APPENDIX 12
Memorandum by the Disablement Income Group
The Disablement Income Group (DIG) has a mission
to improve the financial circumstances of disabled people. Our
main activities include examining the work disincentives within
the present benefits system and considering ways in which disabled
people can be helped to meet the extra costs of living experienced
because of their impairments. Our response to the joint committee
inquiry therefore concentrates on the impact of the Single Gateway
pilots on people with a disability or long-term sickness.
Summary of DIG's Key Points
The aim of the Gateway is to help people to become
more independent by ensuring that "there is work for those
who can, as well as providing security for those who cannot"
(cm 4102). DIG broadly supports this aim, and believes that it
will best be achieved when there is:
1. a mechanism to make the distinction between those
who can work and those who cannot; and
2. provision of appropriate benefits and employment
support, which includes help for people who may not be able to
work today but could, with the right assistance, do so tomorrow.
The present system fails to identify those who can
work from those who cannot, neither does it offer sufficient support
to individuals making the transition into work.
If the proposed "personal capability assessment"
simply adds more questions to the existing all work test, and
other benefit rules remain unchanged, an opportunity to end the
classification of people by the benefit they have claimed may
have been lost.
In the longer term, both benefits and employment
support for disabled people need to be more consistent with the
aims of the Gateway.
1. The Gateway Concept
1.1 The single Work-Focused Gateway (SWFG) is intended
to provide a single point of access to welfare and to help people
find jobs. This will consist of a "Registration and Orientation"
phase for the initial contact with the system, when information
is supplied by the claimant. This phase will be crucial in determining
whether and when someone has a work-focused interview.
1.2 The next phase consists of an interview with
a Personal Adviser, which will be an more in-depth investigation
of an individual's needs and exploration of the barriers to employment,
with the aim of drawing up a plan of steps that the individual
can take.
The importance of Registration and Orientation
1.3 Although attention has focused on the compulsory
nature of the work-focused interview with a Personal Adviser,
an important stage is likely to be at Registration and Orientation,
where claimants will be sifted into those who should have an early
interview and those whose interview should be deferred or waived.
The Gateway paper (Cm 4102) states that "this part of the
process will guide the subsequent course of action by enabling
an assessment to be made as quickly and comprehensively as possible
about the balance of support likely to be appropriate in the particular
circumstances".
1.4 Registration and Orientation staff will therefore
need a broad understanding of the needs of a wide range of claimants
and the skills to identify people whose needs may not be obvious,
such as those with an impairment that may not be visible.
1.5 DIG is pleased to see that Registration and Orientation
staff will be involved in the training conference being organised
by the Employment Service in June, to which DIG hopes to make
a contribution.
1.6 The SWFG raises a number of issues for people
with a disability or long-term illness. The Gateway entry points
must be fully accessible, and both Registration and Orientation
staff as well as Personal Advisers must be adequately trained
and supported to help them identify and assist disabled people.
Staff will need to be fully aware of the implications of the goods
and services provisions of the Disability Discrimination Act which
are due to be implemented in October 1999. These will require
service providers to ensure that their policies, practices and
procedures are accessible to disabled people, and providers may
have to make reasonable adjustments to the way they provide a
service in order to meet these requirements.
1.7 DIG broadly supports the concept of a SWFG; but
is concerned about the interrelationship between the benefits
system and employment support under both the existing system and
the proposed pilots in phases 1 and 3.
2. Identifying Who can Work
2.1 Critics of the compulsory work focused interviews
have argued that these are inappropriate for people who cannot
work because of illness or disability. Hence a "welfare"
role has been suggested as well as a work focus. It is likely
that case management will be most effective where the adviser
can give advice about other benefits (such as Disability Living
Allowance, which is not included in the SWFG), and signposting
to other assistance that might be necessary, such as from local
authority departments. (Perhaps lessons can be learned from the
role of the Special Welfare Officer posts within the former Supplementary
Benefits Commission). However, we also believe the concern about
who should be subject to an automatic interview underlines our
point that there is a need for a better mechanism with which to
decide who has prospects of work.
2.2 The present benefits system fails to make this
distribution. Incapacity Benefit is normally payable to people
who "pass" the all work test, or are considered so severely
disabled that they are exempt from it.
The all work test
2.3 The all work test (described more fully in Appendix
1) is a measure of functional impairment; it does not bear any
relationship to someone's actual prospects of , or capacity for,
work. It has been designed simply to distinguish sick or disabled
people from unemployed people by determining the point at which
someone should not be expected to look for work in order to receive
benefit. It is, in effect, a means of deciding who should be expected
to undertake job search as a condition of receiving benefit. Those
with sufficient functional impairments are then exempt from the
requirements expected of people claiming Jobseekers' Allowance.
2.4 The all work test, then, is constructed around
other aspects of the social security system—not someone's
actual job prospects. As a test of "notional" capacity,
the all work test now sits uneasily with a more active approach
to benefit claimants exemplified by the SWFG. If the objective
is to help those who can do so to return to work, this implies
a focus on actual capacities.
