House of Commons Hansard Debates for 2 Feb 1995

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The Bill is also unfair because people have been paying national insurance contributions. The benefit is based on one's national insurance contribution record, which is extremely important--as it is with the jobseeker's allowance. People are being asked to pay more national insurance, but services are being cut and they are receiving less in benefits.

The Bill is also unfair because the Government are changing the rules and people will get less money than they do at present. It will be the same for the first 28 weeks--£43.45 a week--but, between 28 and 52 weeks, invalidity benefit is £57.60, whereas incapacity benefit will be £52.50. That is a saving of £5.10. The measure is a means to claw back tiny amounts to try to save the Treasury money, but when one adds it all together, it amounts to a considerable sum. The full rate will be payable after 52 weeks and the terminally ill will not be included, for which I am grateful. The Government are also clawing back money from age allowance and dependence allowance, and so it goes on. They are reducing the age bands from three to two and the full rate will be payable after 52 weeks and not 28. At present, the under-40s receive an extra £12.50, those between 40 and 49 an extra £7.60, and those between 50 and 60, an extra £3.60. With incapacity benefit and the change to two bands, the under-35s will receive £12.15 extra, and those between 35 and 45, an extra £6.10. There will be nothing extra for anyone older.

As has been said, with incapacity benefit, the adult dependant will have to be over 60, or looking after children, whereas age is irrelevant with invalidity benefit. Claimants will also receive less money. One can claim invalidity benefit for five years after retirement, but that is not the case with incapacity benefit, which is available until retirement age only. Invalidity benefit is not taxable, whereas incapacity benefit is. The list goes on and on and the changes are totally unfair.

If the Minister taxes incapacity benefit, will he introduce a proper benefit or allowance for those with special needs? The Disablement Income Group estimates that it will cost £87 a week for special needs and I hope that he will take that into consideration. The Minister estimated that 50 per cent. of claimants might have to be reassessed. The Government said that it was likely to be 85 per cent. He also said that it was thought that about 220,000 would be deemed fit for work after the tests, which I find extraordinary. The Department of Social Security has initiated some sort of test and says that one in four of those on invalidity benefit will be deemed fit for work.

The new test will be the same as the current test for the first 28 weeks, whether it is for sickness benefit or new incapacity benefit. But after that, claimants must complete an unwieldy questionnaire of some 72 pages. They will need a considerable amount of help to fill it in and citizens advice bureaux are already receiving many inquiries about problems with it. Their case load will increase dramatically. Members of Parliament, too, will be inundated with people coming to see them about their problems, just as we did with disability benefit and child support. In six months or a year's time, the Minister will have to come back to the House to announce changes in the Act, just as happened with the Child Support Act

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1991. I hope that the problem does not go that far, but I fear that it will. Conservative Back Benchers will complain to the Minister, just as we are complaining now.

The tests are also unfair. For example, a person who can carry a 5 lb bag of potatoes is awarded eight points; and a person who can turn on a tap with one hand is awarded 6 points. But many disabled people overestimate what they can do and do not want to admit that they cannot do certain tasks. So those filling in the questionnaire may say that they can do something whereas they cannot.

I welcome the fact that the Minister said that people with severe mental illness will be excluded. But the section on "mental disabilities", as the Government call them, is still woefully inadequate.

The section on the partially sighted is also woefully inadequate. Will the Minister reassure me--I know that he has had representations about this in addition to the incapacity benefit and medical test--that the wording of the test will be changed so that it says that partially sighted people should be able to read on a sustained basis, rather than just be able to read words? He may have reached some agreement on that, but will he say something about it when he sums up tonight? The medical test should also include the ability to scan and focus areas of text and the words

"functionally useful field of vision".

If claimants manage to fill in those forms, many of them will be seen by doctors from the Benefits Agency medical service, but those doctors will not know the patients. The Government may say that that is a good thing as it will ensure that the system it not open to abuse, but if doctors do not know the patients they will not know the patients' real history or the problems that they have experienced. Furthermore, will doctors who must review cases be trained in the relevant specialities, for instance, in mental health? Under the industrial injuries compensation review, many doctors are brought in from specialist fields. I know that that would be expensive and I doubt whether the Government will take the suggestion on board, but they should be aware of the various specialities. A doctor should not simply be asked to say whether someone with mental illness or a disability is unfit for work. They must have been trained in a particular speciality.

