---

The Minister for Work (Jane Kennedy): I congratulate my hon. Friend the Member for Great Yarmouth (Mr. Wright) on securing this important debate. I am grateful to him for presenting me with the opportunity to explain the basis of entitlement to disability living allowance, or DLA, and the role of the new permitted work rules that are replacing the therapeutic earnings rules. I pay tribute to him for the vigour with which he has pursued his case. As he said, he was a founder of the all-party group on myalgic encephalomyelitis and currently chairs it. The Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Liverpool, Garston (Maria Eagle), has told me about the vigour with which he fights for the cause of ME sufferers, not only in his role as all-party group chair, but from the experience that he has drawn from constituents whom he has got to know during the time that he has represented them. They will be grateful to him for his efforts, as will all sufferers from ME.

When I discussed this debate with my hon. Friend the Member for Liverpool, Garston, I was impressed by the depth of her understanding of the illness and of the detail of her brief. In her unavoidable absence, I am afraid that I will be but a poor substitute.

The Government acknowledge some of the concerns expressed by my hon. Friend the Member for Great Yarmouth, and I hope that I will be able to deal with them in the short time that we inevitably have in an Adjournment debate. If I miss any points, I undertake to write to him. We do not share some of his other
 
11 May 2004 : Column 332
 
concerns, but when my hon. Friend the Member for Liverpool, Garston visits his group shortly, she will take that opportunity to explore them further.

Myalgic encephalomyelitis, or ME, which is otherwise known as chronic fatigue syndrome, describes a spectrum of conditions where the prominent symptoms are fatigue, both physical and psychological, which may affect both physical and psychological functioning. My hon. Friend said that the illness still carries with it a degree of dispute as to its nature. Several names, including post-viral fatigue syndrome, have been used to describe the condition. More recently, the term chronic fatigue syndrome has been more universally adopted. That gives rise to some relief among those of us who are not medical experts.

How does ME relate to entitlement to disability living allowance? I should like to dispel straight away the idea that ME is not recognised by the Department for Work and Pensions as a potentially serious condition that may bring entitlement to DLA. Approximately 14,200 people get DLA because their primary disabling condition is ME, and about 2,200 successful applications are made every year.

Disability living allowance is a tax-free, non-contributory and non-means-tested benefit that is paid as a contribution towards the extra costs that are faced by severely disabled people as a result of their disabilities. However, entitlement to the allowance is not linked to specific disabling conditions or to particular diagnoses. That means that people who have ME qualify for benefit on exactly the same basis as other disabled people—that is, they must meet the entitlement conditions. The Government believe that criteria based on the effect that disability has on personal care needs and the ability to walk are the right approach for determining entitlement to DLA. I am afraid that we have no plans to passport people to entitlement to the benefit on the basis of specific disabling conditions.

Mr. Russell Brown (Dumfries) (Lab): Will my right hon. Friend give way?

Jane Kennedy: I hesitate to give way as this is the debate of my hon. Friend the Member for Great Yarmouth, but I shall make an exception for my hon. Friend.

Mr. Brown: I thank the Minister for giving way. I also congratulate my hon. Friend the Member for Great Yarmouth (Mr. Wright) on securing this debate. The Minister is talking specifically about the assessment of an individual's condition, and my hon. Friend has mentioned visits for medicals, which sometimes take an hour. From my experience of listening to my constituents, I have learned that those medicals can sometimes take only 15 or 20 minutes. That is not an adequate amount of time in which to go through a proper medical and arrive at a true determination.

Jane Kennedy: My hon. Friend makes a serious point, and I shall come in a moment to the training and advice that is given to those who make the medical assessments. I hope that if I get the opportunity to explain the details, I shall be able to allay some of his fears.

It is important when assessing a person's ability to ascertain the effect of the condition on each individual's need for attention, the extent of those needs, for how
 
11 May 2004 : Column 333
 
long they have been present, and for how long they are likely to remain. It is therefore important that time is taken to make that assessment properly and for it to be made for each individual applicant in exactly the same fair and thorough way. With regard to the mobility components, it is important to assess the person's ability to walk and whether they need someone with them on unfamiliar routes.

ME is, by its very nature, a variable condition, and it is not possible to guarantee that someone will qualify for DLA, because the effects of ME affect people in different ways, to different degrees and with considerable variations over time. This approach is no different in regard to other variable conditions, such as mental illness, asthma, rheumatoid arthritis, multiple sclerosis and others—that is not an exhaustive list. I know that my hon. Friends would make a similar case for other illnesses in which similar conditions were experienced.

Andy King (Rugby and Kenilworth) (Lab): My right hon. Friend draws our attention to other conditions, but those other conditions are universally accepted. The problem that we are discussing tonight is highlighted by the fact that many of the GPs—a minority, I hope—who are responsible for carrying out these assessments do not accept that the condition exists. That is a major stumbling block for many of our constituents.

