Select Committee on Work and Pensions Written Evidence

Supplementary memorandum submitted by Leonard Cheshire after the publication of the Welfare Reform Green Paper


  Leonard Cheshire ( 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 is grateful for this opportunity to submit further evidence to the Committee following the publication of the green paper "A new deal for welfare". Broadly speaking the thrust of our previous submission to the Committee remains fully appropriate, however, there are a number of further points that we would wish to make in the light of the proposals in the green paper.

1.  What lessons can be learned from the Pathways to Work pilots in shaping the direction of the reform of incapacity benefits?

  Many aspects of the Pathways to Work (PtW) programme have been incorporated in the proposed Employment and Support Allowance (ESA), but the principles that have made PtW broadly successful have not been transferred wholesale. Notably the green paper is equivocal about the role of the "return to work credit" that is such a vital part of the support mechanisms within the PtW scheme. The green paper states that:

    "We would therefore envisage the roll-out of the `Return to Work Credit' in new Pathways to Work areas." (Chapter 2, paragraph 107)

  Further clarity is required as to what this actually means. The presumption must be that this is stating that it is likely, although not certain, that the rolled-out PtW would continue to operate a "return to work" credit system. This would also seem to suggest that the credit would not be part of the wider ESA, marking a significant shift in the balance of rights and responsibilities within this system. Where both the new ESA and the PtW programme are in operation the potential would arise for a two-tier system.

2.  What are the implications of DWP's proposals for the new structure of incapacity benefits? Do they address the complications inherent in the existing incapacity benefits system? Is a dual benefit the right approach? Could it be improved?

  The approach signalled in the green paper is, in principle, broadly sensible. Such a system will not work, however, without sufficient flexibility, and investment in both training for personal advisers and in developing effective return to work programmes. This must include:

    (i)  Flexibility to challenge decisions quickly, without lengthy tribunal processes, whilst leaving a formal tribunal appeals process available where necessary.

    (ii)  Flexibility to move from one strand of the benefit to the other as circumstances dictate.

    (iii)  Flexibility for DWP decision makers to reach conclusions on individual cases rather than simply assigning claimants through a tick box process.

    (iv)  Flexibility for personal advisers to develop appropriate workplans with each individual claimant.

  The green paper makes reference to adjusting the "gateway" onto Incapacity Benefit. Changing the nature of the assessment procedure to focus on capability for work as well as medical incapacity is a welcome development. It is absolutely critical, however, that this process is not used as a means to tighten the gateway onto the benefit.

  The then Secretary of State for Work and Pensions Alan Johnson stated on 6 December 2004 that the UK already has the "the most stringent gateway into incapacity benefit in the world, as measured by the Organisation for Economic Co-operation and Development" (Official Report, 6 December 2004, Column 913). Tightening that even further and leaving people who are forced out of employment by disability without appropriate support would be unacceptable.

3.  Will the reforms help to improve work incentives for sick and disabled people?

  There is little detail in the green paper about how permitted work rules and test-trading rules can be improved. At present the rules concerning permitted work are complex and often restrictive. A particular problem has been the earnings limit—which has not risen in line with inflation. This is a real problem for a large number of the disabled people that Leonard Cheshire works with and is illustrated by the case below:

  An IB recipient contacted us to say that she volunteered as a representative on her local Primary Care Trust board, which as it entailed only a few hours work a month, she felt she was be able to manage. The payment for attending each meeting was, however, too high for permitted work rules and as a result she cannot be paid for her work, unlike every other member of the PCT board.

  This level must be raised and opportunities to engage in work without risking the loss of benefits should be extended.

4.  What are the implications of the reforms on levels of fraud and error?

  Fraud on Incapacity Benefit remains extremely low—current Government figures suggest that fraud is less than half a percent. The fact that more than half of those who appeal against initial Personal Capability Assessments are successful demonstrates that there is scope for addressing error within decision-making. A more complex assessment will increase the potential for errors to be made, but this could be counteracted by an improved appeals mechanism.

  Leonard Cheshire would suggest enhancing the appeals system to allow initial formal appeals against a decision be made within Jobcentres—this could provide for reassessment of a decision without a full tribunal. Such a system could be particularly important for decisions about which benefit rate claimants should receive, or challenges against sanction decisions. A full tribunal should, however, remain an option for challenging decisions, particularly given continuing concerns about the standard of decision-making throughout benefits system.

4.  Will the reforms address the main areas of concern with the current system?

  Leonard Cheshire believes that:

    (i)  Disability benefits are often insufficient to afford recipients a decent standard of living.

    ii)  The present system often does not provide enough support and encouragement for disabled people who want to work.

  To this end, we would support reforms that would help lift disabled people who rely on benefits out of poverty and provide genuine assistance for those who wish to get back to work. The details presented in the green paper are not sufficient to make a judgment as to whether these key demands would be met. We welcome the proposal to increase the basic rate of the benefit, in particular for those who are unlikely to be able to return to work. Likewise we welcome the principle of Jobcentres providing more programs and support mechanisms to help people return to employment.

  The green paper is not explicit about the rates of the benefit, and proposes scrapping the age additions and adult dependent addition. Leonard Cheshire would be deeply concerned if this meant that new claimants might actually end up receiving less from their welfare entitlement package than is the case now.

  In terms of "return to work activity" we need reassurances that personal advisers will receive sufficient training to ensure that they can deal effectively with a diverse caseload. "Return to work activity" must be well funded if it is to be effective. Engagement with full-time education and voluntary work should both be recognised as important work related activity.