Filling in the questionnaire will present great problems for the mentally ill, many of whom will not bother to fill it in and claim benefit. Some of them are unable to concentrate or have given up their jobs because of panic attacks. Imagine a mentally ill person presented with all those questions. They will make him or her panic even more.

Some people will fall through the net between the incapacity and jobseekers benefits. In a written answer, the Minister of State, Department of Employment said that the problem will not have a great effect and will be taken into account under the new jobseeker's allowance in a similar way to unemployment benefit. But citizens advice bureaux already say that people are falling through the net as a result of the new medical test on invalidity benefit. They try to get unemployment benefit but end up getting no benefit whatever. I can imagine the arguments at the Benefits Agency about what should be excluded from the "area of work", because that point is being argued already. I hope that the Government will think again about the medical test. They seem to be simply clawing back money for the Treasury.

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Another key point is that many people will seek advice. If the Government think that people can rely on citizens advice bureaux, they must ensure that the CAB are given the funds and wherewithal to deal with all the cases that are brought to them, or the Government will have to provide an alternative.

I wish that the Government had decided to simplify the invalidity benefit rather than complicate it and introduce a benefit that would advantage disabled people. The incapacity benefit simply penalises disabled people. Disabled people's organisations throughout the country and hon. Members on both sides of the House want the Minister, even at this late stage, to change his mind and review the medical test and, if possible, the incapacity benefit.

6.6 pm

Mr. Alan Duncan (Rutland and Melton): Thank you, Mr. Deputy Speaker, for calling me once again. I have sat across the Floor from the hon. Member for Glasgow, Garscadden (Mr. Dewar) in many social security debates and was, unusually, gearing up to pay him a compliment. I am sorry that he is no longer in his place to witness it. The manner in which he has approached this matter has been fair-minded. He is always a master of detail and I always learn something when he speaks. He makes broad and encouraging comments in addressing the overall problem of social security and an ever- rising budget. He said in 1992:

"The Labour Party recognises the inadequacies of the present system . . . any government is entitled to review policy and spending patterns".

So they are. He also said on the television series "On the Record":

"I certainly don't take the view that the answer to the problems of the Social Security Department is just spending more money within the framework of the present system".

Indeed, and I commend the hon. Gentleman for both those observations.

Our problem, however, is in moving from those generalities to specifics and I regret that, even before we had a chance to study the details of the Bill, he dismissed it simply as a conspiracy to undermine the welfare state. It is not a conspiracy to do so. Rather, the reforms before us tonight, and the specific matters in the statutory instruments that we are debating, address and fit well within the context of the long-term problems of social security with which Governments must wrestle.

On Second Reading, the Secretary of State said:

"The Bill has three objectives: first, to ensure that the huge and rising sums devoted to sickness benefits are properly focused on those who are genuinely too unwell to work; secondly, to ensure that the cost is affordable; and thirdly, to provide a more rational structure of benefits." --[ Official Report , 24 January 1994; Vol. 236, c. 35.]

That is a good rule of thumb for almost any reform to the social security system and is in tune with the issues with which the Select Committee on Social Security has dealt.

The current structure, which has been changed by the regulations, is inadequate. It is complicated and running out of control. There are currently two main benefits for people who are away from work for short periods because of sickness--statutory sick pay and sickness benefit.

When we consider long-term incapacity we find that most people who have been entitled to either statutory sick pay or sickness benefit become entitled to the

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contributory invalidity benefit after 28 weeks of incapacity until they claim state retirement pension or are able to work again. They have to provide evidence of incapacity--normally to their own doctor. The invalidity benefit currently consists of an invalidity pension paid at the same rate as retirement pension, an invalidity allowance--an age-related addition that is paid to people qualifying for invalidity pension who become incapable of work more than five years before pensionable age--and an additional pension that is based on people's earnings between 1978-79 and 1990-91. The Government have already reformed the additional pension so that no further entitlement arises on earnings beyond April 1991. That measure was part of the package introduced from 1991 to improve the balance of incapacity benefits.

The existing severe disablement allowance is non-contributory and goes to those people who are incapable of work for more than 28 weeks. But the flaws of the existing structure became completely overwhelming and there was increasing and widespread concern that benefits for those incapable of work have been going to people for whom they were never intended. There has been a rapid growth in invalidity benefit at a time when the nation's health has been recorded as improving. The number of people in receipt of invalidity benefit has almost trebled over the past 15 years--from 550,000 to about 1.8 million.

