Q
9John
Howell: On that point about support, there has been an
increase in the budget of one particular funding stream of Access to
Work. Do you see that leading to it being spread more thinly across a
larger number of people or leading to much higher individual use for
larger
adjustments? Paul
Davies: It is difficult to say. What I do know is
that we have had a lot of success at delivering people into employment
using Access to Work as a vehicle, but, as I said earlier, it has taken
a lot of effort. It is inevitable that when you make the system easier
for people, more will be empowered to use it and will take advantage of
it. My view is, so much the
better.
Q
10Mr.
James Plaskitt (Warwick and Leamington) (Lab): I have
questions for each of you. I will come to Liz first to give Paul a
rest. In your evidence, you spoke about the importance of what you
described as self-directed assessment, but you also spoke about the
need for support for people to make those decisions. Especially in
cases where we are talking about mental disability, there is a very
difficult line to determine: at one extreme, someone can make all the
decisions about their care and at the other extreme they cannot. There
is a space in the middle where it can be done with support. Are you
confident that the resources are there to give adequate support to make
this
work? Liz
Sayce: In the spirit of the Mental Capacity
Act 2005 and the principles that lie behind it, there has
been a shift in services around the country towards first
assuming that people will have capacity and offering the support to
enable people to make decisions. There is the thinking that sometimes
people might not be able to make decisions on certain things, but let
us try to help them make decisions. I think that that has been very
welcome. It has led to surprise in that some people who would have
previously been thought of as unable to make decisions are now being
seen as able to make them. That is partly why I used some mental health
examples earlier—people with dementia, schizophrenia or learning
disabilities having choice and
control. We
are learning from the individual budgets that people are able to make a
lot more choice and take a lot more control than would have been
thought 10 or 20 years
ago. In
terms of whether the support is there, it is really important that
there are user-led organisations in every part of the country, as was
laid out in the life chances report. There is, of course, a commitment
to there being user-led organisations in each part of the country that
can provide the kind of peer-led, user-led support that people find
incredibly helpful. So, it is not only the professional, the case
manager or whoever, advising and supporting somebody to create their
own assessment and plan, but other people who have done it
themselves. Very
often, people are initially limited in their imagination, but they then
say, “Oh, you mean that rather than go to the day centre I could
have driving lessons. Then I could go to visit my relative or I might
be able to get a job in the next town.” It had not occurred to
them that they could use the money for driving lessons, but once they
have it, they are on a roll and things begin to develop.
So, I think
that we are still on a path in terms of the implementation of the 2005
Act; we could do even better to ensure that people’s capacity is
supported. Different parts of the country have different levels of the
sort of peer-led support that I am talking about. That is a major
priority, because some people clearly need advocacy and they need to be
brought together so that collections of people can buy something. Some
things that people want are not just individual. There are a couple of
examples that I use, such as two people renting a warehouse together to
set up a
business.
Q
11Mr.
Plaskitt: You are saying that there has to be a framework
to support people who need support with making a
choice. Liz
Sayce:
Exactly.
Q
12Mr.
Plaskitt: Are you satisfied that enough support is there
so that when that new choice arrives it will be optimised by the people
we want to aim it
at? Liz
Sayce: At the moment, we are satisfied that that is
taking place in some parts of the country, and to very high quality. We
can see how it can work. But, it is not taking place in every part of
the country, so we would like to see attention given in the
Bill—I mentioned the analogy in relation to the health
bill—to provision for the voluntary sector to make available
that kind of support, including advocacy and brokerage, because without
that the pace of change will not be what Paul and I have said it needs
to be. We need to move on with this at a more rapid pace, and that
needs advocacy and brokerage to be in place around the
country.
Q
13Mr.
