government would protect people by saying that if there were any mistakes that could not be dealt with, the transitional arrangements would mean that they could be altered within three years by regulation and statutory instrument, as specified in the new clause. The Minister made it sound as though the Government would try to do that in the interests of the public at large, but my hon. Friend the Member for Withington was nearer the mark.
He fears, as I do, that the transitional arrangements are the Government's attempt not to improve the situation but to tie it up because they may not have yet cut out everything that they want to cut out. Therefore, they are giving themselves draconian powers within the transitional arrangements further to turn the screws during the next three years with minimal debate, thereby saving more money for the Treasury and disqualifying more people.
Mr. Burt indicated dissent .
Mr. Pike : I see that the Under-Secretary is shaking his head. I hope that he will also say that my comments are totally unjustified. If that is what he says, I hope that when he comes to an election in two or three years' time, he is able to stand up and say that I was wrong and he was right. I fear that I will be right, and my hon. Friend the Member for Withington and I will be able to tell the Government that we were right to fear what they were doing. The Government have tightened the screws and screwed more people out of their ability to get this new benefit.
Mr. Burt : The hon. Member for Manchester, Withington (Mr. Bradley) opened with a breathtaking argument. We freely gave a concession in Committee by changing the regulations from negative to affirmative--a change that he welcomed at the time--but he then returned to his attack on the regulations altogether. I simply want him to know that I found it breathtaking.
Mr. Bradley : Can I clarify the position ? We welcomed the concession that they should be affirmative, not negative, regulations. We certainly did not welcome the fact that the Government are introducing even more regulations that need affirmative resolution.
Mr. Burt : That was an argument that we had consistently throughout the Committee, and I should reiterate the point that I made then. The hon. Member for Burnley (Mr. Pike) was right in the first part of his remarks, which he directed at the hon. Member for Newport, West (Mr. Flynn), that we are putting the regulations through to give us the flexibility that we need to deal with such a complex matter, recognising that we might not include everything for the sake of people covered by the first set of regulations. We are giving ourselves that room and flexibility.
There has been an argument about whether we overuse that power. We do not believe that we overuse it--that is the reason why we are doing it this way. The hon. Member for Burnley was right to ask what I would be saying in three years' time. At that time, I firmly believed that I should be able to reiterate the assurance that I am giving today. I hope that the fears of the hon. Member for Withington about the regulations will be satisfied by that time.
Column 164We spent a total of 34 hours in Committee, with 13 sittings. We had some good scrutiny there. We do not believe that we have sought additional power. As I said, the arrangements are to give effect to the agreement to make the regulations affirmative for three years. Transitional arrangements are usually dealt with in regulations for the ease of the House and to give us flexibility.
The hon. Member for Newport, West made an interesting contribution. He raised a number of matters relating to Second Reading and Third Reading but touched marginally on the amendment before us now. As always, I enjoyed his contribution. I am only sorry that I did not understand all the Welsh--I wish that I had.
The hon. Members for Withington and for Burnley both made a substantial point about linking rules and treatment of the terminally ill. In Committee, my right hon. Friend the Minister gave a commitment to consider a number of specific issues such as those. He warned the Committee that some of the issues were complex and would take time to explore. Hon. Members may be disappointed but that consideration is not yet complete. I can, however, reiterate my right hon. Friend's commitment to continue to give these issues careful consideration.
Mr. Bradley : May I clarify the range of the Government's thinking on this point ? In Committee, we talked about the terminally ill, people with prescribed conditions and people on the higher rate of component for DLA. Can the Minister give an assurance that each of those areas is being addressed and not only the terminally ill, although clearly they are crucial within that grouping ?
Mr. Burt : Yes, I can give the hon. Gentleman that assurance. I also remind the House that, should amendments to the Bill be required, there will be a suitable opportunity to move them during the debate in another place. This House would then have the opportunity to examine the issues again at consideration.
I hope that I have been helpful in answer to the short debate on the new clause, which I hope will now be able to form part of the Bill.
Question put and agreed to.
Clause read a Second time, and added to the Bill.
The Secretary of State shall, before 30th September 1996, lay before each House of Parliament a report on the operation of the test of incapacity for work under Part XIIA of the Social Security Contributions and Benefits Act 1992, which shall (among such other information as he may think fit) include
(a) an account of the number of people who attended a medical examination under that part of that Act and a description of the type of such examination ;
(b) an account of the number of people who, having attended such an examination were determined as incapable of work ;
(c) an account of the number of people who having attended such an examination were determined as capable of work ;
(d) an account of the reasons for determinations of capacity for work ;
(e) an assessment of the medical test by such persons whom the Secretary of State may choose'.-- [Mr. Bradley.]
