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Rethink makes an additional point that people who suffer from severe mental illness may not open letters or answer the telephone, not through ill will, but often through forgetfulness or disorganisation. That is a particular concern, as anyone who is deemed to fail to co-operate at various stages could face benefit sanctions. A reasonable person would conclude that allowances should be made for such situations, but I encountered a similar problem with a constituency case, related not to incapacity benefit but tax credits. My constituent has a bipolar mental illness, and for long periods she does not open mail or, in fact, deal with any of her affairs. She failed to fill in a form to renew her tax credits, and they were stopped. She
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received demands for repayment of tax credits, even though it appears that she would have been entitled to them had she filled in the form. The Department is insisting on repayment. I approached officials in the Department, but I was told that they had absolutely no discretion in the matter because the form had not been filled in.

I appreciate that that case does not relate directly to the Bill, but it shows what can happen when regulations do not take into account the specifics of particular conditions. Clearly, such situations are much more likely to occur in relation to incapacity benefits. I therefore urge the Minister to ensure that the regulations make provision for someone with sufficient knowledge of the condition to carry out the assessment. Alternatively, as some groups have suggested, much more weight could be given to a written medical assessment from people who are treating the applicant. At present, that does not seem to enter into the equation until the inevitable appeal.

There is genuine concern about how people on benefits would fare if they tried to obtain work. The CAB report disclosed that more than half of such people thought that they would need benefits protection while they tried work. That is a serious problem for those on benefits who would not automatically be subject to the new rules—at least, not initially—but who could volunteer for inclusion. Many fear doing so because they are concerned that, if matters did not work out for them, they could end up worse off than if they had simply remained on benefit. Serious thought needs to be given to the question of whether we could introduce a guarantee period, in which anyone who obtained a job that did not work out within the period would not be worse off. I appreciate that that would not be easy, but it would help a great deal.

The hon. Member for Tiverton and Honiton (Angela Browning) made a very good point about supporting people once they are in work. In the Norwegian scheme, there is a buddy system to help people who find work to complete the initial period, and to make sure that they stay in work. That is essential to allow people with mental illnesses and learning disabilities to become used to the work environment. In those cases, we are not talking about rehabilitation; in many cases, we are talking about getting people into work for the first time. I agree that those on the new allowance should receive automatic access to other benefits, as is the case for people on jobseeker’s allowance. I appreciate that some things, such as prescription charges, are a matter for the Scottish Executive, but others are a matter for the DWP, and I think that the issue needs to be considered again.

Some organisations expressed concern about the use of private organisations to encourage people back to work. They feared that easy cases would be cherry-picked if payment is based on the number of people who returned to work, with difficult cases being omitted from the project. It is vital that that is not allowed to happen, as almost 90 per cent. of people with learning disabilities who are known to social services are unemployed. People with learning disabilities who are employed often work part-time and
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receive low pay. People with learning difficulties can work, and they want to do so. If the reform truly aims to help them into work, serious thought must be given to the provision of services so that we can ensure that providers encourage and support them into work. I was interested in what the hon. Member for Runnymede and Weybridge (Mr. Hammond) said on the subject, and in what the hon. Member for Tiverton and Honiton said about top-slicing. We must ensure that sufficient funds are provided for niche providers, whether or not they belong to a consortium, that provide the greater support required by that group. If we seriously wish to tackle the problem, the easy cases, if there are such things, must not be skimmed off and only those people helped back to work. Serious efforts must be made to ensure that people with lifelong disabilities are helped, too, which will entail serious discussion with employers on employment practices and, in some cases, their views on the employment of disabled people.

The supported group—I appreciate that I am arguing for both sides of the coin—should not simply be labelled as unemployable. The National Autistic Society has called for the establishment of a clear system so that that group receives appropriate advice about work and training opportunities, as well as reassurance that their benefits will not be jeopardised. The reform must encompass everyone and, although I accept that Ministers face a difficult job in balancing all those concerns and desires, we need early sight of the regulations. That leads me on to one area where there may be serious disagreement about the Government’s strategy. The Bill appears to be driven by a desire to save money but, if we genuinely wish to do so, we must achieve joined-up thinking between Government Departments and the devolved Administrations. We must tackle, too, the problem of finding jobs for people who are coming off benefit—a matter that was touched on by the hon. Member for Kingswood (Roger Berry).

A large number of people ended up on incapacity benefit as a result of the mass unemployment of the late 1970s and 1980s, and many of them stayed on it for many years. We must not allow that to continue: when we roll out pathways to work it must be funded as fully as the pilot projects—a point that was well made by the hon. Member for Aberdeen, South. Many organisations have expressed concern that the pilot projects were successful because they were well funded, with everything available at their beck and call. If such support is not available when the project is rolled out, we will not achieve the same success nationally. The initiative must not be viewed as a way of saving money. We may need to spend money, at least in the short term, to save money in the long term. The initiative is worth while, and it has our support, but we need to see the regulations and exactly what has been proposed.