  We also retain grave doubts about the rationale behind imposing sanctions on claimants. Incapacity Benefits recipients are often among the poorest people in society and reducing their benefit is not a sensible way to proceed as it potentially compromises the partnership approach inherent between personal advisers and claimants.

  We do recognise that sanctions are part of the PtW scheme. Sanctions have, however, been very infrequently used within PtW—casting doubt on their potential value. This, against the potential damage the continuing presence of sanctions may cause to any new, expanded national reform programme is the basis of our doubts.

5.  How will the reforms help those who are not able, or not yet ready, to work?

  Leonard Cheshire welcomes the assertion in the green paper that those who will receive the "support component" of the new ESA will receive a higher rate of benefit. There is a real risk, however, particularly for those who are not yet ready to return to work, but who are placed in the lower rate category of the new benefit, that any form of coercion could have a serious detrimental impact on their health.

  In launching the green paper the Secretary of State for Work and Pensions stated that "work is good for people" (Official Report, 24 January 2006, Column 1305). This is plainly a gross simplification. For many people a return to work could have great potential benefits, and could help to improve their health condition. Some people, however, could find that returning to work, particularly if they do not yet feel ready to do so, could worsen their impairment and further distance them from the labour market.

6.  Can the reformed systems support those with variable and manageable medical conditions, or those who are able to work part-time? Are those with mental health difficulties adequately supported?

  Successfully accommodating fluctuating conditions can only be achieved by ensuring that flexibility and genuine understanding of those conditions is enshrined within the new system. This means:

    (i)  appropriate training and resources for personal advisers;

    (ii)  discretion and flexibility within the system to allow personal advisers and other decision makers to react to each individual circumstance rather than simply having to meet targets; and

    (iii)  roles for mental health, and other health professionals within the assessment and decision making procedure.There also needs to be a significant shift of culture within NHS services to recognise that many patients with manageable conditions need easier and swifter access to regular professional healthcare appointments and support if they are to enter and retain employment.

7.  Has Pathways successfully worked with healthcare professionals, including GPs, particularly in rehabilitation initiatives such as the Condition Management Programme? How can healthcare professionals be further engaged in the reform of the incapacity benefits system?

  Using the expertise of health professionals other than GPs in the assessment procedure is a positive step towards ensuring that the process is better informed. Where possible it would also be beneficial to ensure that expert advice is available throughout the benefits process—the impact on individual claimants of benefit sanctions, for example, should be carefully considered with people with an expert knowledge of an individual impairment.

  Involving health professionals in the condition management programme is certainly important, but it is also important to understand the role of social care within the management of conditions.

  Whilst encouraging a return to work through measures such as placing job advisors in GP's surgeries is broadly an acceptable step, it is clear that at no stage should the primacy of GPs and other health professionals in recognising the needs of their patients be undermined by any wider drive to get people back into employment.

8.  Have the private and voluntary sectors been successfully involved in the Pathways pilots? How can they be further involved in the reform of incapacity benefits?

  Involvement in condition management and training programmes is certainly possible, but if involvement extends to the administering of sanctions to claimants then great care must be taken in outsourcing such work. Many charities, for example, could find their core purpose compromised by close involvement in a system that could penalise their client group.

  One useful area of work could be in the recognition of external schemes by Jobcentres. Leonard Cheshire, for example, runs a number of programmes that help disabled people enter employment (such as our Workability scheme, our Discover IT programme or our Ready To Start initiative to help disabled people to start their own business). Whilst not linked directly to the benefits system, these and similar programmes can be useful in helping to improve job-readiness and could be recognised and recommended to people wishing to return to work, forming part of a wider portfolio of "solutions" available to those disabled people who wish to work.

9.  What type of jobs are participants of Pathways moving into? Are they receiving appropriate in-work support to enhance job retention? Are local labour markets able to provide the jobs needed? What is the experience of employers?

  The role that Access to Work (AtW) can play in helping disabled people into employment should not be underestimated. AtW should be recognised and promoted actively through Jobcentres. Where possible, extending the scope of AtW to include volunteering should also be considered, particularly given that the green paper suggests voluntary work can be a stepping stone to returning to full-time employment.

  AtW can play a key part in ensuring the long-term sustainability of employment. This can also be helped by addressing wider issues in the labour market including:

    (i)  challenging continuing discrimination in recruitment and the workplace;

    (ii)  ensuring improvements to the accessibility of public transport—a Leonard Cheshire report into this issue found that nearly a quarter of disabled people seeking work had had to turn down a job offer because of inaccessible transport;

    (iii)  ensuring that the Disability Discrimination Act provisions relating to employment are properly understood, widely promoted and fully enforced; and

    (iv)  working in conjunction with local authorities and the Department of Health to ensure that the role of social care in sustaining and enabling employment is fully recognised.

  Measuring the success of PtW and subsequently the ESA requires an understanding of the type and sustainability of employment generated through the programmes. Assessments of the programmes should therefore attempt to examine not only the number of people that enter employment but also the number of people that remain in that job after six, 12 and 24 months.

  Local jobs markets, social care provision and accessible transport availability must also be taken into account in assessment procedures. A genuine assessment of employability cannot be made without taking account of these factors.

  The role of employers is also crucial. Beyond a welcome consideration of occupational health policies the green paper makes scant reference to the responsibilities of employers to ensure fair recruitment practices and to support disabled employees. This must be a central plank of any reform programme.

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