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Mr. Hague: General practitioners have to provide such a report free of charge and they have to respond to inquiries from the Department. If additional information is required, it is up to general practitioners whether they wish to impose a charge, but many would not wish to do so. They have to provide the basic information to their patients and to the Department free of charge.
My hon. Friend the Member for Isle of Wight was particularly concerned about multiple sclerosis. The Benefits Agency medical services doctor will advise adjudication officers on the basis of the report from the patient's doctor. The severity of symptoms and the care and treatment requirements of the person will all be carefully considered by a fully trained doctor who will be considering all the factors that I have described.
My hon. Friend the Member for Stratford-on-Avon (Mr. Howarth) asked about the medical conditions that will confer entitlement. The new all-work test assesses the limiting effect of medical conditions. It does not depend on diagnosis. Some conditions, such as multiple sclerosis, are so severe that it is likely that a sufferer would be exempt from the test.
My hon. Friend the Member for Stratford-on-Avon and the hon. Member for Glasgow, Garscadden (Mr. Dewar) pointed to research about the reasons for the growth in the invalidity budget and it was accepted that those reasons are complex. They must concede that, even in the PSI documents quoted, nearly half of the growth could not be accounted for by demographic factors, even taking a loose definition of demographic. Research in the Department and independent research shows that GPs are issuing medical certificates to people who are not sick, or who are at least not too sick to work. It is important that we deal with that.
My hon. Friend the Member for Stratford-on-Avon asked about the savings and referred to a written parliamentary answer that I gave him a few days ago about the change in expenditure that would result from extending the exemption from the test to existing claimants aged 55 and over or aged 50 and over. He quoted my reply accurately when he said that the amount involved would be £15 million if people aged 55 and over were exempted and £45 million in the coming year if people aged 50 and over were exempted. However, as I pointed out at the end of that written answer, the figure would be much higher for subsequent years. By the third year, the figures involved would be £105 million if all those aged 55 and over were exempted, or £210 million if all those aged 50 or over were exempted.
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Those are huge sums of money, besides which it would scarcely be fair to new claimants of the benefit to exempt existing claimants on that scale, given the research that I have just quoted that seems to suggest that there are people receiving invalidity benefit who are capable of work.I ask my hon. Friend to think about the pressures that are imposed on the rest of the social security budget if those sums of money are spent without confidence that they are focused on the people for whom they are intended. I ask him to think about where else we could make reductions of the scale that we are talking about here and that he advocated spending.
The hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) asked about the percentage of existing claimants exempt from the test. He referred a number of times to a figure of one quarter. The figure that I have given of 220,000 people among existing claimants being found incapable of work is nearer to one eighth of the total number who are currently receiving the benefit. About one half are exempt from the new medical test because of the combination, to which the hon. Gentleman referred, of those who are 58 and over and those who fit the other criteria set out in the regulations. It is not possible to come up with local figures from the national figures, but I have published the national figures in the past and can do so again. However, I do not have figures for the hon. Gentleman's constituency.
The hon. Members for Garscadden and for Merthyr Tydfil and Rhymney expressed concern about people being worried and citizens advice bureaux being inundated with inquiries. We have developed a strategy for advising existing claimants, advisers and the medical profession about the changes. Leaflets have been published and order books include relevant messages. Further steps will also be taken. The hon. Member for Rochdale (Ms Lynne) made an important point about the ability for sustained reading. When a Benefits Agency doctor considers vision, he will also take into account the ability to read text on a sustained basis, rather than the ability to read individual letters or words; the ability to scan and focus on areas of text quickly and reliably. I hope that that reassures the hon. Lady.