Jane Kennedy: My hon. Friend's point is well made.

It will probably help if I turn now to the training and advice that is given to those whom we charge with the job of making the medical assessment of those applying for disability living allowance. All examining medical practitioners—EMPs—already get specific training about ME or chronic fatigue syndrome. It was first issued in 2001, and updated in 2003. My hon. Friend the Member for Great Yarmouth asked us to look again at the detail of that training.

The training stresses the need to consider the variability of symptoms and not to take a snapshot view, which was the concern expressed by my hon. Friend the Member for Dumfries (Mr. Brown). The training that EMPs receive instructs them not to include irrelevant information in their reports. Information should be included only if it has a material bearing on the assessment. Similarly, visits at short notice are not in keeping with the expected professional standards unless they have been agreed to by the customer. The doctors employed by medical services to carry out examinations for DLA purposes also have to meet specific recruitment criteria and are required to attend a prescribed training course prior to commencing work. We should not experience any scepticism on the part of those whom we are charging with the task of carrying out these assessments—the examining medical practitioners.

In addition to that training, the EMPs are issued with relevant guidance, and the Department's chief medical adviser must approve all doctors who carry out the examinations. The standard of their work is monitored and approval can be withdrawn if a doctor fails to meet the necessary standards. They are also required to undertake an annual programme of training to refine their skills and update their knowledge of disability medicine and other relevant topics.

People should complain if the expected standards are not met, and Department for Work and Pensions medical services will always respond to complaints
 
11 May 2004 : Column 334
 
about individual doctors. Department for Work and Pensions medical services do not get a greater incidence of complaints about chronic fatigue syndrome or ME than other conditions, and they should be viewed in the context of the overall number of complaints, which is 0.4 per cent. of all medical assessments made. I believe that that is a good record. However, that is not to say that we do not take complaints seriously.

Claim forms were mentioned. We are listening to the feedback from customers who use the forms. The claim forms for disability living allowance and attendance allowance are designed to enable disabled people to give a full account of the effects of their disability, rather than to cover any specific illness or disability. We do not have specific forms for different illnesses. However, we acknowledge the length of the claim forms and the fact that some of the questions may not always be relevant to each individual's needs or straightforward to answer. We accept that they have been a cause of concern for some disabled people. Consequently, we developed a new style of attendance allowance claim form in 2002, which, after successful evaluation, has been in use nationally since November 2003.

The new version reduced by half the size of the claim pack, and has a simpler style and fewer questions, making it much easier to complete. The form has been designed to enable people to tick the relevant statements from a prompt list provided on it and to tell us briefly, in their own words, the sort of help that they need during the day or night. Following the success of the new AA claim form, we are developing a new, shorter DLA claim form, which we hope to test shortly in the area served by the Glasgow disability benefit centre—unfortunately, not the area of my hon. Friend the Member for Great Yarmouth.

In the few minutes that I have left, I want to consider the permitted work rules that my hon. Friend mentioned at the end of his contribution. We are replacing "therapeutic work" with new permitted work rules. Benefits such as incapacity benefit, severe disablement allowance and income support, which are awarded on the basis of incapacity, are intended for people who are incapacitated by the effects of their condition. Benefit cannot therefore normally be paid to people who work because the basic entitlement condition is not satisfied. However, we recognise that allowing a limited amount of work can help to improve a person's condition, increase their chances of returning to the labour market and help them to achieve lasting paid employment.

Previous rules allowed benefit to continue if work was undertaken on the advice of the claimant's GP and it was confirmed that the work would help to improve, prevent or delay deterioration in the condition that entitled the person to benefit. That was often described as "therapeutic work." As my hon. Friend said, earnings could not exceed a prescribed limit and the work had to be done for less than 16 hours a week on average. However, the therapeutic work rules were of limited use when a person could not demonstrate that a specific job would be beneficial to their medical condition, for example, blindness, paraplegia—or, indeed, ME. They allowed a person to do some paid work on a limited basis only if it satisfied the therapeutic requirement and they applied to a relatively limited number of people on incapacity benefits.
 
11 May 2004 : Column 335
 

Therefore, as part of our commitment to remove the barriers to work for those with a health condition or a disability, we introduced new, more flexible work rules from April 2002. They replaced the therapeutic rules, which my hon. Friend is almost wishing back because he is not satisfied with the replacement. These are what we call the permitted work rules.
 
11 May 2004 : Column 336
 

The permitted work rules are still at a relatively early stage and are undergoing evaluation by independent researchers. I am sure that my hon. Friend the Under-Secretary will be happy to go into this in greater detail when she meets with my hon. Friend's all-party group very shortly.

---