Mr. Alan Howarth: My hon. Friend alluded to what he described as increasing concern that invalidity benefit was going to people to whom it should not. What evidence has he of that concern? What evidence has he that the concern may be justified?

Mr. Duncan: It is self-evident that, if the health of the nation is improving while, at the same time, the number of people deemed to be disabled and in receipt of benefit is increasing dramatically, there is something inconsistent in the way that disability benefit is delivered. I shall tell my hon. Friend the figures with which one has to wrestle.

Expenditure on benefit has more than doubled over the past 10 years, even after allowing for inflation. It more than trebled in cash terms--from £1.6 billion in the financial year 1982-83 to £7 billion in 1993- 94. If the system remained unreformed, the estimate is that spending could rise to £10 billion by the end of the century. It has become the largest contributory benefit after the state pension and one of the fastest -growing areas of expenditure in the system. I commend the Government for addressing the problems of a set of circumstances with which it is increasingly impossible to live. Those who are capable of work, but unemployed, should not be in receipt of incapacity benefit. Instead, they should receive benefits designed for those who are unemployed and, in particular, they should be designed to help such people back to work. Long- term dependence on incapacity benefit reduces motivation, causes skills to deteriorate and makes it harder for the recipient to take employment when work becomes available. It entrenches a distortion in the labour market which is severely detrimental to the long-term welfare and prosperity, not just of the country, but of the individuals involved. Another problem with the system was that general practitioners were experiencing severe difficulty fulfilling their role as the gatekeeper to invalidity benefit. The current system has placed them in an unfair position--a nasty and invidious position--in relation to their patients.

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It is almost impossible for a GP to maintain a cordial relationship with a patient for whom he has care and a duty of care when he is also asked to be the effective vetter of the patient's right to a state-provided benefit. It is as well that the GP's role has been significantly reduced to a more administrative one.

The new system to be introduced in April amalgamates the myriad benefits into a single new benefit. It will be contributory and paid as of right, irrespective of means, to everyone who satisfies the necessary conditions. I think that the eligibility conditions have been fairly drawn. For the first 28 weeks of incapacity, people will be able to receive incapacity benefit if they are incapable of working in their own occupation. After 28 weeks, a new medical test of incapacity for all work will apply. It will apply in respect of both incapacity benefit and other benefits paid on the basis of long-term incapacity.

There will be three rates of payment. The lowest will be payable for the first 28 weeks of sickness, when many people have occupational sick pay and other resources to call on, and will be paid at a rate equivalent to existing sickness benefit. After 28 weeks, an intermediate tier will be payable, set at the current higher rate of statutory sick pay. It will ensure that the benefit level is maintained for those who have been receiving statutory sick pay. The highest rate of incapacity benefit will be payable after 52 weeks of incapacity and will be set at the current basic rate of invalidity benefit.

Existing claimants will continue to receive the rate of benefit in payment at the time of the change. In recognition of the overlap that now exists between state and private provision, the earnings-related additional pension on invalidity benefit will be abolished for new claimants and frozen for existing claimants. The Government have also undertaken to continue to uprate the remainder of the benefit. Many people undertake voluntary and therapeutic work, and certain changes contained in the measure will assist them. From April, all recipients of incapacity benefit will be able to undertake voluntary work for up to 16 hours a week while receiving benefit.

Under the existing system, many factors are considered when taking decisions on incapacity. Such factors include age, skills, education, experience and something dubbed "other social factors". But the trouble is that the list precludes a tight definition of incapacity and makes it difficult to determine precisely whether someone is eligible to receive the benefit.

The new system has considerable advantages and, under it, for the first 28 weeks of incapacity, people will be able to receive the lower rate of incapacity benefit if they are incapable of working in their own occupation. After 28 weeks, a new medical test of incapacity will apply. That medical test will involve the claimant, the claimant's GP and the departmental doctor. In an assessment of the claimant's ability to carry out a range of work-related activities, certain tests will apply. A significant advantage over the former system is that the GP will be involved only in a limited role and in supplying purely medical information.

