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Work & Pensions Committee - Minutes of Evidence1493

Back to Report

Oral Evidence

Taken before the Work and Pensions Committee

on Wednesday 23 November 2011

Members present:

Dame Anne Begg, in the Chair

Debbie Abrahams

Harriett Baldwin

Andrew Bingham

Karen Bradley

Sheila Gilmore

Oliver Heald

Glenda Jackson

________________

Examination of Witnesses

Witnesses: Amanda Batten, Director of External Affairs, National Autistic Society, Neil Coyle, Director of Policy, Disability Alliance, Paul Farmer, Chief Executive, Mind, Geoff Fimister, Campaigns Officer, RNIB, and Eugene Grant, Public Policy Officer, Scope, gave evidence.

Q104 Chair: I welcome you to the second formal evidence session of our inquiry into the change from Disability Living Allowance (DLA) to Personal Independence Payment (PIP). I apologise for the numbers on our side being a bit thin. The reason is either fog or leaves on the line. I am sure that my colleagues will turn up soon. Could you briefly introduce yourselves and the organisations you represent? We’ll start with Amanda.

Amanda Batten: My name is Amanda Batten. I’m director of external affairs at the National Autistic Society.

Chair: Although there are microphones in front of you, they are for the sound recording. They don’t amplify the sound, so please speak up nice and loud.

Paul Farmer: I’m Paul Farmer, Chief Executive of the mental health charity Mind.

Eugene Grant: I’m Eugene Grant, Public Policy Adviser at Scope.

Geoff Fimister: I’m Geoff Fimister, policy adviser to the Royal National Institute of Blind People (RNIB).

Neil Coyle: I’m Neil Coyle, Director of Policy at Disability Alliance and Director of Policy and campaigns for Disability Rights UK, which opens its doors next year and is made up of Disability Alliance, the National Centre for Independent Living and Radar.

Q105 Chair: I think I followed that. I’m sorry you’re all a bit crushed on the top table. There’s more room in Portcullis House, but unfortunately we are in this room this morning.

One of the main criticisms of the existing DLA criteria is that they are far too heavily weighted towards people with physical disabilities and impairments and do not adequately reflect the impacts of sensory and intellectual impairment. We had a very well attended public meeting in South Wales yesterday. It was so big that we had to change the venue at the last minute. The local autistic society had been very active in getting its members there, so the questions were very much about the effects of the new PIP on autistic people in particular. Is what I’ve referred to one of the main criticisms of the existing system?

Amanda Batten: Yes, the National Autistic Society would certainly concur with that. The current DLA application and assessment process is very focused on physical difficulties. That makes it quite difficult for people with conditions such as autism to fill in the form. In practice, people tend to rely on the "Any other information" box at the end. That’s once they’ve got through the 50 pages that they can’t quite relate to. The disadvantage of that is that sometimes people feel like the benefit is not for them, and perhaps are discouraged from applying, or they need help and support to fill in the form.

An example of that would be the mobility section. It rightly talks about how far you can physically walk, which is obviously appropriate for some groups, but it would not give you an opportunity to talk about the challenges you might face with mobility if, for example, you have difficulties planning and following a journey. Some people with autism might find the environments in public transport totally overwhelming-very difficult to navigate; might not be able to cope with changes in routine; or have no concept of safety or hazards. So they may face barriers in terms of mobility but it is quite hard to capture that in the current system.

Neil Coyle: If I can just add to that: the criticism there is of the process for entering the benefit. The criticism is not of the benefit in terms of what it allows you to achieve once you have accessed DLA, in the way it is paid, in the fact that it is paid to people in work or out of work. Those kinds of issues mean it is very flexible. It is the process for getting in that was the focus of the quest for reform in the past. Most of us have sat together and asked governments of different times to reform DLA in the past-in particular focused on the process for entry, and the bureaucracy involved in trying to get on to DLA. It should probably be noted that about one in eight of the people who will be going through the new assessment process for PIP are those with learning difficulties.

Q106 Chair: Okay. We will be picking up later on whether what is being proposed in the second draft of the criteria in the PIP will answer some of those questions, or not. Just at the moment I am really trying to codify-because the Government say that DLA is poorly understood and poorly accessed by certain groups of people. I am just trying to get that critique of the existing DLA at the moment.

Geoff Fimister: Throughout the lengthy consultative process over DLA and PIP, we have repeatedly pressed the issues around communication and orientation and the need to address those dimensions that are so important to people with sensory impairments. We feel we are beginning to get that argument across now; the debate seems to be shifting to an encouraging extent.

