Welfare Reform Bill

Memorandum submitted by Turning Point (WR 45)

1.0 About Turning Point:

1.1 Turning Point is a leading heal th and social care organisation, with over 40 years experience of supporting people with complex needs, including mental health conditions, substance misuse issues and those with a learning disability. We work in over 200 locations, providing specialist and integrated services that meet the needs of individuals, families and communities across England and Wales. Turning Point is a social enterprise reinvesting its surplus to provide the best services in the right locations for people with a range of complex needs who need them the most.

2.0 Introduction:

2.1 The Welfare Reform Bill does come some way in establishing how the benefits system can be simplified. Navigating around the welfare system can be difficult for individuals, often preventing people from progressing. Nevertheless, simplification should not be used as a justification to reduce the accessibility of support. Reform of this system requires sensitivity to people’s needs and, at a time when unemployment has reached over 2.5 million, a culture of individual blame for unemployment should not be encouraged. Long durations of high unemployment mean it is possible for the unemployed to be divided into two tiers, those who are close to the labour market and those who are not. Those who are furthest away from the labour market are likely to fall even further behind and any reforms to the welfare system should not further disadvantage those with the greatest need.

2.2 Employment is good for us, it helps to build positive mental health, creates wider social networks while also acting as the main route out of poverty. However, for some people work is a distant ambition, inhibited by complex needs which act as a barrier against individuals entering the workplace and sustaining employment.

2.3 Turning Point would like to seek further clarification of how the reforms will take into account the complex needs which can prevent an individual from sustaining employment. Our main points of concern are listed below.

Key Points:

A. There is a need for people to take responsibility for their own progression towards employment, nevertheless, the use of sanctions must be undertaken sensitively and there should be recognition of how individuals’ complex needs affect their engagement in progressing towards employment.

B. The transition from Incapacity Benefit to Employment and Support Allowance is of particular concern when the Work Capability Assessment has been demonstrated by the Harrington Review to be flawed. The recommendations of the reforms should be implemented quickly to ensure that people are not being assessed under a flawed system.

C. The reforms to contributory ESA means that it is also necessary to consider the wider context of how support is administered to those in employment who encounter emotional difficulties.

3. 0 Supporting the Long-term Unemployed:

3.1 There is a great deal of expectation that the Universal Credit will simplify the benefits system and increase the entitlements of around 2.7m households while also providing better work incentives for many. However, the Bill’s impact assessment states that 1.7 million people are due to have reduced entitlement. Furthermore, while the government has suggested that no current benefit recipients will be worse off in cash terms due to the Universal Credit, it is questionable how long this commitment will be maintained.

3.2 The problems of long-term unemployment are well-known, for example, depression and anxiety are 4-10 times more prevalent among people who have been unemployed for more than 12 weeks (Royal College of Psychiatrists, 2008). Consequently, what is needed for the long-term unemployed is support for them to address the barriers which are preventing progression within their job search.

3.3 Participation in the workplace is dependant on having the right mix of skills, stable housing and effective support in addressing mental health and substance misuse challenges. Reform to the welfare system goes hand in hand with the introduction of the Work Programme. Turning Point is encouraged by the Work Programme and the opportunity it offers for support for the long-term unemployed to access the support they need. Nevertheless, the design of services within the Work Programme must have the capacity to identify and support those with previously unmet need. There is an opportunity within Clause 29, and its focus on the contracting out of work-related requirements, to establish the need for providers to consider and respond to the complex needs of those who are furthest away from the labour market.

3.4 Policies which increase deprivation through significantly reducing income will only exacerbate complex social problems and so a policy of welfare reform must also be complemented with innovative services which are essential to help support people gain employment. In Turning Point’s experience those with the most complex needs often have difficulty accessing the services which offer the most appropriate support. In particular, those with low-level and common mental health conditions such as depression and anxiety often do not receive support early enough to address the obstacles these emotional barriers place in front of the search for employment. Turning Point established Rightsteps Employment to address this difficulty. This is a telephone based service for those who need support in addressing the emotional barriers which obstruct the search for employment and the model also has the potential to support those close to losing employment because of personal emotional difficulties.

3.5 Rightsteps Employment supports those who suffer from a lack of motivation, low confidence, lack of interest and a negative attitude towards employment; these are the main barriers which prevent an effective search for employment and can prevent progression for those who are in employment. Those with complex needs often find they are bounced around different agencies without accessing effective support. A strength of the Rightsteps Employment model is that it establishes strong case management through a centralised computer system which records the progress of specific interventions decided in conjunction with service-users. This not only provides clear outcome measurements but also ensures the model can be scaled-up to support those with a learning disability, mental health condition or substance misuse issues when finding employment.

4.0 Claimant Commitment:

4.1 Clause 14 of the Bill sets out the requirement for claimants of Universal Credit to sign up to a claimant commitment which will set the terms of what is expected of them within their search for employment. In principle it is necessary for an individual to take responsibility to support their own progression towards employment. The Bill acknowledges that this commitment can be adjusted according to changing circumstances of the individual. It is often the case that those who are long-term unemployed are likely to have unmet complex needs which negatively affect the search for employment. Such complex needs can mean that conditions fluctuate, altering and affecting the level of engagement an individual is able to demonstrate towards their search for employment, this is especially the case for those with a mental health condition or those experiencing substance misuse. While the claimant commitment is intended to create greater transparency as to just what is expected of the individual, there is a danger that the system of establishing these commitments will not be able to respond to the changing needs of the individual. The ramification of not adhering to the claimant commitment is manifested through the sanctions regime.