The regulations that we are considering are detailed and the hon. Member for Rochdale (Ms Lynne) has quibbled with some of the tests included in the questionnaire--I can see why in many respects. The own occupation test

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and the all work test which are defined in the instruments have been researched extensively. In seeking to define them, the Government have received more than 350 responses since the publication of their consultation document on 1 December 1993. The Government have evaluated all the information and they have come up with detailed, clear and undeniably workable guidelines.

The methods of dealing with those who suffer from mental health problems-- with which the hon. Member for Rochdale is intensely concerned; indeed, she raised the matter during the proceedings of the Disability Discrimination Bill this morning--have been addressed and the provisions have been designed properly. I have read them in considerable detail and assessed how they will replace the existing system and I commend them to the House.

6.20 pm

Dr. Jeremy Bray (Motherwell, South): The hon. Member for Rutland and Melton (Mr. Duncan) is concerned, quite correctly, about avoiding the ghettoisation of the unemployed and the handicapped. He has advanced proposals in support of a scheme which at least makes a return to employment possible; that is a laudable objective. However, I wonder whether he is being entirely realistic.

I shall deal first the plight of those who suffer from mental illness--in either severe or moderate forms--which is not exempt from the test. People generally refuse to acknowledge their illness and they take violent exception to the suggestion that they may, in any way, be mentally ill. Therefore, those who suffer mental illness often make a very traumatic entry into the health service. The argument about whether people are mildly or severely mentally ill is totally irrelevant.

If such people lose their jobs and are then forced to deal with the most difficult aspects of social security provision, a temporary breakdown could easily become a permanent disability. When we identify the support mechanisms available to the mentally ill, it is obvious that the overwhelming burden of responsibility falls on community care and the health service. However, I do not think that the social security system can wash its hands entirely of its responsibilities.

I welcome the exemption of the severely mentally ill from the work test, but the fact that the mildly mentally ill will be subject to the test poses all sorts of problems. Regulation 18(1)(b) states: "where a person . . . fails without good cause to attend for or submit himself to medical or other treatment . . . he shall be disqualified from receiving benefit".

That provision may overlap with the Government's proposals in the legislation dealing with the supervised discharge of the mentally ill and with community care arrangements. Have the Government thought about how regulation 18 will operate when community care arrangements vary hugely from one health authority to another and when the attitudes and the understanding of social security staff vary a great deal from one office to another? There is a standard system, but practical interpretation of it varies widely. I do not think that Motherwell is in the worst position in that regard, but I do not think that we fare particularly well either.

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In building up the community care provision, it is essential that the Departments of Employment, of Health and of Social Security work together very closely. The Department of Employment supports many admirable access-to-work schemes for the mentally ill which are run by people who have been mentally ill themselves. Mentally -ill people receive a sympathetic hearing from departmental staff and they are encouraged to take on more and more work. However, there is a danger that they will take on too much work, which may have disastrous consequences. It could prove beneficial to link the access-to-work schemes more closely with the health service--in terms both of national policy and of the local delivery of that policy. It is in the softer aspects of the organisation and provision of opportunities to return to work, rather than the hard, practical rules which are considered by the House, that the greatest progress will be made. Returning people to work successfully requires constructive and sensitive organisation and the regulations should be drafted in such a way as to achieve some flexibility. I do not think that that flexibility is achieved in the regulations as they stand at present and they overlap with legislation which is yet to come before the House. I trust that the Minister and his departmental colleagues will continue to give careful attention to those matters.

6.26 pm

Mr. Keith Bradley (Manchester, Withington): We have had a thoughtful debate, and I commend the effective contributions from both sides of the House, which will form a major part of the on-going debate on the regulations. They will continue to come before the House for a number of years and we shall be able to monitor their effects.

However, I must immediately take issue with the contribution of the hon. Member for Rutland and Melton (Mr. Duncan). He said it was self-evident that, because the health of the nation is improving, the number of people on invalidity benefit should be falling. If he looks carefully at the research undertaken by the Department of Social Security--

Mr. Duncan: I thank the hon. Gentleman for giving way. I did not say that. I said that if the health of the nation is improving, it is curious that the number of disabled people appears to be increasing as fast as it is.

Mr. Bradley: I accept the hon. Gentleman's rewording of what I thought he said. Even so, I should be grateful if he would read the research from the Department of Social Security before making such assumptions. DSS statistics and independent research show clearly that the growth in the number of claims is more to do with people spending longer periods on benefit than with an increase in the number of people making claims.