Plaskitt: That is very helpful. Thank you. Paul, picking
up exactly where you finished, in your evidence you raised a concern
about the pace of progress that has taken place, and I think that you
implied that there was a question about the pace going forward from
here—whether it would come through quickly enough. Are you
saying that you have encountered institutional inertia in bits of the
system? Will that still be a problem as the Bill comes into effect? If
you do think that, what can be learned and applied from the Oldham
experience? Does something else need to be done in the Bill to help us
overcome that problem, or is what is here
sufficient? Paul
Davies: All the tools required to do all this are in
place. All the knowledge and the experience required to make all this
work are in place. As my colleague said, the fact that it is working in
some parts of the country shows that it can be done; there is
absolutely no reason why
not. The
fact that that is not being done more widely is of huge concern: not
only Oldham but all the other individual budget pilot sites were told
very early on that some things would never work, by people who
apparently knew that they would never work. Individual budgets would
never work for people with mental health problems. They would never
work for people with learning disability, or for people who misused
substances, or for people with dementia. Frankly, that is
rubbish—I choose my words with care—and experience shows
that it
is. It
seems to me that the centre—the Government—has invested a
lot of time and effort in putting those mechanisms in place and working
up the experience and the tools to make it all happen, and they are all
available, but the direct answer to your question is yes, it seems to
me that there is a lot of inertia in the system.
It falls into
two parts. Quite honestly, some folks just do not get it, for want of a
better description, and some say, “That’s all in the
‘Too difficult’ box and we can’t really do
it.” Well, you can; any organisation can. I believe that there
are the resources to provide the support out there, but at the moment
they are doing other
things. If
you look, for example, at productivity in adult social care, you will
see that the Commission for Social Care Inspection went down at the
same time as investment went up. There are reasons for that, and I
feel—it is not just my own feeling—that a lot of that is
tied up in the front end of services and in the nuts and bolts of
making services work.
It seems to
me that a simplified system of the sort I mentioned earlier would
enable organisations to participate fully, taking full advantage of the
tools that have been put in place to deliver a system that is quicker
and slicker and more effective for people. Unusually for someone from a
local authority, I am not sitting here saying that we need considerably
more resources to be able to do that—not at all. I am saying
that a bit more direction and a bit less permissiveness in the Bill
would unlock all
that. People
have had the option of direct payments since the 1990s, but across the
country there are people who ask for a direct payment and are told that
they will have to wait until the money becomes available the following
year. I do not think that that is written anywhere in the legislation.
There are issues about unlocking what has to be done.
Returning to a
point that John Howell asked me about, in the original guidance on the
community care legislation, some cracking good examples were given of
what could be done in large rural areas. One that stuck in my mind was
the suggestion that we could ask the landlord of the local pub to
provide the meals for the elderly population of that rural area. That
never really happened, and local authorities instead commissioned
200,000 frozen meals on wheels a year because we felt more comfortable
with that.
If we are not
using direction—instruction—and if we are not using good
practice and the good work that is going on to guide and instruct
practice, the pace will not be quick, and it has not been quick so far.
It will remain at a relatively unsatisfactory level if those things are
not in place. The system is a big system, as are all such systems, as
far as the individual is concerned, and they are very difficult to
organise. Unless there is a duty to co-operate and to deliver that
single, wrap-around approach to the individual, the system will not
work. If you do not do it that way, it will require people of good will
and a critical mass within particular leadership
organisations—the local authority or whatever it might
be—to deliver
it. I
also echo the point about user-led organisations. The Government have
been fantastic at saying that they are trying to get away from the
top-down approach and that they want people to be co-producers in this,
but if we are to get the best out of that, we must ensure that there
are in place not only statutory support mechanisms, but non-statutory
mechanisms. A
responsibility to involve everyone who can help and support an
individual needs to be included, and it needs to be our responsibility.
There needs to be more than just a statement that we can do it or that
we might do it if we feel like
it.
