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Mr. Burns: That is an interesting point, and I hope that the Government will consider it.
What I am about to say is in no way a criticism of those who will carry out the interviews. As the Minister rightly said, they will be given first-class training to make them as well equipped to carry out their work as is humanly possible. Sadly, there is a stigma attached to those with mental illnesses, and a lack of understanding of the problems that they experience and the way in which they respond to circumstances and challenges. However well trained people are, the interviews will be carried out across the whole range of society, and I fear that there could be problems because, through no fault of their own, not all staff at all times will be able to live up to the highest standards of their training.
Some individuals may be so unwell that, as well as being unable to attend, they are unaware of the impending interview. The Minister sought to allay those fears, and to some extent I have been reassured by what he said on that narrow issue. There will always be the fear, before, during and after the interview, that people with mental illnesses may lose their benefits because they have not been able to answer the questions or cope with the interview properly. The increased tension and concern could contribute to a relapse.
We should not duck the issue that, because of their condition, some people who are called for interview will not understand at all what it is about. They will be totally confused both in the run-up and during the interview itself. Given all those circumstances, I wonder why the Government are not prepared to reconsider.
I asked about schizophrenics or others with mental illness who have a history of, or may be prone to, violence, especially if they are tense or under pressure. That could cause grave problems to the individual concerned and, equally importantly, to the officials and staff involved in the interviews or other parts of the process.
I am bewildered about why the Government are not prepared to budge on what is a very sensitive issue. They certainly say that they want to handle the matter sensitively, and I do not doubt their sincerity, but that is not enough: they should be prepared to think again.
Mr. McWalter:
If we gain an assurance that therewill be an explicit input from the medical profession,
Mr. Burns:
I am not convinced that it would, although it might settle some of them. The hon. Gentleman's suggestion has merit, and should be considered further, but I fear that it might cover fewer people than he imagines. There is still a great lack of understanding of problems and treatment patterns. The medical opinion on a person could be wrong or could not be relevant at the time. The suggestion would not be a catch-all way of allaying all fears. The Government should consider it, but I do not think that it would be helpful in all that many cases.
Mrs. Browning:
The intervention by the hon. Member for Hemel Hempstead (Mr. McWalter) and the Minister's comments earlier both referred to the point that medical evidence would show whether an interview would be inappropriate. However, officials would have to obtain the permission of the person concerned before accessing those medical records. While that lengthy process was going on, the person would be aware that an interview was pending and that could cause them stress.
Mr. Burns:
That is a powerful and important point. Another issue is the civil liberties aspect, given that the medical history of individuals is not normally made available to officials of the Benefits Agency or the Employment Service. The Government should consider that point carefully, because such an approach could cause more problems and complications than the suggestion by the hon. Member for Hemel Hempstead (Mr. McWalter).
Mrs. Lait:
I agree with everything that my hon. Friend has said. Does he agree that some people with fluctuating mental conditions could perform ably at an interview, but, by the time they were fed through the system and went to see an employer, they might have relapsed? That could cause problems and tensions between the Benefits Agency and the employer.
Mr. Burns:
That is a relevant and interesting point, and my hon. Friend is right.
Mr. Pickles:
Does my hon. Friend agree that it would make more sense that the person performing the interview should undergo a personal capacity assessment? The Government's proposals contain no such requirement and they resisted amendments in Committee to include it.
Mr. Burns:
My hon. Friend makes a pertinent point. I fear that the Minister will not be able to answer that point because he was not listening to my hon. Friend. He will be able to read the intervention in Hansard tomorrow and, I hope, will accept the point.
No one disputes that the ethos behind the Bill is twofold. First, it is to encourage people into work or back into work. Secondly, it is to make savings in the welfare budget.
However, the Minister's resistance to giving serious consideration to exemptions to those suffering from severe mental illness contains an irony. Have Ministers considered that, if they force an individual suffering a mental illness to an interview and he or she suffers a relapse, that could cost the state far more in treatment than might be saved by forcing him or her to an interview? It is a supreme irony that what is a cost-cutting, money-saving, Treasury-driven Bill could, in this narrow instance--the Bill may contain other examples--have the opposite effect and cost the state more than it would save.
