Memorandum submitted by Leonard Cheshire
Disabled people currently have an employment
rate of just over 50% and there are 2.8 million people of working
age claiming incapacity benefits. DWP has a PSA target to increase
the employment rate of people with disabilities and the Government
has a long-term aspiration to increase the overall employment
rate from 75% to 80% of the working-age population.
Consequently helping more disabled people move
into employment, while also supporting those who are unable to
work, has a central role in the Government's welfare to work strategy.
The Committee seeks written contributions on
this issue from interested organisations and individuals. Oral
hearings will take place in the autumn. The deadline for written
evidence is 3 October 2005, although the Committee will accept
supplementary memoranda once the Government's Green Paper on the
reform of incapacity benefits is published. Written submissions
should be submitted in accordance with the guidelines.
Leonard Cheshire (www.leonard-cheshire.org)
is the UK's largest voluntary sector provider of support to disabled
people. It supports over 21,000 disabled people in the UK (90%
in their own homes, 10% in care homes) offering a range of flexible
social care services to meet their needs. The charity campaigns
for the rights of disabled people in the UK and raises awareness
of the issues affecting them. The charity also works with disabled
people in 57 countries worldwide working in partnership with more
than 255 autonomous and locally managed services and organisations.
Leonard Cheshire's breadth of experience, knowledge
and constituency of disabled people gives it a unique platform
from which to engage in public debate and to campaign on the social
policy and civil rights issues that impact upon disabled people.
Leonard Cheshire believe that the reform of
Incapacity Benefit (IB) should be viewed as a golden opportunity
to address disabled people's poverty by offering genuine support
and assistance for those looking to return to employment and providing
genuine financial security and dignity for those for whom full-time
employment is not a realistic option.
If security and dignity is to be achieved then
the basic rate of IB must be raised. At present the average IB
payment is around £84 pounds a week. If this was considered
as a "nine to five" job then it would work out at well
under half the minimum wage. For this reason a recent study by
Leonard Cheshire into disability and debt found that many disabled
people who rely on benefits for their income can end up living
The reform of IB must work from the principle
of addressing and alleviating disabled people's poverty.
We would also urge caution with regard to the
use of compulsion in the IB system. As a point of principle Leonard
Cheshire does not believe that return to work activities should
be forced on claimants. We believe that, whilst such activities
may be very helpful for some claimants, a "one size fits
all" approach to disability can never be effective and as
such there must be flexibility within the system to ensure that
no-one is being forced down a certain path when that path may
end up being detrimental to their health and general well-being.
The current Personal Capability Assessment (PCA)
is already extremely stringent and can be a difficult and traumatic
experience for many claimants. To use any reform of the benefit
to try to further tighten this procedure and narrow the gateway
on to the benefit would be socially unjust and would be fervently
opposed by many disabled people and their organisations.
The Employment Capability Assessment proposed
in the DWP's Five Year Strategy could be a very welcome development
if it can begin to assess wider reasons for disabled people's
absence from the job market including employer discrimination,
the local job market, the availability of accessible transport
and social care services and so on. Care must be taken, however,
to ensure that the process becomes no more stressful for claimants
than it already is.
It is also important to note at the outset that
if someone is unemployed it should not mean that they have been
written off and cannot be a valued citizen. Citizenship is a broad
term and contributions to society are not limited only to paid
employment. For example, volunteering, civic participation and
the self-management of chronic conditions should also be regarded
as "work". Leonard Cheshire would also point out that
being in paid employment is not necessarily appropriate or beneficial
for all people. There are people for whom being forced to seek
paid employment would be detrimental and it would be a profound
dereliction of duty not to offer this group the appropriate support.
In this document Leonard Cheshire has responded
to the particular questions and areas raised as part of this consultation.
1. REFORMS TO
1.1 The early results of the Pathways to
Work (PtW) pilots have been extremely encouraging. The emphasis
of the benefits system needs to change from what people could
not do to what they couldfrom disability to capability.