My hon. Friend the Member for Glasgow, Garscadden (Mr. Dewar) and the hon. Member for Stratford-on-Avon (Mr. Howarth) referred to research conducted by the Policy Studies Institute which shows that demographic trends account for much of that increase. The trends include: an increase in the number of women paying national insurance contributions; an increase in the number of people above pension age; and a gradual increase in the number of people with disabilities, with a significant rise over the period of the increase. In future,

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I hope that the hon. Member for Rutland and Melton will look at the statistics more carefully before making rather broad-brush assumptions about why the number of claims for benefit has increased.

The regulations give us the opportunity to debate for the first time the new test of incapacity for work and the transitional arrangements. They are crucially important for thousands of people who are disabled and chronically sick and for those who will be so affected after April this year. The provisions are wide-ranging as they apply not only to incapacity benefit, which replaces sickness benefit and invalidity benefit, but to the assessment of incapacity for severe disablement allowance, income support and credit only cases. They range further than merely the assessment for incapacity benefit.

The reasoning behind the new test--to cut the increasing number of claims-- has been perceived as a problem only in the case of invalidity benefit and not for the severe disablement allowance and for income support.

This is the first and last time that the House will have the opportunity to debate the details of the new incapacity test before it is implemented. We complained during the passage of the Social Security (Incapacity for Work) Act 1994 that no definition of the medical test appeared in the Bill, so we could not debate it. Considerable concern was expressed in both Houses about the nature of the test. No details of the new definition were available because consultation and development were being undertaken simultaneously. We did not have the benefit of understanding that process while considering the Bill to implement the test.

It eventually became clear that the test would deal only with functional ability and would not be more wide-ranging. A person's incapacity is reduced to a set of formulas that omits other factors relevant to incapacity, which are used in the formulas for invalidity benefit--age, education, work experience and skills.

The October 1994 consultation document confirmed that the exclusion of relevant factors was a particular concern of many respondents to the February 1994 consultation. Even some members of the expert panel established to advise on development of the test expressed their concern. The test did not enjoy a consensus among all panel members but was the subject of considerable disagreement. That has not been properly explained in the House or elsewhere.

Professors of rehabilitation, for example, were not asked to participate as members of the panel, but expressed their considerable concern about the development of the test. They wrote to The Times on 12 April 1994 to express their grave doubts about the way that the matter was handled.

It is nothing short of cruel that people found to be capable of work on functional grounds should be expected to find employment when there is no work for them to do. Regulation 27 acknowledges exceptional circumstances in which someone could fail the functional test but nevertheless be deemed as incapable of work, and is to be welcomed. However, the October consultation document suggested that the provision was made because the evaluation studies revealed that, in some cases,

"the functional assessment was not appropriate".

If Benefits Agency medical service doctors found during clinical examination cases that could not be assessed on functional criteria alone, that must cast doubt

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on the validity of the test. Despite the BAMS reservations, the Government decided to go ahead with a clearly one- dimensional, functional test. One questions whether the principal rationale is to save money rather than to ensure accurate, proper and wide-ranging assessment of a person's incapacity.

Part III of the regulations, and particularly regulation 24, defines the all-work test as meaning an individual's inability to score a set number of points in the scale of descriptors in the schedule. Unlike the provisions for early assessment of incapacity for a person's own occupation in chapter I, which is applicable for the first 28 weeks, or for exempt work under regulation 17, part III contains no definition of "work" for the all-work test. That reduces someone's capacity to undertake all work to a crude assessment based on the performance of such functions as picking up a 2.5 kg bag of potatoes.

Incidentally, one change might be dubbed the metric meanness test. During consultation, the proposal to assess a person's ability to walk was based on yards, but that was changed to a metric measure, which will make it more difficult for the individual to score points.

Except for the estimated 15 per cent. of claimants who will be treated as incapable of work under regulation 10, most claimants will have to score at least 15 points in a test of physical or mental functions, or at least 10 in a test of mental ability alone. Many organisations throughout the country have expressed great concern about the score targets. We pay tribute to organisations such as the Disability Alliance, the Disablement Income Group, the citizens advice bureaux, MIND, the Multiple Sclerosis Society, the Child Poverty Action Group and many others, which provided a wealth of information that made our debates more effective. They clearly explained the problems that they envisage our constituents will present at our surgeries in future. We welcome the contributions of those organisations.