The Minister has been reasonable in this debate, although he has not budged an inch. I urge him to listen to all the contributions, from Conservative, Labour and Liberal Democrat Members, and, on reflection, to think again. If he continues on his current course, the Government will bitterly regret it when it becomes apparent how much suffering the Bill will cause to a section of the community who deserve our help instead of the burdens, worries and confusion being placed on their shoulders.
Mrs. Dunwoody:
I wish to ask a few questions of my right hon. Friend the Minister. Who will be asked to give evidence about the state of mind of a person who is to be brought to an interview? At the moment, it is mostly the Department's own doctors who are required to give evidence on physical disability. Will the support of a general practitioner not be regarded as sufficient evidence that an applicant is not fit to be interviewed?
I am also worried about the calm assumption that those who suffer from some form of mental illness can be easily and rapidly clinically diagnosed. That is not my experience. Especially in cases of recurring clinical depression, people's mental states fluctuate so widely that they can be capable of being coherent at an interview and within a short time become incapable even of being summoned to an interview. I dealt recently with a case in which the mere announcement that a meeting was to be held six weeks later to examine an applicant's case history in detail reduced the person in question to a state that required considerable medical assistance.
Another difficulty is that some general practitioners ask for extra money if asked to provide any form of certification. They feel, with some justification, that they are doing the work of the Department and they see no reason to expand their existing responsibilities.
I hope that my right hon. Friend the Minister has considered those points and will be able to provide a coherent answer, because to insist on a particular machinery to achieve a result without having thought about the implications for those who could be damaged by it is not an advance--it is a retreat. Many of the objections that have been raised may be artificial and unnecessary, but by the time we find out, people could already have been damaged. That is not, I believe, the intention of the Bill or of Ministers, but they must be prepared to think of the answers before, not after, the situation deteriorates.
Mrs. Browning:
I declare two unremunerated posts, one as vice-president of the Alzheimer's Disease Society and the other as specialist councillor on the national council of the National Autistic Society. The speeches we have heard so far have raised genuine concerns. I am
I repeat to the Minister something that my hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith) said. Talking about the interviews that people would be required to attend, he asked, "Why wait and see whether it hurts?" Ministers have a duty of care not to introduce legislation when they are unsure whether the process that they are introducing by statute will cause hurt to certain identifiable groups. There is enough knowledge about mental health, especially schizophrenia--as was so ably argued by my hon. Friend the Member for West Chelmsford (Mr. Burns)--and many developmental disorders, to make it possible to predict today that there will be hurt if those groups are subject to the process that the Minister proposes.
The Minister said that he was surprised by my earlier intervention, because he felt that I had an integrationist approach to employment opportunities for people with disabilities. He is absolutely right, but that does not mean that I do not recognise that although, for those two specific groupings, integration is to be achieved if possible, the process whereby it is achieved is absolutely key to whether integration is a good thing or hurtful and harmful.
It has been said that some people's response would depend on the day on which they were invited for interview. Much has been said about mental health problems--specifically, schizophrenia--with which I entirely agree, and I endorse what has been said. I shall not develop that further. I want to explore in more depth what happens when people with developmental disorders are interviewed.
The hon. Member for Crewe and Nantwich (Mrs. Dunwoody) spoke of the impact on a person who was given six weeks' notice to attend an interview. If something suddenly happens to a person within the autistic spectrum disorder grouping that is not part of their usual routine, the magnitude of the distress that they suffer is very different from that suffered by someone with a physical disability.
I want to draw a distinction. In my constituency, I know of some young people with cerebral palsy who are well qualified and deserve to be in employment for 101 reasons. I would wholeheartedly support a process that would enable them to get into work tomorrow as a result of attending an interview. However, although some people with autistic spectrum disorders have the potential to obtain employment, to be realistic--this is not being unkind to them--they are very few. For many, setting them up to fail--which is what we are contemplating--compounds their distress, and compounds their feelings about themselves and the rest of the world.
6.30 pm
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