The hon. Lady also asked about the questionnaire, which I think she said would run into 72 pages. That might scare people, but it is actually 20 pages long. It is clear and easy to complete. It has been put through market research with existing claimants and their comments particularly stress that it was easy to complete. The comments were most positive. Help will be available from specially trained staff for those who need assistance with the questionnaire. One of the most frightening things about all our debates on these matters is that the Opposition, fully aware that an unreformed invalidity benefit budget would head to about £10,000 million by the end of the century, and knowing that the benefit is not as focused as it should be, still have no alternative policy for dealing with the problem. The House and the nation are left not knowing how the Labour party would respond to that after all the debates that there have been in Committee and on the Floor of the House. After tonight's debate we are none the wiser. The Opposition know the pressure on other social
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security programmes if we do not focus on those who need these benefits most. They know the difficulties created for other sectors of Government spending.In the past few weeks, the Opposition have come to the House several times to vote against raising revenue; last night they came to the House to vote in a way that implied the spending of a great deal more money. They are going to do that again tonight. They oppose what we are suggesting-- sensible and timely reforms--without having an alternative to put in the place of those reforms. We would receive more positive proposals, and more of an impression of awareness of the need to act, from the average ostrich than we receive from Opposition Front Benchers. Few things could better illustrate the Labour party's fiscal irresponsibility.
This is a necessary and timely reform. It focuses on the people who need benefit most--
It being Seven o'clock, Madam Deputy Speaker-- put the Question, pursuant to Order [27 January].
The House divided: Ayes 275, Noes 232.
Division No. 62] [7.00 pm
AYES
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Ainsworth, Peter (East Surrey)Aitken, Rt Hon Jonathan
Alison, Rt Hon Michael (Selby)
Allason, Rupert (Torbay)
Amess, David
Ancram, Michael
Arbuthnot, James
Arnold, Jacques (Gravesham)
Arnold, Sir Thomas (Hazel Grove)
Ashby, David
Aspinwall, Jack
Atkinson, Peter (Hexham)
Baker, Nicholas (North Dorset)
Baldry, Tony
Banks, Matthew (Southport)
Banks, Robert (Harrogate)
Bates, Michael
Batiste, Spencer
Bellingham, Henry
Bendall, Vivian
Beresford, Sir Paul
Booth, Hartley
Boswell, Tim
Bottomley, Peter (Eltham)
Bottomley, Rt Hon Virginia
Bowis, John
Boyson, Rt Hon Sir Rhodes
Brandreth, Gyles
Brazier, Julian
Bright, Sir Graham
Brooke, Rt Hon Peter
Brown, M (Brigg & Cl'thorpes)
Browing, Mrs. Angela
Bruce, Ian (Dorset)
Burns, Simon
Butcher, John
Butler, Peter
Butterfill, John
Carlisle, John (Luton North)
Carlisle, Sir Kenneth (Lincoln)
Carrington, Matthew
Carttiss, Michael
Cash, William
Churchill, Mr
Clappison, James
Clark, Dr Michael (Rochford)
Clifton-Brown, Geoffrey
Coe, Sebastian
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Colvin, MichaelCongdon, David
Conway, Derek
Coombs, Anthony (Wyre For'st)
Coombs, Simon (Swindon)
Cope, Rt Hon Sir John
Cormack, Sir Patrick
Couchman, James
Cran, James
Currie, Mrs Edwina (S D'by'ire)
Curry, David (Skipton & Ripon)
Davies, Quentin (Stamford)
Day, Stephen
Deva, Nirj Joseph
Delvin, Tim
Dicks, Terry
Dorrell, Rt Hon Stephen
Douglas-Hamilton, Lord James
Dover, Den
Duncan, Alan
Duncan Smith, Iain
Dunn, Bob
Dykes, Hugh
Eggar, Rt Hon Tim
Elletson, Harold
Evans, David (Welwyn Hatfield)
Evans, Jonathan (Brecon)
Evans, Nigel (Ribble Valley)
Evans, Roger (Monmouth)
Evennett, David
Faber, David
Fabricant, Michael
Field, Barry (Isle of Wight)
Fishburn, Dudley
Forman, Nigel
Forsyth, Rt Hon Michael (Stirling)
Forth, Eric
Fowler, Rt Hon Sir Norman
Fox, Dr Liam (Woodspring)
Fox, Sir Marcus (Shipley)
French, Douglas
Gale, Roger
Gallie, Phil
Gardiner, Sir George
Garel-Jones, Rt Hon Tristan
Garnier, Edward
Gill, Christopher
Gillan, Cheryl
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