The arbitrary nature of the 15-point cut-off, with no other factors to be taken into account, means that a score of 13 or 14, while confirming substantial disability, would disqualify a person from incapacity benefit. The closeness of reaching the threshold will not be taken into account. That means that anyone who cannot

"stand for more than 30 minutes before needing to sit down" and merits a score of seven, and cannot

"raise one arm to his head to put on a hat"

and merits a score of six, and so achieves a total score of 13, will be two points short of being eligible for the benefit. Crucially, on the mental disability scale there could be people suffering from depression, anxiety or panic attacks who will also fail the test, but who would be unable to sustain the routine of work or travel to work. An individual with a mild or moderate mental health problem must score at least 10 points to qualify for benefit. Someone who frequently

"feels scared or panicky for no obvious reason"

and scores two, is

"scared or anxious that work would bring back or worsen his illness"

and

"too frightened to go out alone"

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would score one point on each count, to achieve a total of only four, and not be entitled to incapacity benefit. I urge the Minister to reconsider wider matters.

Mention was made of problems associated with the interface between incapacity benefit and the jobseeker's allowance. We will monitor that carefully when the Bill introducing that allowance is enacted and its implications are clearer. Members on both sides of the House urged the Minister to reconsider the age factor. The passporting of people aged over 58 in the transitional regulations is recognition that age has an impact on a person's ability to undertake work. Age banding or some other mechanism should be used, rather than an arbitrary cut-off age of 58.

The regulations are before the House again because of the original failure to include severe mental illness. Can the Minister give an assurance that the amended regulations are not faulty? I shall give one example. I am sure that the Minister will be able to allay my fears, but on page 7 of the regulations, under the heading "Treating as Capable, Disqualification" it sets out where a person should be treated in that respect as being

"under regulations 10 to 15 or 26".

That is someone who is treated as capable for work. However, section 27 deals with the person's capability for work. I just want to ensure that that is my misreading of the regulations rather than an error.

I would like further assurance from the Minister that he will comply with the comments made by his predecessor, the right hon. Member for Chelsea (Sir N. Scott), who said:

"Regulations will, however, be made before the full commencement of the Act."--[ Official Report , 21 June 1994; Vol. 245, c. 148.] As the Minister has agreed that there will have to be amendments to the regulations, and that those amendments will have to be affirmative regulations, will he assure us that they will be brought before the House before the Act is implemented, because flowing on from that is the guidance that the Benefits Agency staff and many other advisers throughout the country will require to ensure that the regulations and the benefit are properly administered? We do not want a repeat of the chaos that ensued following the introduction of the Child Support Agency. I urge the Minister to look carefully at the regulations and the guidance to ensure that the training and all the possible eventualities following the introduction of the benefit are properly addressed before the Act is implemented.

The points of concern over the regulations have already been identified. We are concerned that they contain a significant omission--that is, they do not take into account the effects of pain, stiffness, fatigue and the variability of functional limitations in fluctuating, relapsing or variable conditions. We heard examples of that from hon. Members on both sides of the House. I should like assurances that those factors will be properly considered by the Benefits Agency medical services when assessment is undertaken. We want further assurances about exactly who will be included in the exempt group under regulation 10. A number of chronic conditions listed are described as "severe", but what precisely is severe? For example, what is

"a severe and progress neurological and muscle wasting disease"?

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At what point does a person's condition become severe? Will there be provision for people to move from not severe into the severe category? How will that be assessed? What certificates will be required to ensure that that transfer is included?

We would like assurances on the interaction between exempt groups and functional scoring. The dividing line between the two could be quite crucial. If someone falls outside the exempt group, he or she will have to go through the functional scoring test--for example, people with learning disabilities falling outside the "severe" category. The mental disability scale is totally inappropriate, as it involves descriptors, which are compared with someone's mental state at the time when the claim was made, rather than as the condition developed. That does not address the needs of people with learning disabilities who have not acquired a mental health problem. There are other examples of where the change in the circumstances and the functional scoring at the point of the claim is inappropriate, because the condition could have been with that person since birth. It is important that all Conservative Members are quite clear about what they are voting on and of the effects that it may have on their constituents who eventually come to see them about the legislation. Let me give a concrete example of what effect the legislation will have in practice. It is of a person aged 55 and who been on invalidity benefit for five years. He has chronic emphysema and chronic bronchitis. He has worked as a miner for 30 years and has limited learning and writing skills. His children have grown up and left home, but he continues to live with his wife, who is not in work. Under invalidity benefit today, he would be entitled, with each of the elements, to £109.30 a week. After the uprating in April 1995--to be fair to the Minister--he will receive £111.45.