Could I also say that I spoke to my colleagues in Neath last night, to see how it went, and I think people do not expect Parliament to come to them. I think your visit was very positively received, from the comments that I got back.

Chair: We are glad to hear it, because the last speaker at the meeting was less than complimentary, but it did mean as a result that lots of people said, "No, thank you, we are really glad you did come." It was nice to do it, and we are glad we did it.

Eugene Grant: I think one of the things with the current DLA process is that it is very complex and arduous to complete, which is what some of my colleagues were saying; but also it is very deficit model-focused-it focuses very much on what somebody cannot do, which is particularly arduous to fill out. More than that, it also centres specifically on impairment, and what someone cannot do as a result of their impairment, rather than the barriers that society throws at them as a disabled person. I think that is a real shortcoming of the current process.

Q107 Chair: Okay. I will come back to you on whether the new process makes that any better. Paul, I think you want to say something briefly.

Paul Farmer: Building on your question about those groups who have historically found it relatively difficult to claim DLA-people with mental health problems I think constitute only around 17% of the total number of people who claim DLA at the moment, which feels disproportionately low-like Amanda, many people tell us about the challenges and difficulties of completing the form and being able to articulate effectively some of the challenges.

Equally, people who have been able to overcome that hurdle tell us about what a really very progressive benefit it is for them. For people who are in work it is helping them to stay in work. For people who are out of work but looking for work it is giving them that additional support to be able to do that effectively. For people who are unwell as a result of their mental health problems, they are telling us that it is preventing them from relapsing and potentially high-cost stays in hospital. The very flexible nature of the benefit makes it quite a progressive benefit for people. But on the entry system I agree with colleagues. It is extremely difficult for people to get in at the moment.

Q108 Chair: There will be questions coming up about the widening of the criteria, so I want to stay clear of that, but can I ask you a question we asked of our first set of witnesses? You have made criticisms of DLA. Did it require the introduction of a new benefit to sort out those criticisms or would it have been possible to reform DLA as a benefit as it stood? All of you have talked about the importance of it as a benefit once it is in receipt, but would it have been possible to change or reform the gateway, or find other means of improving the operation of the gateway on to DLA, and perhaps to check that people would still qualify for the benefit?

Geoff Fimister: Looking to improve DLA and all the issues that are being discussed could have been approached within the context of DLA itself. I don’t think there was a necessity to create a new benefit in that sense. We have simply taken it that the creation of a new benefit was a vehicle for introducing significant spending reductions. I really don’t see why it was necessary in terms of improving the benefit.

Q109 Chair: But Neil, your organisation has a website where you have a list of all the relevant DLA case law and it runs to 57 pages. Isn’t that the problem? Because it has been going for a long time, the case law has built up; it has got more and more confusing and therefore a fresh start on a new benefit would be useful.

Neil Coyle: If the Government had wanted to say that it was perhaps too easy to access as it currently stood, or that they wanted to make a significant reduction and to change the levels of payment-it was all possible. The Government could have acted to overrule some of those 57 pages-I didn’t realise it was that long-of case law. The Government have the power to do that. As Geoff has mentioned, instead of being completely frank about the Government agenda, it feels to many disabled people and disability organisations that the introduction of a new benefit, at considerable cost, is designed to mask a reduction rather than genuinely to deliver an improvement that would change all of that case law.

Amanda Batten: Can I just add that we were generally open as to whether DLA could have been reformed or whether a new benefit in principle was preferable. It is certainly the case that DWP has looked at and revised the existing child DLA form and has been doing some work on that, so there have been some improvements, which, potentially, could have been an alternative avenue for progressing.

Q110 Chair: My last question is around the perception of DLA. One of the criticisms that the Government have is that the perception among many DLA claimants is that it is an out-of-work benefit; it is not an in-work benefit. Part of the reason why we went to Port Talbot in South Wales is that it is the area with the highest proportion in the country of working age people who claim DLA. It is no coincidence that it is also an area of de-industrialisation and high unemployment. How widespread is that misperception with regard to DLA? Do you find that from members of your organisations?