2.5 Functional Limitations—which is what the
all work test measures—are not necessarily a good guide
of work ability or prospects. People who are considered so disabled
as to be exempt from the all work test (such as someone who is
registered blind) could even be in a better labour market position
than someone who has failed the all work test because they do
not score sufficiently highly across the descriptors but may nonetheless
suffer pain and fatigue that limits their work options.
Personal capability assessment
2.6 The proposed "Personal Capability Assessment",
due to replace the all work test, is intended to look at someone's
"capacities" as much as incapacities. DIG understands
that the personal capability assessment is to involve a series
of extra questions that will be obtained in addition to, and at
the same time as, the questions contained in the current all work
test. This leaves the all work test as the "gateway"
to benefit but under a different name.
2.7 There may be scope for the additional questions
to address someone's actual prospects of work, and so to be more
consistent with the aims of the SWFG. This may be difficult to
achieve in practice if assessments are carried out within the
context of a medical examination by a clinician focusing on functional
impairments.
2.8 At this stage it is also unclear how the personal
capability assessment might relate to employability assessments
which may be carried out by Personal Advisers. There are issues
here about whether doctors are the best assessors of work prospects
for disabled people, when factors determining access to employment
include the social and environmental as well as individual. It
would be more obvious if the personal capability assessment was
to be adapted for use by Personal Advisers.
2.9 There is a danger that disabled people (compared
with other claimants) could be faced with two contradictory tests;
a functional impairment test as well as a compulsory work interview.
If the work- focused interview takes place before the personal
capability assessment, someone may believe that they have to present
themselves in positive light in order to find work, but may as
a consequence "fail" the test and as a result be refused
Incapacity Benefit. Or, if interviewed after the status of incapacity
for work has been confirmed, people may be worried that their
benefit will be put at risk if they accept the advice offered.
2.10 If Incapacity Benefit is retained largely unchanged,
the opportunity to make the SWFG work for disabled people could
be missed. One of the aims of the gateway is to end the "categorisation"
of claimants: "We will treat people as individuals, rather
than categorise them as "unemployed", "lone parent"
or "disabled"—labels that tend to stick permanently
and do nothing to help individuals focus on how they can become
independent through work" (The gateway to work: Cm 4102).
2.11 The SWFG challenges the current benefits system
because it seeks to develop a more personalised service on top
of a benefits system that is based on "mass - produced"
categories for benefit entitlement. In the longer term a there
may be a case for a more fundamental review, considering the balance
between benefits which have flexibility for the individual within
a framework of national entitlement.
3. Incapacity Rules
3.1 According to the explanatory notes accompanying
the Welfare Reform and Pensions Bill, the purpose of the SWFG
is to "assist claimants to identify and take steps to overcome
the barriers to work; and to improve their employability so that,
where appropriate, they can move into sustainable employment".
3.2 A further danger of a notional test like the
all work test is that it conveys a label of being unable to do
any work (even if in practice it fails to make this distinction).
This, in combination with other benefit rules, implies that activities
that may call into question someone's incapacity for work can
result in loss of benefit. For instance, people who undertake
work preparation activities (including employment rehabilitation
courses) may find that a full time course still requires them
to demonstrate that they are incapable of work, and even part
time attendance can cast doubt on a person's incapacity.
3.3 Rules governing work that is exempt (so-called
"therapeutic earnings") are also narrowly defined. Work
has to be fewer than 16 hours a week; it has to improve or prevent
deterioration on the condition which is the main cause of incapacity;
and payment must be below £58 per week, otherwise all benefit
for that week is lost. Ironically people with stable conditions
(that might be easier for employers to accommodate) cannot take
advantage of this concession.
3.4 If these rules remain unchanged for the SWFG
pilots, people labelled as incapable of work who try out part
time work or study could still be penalised by the benefits system
if the activities they engage in could suggest some capacity for
all work. Although there is to be no compulsion to act on the
advice of an adviser, disabled people who did so could find their
benefit at risk unless the regulations are amended.
3.5 This seem to constrain the options which can
be tested by the SWFG pilots. DIG recommends that both main pilot
phases should test out the effectiveness of a "benefit amnesty"
so that activities undertaken on the advice of a Personal Adviser
do not result in immediate loss or reduction of Incapacity Benefit.
4. The Gateway Pilots
4.1 The SWFG pilots will be developed in there phases:
Phase 1: beginning in June 1999, four
pilots will test the basic model. These will take place under
existing benefit rules and alongside the separate New Deal initiatives
for lone parents, young people, over 25s as well as the pilot
projects tested under the New Deal for Disabled People.
Phase 2: beginning in November 1999,
this will include the development of call centres and the private/voluntary
sector variant of the basic model.
Phase 3: from April 2000, subject to
legislation, an interview with a personal adviser will be a compulsory
element of the benefits system, starting initially in the pilot
areas before national implementation.
4.2 DIG's main issues of concern arise under Phases
1 and 3. (Our concerns about Phase 2 are that call centres need
to be as accessible to disabled people as local offices, and that
the private/voluntary sector variants ensure that the disclose
of personal details is closely monitored. Whilst exchange of information
may be necessary during the course of a claim, disabled people
can feel that information about them is kept from them, or may
fear that others could obtain their personal details and use it
against them.)