Let us look at a neighbour who has been through the same experience at work and has had to leave work, perhaps with the same chronic ailments, but has not yet claimed, so will be a new recipient of incapacity benefit. In the first six months, he will receive £52.50 in statutory sick pay. At 28 weeks, if he falls within the exempt group, he will be treated as incapable of work and therefore be entitled to benefit, but at the 28-week stage, his benefit remains at £52.50. Only when he has been incapable of work for a year does his benefit go up, this time to £58.85. He receives no age allowance, as he has become incapable of work after the age of 45. While his neighbour will be getting £111.45, he will get £58.85--a difference of £52.60 per week. Because of the delay in receiving the full rate of benefit, there will be a further loss of £152.40 in the waiting time of 24 weeks.

I want Conservative Members to be absolutely clear that tonight they are voting for a potential difference between the current invalidity benefit of £111.45 and the new rate. Someone who is in exactly the same position, has passed the medical test and so is a "genuine"--to use the term of the hon. Member for Rutland and Melton--claimant and recipient of incapacity benefit will receive £52.60 less per week. Conservative Members should not say that we have not told them. We have told them at

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every stage of the Bill--on Second Reading, Committee, Third Reading, and now on the regulations. That is the sort of case that Conservative Members will see coming through the doors of their advice bureaux. They should not come back to the House and say that we did not tell them.

6.47 pm

The Minister for Social Security and Disabled People (Mr. William Hague): We have had an interesting and varied debate. Hon. Members on both sides of the House have asked me to respond to a number of questions. I will attempt to do that in the time available. The hon. Member for Manchester, Withington (Mr. Bradley) asked me specifically about amendments to the regulations in future. Both he and I have had a number of discussions about that in recent times. I can tell him, as indeed he is already aware, that a number of amendments, which, I think, we would all want to make, have been identified since the regulations in their first draft were laid at the end of November. He is an extremely perceptive reader of the regulations in that he has spotted one of them--a 26 needs converting to a 27. There are others--very soon, he may be recruited as a civil servant to the Department of Social Security--such as the therapeutic earnings limit needing to be updated from £43 to £44, and so on. There are discussions with the Terrence Higgins Trust about the definition of immune deficiency. We want to ensure that we get these things right. Any such amendments will be laid in good time before the test comes into operation. They will be affirmative and none of them involves any policy change.

My hon. Friend the Member for Rutland and Melton (Mr. Duncan) gave a good summary of the case for reform of the current arrangements. He particularly referred to the position of GPs who, of course, for some time have been acting as policemen for the social security system. That can, as he said, undermine the doctor-patient relationship. The future restriction of GP involvement mainly to short-term claims will significantly reduce the burden upon them because they will need to complete many fewer statements of incapacity and the Department will be writing to them for further reports far less often.

My hon. Friend the Member for Isle of Wight (Mr. Field) particularly asked whether the questionnaire seeks advice on variable conditions. It contains space for claimants to give information on all the effects of their condition, including pain, stress, fatigue and variability. There is a question in each functional area and at the end it asks claimants whether there is anything that they want to say about pain or stress.

When the Benefits Agency medical services doctor assesses someone for the all-work test, he will take full account of the history and evolution of the medical condition, the effect that it has on daily life and normal tasks over a period of time and the limitations that are imposed by it. The doctor must also justify his choice of descriptors in terms of any variability or fluctuation of those effects and also the effects of pain and fatigue. I can assure my hon. Friend that that point is being emphasised

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in the training given to doctors. The test will not be a snapshot at a point in time but an assessment of variable conditions over a period.

Mr. Alan Howarth: Will my hon. Friend give way?

Mr. Hague: I shall give way once, but I have many questions to answer, including some from my hon. Friend.

Mr. Alan Howarth: Reverting to the role of general practitioners, will my hon. Friend confirm that it is unacceptable to the Government that GPs should charge claimants fees for their part in the process, that that really is outrageous where it occurs and that the Government regard it as completely inconsistent with the principles of the NHS?

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