Schemes such as PtW will help to do just that.
1.2 The DWP's five year strategy proposed
that there will be sanctions in place for recipients of the provisionally
titled Rehabilitation and Support Allowance (RSA), the entitlement
proposed for those the Government expect to return to work, who
do not fully engage in return to work activity. The strategy does
not however indicate what those sanctions might be, and whether
they could include cutting a claimant's benefit. Leonard Cheshire
is instinctively opposed to the idea of such sanctions and would
therefore urge great caution in setting them. Those claiming IB,
or its replacement entitlements, will require support and encouragement
in returning to work; sanction and condemnation have the potential
to be deeply damaging and to exacerbate social exclusion and poverty.
Leonard Cheshire will wait to see firm proposals from the Government
in this area before commenting definitively on this proposal.
1.3 The strategy also says that some return
to work activity will be compulsory for those claiming the provisionally
titled Disability and Sickness Allowance (DSA)the benefit
proposed for claimants for whom work is not considered realistic.
It is not clear from the paper, however, whether there will be
any sanctions in place for those on DSA who are considered not
to be engaging at all in this activity. It would surely be inappropriate
to impose sanctions on those for whom a return to work is not
a viable option. Leonard Cheshire awaits the Government's proposals
in this area but would oppose any moves to impose compulsory work
focussed activities on this group of claimants.
1.4 Media reports at the time of the publication
of the Five Year Strategy suggested that there might be a split
of approximately 80% to 20% between the RSA and DSA respectively.
It is assumed that these proportions are probably drawn roughly
from the list of those impairments within the current system that
do not require claimants to re-sit PCAs. This distinction is clearly
unlikely to be the best method for discerning how to separate
claimants at the PCA stage. Some conditions may be long-term,
and hence not require constant re-evaluation through the PCA process,
but may not provide a considerable barrier to work, whereas some
might fluctuate considerably and greatly curtail an individual's
opportunities for employment.
1.5 Leonard Cheshire understands that it
will be necessary to draw a line at some point to separate the
two proposed benefits. We would, however, urge that definitions
set for the PCA process are not too rigidly applied. Given the
variability of disability, to operate a simple list of conditions
that qualify for each benefit would be a clumsy method for separation.
Any point of separation should be based on an individuals abilities
rather than their disabilitiesbut recognising that these
may change over time. Conditions like multiple sclerosis can fluctuate
considerably and what may be appropriate for one person may not
be appropriate for another. Setting any sort of percentage target
for the level of inflow on to each benefit would not be an appropriate
way to separate the two benefit strands
1.6 The PCA process should not simply be
a question of box tickingbut should be a flexible needs-based
assessment. The level of successful appeals against PCA verdicts
at present would indicate that refinements are certainly needed
to the system. There would, however, most likely be extra costs
involved in making the PCA process more effective in recognising
clients' needs and abilities. Leonard Cheshire would seek more
information from Government about potential costs, and potential
future funding for the reform programme.
1.7 The proposed "Employability and
Support Assessment" will also play an essential part in this
process. It is vital that this assessment takes a holistic view
of an individual claimant's circumstances alongside external drivers
such as local labour market conditions, employer discrimination
and the availability of any necessary public support services,
such as social services and accessible transport. Leonard Cheshire
again awaits further details before commenting substantively on
1.8 The cornerstone of the decision-making
process at PCA stage should be an assessment of an individual's
immediate and long-term support needs. Any decision taken purely
on the immediate potential to return to work will be difficult
and potentially prejudicial, particularly to those with fluctuating
1.9 There must be sufficient scope for individuals
to switch between the benefits should circumstances change, but
this should not predicate a requirement for constant reassessment
through the PCA procedurewhich can be difficult and burdensome
for many disabled people. There will need to be careful linking
rules established between the two strands of the benefit to ensure
that shifting from one to another will not incur unnecessary sanction
2. PATHWAYS TO
2.1 Leonard Cheshire welcomes the early
findings on the effectiveness of the PtW programme. It would seem
sensible to build much of this successful formula into any new
system. Evaluation of the way in which PtW has been successful
and ways in which it could be improved will be important in charting
the course of a new IB system. Leonard Cheshire therefore awaits
further results from the extended PtW pilots.