Brought up, and read the First time.
The Secretary of State shall, before 1st April each year after the commencement of this Act, lay before Parliament a report concerning appeals against determinations that a person is capable of work, which shall, among such other matters as he may think fit, for each area of the Benefits Agency Medical Service
(a) specify the number of occasions on which an appeal was heard more than ten days after it was made, and the average time between the making and the hearing of the appeal ;
(b) summarise the outcome of all appeals ;
(c) report on the extent to which medical or other evidence influencing the outcome of an appeal ;
(d) summarise the reasons for any failure by a claimant to attend a hearing ; and
(e) report on the use made by claimants of representations at an appeal.'.
Amendment No. 22, in clause 5, page 11, line 28, at end insert (c) defining the way in which relevant evidence or information submitted by that person or by any medical practitioner or professional health worker will be used during the assessment'. Amendment No. 24, in clause 6, page 13, line 17, leave out lines 17 to 23 and insert
(4) When a social security tribunal is to determine an appeal concerning a determination that a claimant was capable of work the tribunal shall sit with the claimants' general practitioner,'. Amendment No. 25, in page 13, leave out lines 18 to 26 and insert
for appeals against determinations that a person is capable of work to be heard by a tribunal constituted under section 42 of this Act.'.
Amendment No. 26, in page 13, line 26, at end insert
(5) When a claimant has made an appeal to a social security tribunal concerning a determination that he was capable of work (a) the tribunal shall hear the appeal within ten working days of the appeal being made ; and
(b) the claimant may be accompanied at the hearing by any person whom he nominates.'.
Mr. Bradley : This substantial group of amendments goes right to the heart of the Labour party's opposition to the Bill, and it shows why we have consistently and rigorously opposed the Bill on Second Reading and throughout Committee, and why we will continue to do so. The clear purpose of the legislation is that the Department of Social Security must make its contribution to the cuts in public expenditure because of the Government's economic mismanagement. The £50 billion public sector borrowing requirement overspend is being addressed by the Government, and the Department of Social Security has looked at the people in the greatest need to try to make its contribution. It is clear that the legislation is Treasury-led, and its purpose is to make substantial cuts in the amount of money available to disabled people.
By the Government's own admission, they expect to save £550 million in 1995-1996 and a staggering £1,450 million in the following year. There can be no greater testimony to the fact that this is about saving money, rather than about a rational and careful replanning of benefits to meet the real needs of disabled people. Those benefits must be made in conjunction with a co-ordinated and coherent policy by the Government to try to enable people with disabilities who are able to return to work to do so. Those who cannot return to work should receive an adequate and proper level of income to meet their needs and those of their family.
Column 166We have made much this afternoon of the fact that the Government are introducing this measure by regulation, rather than by primary legislation. The purpose of new clause 3 is to enable there to be proper parliamentary scrutiny of the medical test, which is a vital element of the new legislation. It is a disgrace that the medical test on which all of the decisions are to be made about whether a person is eligible for the new benefit is not before the House as we debate the legislation. The test does not form part of the Bill, and it will be brought forward at a later stage by regulation. It is a great abuse of Parliament that the Opposition are not able to examine properly today the details of the medical test, and that we must wait several months before that test is available for scrutiny through regulation. When it is brought forward, there will be no opportunity for the Opposition to amend the test, and we must accept it or reject it on regulation. That is an unsatisfactory way of dealing with the crucial matter of determining whether a person with disabilities is able to work.
The purpose of new clause 3 is to force the Government to produce a report to Parliament about the way in which the medical test will operate in practice. That report is crucial to ensure proper parliamentary scrutiny and understanding of the way in which the medical test will operate.
The report is also crucial because of our general views, which we explored in detail in Committee, on how the Government are developing the medical test. The process is a consultation sham. It is outrageous that a Bill entitled the Social Security (Incapacity for Work) Bill does not contain a definition of incapacity for work. The medical test is intended to exclude people rather than make them eligible for incapacity benefit. A test of incapacity based on functional limitations alone is inadequate, unfair and unworkable, and the way in which it will be used for new claimants, compared with people in receipt of invalidity benefit, will be inequitable. If one wants to determine how the test will work in practice, the type of work that someone can reasonably be expected to do must be included in the Bill, but it contains no definition of the work that will apply to the test.
