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Mr. Hutton: I am grateful to the right hon. Gentleman—yes, we do, and we set out three specific proposals in the Green Paper that will address that. I agree that it is not acceptable for 50 per cent. of such appeals to be subsequently overturned. We need to consider that fairly and reasonably. That will be part of the review of assessments that we have set in train today, and if we can work with a variety of different stakeholders to improve the efficiency and effectiveness of the medical assessment procedure, I hope that we can alleviate the need for so many appeals.

Mr. Frank Field (Birkenhead) (Lab): I congratulate the Secretary of State on the resolve that he has shown today, noting that he does so as the economic boom slows down and the welfare-to-work budget is fully spent. Does he accept that many of our constituents are anxious to go back to work but are worried that if they get a part-time job, the job might fold and they will lose housing benefit? In those 100 constituencies with the highest number of incapacity claimants, will he scrap all the restrictions on part-time work, provided that claimants tell their local office what they are doing? They could be reviewed within, say, six months, to see in what other ways we can build on the successes that they have made individually, without waiting for anyone at the centre or anywhere else to direct them.

Mr. Hutton: I am grateful to my right hon. Friend. Yes, we are prepared to consider the issues to which he
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has referred, particularly in relation to the permitted hours rule and the notional earnings rule. My right hon. Friend the Minister for Employment and Welfare Reform has indicated that we are examining those areas, and I am happy to talk to him and other right hon. and hon. Friends who have an interest in this matter. I remind him that one of the important parts of the pathways to work schemes, which have helped enormously, has been the £40 return-to-work credit, which has helped bridge the gap between benefits and work. It was entirely remiss of me—I should have paid proper tribute to my predecessors as Secretary of State, some of whom I can see in the Chamber. In particular, my right hon. Friend the Member for Oxford, East (Mr. Smith) made some of the important early decisions, which were right and proper. I want to pay tribute to their contribution, too.

Mrs. Iris Robinson (Strangford) (DUP): Does the Secretary of State agree that many people would love to be back at work, but the Government have a history of being mean with drugs such as Enbrel, Remicade and beta interferon? We could see many more people off benefits and back in the work force if they got those life-changing drugs.

Mr. Hutton: I respect the hon. Lady's argument and the point that she has made. The changes that we have made have been designed to speed up access to some of those latest medical interventions and drugs, and we have made significant progress in doing that. In relation to Northern Ireland specifically, she will be aware that these particular reforms are a matter for Northern Ireland, and I understand that my right hon. Friend the Secretary of State for Northern Ireland will be publishing these proposals for consultation in Northern Ireland shortly.

Mr. Andrew Smith (Oxford, East) (Lab): I thank my right hon. Friend for his kind remarks. I welcome the measured way in which he has brought forward this statement. In particular, I welcome the extension that he has announced of the successful pathways to work programme to the whole country. Does he agree that availability of good-quality rehabilitation and a continuing drive against discrimination in the workplace are crucial for the confidence of benefit recipients and for the prospects of success in helping more of them into jobs? Can he tell the House a bit more about rehabilitation and other support services that will reassure people that this is about helping them forward?

Mr. Hutton: I am grateful to my right hon. Friend, and his decision to roll out pathways has given us the opportunity to go further. We have had two years of experience with pathways. In relation to his point about condition management programmes, we know from the success of pathways schemes that it is important for benefit recipients to have access to good-quality rehabilitation. That may be physiotherapy, cognitive behavioural therapy or any other service that we can provide. The NHS has been a good partner in delivering those services as part of the pathways to work schemes, but I think that it will be necessary to broaden the range of providers who deliver those services to Jobcentre Plus and to benefit recipients. We will work in partnership
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with organisations locally as well as nationally to ensure that there is the widest possible access to services that will help recipients to get off benefit and back into work. I am grateful for everything that my right hon. Friend has done.

Mr. Paul Goodman (Wycombe) (Con): The Secretary of State has set himself the admirable aim of getting 1 million people off IB in 10 years. Since he has been so specific, can he tell the House how many people he expects this package to get off IB by the end of this Parliament—by, say, June 2010?

Mr. Hutton: No, I am not going to set annual targets. We are not going to do that. This programme of investment and reform will take at least a decade to deliver. I think that all my hon. Friends will be slightly surprised to hear a Tory Member of Parliament asking for more targets. We are not going to do that.

Dr. Howard Stoate (Dartford) (Lab): May I tell my right hon. Friend as a GP that, by the time someone has been off work for six months, say, with a bad back, their chances of getting back to work are disappointingly low? Therefore, the real challenge is to prevent people needing incapacity benefit in the first place. I am particularly pleased by his statement that he wants to introduce employment advisers into primary care services, which is extremely welcome and overdue. Will he ensure that those advisers will be involved with the patient from the moment they are off sick, so that we can reduce the amount of time that they are off sick, and they go back to work before they get anywhere near incapacity benefit?

Mr. Hutton: I am grateful to my hon. Friend for his comments. We should wait to see what the employment advisers can do for patients in primary care trusts. I am confident that they will be able to make a significant difference and provide more choice for people, rather than people being presented just with the unpalatable prospect of being signed off and going on to benefit. We should be able to do more for people in that situation. I hope that the other potential spin-off benefit of putting employment advisers into GP practices will be to relieve some of the pressure and work load on GPs themselves.

Angela Browning (Tiverton and Honiton) (Con): The Secretary of State has repeatedly referred to getting people back into work, but how will he deal with the group of people in their 20s, 30s and 40s who have never been in paid employment? I am talking about people with lifelong disabilities such as autistic spectrum disorder, chronic mental health conditions and learning disabilities. Is he going to have a special package for them, because to put them through the same process as someone with a back injury would be wrong? They need much more specialised assistance. I would welcome it if some got the opportunity to get into work, but that will not be easy. It will require a lot of resources. Will he bear it in mind that many of them have undertaken independent living and that maintaining independent living and not being overburdened with paid employment will require a lot of flexible packages?
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Perhaps they can work part-time—even a quarter of a week, not necessarily half of it—in order that independent living remains viable.

Mr. Hutton: I pay tribute to the hon. Lady's extensive knowledge and experience in this area. I would be happy to discuss with her any of those ideas in more detail. That is right and proper. The whole point of the reforms is to try to personalise and individualise as much of the support and help that we provide to people on incapacity benefits as we can. I do not think that a one-size-fits-all approach would be right. I indicated in response to other questions that we are prepared to look at some of the alternatives to encourage part-time work. Nothing in the proposals affects the issue of disability living allowance. We are not proposing any changes to that. I understand that my right hon. Friend the Secretary of State for Health will outline shortly further proposals in relation to individual budgets, which I know that the hon. Lady follows with some interest. I hope that that will provide greater choice and flexibility, to which she has referred.

Mr. Michael Meacher (Oldham, West and Royton) (Lab): Does my right hon. Friend recognise that there are considerable differences between north and south? The percentage of working-age adults claiming incapacity benefit, for example, in Merseyside, south Wales and the north-east is six to 10 times higher than in the south-east. We all know that the previous Conservative Government shifted probably over 1 million people off unemployment benefit on to incapacity benefit to get the unemployment figures down. Does that not suggest that we cannot solve this problem purely by getting tough on incapacity benefit? It can be solved only in conjunction with a much tougher regional industrial strategy to increase employment opportunities in areas of persistent high unemployment.

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