3. THE EXPERIENCE
3.1 The PtW programme has successfully encouraged
many people receiving incapacity benefit back into the workplace.
The pilots saw people who had not initially been on the scheme,
request to be added. If awareness of the scheme were to increase,
we believe that more people still would want to join PtW.
3.2 There is some concern over the capacity
within Jobcentre Plus to deliver the appropriate level of support
on a nationwide level. This is discussed in further detail in
6.1. It is important that the scheme does not become excessively
target driven; avoiding a situation where only those people who
are "closest" to the labour market receive proper support.
4. SUPPORT FOR
4.1 The principle behind any return to work
activity must be to assist a claimant in looking for work, and
to offer preparation and support for returning to the workplace.
Activity need not only focus on the application process, but also
on practical support in the workplace including information about
what statutory support is available, and what protection is offered
by anti-discrimination legislation. The benefit system must work
in tandem with programmes like Access to Work, that provide real
and tangible assistance in the workplace, if the Government is
to meet its ambitious employment targets.
4.2 Action plans for those that are keen
to return to work should be agreed with each individual claimant.
This means that there must be a wide range of possible activities
on offer to suit each individual's needs. There should not be
a set list of activities in which all claimants must engage if
those activities will plainly not be of benefit to the individual.
4.3 The role of Personal Advisors (PAs)
in engaging claimants in return to work activity will be crucial.
Much of the success of the Pathways to Work pilots has stemmed
from highly trained PAs with the freedom to engage on an individual
basis with claimants. Any new system must utilise highly trained
PAs in a way that offers them the freedom to seek the best results
for clientsthis means that their work should not be excessively
target-driven. Requiring PAs to hit targets regarding what return
to work activities clients are engaged in will curtail PAs freedom
to work personally with clients. Comprehensive Disability Awareness
Training must be part of the PAs training programme to ensure
that they are able to make reasoned and considered judgements
regarding their clients. Where Pathways to Work is effective we
believe that it has and will help to address a large concern with
the current systemthe difficulty people with disabilities
have in returning to and remaining in work.
4.4 Return to work activity could also include
broader societal components that are nonetheless crucial to finding
employment. For example, a survey conducted by Leonard Cheshire
found that 23% of disabled people had been forced to turn down
a job because of inaccessible transport. Nearly half (48%) said
that inaccessible transport had restricted their choice of jobs.
Support in dealing with the public transport system may be crucial
in empowering some disabled people to enter paid employmentthis
could be included as an option in return to work activity programmes.
4.5 PAs should be able to offer official
programmes of work placement and work experience within the new
benefit system. Such programmes could help claimants that wish
to return to the workplace gain experience, perhaps in a new area
of work, and could also help employers discover the potential
benefits of employing disabled people. Offering work placement
may be a useful way of improving the perception that employers
have of disabled employees. Any such schemes should be operated
on an opt-in basis to ensure that disabled people are not pushed
into a work environment where there is not appropriate support
4.6 In order to facilitate a return to work,
there must be increased awareness of, and funding for, the Access
to Work scheme. Employers in particular need to be made aware
of the benefits of using the scheme and the relatively minor costs
of making adaptations that can help to empower a disabled employee.
4.7 Approximately 40% of those on IB have
mental health difficulties.
It is crucial that PAs are appropriately trained to support those
with mental health conditions in to work. Incapacity can be caused
by conditions that fluctuate in the effect that they have on claimants,
and inevitably cause different limitations on their ability to
work. This is especially true for those with mental health difficulties
and must be recognised by the system and PAs.