Our first major criticism, and the reason why a report to Parliament on medical tests is so vital, is that the way in which the test is being developed has no validity. We welcomed the explanation that medical officers from the Department of Social Security gave about how the test has been developed, but that explanation did not comfort us that the outcome of the final deliberations will be a test that has any relevance to determining whether people are able to work.
As we have stated before, it is to say the least very unsatisfactory that the so-called panel of experts who will draw up the medical test have to remain secret from the public, and that their deliberations will take place behind closed doors. It is also unsatisfactory that the Government are not prepared to release the names of the people who are devising the test on behalf of disabled people until after the process has been completed.
A crucial element of new clause 3 is that, when a report is prepared after the medical assessments have been scrutinised, it will be passed to the group of experts for their views. It is important that they should continue to have a role once they have gone public and that they should have some voice in the way in which the test operates.
Column 167We are concerned about the fact that it is not clear how the final test will be validated by the group of experts. In Committee, we sought clarification of whether the test will be based on a consensus model, the Government will take views on the test and impose their final solution on the group of experts--regardless of whether they agree--or there will be room for public dissent. We would welcome an explanation from the Government.
I am sure that all my hon. Friends, and Conservative Members, will have received briefing after briefing. I have here a sample of those that I have received from organisations throughout the country. Those organisations carefully analysed the consultation document that the Government published, and the briefings explain why they are so critical of the Government's attempt to introduce a purely functional test that can be applied to the world of work for people with disabilities.
Those bodies also assert very strongly that they have been asked to take part in consultations on a document that changed almost before the ink on the first draft was dry. The whole exercise is such a mutant creature, such a changing phenomenon, that it is not clear at what point the final word will be said.
We welcome the Government's undertaking in Committee that, following completion in August of the final deliberations on the medical test, the form of the new test will be published, and that further public consultation on the outcome of the deliberations will be allowed. I hope that, in the context of this new clause, the Government will be able to assure us that they do indeed intend to engage in that process. There must be new and full consultation when the new medical test has finally been devised.
We are greatly concerned at the fact that, in the absence of a definition in the Bill, it is difficult-- almost impossible-- to debate incapacity for work. On this ground also, the new clause is important. We are told that a full definition will be provided in regulations. Without knowing how the Government intend to use the medical test in practice, it is very difficult to look forward to a clear understanding of the relationship between the medical test and the work situation. The Bill itself should contain a proper definition so that we might have an opportunity for parliamentary scrutiny.
Given the consultation document's criticism that case law has "broadened and blurred incapacity beyond its original meaning", and given that part of the thrust of the Government's argument seems to be that they need to tighten up the way in which invalidity benefit is currently administered, it is surprising that a precise definition has not been provided.
A clear definition in statute law might have gone some way towards resolving any supposed problems of misinterpretation of the original intention. If the Government had addressed their mind to that point, all the other proposed changes in the administration of invalidity benefit might have fallen away, and it might have been seen as inappropriate to introduce this new benefit. This can only give additional thrust to the theory that the main purpose of the Bill is to cut public expenditure rather than to focus benefit effectively on people with disabilities.
There is little evidence that the only way properly to target--that is the Government's terminology ; they used the word "focus" in Committee ; we believe that the proper word is "cut"--invalidity benefit is to set about this
Column 168elaborate new procedure. We believe very strongly--no one has suggested otherwise at any stage of debate on the Bill --that not every person in receipt of invalidity benefit is a genuine case. It would be absurd to make such a suggestion. However, the dismantling of the whole system and the introduction of entirely new procedures--in particular, the new functional medical test--does not support the Government's contention that they are trying to help disabled people rather than to take essential benefits from them. If the Government's purpose is genuinely to focus invalidity benefit, why will people who pass the medical test receive benefit at a lower rate ? If the purpose is simply to tighten up the rules and ensure that the medical test is properly applied, why will there be a cut in the amount of money available to people with disabilities who pass the test ?
This is a crucial question, which the Government must answer. They must tell the public why, if they are simply trying--in their terms--to wean people off invalidity benefit, those who pass will receive benefit at a lower rate.
