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David Taylor: Like me, my hon. Friend might well have had contact with Schlumberger Sema regarding miners' compensation and its performance can be patchy. Will he comment on its recent performance when dealing with people with mental health problems? Such people find it especially difficult to get a fair deal and to obtain the right decisions at medical appeal tribunals. Is he happy that the company's doctors are appropriately trained to deal with such cases?
Mr. Steinberg: No. One of the complaints by citizens advice bureaux concerns the standard of doctors' assessment of people with mental illness, and it gave us some shocking examples in which such people were failed. Our report makes some recommendations, so I suggest that my hon. Friend read it.
Citizens advice bureaux, which are involved with the claims process, report that across the country personal capacity assessments are throwing up a large number of benefit withdrawals, despite fact, as detailed in the PAC's previous report, that the Department for Work and Pensions is establishing more rigorous targets for the quality of Schlumberger's medical reports. Although the proportion of reports rated substandard has halved from 6 per cent. to 3 per cent., that is still a huge number of mistakes affecting 30,000 cases. Schlumberger doctors underestimate miserably the severity of claimants' disability. Citizens advice bureaux have dealt with scores of such cases, most of which arise because examining medical practitioners employed by Schlumberger fail to provide a correct PCA score to decision makers in the Department for Work and Pensions. For example, a man in the east midlands with
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cervical spondylosis and heart disease who had received incapacity benefit for 10 years was exempted from the PCA on the ground of severe illness in 2000, but not in 2004, even though his condition had deteriorated. The examining medical practitioner awarded him only six points—15 is the threshold—even though the client disagreed with five of the zero scores, and his GP and consultant said that he must not work.
In the west midlands, a man with severe heart disease was told by his GP that he should not work, but the examining medical practitioner thought otherwise and decided that he had failed the PCA. He did not start work again, but he had a heart attack five months later and needed a coronary artery bypass, suggesting that his GP was right and the Schlumberger doctor wrong. A man in the north-west with severe arthritis in all his joints who had received incapacity benefit for 10 years was not awarded any points at his medical examination, which lasted 10 minutes.
Such cases must be looked at so that tests are done properly in future. One questions whether the EMPs are merely going through the motions in an assessment or are genuinely concerned about the people whom they assess. It is a great concern that the withdrawal of incapacity benefit, which may have been someone's only income for many years, may result from a short, sloppy examination by a Schlumberger doctor. We were told that 22 doctors have been sacked and 40 have been told to improve, which is a poor record. The report shows that it is not just Schlumberger doctors who need to improve—many GPs are reluctant to complete medical reports for their patients because it may harm the patient-doctor relationship. I find that a weak excuse. Perhaps they do not like filling in forms or having their normal procedures disturbed. I have regularly found that to be the case with some GPs.
When an individual fails the personal capability assessment, incapacity benefit stops immediately and there are knock-on effects: income support stops because the person is expected to claim jobseeker's allowance, having been declared fit to work. Housing benefit and other benefits may stop. The individual can do one of two things—appeal and claim jobseeker's allowance, or claim 80 per cent. of income support until the appeal is resolved and reapply for housing benefit and the other benefits. That can all be traumatic. People's income could drop to as little as £44 a week. For those under 25, it could drop to less than £35 a week. That causes stress and could endanger health, so benefits should be stopped only on sound evidence, not on the basis of sloppy findings by a doctor who may just want to get the case out of the way.
We found that there were administration problems with the Schlumberger doctors. When that happens, the stress and the inconvenience caused to disabled people can be worse than one imagines. In many cases the effect is made more serious by benefits being stopped as a result of an unjustified decision. I shall give examples. The client of a London citizens advice bureau informed Schlumberger that he would be unable to attend a PCA examination and his invalidity benefit was stopped. The problem was compounded because although the Department for Work and Pensions agreed that the
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invalidity benefit should be reinstated, the computer system went wrong and he never received it. Such administrative errors are not at all helpful.