5.0 The Sanctions Regime:

5.1 There are significant concerns created by the sanctions regime incorporated within the Bill (Clauses 26 and 27), by which jobseekers may have their benefit entitlements restricted by as much as three years if they fail to meet specific requirements, also laid out in the Bill, such as attending work experience, skills assessments and engaging in a job search. Sanctions may also be imposed upon those who resign or are dismissed from work due to misconduct.

5.2 Turning Point has argued that welfare reform needs to handled with boldness but also sensitivity and this is most pertinent to ensure the reform of the sanctions regime does not exacerbate the social problems which can obstruct the search for employment. For example, the risk of someone from the poorest fifth of the population developing a mental health condition is around twice that of the population as a whole, (New Policy Institute and Joseph Rowntree Foundation, 2010) . Furthermore, research suggests that the fear of losing benefits can cause unemployed alcohol misusers significant stress and can contribute to a relapse. This fear was also reported to be a barrier to engaging with employment support and treatment services (DWP, Research Report 718 , 2010) .

5.3 However, there has been public acknowledgement that the most punitive sanctions would only be applied as a last resort and the government has stated that the application of these sanctions will be further controlled through forthcoming regulations.

5.4 The content of regulations is vital to ensure that those with complex needs are not further disadvantaged by the reforms to the welfare system and there should be further assurances within the Bill as to how these regulations will factor in the needs of those with substance misuse difficulties, mental health challenges or a learning disability. There is an opportunity to have this concern addressed within the Bill within Subsection 8 of Clause 27. This subsection enables the duration of a fixed period sanction to be decided with referenced to previous failures; there is the potential for this subsection to also refer to the need to consider extenuating circumstances which may have prevented an individual from engaging with the search for employment. This would mean the effects of complex needs are acknowledged before a sanction is applied and would ensure those with a learning disability, mental health condition or difficulties with substance misuse are not disadvantaged by the sanctions regime.

5.5 The complexity of the welfare system does mean that much of the detail must be captured within regulation. It is not only that effective regulations are needed, but also that Jobcentre Plus staff members have effective training in recognising how complex needs manifest themselves and the barriers these personal challenges can place in front of someone’s search for employment. This should also be complemented by an effective and robust appeals process.

6 .0 Empl oyment and Support Allowance:

6 .1 Sensitivity within the welfare system is dependent on the system being able to adapt to the needs of the individual , something which is challenging for any process of welfare reform. Reflecting these concerns is the plan to time limit contributory ESA to one year, as mentioned in Clause 51 of the Bill. According to the DWP’s own impact assessment, this would affect around 90% of those on contributory ESA for longer than 3 months. Clause 38, subsection 5, establishes the regulations which will require a claimant to provide evidence or attend a medical examination to establish whether individuals have a limited capability for work.

6.2 Nevertheless, the Harrington Review, published in November 2010, has raised strong concerns surrounding the Work Capability Assessment which will be the background of this reform. The assessment process was found to not effectively consider the needs of the individual and was critical that the assessment was unable to take into consideration the effects of fluctuating conditions, such as mental health difficulties. The Harrington Review explicitly recommends that ‘Mental, Intellectual and Cognitive’ champions are introduced within Medical Examination Centres in order to build understanding of individuals who have mental health issues and/or a learning disability. While the government has shown support for Professor Harrington’s recommendations, there are concerns that the implementation of these reforms will be slow, meaning that many people will be assessed under the inadequate current system. There is a need for the Bill to acknowledge the requirement for regulations to provide an assessment process focused on the individual.

6 .3 Any attempts to reform welfare should be established with a view to not only support those who are long-term unemployed but also help those who are in employment remain there. The recent announcement of Dame Carol Black and David Frost’s review into reducing high levels of long-term sickness absence is encouraging but this needs to take a supportive approach which places the individual at the heart of services.

6 .4 Mental health difficulties is one of the most prevalent reasons for why someone goes on long-term sickness absence, recent estimates put the cost of mental ill-health at £30-40 billion, attributed to lost productivity and NHS costs (Department of Health and Department of Work and Pensions, 2009). Turning Point has found that it is often the case that people who take long-term sickness often do not receive support until 28 weeks, at which point statutory sickness finishes and an individual is likely to be moved on to ESA. For reform of the welfare system to be efficient it must also consider early intervention for those at risk of losing employment through long-term absence.

7.0 Conclusion:

7.1 Welfare reform affects some of the most vulnerable people within our society and it is a difficult task to ensure people get the support they require while also reforming the system to create further efficiencies. Those with complex needs, who are often furthest away from the labour market, are often those who need the most support but are the least likely to receive it. The reformed welfare system must be able to take a person-centred approach and respond to the individual needs of those who rely on the welfare system. This is a difficult challenge but one which needs to be addressed to ensure that those with complex needs are not further disadvantaged by reform of the welfare system.

April 2011

References:

D epartment for W ork and P ensions , Alcohol Misusers’ Experience of Employment and the Benefit System , Research Report 718 (2010 )

Department of Health and Department for Work and Pensions, Working our way to Better Mental Health: A Framework for Action (2009)

New Policy Institute and Joseph Rowntree Foundation, Monitoring Poverty and Social Exclusion (2010)

Royal College of Psychiatrists, Mental Health and Work, (2008)