8.37 pm

Natascha Engel (North-East Derbyshire) (Lab): I am a big fan of the proposals. It is not going too far to say that if we get it right, the Bill more than any other piece of legislation could be what this Labour Government are remembered for. Together with our Sure Start programme, the Bill finally gives people on incapacity benefit a chance to work their way out of poverty.

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I echo some of the thoughts expressed by my hon. Friend the Member for Kingswood (Roger Berry), especially the point that on average a person on incapacity benefit will receive less then £80 per week. There are an estimated 2.7 million people on incapacity benefit. That is 2.7 million people living on £80 per week. I do not think that any of us in the House can imagine what living on £80 a week must be like. People on incapacity benefit are poor. Not having a job is far more likely to mean that they are depressed and stressed. They do not have access to the social life that working can bring. Work is good for people’s mental and physical well-being. Second to winning the national lottery, it is still the best way out of poverty.

Beveridge understood that when he first thought of the welfare state. His welfare state was proactive. He intended it to rid the world of want, disease, squalor, ignorance and idleness. His welfare state was founded on universal access to free health care and education, decent housing, and a benefit system that would provide security for those who could not work, and most crucially, help to find a job for those who could. From education and health to unemployment benefit and welfare, the Beveridge plan had security at its heart, but work was its lifeblood.

The welfare state did just that, until Thatcher and our changing economic landscape made welfare a passive dumping ground for the victims of industrial decline. Millions of people were written off on the benefit system with no expectation that they would work. Those are not just numbers; they are people. Most of us have seen the harm, the upset and the chaos that worklessness causes. It robs people of their dignity, self-confidence and self-worth. It is no surprise that suicide rates are 35 times higher among the long-term unemployed. To leave people on incapacity benefit and not to help them find work is not an option. No one is arguing that the modern welfare state adequately reflects modern labour markets and employment patterns. We need welfare reform, but we need to get it right.

The Bill recognises that the world of work has changed since the days of Beveridge, or even Thatcher. It is no longer the case that incapacity benefit claimants are all men from the industrial heartlands with bad backs. As many hon. Members have mentioned, mental health problems caused by stress at work may be as big a problem in this century as industrial injuries were in the last century. That is why it is vital that we focus on identifying mental health problems that impact on people’s ability to work and finding better ways to help people overcome them.

In order to do that, we need to find better ways of engaging with employers—another issue that has been highlighted by many hon. Members. We should ensure that people do not feel forced out of work in the first place, but more importantly, we need to educate employers about mental health issues. There is still too much stigma attached both to mental health problems and to physical disability.

Most employers tend to be in small and medium-sized firms. We no longer have great monolithic state institutions. Instead, we live in the age of the flexible labour market, which is fine for those who are qualified and skilled enough to be in control of it, but it is not fine for the unskilled and semi-skilled whose lives are
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determined by it. Flexibility means that no one size fits all, and flexibility does not suit everyone. Flexibility means that we have to tailor our welfare state to meet the work and welfare needs of individuals.

That is why the pathways to work pilots have been the single most successful intervention for getting people off benefits, out of poverty and into sustainable, meaningful work. My constituency is North-East Derbyshire, which falls into the Derbyshire pathways to work pilot area, which was the first pathways area in England.

A claimant who takes part in the pathways pilots gets a personal adviser who will take them through the journey from incapacity benefit to sustainable work.

One of the elements that has worked best in pathways to work has been the condition management programmes. People who have been away from work for long periods often have additional needs, such as dealing with the stress caused by poverty and not working, or the pain that they are experiencing from their illness or disability.

Specialists are brought in to work with claimants until they can manage their condition. Jobcentre Plus works closely with local colleges to ensure that the necessary training is given to qualify people for suitable jobs.

As a result, 25,000 people nationally have entered work through the pathways pilots, which, as we heard, have been running for just over two years. People who leave IB for work in pathways areas earn on average £72 a week more than elsewhere. That is a significant statistic because it is a direct result of pathways making sure that people get the right job, not just any job. That is an important part of the welfare reforms.

There is a national downward trend of 1 or 2 per cent. in people claiming incapacity benefit. In my area that figure is well over 6 per cent. The national roll-out of pathways is key to the reforms, but the most needed reform is changing the medical examination to a personal capability assessment. At present, a person claiming incapacity benefit has to go to a medical examination centre about once a year. The doctors who work at these centres are testing for incapacity. They ask questions and tick boxes. Enough so-called right answers mean that the person can stay on incapacity benefit.

I have lost count of the number of people who have told me that doctors at the medical examination centres do not look at them. They do not even look them in the eye. Hopefully, that will change when doctors and personal advisers look at what a person is capable of doing, and not just for the few moments that they spend being assessed. Too many people with fluctuating conditions and mental health problems fail the test because at the time of their assessment they are feeling okay. The personal capability assessment must look at a person’s long-term history and the person must be looked at physically. Getting rid of the computer screens at medical examination centres would be a very good start to doing that.

