|Previous Section||Index||Home Page|
The personal capability assessment is currently the only access point to the new employment and support allowance because existing claimants on incapacity benefit will not be transferred. It is therefore vital that the PCA is useful, effective and does not cause problems but leads to their resolution by identifying peoples capabilities to work rather than their overall incapacities.
However, too often, laws and regulations are made in the hope of achieving an outcome. As a member of the Science and Technology Committee with a background in business, I believe in evidence-based policy making. That is why we must acknowledge that laws and regulationsthe PCA is largely a regulationoften have unintended consequences. In some cases, regulations have the opposite effect to that desired. Evidence is therefore vital and that produced so far is rather dubious. Only a small sample of assessments was made in reviewing the PCAit ran only into the hundreds, if I am correctand some conditions were missing. For example, nobody in the sample had disabilities on the autistic spectrum. I urge the Minister to consider new clause 3 carefully because if there is no evidence for effectively establishing the new PCA, surely it is important to produce a report to show its effectiveness, at least for the first few years until we are confident that peoples lives are not being destroyed due to insufficient data.
My key concern is about people who face a mental health challenge. If people who suffer from depression, are in remission from it or who suffer the other disorders and challenges that those with mental health problems encounter, are confronted with a PCA in which they are not confident, that could trigger another episode of their condition. So we need to be very careful about the PCA, and one way of ensuring that it produces the intended consequence of identifying peoples capability for work is to report on it. There is a fundamental difference between a report on the outcomes of a policy and a review of that policy. New clause 3 calls for a report on the outcomes, not a review.
If the Secretary of State and the Minister are confident that the new PCA will work, why do they oppose disclosure in the form of what I imagine would be a fairly straightforward annual report? Why would they feel the need to hide anything, or cover it up? Will the Minister take responsibility for any harm done to those with a mental health condition if the PCA is not effective or if it is not implemented correctly? From what I can see from the lack of data and evidence, and from the performance of the previous capability assessments in which 50 per cent. of appeals were upheld, the present PCA is based on a lot of hope and aspiration but very little fact or evidence. We have an opportunity here, and if the Minister will not accept new clause 3 in its present form, I urge him at least to give a strong indication that he will introduce proposals for some kind of report on the personal capability assessment element of the Bill.
The Minister for Employment and Welfare Reform (Mr. Jim Murphy):
It is a pleasure to respond to what has so far been a typically constructive debate. It has been consistent with the tenor of our detailed scrutiny of the Bill upstairs in Committee. Some might say that despite my contributions, we had some of the most
informative and productive exchanges that I can remember in any Standing Committee on which I have had the pleasure to serve in my mere decade in this place.
Mr. Ruffley: I have no desire to interrupt the hon. Gentlemans flow, but in a spirit of bipartisanship, may I ask whether he was aware that, after the first day of our deliberations upstairs, one of the policemen commented to one of my hon. Friends that it had been the most constructive and good-natured debate that he had heard in all his time on the upstairs corridor?
Mr. Murphy: I was not aware of that. I had been labouring under the illusion that those fine members of Her Majestys constabulary did not listen to the detail of our conversations, and that they perhaps participated in sudoku or some other leisure pursuit in Committee. However, it is enlightening to hear what the hon. Gentleman says. The success of our discussions was at least in part down to the contributions made by him and his Front-Bench colleagues, as well as by the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), by the hon. Member for Yeovil (Mr. Laws) in a passing visit and by the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stirling (Mrs. McGuire) [ Interruption.] I want to make some progress, but I must not forget the contributions made by my hon. Friend the Member for Glasgow, North-West (John Robertson) and those from many other airts and pairts of Great Britain.