Q
14Paul
Rowen (Rochdale) (LD): I would like to move on to clause
8, which deals with the conditionality aspect for payments of
jobseeker’s allowance and employment and support allowance. The
Government have an ambitious target for getting people off incapacity
benefit and back into work. What are the challenges and what support
and training need to be put in place for Jobcentre Plus to be able to
carry out some of the new powers that are in this
Bill? Liz
Sayce: First, there are some issues with the
graduated approach to conditionality and the use of the just cause for
people not complying with particular aspects of what is expected under
conditionality. We need to be absolutely sure that included in those
just causes are things like inaccessible processes, transport
difficulties that disabled people may face and issues that the parents
of disabled children may face where perhaps it is much harder for them
to find accessible child care facilities to enable them to take up
their responsibilities in employment. There is a big training need
there to ensure that people get treated fairly through this new
system. Secondly,
Access to Work was mentioned earlier. In relation to work-related
activity, at the moment Access to Work relates to employment but not
necessarily to some of those other vocational activities, training and
so on. Sometimes it is difficult for people to participate in the very
thing that they need to enable them to get
back into employment. We would like to see the resources on Access to
Work go into publicising the scheme more and ensuring that it is there
for those other work-related activities, as well as paid employment
itself. There are obviously concerns among disabled people around the
country about conditionality. It is the issue of fairness. The training
point is very important. People should not end up at the end of that
conditionality route being expected to do community-based voluntary
activity in order to get their benefits if the process leading up to
that has not been fair. Some real questions are being raised by a
number of disability organisations about
that. The
final point is about getting skills. During a recession people want to
keep their job if they possibly can or to get into work, and we applaud
the intention not to take the foot off the pedal on welfare-to-work
provisions. However the reality is that some people will be out of
work. What better time for people to refresh and update their skills
and to be ready for exactly the sort of jobs that will exist in the
economy when we come out of the recession? At the moment,
unfortunately, a third of people with no skills in this country and no
qualifications at all are disabled people. Disabled people have been
left behind by the skills revolution. That is an area of major
importance and we need to make sure that the support services, the
right to control, Access to Work and all these budget streams can be
used by people who are seeking to develop their skills and their
qualifications, as well as by those who are directly engaged in the
labour
market.
Q
15Mr.
Peter Lilley (Hitchin and Harpenden) (Con): Mr.
Davies, you mentioned that something like a fifth of the people with
personal budgets in the country are in Oldham. Is it reasonable to
suppose that you have probably pushed the process of moving towards
personal budgets as far as is possible within the present legislative
framework? If so, to what extent do you think the measures in the Bill
and the programme of development that the Government have spelled out
will enable you to carry it further or make it easier for other
authorities to develop? Is there anything you would like to see in the
Bill that would enable you and others to carry it further and
faster? Paul
Davies: We are probably reaching the limits of the
current legislation. In some cases we may have gone beyond those
limits. There is something about the current system being stretched in
terms of how one can manoeuvre within it. That is not to say that it is
not, in some senses, quite permissive. The difficulty with a permissive
system is that you can do it if you want to, or not, as the case may
be, and I think that is what has caused some of the problems.
However, in
direct answer to your question, I would like to see something that was
more directive regarding organisations. For example, it is very
difficult for somebody in Jobcentre Plus to understand—through
no fault of their own—some of the difficulties associated with
dealing with people who might have had chronic schizophrenia, or
something similar, for some time. I think that a more directive duty to
work closely with those agencies that understand all of that—and
it is a duty to work together; it is not just a one-way
street—would make a big difference. This is a many-hammers
question, because every individual is a complex person with their own
needs and requirements. Unless we can get all those agencies working
together—I truly feel that that has got to be directed; I can
see no other way around it—we will not achieve what we need to
achieve. I
would like to expand on the point about conditionality. The
Government’s social care reform has conditionality within
it—it is outcome-focused, there is a contractual requirement and
the local authority retains the right to say whether a particular
arrangement will go forward if it is satisfied that that arrangement
makes best use of public money and is safe, among other things. It is
not rocket science to have a similar conditional arrangement around
every other element of this. That conditionality is there elsewhere in
other parts of the Government’s programme. I think that best
practice should be shared, not only across local authorities but across
central Government as well, and I think that would make a huge
difference.
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