5.1 Healthcare professionals and particularly
GPs will of course always have some sort of role within the IB
system. Leonard Cheshire would, however, warn against their role
being excessively controlled by Government. We were concerned
at suggestions in the DWP five-year strategy that GPs could be
censured for signing too many sick-notes, and by subsequent comments
from the DWP about work being beneficial to health. Whilst in
many cases work may indeed be beneficial, clearly this will not
always be the case and GPs must retain the discretion to advise
their patients to the best of their ability without any external
pressure. It is also important that GPs are not the only healthcare
professionals involved in the development of initiatives such
as the condition management programme. The reasons why people
are out of work can be complex and it can often require specialist
knowledge, particularly with regard to mental health conditions,
when assessing the appropriate ways to return to the workplace.
GPs, by definition, tend to offer a very broad medical knowledge
base and may not be best placed to solely produce a rehabilitation
programme. It is important that all healthcare professionals also
respond to the individual needs and requests of claimants, and
accept that their views are often the most accurate and valid.
6.1 The reform of IB, even if not applied
to existing claimants, will inevitably mean a large change for
those who currently claim it, and who will claim in the future.
It is essential that there is sufficient scope within Jobcentre
Plus to introduce, implement and explain these changes. This can
sit uneasily alongside the DWP's efficiency agenda. The expansion
to the PtW scheme will require more people to be employed in the
sector, and the reforms proposed in the DWP's five-year strategy
will require highly trained personal advisors delivering highly
personalised support. It is important that PAs are given the freedom
to tailor their advice and support to individuals and are not
driven by targets.
6.2 The large number of PAs that will need
to be recruited or upskilled from the current workforce to implement
the expansion of PtW and the subsequent reforms of IB will require
significant extra resources.
7. THE ROLE
7.1 The basic principle of any reforms must
of course be to deliver proper support to those who cannot work,
and genuine, effective assistance for those who are looking to
return to the labour market. As such it is understandable that
the DWP has already begun looking at the role that voluntary and
private sector providers could play within the system. The voluntary
sector can offer enormous expertise, innovation and knowledge
of specific impairments. There are some concerns, however, that
if charities were to be those who delivered frontline services
then it could compromise and distance them from their own charitable
purpose. In particular, if sanctions were to be introduced as
part of the reform to Incapacity Benefit it could lead to a situation
where a charity was introducing sanctions against some of its
own beneficiaries. This would be unacceptable.
8. LOCAL LABOUR
8.1 Work must be undertaken with employers
in the local area to make them aware of their legal obligations
and to improve the provision of possible jobs for disabled people.
The Government should consider what sort of incentives might be
offered to employers who actively seek to employ disabled people.
In areas of high unemployment particular efforts may need to be
made to ensure that there are jobs available for claimants and
those employers are fully aware of the benefits of employing disabled
people. In particular ensuring that a wide breadth of jobs is
available will help encourage those that wish to find work.
8.2 Assessments of employability will need
to take into account the dynamics of the local economy and the
availability of jobs in the local area. This may help determine
what return to work activity might be most beneficial. Given that
there is often an understandable correlation between areas of
high unemployment and numbers of Incapacity Benefit (IB) claimants
it will always be important not to force claimants to undertake
return to work activity that will not realistically provide any
help in entering full employment. Such activity would simply be
8.3 The Government's proposal to appoint
a national director for occupational health may help work to reduce
the number of accidents at work and encourage best practice with
regards to health and safety. Neither this nor the Workplace Health
Direct help line proposed in the five year strategy will challenge
A central tenet of any reform of welfare benefit
must be the elimination of "benefit poverty". Poverty
levels amongst disabled people are significantly higher than people
without disabilities. Paid work is a possible route out of poverty
and Leonard Cheshire welcomes constructive moves, which enable
unemployed disabled people to become employed. In parallel, we
also ask that disabled people not able to work be properly supported
through enhanced levels of benefit enabling them to live a life
of dignity and not one of poverty.
3 October 2005
29 DWP official figures, see: http://www.dwp.gov.uk/asd/asd1/ib_sda/ib_sda_feb05.asp#tables Back