I am pleased to follow the hon. Member for Windsor (Adam Afriyie) in this debate because he played an important part in our deliberations in Committee and has rightly said that our approach to welfare reform should be evidence based. He is also right to say that incapacity benefit in its present form has not kept pace with the changing nature of disability, given the emergence of mental health conditionsparticularly fluctuating mental health conditionsover the past two decades, and the changing gender make-up of the present IB customer base. About 40 per cent. of those on IB at the moment are women. We know that there has been a transformation in the sense that IB had previously been considered a legacy of our industrial heritage, but that is no longer entirely the case.
IB has not kept pace with the changing nature of society and the legal rights that disabled people now enjoy in the United Kingdom. It has not kept pace with attitudes to those with learning difficulties, many of whom, it is now recognised, can play a productive role in the labour market. Progressive employers are now seeking ways to involve many people who have a fluctuating mental health condition or learning disability in active employment.
The benefits system has not kept pace with such social changes as it should have done. Notwithstanding that, progress has been made. If we can continue as we did in Committee, without the traditional partisanship, it would be helpful.
In passing, the number of people on incapacity benefit has decreased significantly recentlyby about 54,000 in the past year. The most recent figure for the number of people on incapacity benefit is, I think, 2.69 million. If we had continued the trajectory as it
was in 1996-97, however, that figure would be 4 million. Of course, much more needs to be done to support more of those 2.6 million to get off incapacity benefit.
I also want to allay the fears expressed by the hon. Member for Daventry (Mr. Boswell) about the Government setting an arbitrary upper target for the number of people on incapacity benefit. He knows that that is not what the Bill is about, and it would be reactionary and wrong for this or any alternative Government to set an upper limit for the IB caseload. We have set a target of reducing the number by 1 million, but we are not seeking to achieve that through a legislative cap; we are providing the support to enable that as a public policy intent. That is what underpins the Bill.
Let me comment briefly on the new Government amendments. As we have said, we want everyone to have the opportunity to work. That is why we have based entitlement to the support group on the most severe disability, which would make it unreasonable to require the person to engage in work-related activity. That underpins Government amendment No. 18. In relation to clause 9, the 46 descriptors in draft regulations, which have been provided in the Library of the House, reflect such a severity of disability.
Mr. Redwood: One of the problems that will doubtless emerge is that different assessors, even in the same locality, will have a different view of how to score particular types of disability and whether people qualify for the support benefit. That is true of any system, but it is particularly acute in a new system, when many peoples judgments are up in the air, and people worry about whether they have been more harshly treated than others. What will the Minister do to try to ensure greater consistency of judgment and greater clarity on how to score?
Mr. Murphy: I will come to those points later. In general, however, the right hon. Gentleman is correct. Without being too churlish, he and I do not always find ourselves in agreement, but he is absolutely correct about the need for national consistency in assessments, not just in relation to incapacity benefit and employment and support allowance, but with regard to all sorts of other entitlements to benefits, including jobseekers allowance.
On Government amendment No. 18, we recognise that there are circumstances in which a person might not satisfy any of the 46 descriptors were they applied. We would still, however, want to treat them as having limited capability for work-related activity, and therefore as having access to the support group. As I said in Committee, paragraph 9(a) of schedule 2 allows us to provide in regulations for certain groups of people to be treated as having limited capability for work-related activity. For example, a person with a point of weakness, such as an aneurysm in one of the arteries to the brain, could put his or her life at risk by engaging in anything requiring even slight effort. We would automatically place such a person in the support group, even though they would not meet any of the 46 specific descriptors were they applied at that stage.
Those circumstances do not necessarily imply that someone should be treated as having limited capability for work-related activity for an indefinite period. Peoples condition and indeed circumstances may well change, and we want to ensure that we can respond to those changes. The amendment makes that possible.
Amendments Nos. 26 and 47 are concerned with consistency and continuity. They simply maintain long-standing benefit rules. Amendment No. 26 allows regulations to be made so that a person who is disqualified from receiving employment and support allowance because of his or her own misconduct can be treated as not having limited capability for work for the purposes set out in regulations. Consequently, he or she will not be entitled to the allowance for the period of disqualification. The provision can also confirm entitlement by treating the person as having limited capability for work.