4.3 Phase 1 is to take place under current benefit
rules, before legislation has been passed to make the interview
compulsory. This means that people making a claim for Incapacity
Benefit, Income Support or Severe Disablement Allowance will be
invited for an interview with a Personal Adviser on a voluntary
basis.
4.4 They will go through an all work test, or be
assessed as exempt from it, as well as being informed that they
can have an interview with an adviser about work, although this
will not be compulsory. People who are eligible for the New Deal
for Disabled People Personal Adviser pilots are those receiving
one of the incapacity benefit after 28 weeks.
4.5 We understand that, in practical terms, the SWFG
pilots in phase one appear to differ from the New Deal for Disabled
People Personal Adviser service now being piloted in two main
respects. These are in the timing of the invitation to see an
adviser (immediately in the SWFG pilots rather than subsequently
in the New Deal for Disabled People areas); and in access to the
changes being piloted in the benefit system, such as access to
Employment Service assistance like Jobmatch payments and work
trials whilst on benefit (only in the New Deal for Disabled People
areas).
4.6 The next substantive element of the SWFG (Phase
3) will take place once legislation containing provision for the
interview and the personal capability assessment has been passed
(April 2000). This will involve the requirement to attend a work—focused
interview as well as the personal capability assessment (which
includes and replaces the all work test).
4.7 The Registration and Orientation phase will be
of prime importance in determining if someone is to have an immediate
or deferred interview. At this stage it is, unlikely that it will
be known if someone will be exempt from the Personal capability
assessment (if current all work test exemptions are retained)
or should be referred for a medical examination.
5. Conclusions
5.1 DIG supports the broad aims of the SWFG but is
concerned that the interface between the benefits system and employment
support for disabled people needs to be more consistently developed
with the SWFG framework.
5.2 In the longer term there needs to be a more seamless
service between agencies so that people are treated as individuals,
that their actual capacities are assessed. Security afforded to
those who are considered unable to work should extend to those
who may become able to work given the right conditions.
5.3 DIG suggested in discussion papers produced in
1997 that a strategy from welfare to work for disabled people
could include the following elements:
— Exploring an interactionist perspective
on disability that considered both the individual and their environment;
— Replacing the all work test of incapacity
with an assessment of employability, carried out at around three
months instead of six;
— Assessing the impact of an individual's
impairment in a work setting, by experts in vocational rehabilitation,
not doctors;
— Introducing an individual action plan
based on the results of the assessment, so that the disabled person
receives individual attention from a named person, like a Disability
Employment Adviser, to put the plan into practice;
— Changing the nature of the benefits system,
by replacing predetermined rules with individual income security
so that benefits support whatever activities are agreed in the
individual's plan;
— Ensuring that Employment Service is more
proactive, that schemes are tailored to the individual, and support
to employers, including recruitment as disability symbol users
(the "two ticks" scheme), is stepped up.
(Investing in disabled people: a strategy from welfare
to work, 1997)
5.4 We are currently working on a revised policy
paper to update and take account of the discussions that have
been generated as a result of the earlier paper, which will include
options for how a seamless system could develop in the future.
April 1999
Annex—The all Work Test and Exemptions from
it
The all work test involves scoring people's functions
across 14 physical activities and a separate set of activities
concerning mental health. To pass the test someone needs to score
at least 15 points.
The physical activities include
- Walking on level ground with a walking stick
or other aid if normally used
- Walking up and down stairs
- Sitting in an upright chair with a back but no
arms
- Standing without the support of another person
or use of an aid except a walking stick
- Rising from sitting in an upright chair with
a back but no arms without the help of another person
- Bending and kneeling
- Manual dexterity
- Lifting and carrying by the use of the upper
body and arms
- Reaching
- Speech
- Hearing with a hearing aid or other aid if normally
worn
- Vision in normal daylight or bright electric
light with glasses or other aid to vision if such aid is normally
worn
- Continence (other than enuresis)
- Remaining conscious without having an epileptic
or similar seizure during waking moments
The descriptors for mental disabilities concern completion
of task, daily living, coping with pressure, interaction with
other people.
Exemptions from the all work test are
- people receiving the higher rate of the Disability
Living Allowance care component
- People assessed as 80 per cent disabled for other
benefits like Severe Disablement Allowance or industrial injuries
- People who are terminally ill (death to be expected
within six months)
- People who are registered blind
- People with conditions such as tetraplegia, dementia,
paraplegia, persistent vegetative state
- Where medical evidence suggests that someone
has
— Severe learning disability
— Severe and progressive neurological or
muscle—wasting disease (such as advanced multiple sclerosis)
— active and progressive forms of polyarthritis
— progressive impairment of cardio—respiratory
function
— dense paralysis of upper limb, trunk
and lower limb on one side of the body (e.g. from a severe stroke)
— multiple effects of impairment of function
of the brain or nervous system causing severe and irreversible
motor, sensory and intellectual deficits
— manifestations of severe and progressive
immune deficiency states
— severe mental illness
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