It can be the most satisfying and rewarding thing in the world to see someone’s life change because they have been helped back to work. I went with the Work and Pensions Committee to visit Derby so that we could see for ourselves how the pathways to work pilot was running. It was incredible. People who had been
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helped back to work were often very tearful and spoke of their lives having been given back to them. I have never seen such a dramatic difference being made to people’s lives.

But there can also be deep frustration. We can work in partnership, we can work laterally, we can identify different pots of resources, but what happens when someone agrees to a back-to-work plan, they are taking part in pain and condition management, they sail through skills training and education, they are ready and eager to go to work, they are totally job ready, and then there is no job for them to go to? That is where the cities strategy comes in, which is the best bit of the Bill. Our cities have the highest concentration of incapacity benefit claimants, and it is right that we target the greater number in the cities. The cities strategy pools resources and initiatives within a city and brings together local partners to work within and as a community to improve economic regeneration through skills, employment and health.

This is fantastic stuff, but what happens in rural areas such as North-East Derbyshire? We have no cities, but we do have high concentrations of incapacity benefit claimants. It is like lots of ex-mining communities where many people live in isolated, rural villages with poor transport links and no cars, and those are the people on incapacity benefit. Transport infrastructure in cities is much better than it is for people in the countryside, and someone who lives in a city will have a wider range of jobs available in a smaller area. Fundamentally, the cities strategy is about going out to the areas where we know the largest number of incapacity benefit claimants live rather than calling them in to jobcentres. There is no reason why we cannot transfer that model to a rural setting.

We will be setting up a rural pilot in North-East Derbyshire, bringing together all the key stakeholders from welfare rights organisations, Jobcentre Plus, some private and voluntary training providers and job brokers, Chesterfield college and large employers. We will work together to ensure that our current labour markets and future jobs and skills needs are properly mapped. It is the only way to ensure that local people at least have a chance of getting local jobs.

One final thought. The Bill can be as radical and imaginative as the very creation of the welfare state itself, but the reforms need to be carefully thought out. They must meet the needs of a wide-range of different people with minor or severe conditions, people who are recently out of a job and others who have never been able to work. If we get this wrong, we let down the most vulnerable people in our society. But if we get it right, we could lift millions of people out of poverty and give them back their lives.

8.47 pm

Sammy Wilson (East Antrim) (DUP): This legislation, at least as it stands, does not apply to Northern Ireland. As one who the chattering classes have described as coming from the celtic fringe, I hope that I do not incur the wrath of others on the Opposition Benches for taking part in this debate. I wanted to join in the general outbreak of consensus
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and good will that there has been on this Bill towards the end of this Session for two reasons in particular—first because it is an important part of the economic policy that will keep the United Kingdom working well, and secondly because it is an important micro-economic policy that deals with a vulnerable group of people, whom we simply cannot dismiss and say that they have no part in the economic life of our country.

I hope and believe that the Bill will eventually apply to Northern Ireland, because much of what has been said about other parts of the United Kingdom here tonight applies even more so to Northern Ireland. It is well known that members of my party do not trot into the Lobby with the Government too often, but I congratulate them at least on the macro-economic policy in Northern Ireland, where we are now experiencing the lowest level of unemployment that I can remember in my lifetime. However, our economy still contains significant pockets of people who have faced unemployment for a long time. In parts of Northern Ireland, up to 40 per cent. of the working population is on incapacity benefit, and I do not believe that all those people cannot contribute in some way to the economic life of that part of the United Kingdom. If the Bill were to channel such people back into work, it would do them a favour, and it would do our economy good.

As the hon. Member for North-East Derbyshire (Natascha Engel) has said, the system will examine people’s personal capabilities. I have dealt with too many constituency cases in which GPs have treated people week after week, month after month and year after year simply by writing them a line, because they are disabled.

On the assessment for incapacity benefit, 70 per cent. of those whose cases are reviewed in Northern Ireland have the outcome changed on appeal, which indicates that the initial assessment is not done that well. People’s personal capabilities are important, and perhaps the new system will focus on the contribution that people can make.

I have a couple of concerns that I would like the Minister to address. First, Age Concern has pointed out that even under the existing pathways programme, the people who do not get moved into work easily are over 50, but I cannot see anything in the Bill indicating that there will be a greater success rate for over-50s.

Secondly, if we are to meet the Government’s target in Northern Ireland, more than 30,000 people who are currently regarded as disabled in some way must be put into jobs, which will require a massive change, and the change will probably need to be greater in the public sector than the private sector. Given the importance of the public sector in Northern Ireland, it worries me that we are holding out the promise of a new route to work for people, who may find themselves in endless work-related programmes, but may never get into work.

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