So new clause 3 is intended to bring a report forward on the medical test, because we believe that the test of functional limitation is inadequate, unfair and unworkable. As a tool for assessing incapacity, the test is inadequate. The Government have based their research on the previous Office of Population Censuses and Surveys scales, which were defined very much for research purposes and not for the purpose to which they are now being applied. We believe strongly that other factors, and not just functional limitation, must be taken into account when using the medical test. Not only must we look at the individual's medical condition and disability ; we must also assess the effect of their condition on their ability to carry out a range of social and functional activities, including the ability to travel to work, and their capacity to sustain functional and social activities within the specific demands and constraints of the workplace. A study undertaken by the Policy Studies Institute suggests that four criteria are important in the assessment of work capacity--age, skills, the accessibility of the job and discrimination by employers--and that a much wider test than the purely functional one proposed by the Government must be applied.
The test, we believe, will produce unfair results. We were encouraged to a certain extent by the fact that now included in the medical test will be open-ended questions for applicants to answer, to explain some of the limitations imposed by their incapacity. But, by their very nature, open- ended questionnaires are difficult to analyse, and it will be hard to produce consistency of treatment as between claimants.
As anyone who has undertaken social research knows, the interpretation of open-ended questions and their answers is extremely difficult. So there will be great differences in treatment, not only within Department of Social Security offices dealing with these matters, but between offices throughout the country. That is the importance of the new clause--that a report will be presented to Parliament so that we can look at the analysis to ensure fairness and equality of treatment throughout the country.
We are also concerned that any functional medical test will fail to take into proper account what has been mentioned in many of the briefings that we have received
Column 169on this from organisations such as the Multiple Sclerosis Society, Arthritis Care and others : fluctuating conditions whereby people's ability to work varies from day to day, or even situations in which, as a result of undertaking some task at work on a particular day, they may be prevented from doing it the following day. We are also concerned that the functional test arrangement will not properly reflect the condition of people suffering from long-term debilitating illnesses such as myalgic encephalomyelitis.
We are concerned about people whose disabilities are invisible, particularly those with chronic pain, who often experience difficulty in convincing others that their pain is real. There is a great deal of research on this point, and the sensitivity with which the medical test is applied will be crucial in ensuring that people who genuinely can or cannot work are properly and uniformly assessed. We have no confidence, from the way the test is currently being organised, that it will lead to that conclusion.
Finally, we are concerned about people who have "managed" their disability through the use of medication and so on, but who have great difficulty in undertaking tasks to which the test may be applied. There are difficulties not only in the way in which the medical test will be applied to people's current occupation, but in the way in which it will be applied to all work.
We are very worried that the all-work test will not reflect the relationship between the ability of the individual, through the functional medical test, and the real work opportunities for disabled people. We are worried that that will not be applied in a way that will lead them into real employment because, by the Government's admission, they expect 200,000 people who would currently claim invalidity benefit not to receive the new incapacity benefit, but to end up as unemployed.
That is the reverse of the Government's previous policy, by which they sought to reduce unemployment by pushing people into any benefit they could find that was not unemployment benefit. Invalidity benefit was one such benefit that the Department of Social Security found, but it now wants to reverse that trend and to force people on to the dole queue rather than giving them a proper level of benefit. The other part of the group of amendments which is crucial aims to link the medical test to the appeals procedure. In Committee, we had some debate about the appeal procedure, but by our proposed new clause 4 we are strengthening the deliberation and looking towards the Government to give further comment and consideration to the way in which the appeals procedure will work in practice.
The mechanism which we are employing is the presentation of an annual report to Parliament so that we can give proper scrutiny to the way in which the appeals procedure operates. Linked to that appeals procedure is the role of the general practitioner and of medical and other professional advisers in the appeals procedure. There were some welcome comments in Committee about the way in which the appeals procedure would work. We welcome the points, for example, that appeals could be made to a social security appeal tribunal unless otherwise specified, that the GP will continue to have a role, and that a decision of "fit to work" reached by the Benefits Agency medical service will be accepted by the Employment Service, so that people will not fail tests by both agencies
Column 170and fail to qualify for any benefit. Those points were welcome, but we need much greater clarification of the way in which the appeal procedure will operate.
I know that the Minister said in Committee that further thought and discussion about the appeals procedure were continuing, but it is clear that we need to flag up some of our anxieties even more firmly.