Importantly, that replicates the current approach in section 31(1) of the Social Security Act 1998, which provides for regulations to allow a person who is disqualified from receiving incapacity benefit on similar grounds to those that will apply to employment and support allowance to be treated, for prescribed purposes, as not being incapable of work and therefore not entitled to benefit. Amendment No. 47 provides for the repeal of that provision once the migration of existing cases to employment and support allowance is completed.
I hope that that was as informative as it is possible for the explanation of technical Government amendments to be. Let me now deal with proposals that have attracted considerably more attention, starting with new clause 3.
As was suggested by the hon. Member for Inverness, Nairn, Badenoch and Strathspey, when we implement a new policyparticularly one as important as thismonitoring must be a continuing process, and we certainly intend that to apply to employment and support allowance. The hon. Member for Daventry spoke of consistency in contractual arrangements, particularly in the private and voluntary sectors. He and other Members may have availed themselves of information placed in the Library, which explains how we intend to make that a reality.
The hon. Gentleman also found himself in agreement with my hon. Friend the Member for Hendon (Mr. Dismore), who presented a ten-minute Bill earlier today. What surprised me most was the fact that my hon. Friend managed to present his proposals in 10 minutes, which was probably a first for him.
The revision of the PCA has naturally attracted substantial interest. It is, of course, essential for us to evaluate the way in which it will work. The first stage of the test carried out in October and November was a limited evaluation of the revised descriptors and scores to enable us to begin drafting regulations. A second, more detailed, evaluation of the PCA will begin shortly. It will enable us to refine and fine-tune the recommendations of the working groups, while also ensuring, before we implement it, that the revised PCA constitutes a robust and accurate assessment of limited capability for work.
Members in all parts of the House referred to the initial dry run of the descriptors. I hope that I can reassure the hon. Member for Inverness, Nairn, Badenoch and Strathspey and others. From the Governments point of view, this is work in progress. The initial evaluation was intentionally a small study, intended to confirm that the revised descriptors and scoring system would work. As those who served on the Committee will know, it has always been the case that further evaluation will take place as the task of refining the descriptors evolves.
I stress that we are not drawing any firm conclusions about the effect of the revised descriptors on the benefit allowance or disallowance rate from such a small sample of cases. The next phase of evaluation, which is due to begin soon, will involve a larger and more representative sample, and representatives of the consultative group will be invited to take part. There will thus be a wider audience and a much greater number and variety of cases.
Mr. Murphy: I shall address the independent nature of the assessment and monitoring shortly, but I anticipate that the points of the hon. Member for Inverness, Nairn, Badenoch and Strathspey will be of a similar tone to those of my hon. Friend the Member for Kingswoodalthough I might be wrong, of courseand I would like to respond to both.
Danny Alexander: I welcome what the Minister says about a further and more detailed evaluation and the involvement of independent groups. Will he also assure us that information will be made available to the House so that we can scrutinise all relevant matters as well as the independent groups? If that is done, the concerns that exist can be allayed before we move forward with draft regulationsor, indeed, with putting the new test into practice.
Mr. Murphy: I will be happy to do so. We will certainly publish the report of the initial dry run before the Lords Committee stage, and we will hold discussions with the hon. Gentleman and others about the most appropriate time to inform this House and the other place about the specific outcomes of the second, and more substantial, process of utilising the new 46 descriptors. We will also seek to publish as much information as possible on the time scales that have been mentioned.
Despite some of my comments and the hon. Gentlemans kind words in response to them, I am not attracted to new clause 3. Involving the Office for Disability Issues, which is of course part of the Department for Work and Pensions, by asking it to provide an annual report on the operation of the PCA would distort the natural accountability by placing at least some of the responsibility for operational stewardship elsewhere in the Department, rather than with those responsible for the specific policy and its operation.