A citizens advice bureau in East Anglia reported that a young man with severe learning difficulties and behavioural problems missed two appointments for his assessment, the first time because he was ill, and the second time because his mother was too ill to take him and he needed to be accompanied. Each time his mother had informed the medical centre of the reason and was told that it was okay. What happened? His invalidity benefit and income support were stopped and he had to apply for a crisis loan for food. That is not good enough. The administration must be better than that.
Most medical examinations relating to disability living allowance and attendance allowance are carried out at clients' homes by doctors who are not employees of Schlumberger, but have jobs elsewhere as GPs. They often try to fit their medicals outside their working hours, which can result in phone calls to clients inappropriately late at night or early in the morning, and requests that can appear to be demands to carry out medicals at weekends or in the evenings. For example, an 80-year-old asthmatic man received a phone call at 7 pm on a Saturday to say that the doctor would call at 8 am the following day—Sunday—to examine him in his own home. He found it difficult to be up and dressed by 8 am, he was distressed when he was asked to go up and down the stairs several times, but he was afraid to tell the doctor that the time proposed was inconvenient. That is no way to do business, is it?
Also in the south-east, a mentally ill woman was telephoned at 7.20 am by a Schlumberger doctor who wanted to conduct a medical the same evening. The client was naturally confused and distressed by the call. That cannot be fair on the patient, who made an appeal. As far as I am concerned, such GPs are moonlighting. The conduct is not appropriate and needs rectifying.
Notwithstanding all the problems, improvements have been made, but the Government still have a long way to go. I am confident that the two reports that we produced on these matters will lead to further improvements and will consequently give a better deal to people who, unfortunately, have to apply for benefits.
4.54 pm
Mr. Richard Allan (Sheffield, Hallam) (LD): Unlike the hon. Member for City of Durham (Mr. Steinberg), I have not refused Wimbledon tickets, but I like to think that I, like him, would choose Westminster over Wimbledon this afternoon.
This is the second occasion on which I have participated in the debate on Public Accounts Committee reports. I became a member of the Committee last autumn and am still enjoying the experience, although it can be challenging. I found it particularly tough to get my head around resource accounting, my momentary understanding of which disappears as soon as I leave Committee Room 15 or 16, where the Committee meets. I pay tribute to staff from the Committee, the National Audit Office and the Treasury, who try hard to help us understand concepts such as private finance initiatives and resource accounting.
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I joined the Committee because I am interested in information technology. Sadly, I have not been disappointed, because IT failures are a recurrent theme in our deliberations. Rather than discussing IT failures, however, I want to remark on two forward-looking technology reports and the Government's responses to them. The 10th report "Purchasing and managing software licences" and the 11th report "Helping consumers benefit from competition in telecommunications" examine how we can improve things rather than what went wrong in the past. The 10th report is important for the Government, and the 11th report is important for consumers.
The 10th report seeks to secure better value from Government investment, which, as our Chairman rightly mentioned, is a key theme in Committee. In the software arena, better value could be obtained in three ways. First, prices from existing suppliers could be driven down through mechanisms such as the memorandum referred to in the report. Secondly, new ways to license software—specifically those offered by open-source software—could be explored. The third option, which is not a feature of the report but is important, is software asset management, which involves knowing what software one has and whether it is being used correctly.
Those three options interrelate to a significant degree. I have no doubt that the pricing of commodity software, which is covered by the memorandum, has been affected by the growing success of open-source software, which offers a genuine route to competition. Until recently, no significant competitor offered desktop software, but competition is increasing and is affecting prices directly. Multi-million pound savings have already been credited to the memorandum, and the credit for that should go to thousands of friendly hackers, who have produced open-source software alternatives that provide real competition for some of the established players.
Credit is especially due to Richard Stallman, who is the philosopher of the free software movement and the author of the general public licence, which is also known as the copyleft licence rather than the copyright licence, and which has been critical in developing competition. The participation of thousands of people around the globe in such work has resulted in significant savings to the public purse.
The alternative licensing model for free software is described as "free as in speech, rather than free as in beer", which is American shorthand to describe a completely different approach to software production. The Government response refers to their open-source software strategy, which will be updated in the autumn, and I hope that the public sector takes an increased interest in that software development model as a result of that review.
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