One issue which was mentioned to us since we debated the Bill in Committee and which is important to many organisations representing disabled people, is the current delays in the hearing of appeals--the time that it is taking for decisions to be made. As a result of what we believe to be the more stringent nature of the new medical test--I emphasise that we cannot say for certain the way in which it will operate, because it is not before us to debate--and the arbitrary way in which we believe that it may be applied, not only to current work patterns but to all work employment, it is essential that the Government provide some certainty about the length of time that they would expect the appeals to take.
There will be a growing number of appeals. We must ensure that the Government will commit the resources to ensure that the appeals procedure is effective, and that the time scale in which claimants can expect a decision to be made is satisfactory. It must be especially satisfactory because of the structure of the new benefit. There is a change in rates at 28 weeks. Up to 28 weeks, a lower rate of benefit will be paid than after 28 weeks. Claimants will not qualify for the full rate of benefit until after 52 weeks. Therefore, we must be especially sure that the appeals procedure does not flow over that timespan, and that people do not lose on changing rates of benefit in that time.
Therefore, we very much welcome some consideration and further comment by the Government about the way in which the procedure will work, what resources will be provided and what the cost of those resources will be to the Government, to ensure that a satisfactory procedure is put into place.
What is crucial, as a result of the much more limited nature of the medical test, is the way in which the reports of medical officers, general practitioners and other medical professionals will be dealt with at the appeals stage. The Government are setting about a system which limits the role of the GP at the initial point of assessment. GPs will be allowed to produce their medical evidence on the condition of the claimant, but will not be allowed to give an assessment about the way in which that condition relates to the claimant's ability to work--or, if the GP chooses to do so, I suspect that that information will be ignored.
Mrs. Gwyneth Dunwoody (Crewe and Nantwich) : I have a constituent who received support from his general practitioner, who was told by the Department's doctor that he was perfectly fit to work and then had three subsequent different examinations by different doctors, all of whom said that he was incapable of working.
This morning, I received a letter--not from Monsieur Bichard, but from the personnel director of the agency, which I thought was a new development-- which said cheerfully, "Yes ; it is perfectly true that it did take 18 months. He has now got all the money back, and how inconvenient." There was not even a word of apology. Does my hon. Friend think that there will be a great deal more of that in future ?
Mr. Bradley : I am grateful to my hon. Friend for mentioning the way in which the appeals procedure currently operates. Interestingly, evidence from agencies such as citizens advice bureaux up and down the country shows that, when a case has gone to appeal, ultimately the evidence that was given by the GP is upheld at appeal. I therefore suspect that we shall get into more and far more elaborate appeals, which will take an enormous amount of time, effort and cost, and which will fall back very much on the original assessment that may have been undertaken by the GP.
No one suggests that the current situation is perfect ; no one suggests that all GPs are happy with the current arrangements ; but there is a strong feeling that, if GPs were given far greater guidance, better training and help in preparing the reports for the Department of Social Security, far fewer people might have had to go to appeal and then fall back on the GPs having to draw up new reports
We seek greater clarification of the role that GPs and other medical officers and assessments will play, and of the stage at which they will participate. It is feared that this will give rise to a massive number of discontented claimants who feel that they have been harshly treated by the medical test or its harsh interpretation. The test has limitations because of its functional elements in relating the multitude of different conditions, illnesses and disabilities that people have. It is difficult to fix those into a set of procedures and to make a one-off determination about whether people are capable or incapable of work. I believe that it will cause great distress and anxiety.
I feel that the Government have not understood the threshold that they are trying to determine between capacity and incapacity for work. We are worried--because we have evidence of it throughout the changes that have been made to the social security system--that the guiding force in all the decisions will be the Treasury. Under the social fund, for example, people with exactly the same needs and circumstances are treated totally differently, depending on what time of the year they walk through the door.
Although the Government will deny it, there is a fear that, if the medical test, however it is devised, does not limit the number of claimants to the amount of money which the Government expect the benefit to cost--even if the amount is not set in concrete--they will immediately change the threshold and the weighting of factors within the test to limit even further the opportunity for disabled people to be eligible for the new incapacity benefit.
As all Government policy at the current time seems to be governed by that overriding Treasury figure, which is designed to force down public sector borrowing, but which causes those with greatest need to suffer as a result, that must cloud our judgment on all the Government's decisions.
It is important that the new clause should enable proper scrutiny by Parliament of matters that are not contained in the Bill. It is crucial that Parliament be given an