My hon. Friend the Member for Kingswood explained why he was not attracted to new clause 3, and there are additional reasons why the Government are not attracted to it. The Department is already required under disability discrimination legislation to produce a disability equality scheme. Active involvement of disabled people is already required in meeting the duty to promote disability equality. The additional obligations that new clause 3 proposes be imposed on the ODI would merely replicate the good work already being carried out by Departments, including the DWP, in meeting their duty to promote disability equality.
I have spoken about the new clauses problems in respect of accountability. I have also referred to existing provisions on disability equality and the impact on disabled people generally. New clause 3 would create further problems in respect of the feasibility of requiring the ODI to provide reports on the operation of the assessment of limited capability for work. That is because of what the ODI would be asked to evaluate. The assessment of limited capability for work will inevitably involve clinical judgment because it will deal with the effects of medical conditions on individuals who have symptoms that cannot be measured precisely or exactly, such as pain. New clause 3 would require the ODI to review, evaluate and assess policy in the area of clinical judgment and would require the ODI to assess medical quality standards. Understandably, the ODI is not equipped to carry out such an evaluation process. It does not employ health care professionals, who would be needed to judge whether clinical judgment is being correctly applied.
We have much more effective ways of carrying out that assessment. That brings me directly to the point made by my hon. Friend the Member for Kingswood. There are more effective mechanisms for independently evaluating the revised PCA to ensure that it effectively assesses limited capability for work, before it is implemented in 2008. We will also continue to monitor the effectiveness of the revised PCA following its implementation. For the first two years after it is implemented we will involve in its ongoing evaluation the independent experts from the technical working groups that advised us on the transformation of the PCA. For the period from 2008 to 2010, those independent experts will remain in place to offer assessment, challenge and observations about the operation of the revised PCA during the first two years.
The Minister has already said that he is willing to make public the assessments between now and the completion of the Bills passage, but is he also willing to make public the data that he just described
after that passage during the first two years of operation? It would then not only be a matter of consultation between him and the independent experts, but could be reviewed by the House and, more particularly, the Select Committee as well.
Mr. Murphy: The hon. Gentleman has helped with our deliberations on the Bill at all stages and he has offered another reasonable suggestion. Subject to the caveat that there are no issues of commercial confidentialityI cannot see how it would apply in this matterwe would be able to provide that information to the House and the relevant Select Committees. I hope that that also reassures the right hon. Member for Wokingham (Mr. Redwood) about micro-assessment and the ongoing day-to-day basis of how the revised PCA operates over the first two years. It is important that we learn about the changing outcomes of the appeal processes and assess whether we have got that right in the first two years. That provides an additional external check on how we manage the operation and effectiveness of the new PCA. After that time, we will still be subject to the usual channels of parliamentary scrutiny through Select Committees, the Public Accounts Committee and parliamentary questions.
For all those reasons, we do not accept new clause 3 as we do not believe that it is a desirable way of auditing the application of the PCA. In addition to those protections and the independent and crucial parliamentary challenge that I have mentioned, the Government would reflect further at the end of the three-year period. Having gathered all the evidence and having learned from consultative groups and the observation of Select Committees about the nature of the appeal mechanisms, we would then consider the most effective way of continuing to keep on top of the issues with an active review and independent assessment of the continuing role of the PCA beyond 2010. I hope that that reassures the hon. Member for Inverness, Nairn, Badenoch and Strathspey enough to tempt him to withdraw the motion, but I am not sure that it will.
I should like to move on to deal with issues raised by my hon. Friends, particularly on amendment No. 71. I am glad that my hon. Friend the Member for Kingswood has provided the Government with another opportunity to put our intentions on the record. We intend that the powers in clause 17 will be used only if a customer purposely and without good cause is found to have a limited capability for work, resulting from their own misconduct, failure to follow medical advice or failure to observe prescribed rules of behaviour. That includes misconduct leading to injury or a refusal to follow standard medical advice recommended by a doctor or hospital that could improve their condition and allow them to return to work.
|Next Section||Index||Home Page|