Paul Farmer: Like all benefits, I suppose that this benefit is often misunderstood and often very hidden. Lots of people don’t know about DLA in the same way that a lot of people don’t know about Access to Work as a support mechanism for disabled people in work. Potentially, it is a tool to enable people to stay in work. Interestingly, I had a message just this morning from somebody who knew I was coming to this Committee and who has a mental health problem. They said, "I, for one, would not be able to go to work if I do not continue to get my mobility DLA. This would worsen my mental health and would leave me isolated and feeling worthless. I would feel that I am not contributing to the tax system or to society." There are clearly people who do understand that DLA is an in-work benefit as well as an out-of-work benefit. In wider terms, I don’t think the public understand that. The recent media coverage certainly suggests that there is not a particularly good understanding of it in the media.

Q111 Chair: So the proportion of people who qualify for DLA but are not claiming it are likely to be the ones in work, is what you are saying. The ones out of work are looking to maximise their income and therefore know about DLA, because they will have gone through Welfare Rights or Jobcentre Plus, which might have suggested it, but people in work do not get it. Do we know whether, if the DLA criteria are tightened, people presently in work who receive DLA are likely to fall out of work if they no longer qualify? Can you quantify that at all?

Neil Coyle: In the survey that Disability Alliance ran for a number of organisations alongside the Government consultation, more than half-I think it was 54%, off the top of my head-of those currently in work and receiving DLA said that without DLA or with a reduction in DLA, working the number of hours that they worked, or working altogether, would not be possible.

There is another side as well, which is about circumstances changing and DWP requiring a review based on someone going into work. There is a misunderstanding on the officials’ side which has led to a question mark being put over somebody’s need for DLA on entering work. Of course, being in work can have higher costs for disabled people: more transport, for example. That misunderstanding and misperception works two ways, but there is a real risk that people could be less likely and less able to work without the support that DLA provides. In particular, people in work told us it was due to transport costs.

Q112 Chair: But you will have heard people say, as I certainly have, "Oh, I can’t take the job, because I’ll lose my DLA." No matter how much they are advised that that is not necessarily the case, that perception is still very strong among people.

Geoff Fimister: Yes, I think that’s probably true. We have undertaken research, with both Attendance Allowance and DLA, into how blind and partially sighted people actually spend it. The DLA research we did in association with Action for Blind People. Some of the most powerful case examples we got were from people who were in work. They were very articulate about how important it was to them when paying for assistive technology, travel and so forth. DLA can be a powerful reinforcement to people’s ability to take up and remain in work. Although we cannot quantify it, I am quite sure you’re right that there is a misconception among many people that it is an out-of-work benefit. What that suggests to us is that, as with many benefits, there is a very strong case for high-profile publicity, whether it is called DLA, PIP or whatever. We hope that as the benefit develops, that will be part of the Government’s agenda.

Q113 Chair: I think it’s easy for people to understand, if you are sensory impaired or have a physical disability, that DLA is clearly an advantage if you are in work, because of the things you need to buy in order to access work, including Access to Work itself. But what about people with mental health problems? Is that not the group with the biggest fear of losing their DLA if they go into work? Is that different from people with sensory impairment and physical disability?

Paul Farmer: Because the benefit is not always that well understood, there is always a potential for that fear, but the same issues apply about clear communication and clear messages for people who are currently experiencing it. Significant numbers of people with mental health problems who are currently on Incapacity Benefit will be reassessed under the WCA1. There is an opportunity to communicate effectively with people about what is and isn’t a part of those processes. One of our concerns about how this particular piece of work is being looked at is that it is often done without that broader context.

As I said, many people are currently going through the WCA, and many people are facing challenges as a result of other cuts in local authorities and other places. We know that this is a very unusual benefit in many ways, precisely because of its very personalised element, yet it is very misunderstood. We really want to encourage people with mental health problems-we certainly use all our channels to encourage them-to understand that this is a benefit which you don’t lose if you find a job. That is a very important message. We know that people can be fearful of both the financial and the human costs of taking that step, but we know that among disabled groups, people with mental health problems have an extremely high want-to-work rate and, unfortunately, an extremely low in-work rate.

There is a lot of support we can usefully give. I would guess, for instance, that Work Programme providers are not telling people that their DLA is not necessarily going to be affected. I would guess community psychiatric nurses are probably not telling people with mental health problems that their DLA is not affected. It appears that it is not particularly well understood. There is certainly a need for a far greater widening of understanding about what this benefit is but also what it is not.

Q114 Harriett Baldwin: In that context, have you tested the change of the name from Disability Living Allowance to Personal Independence Payment on any of your user groups? Does it better convey what the benefit is for?

Paul Farmer: Interestingly, someone said to me yesterday that they were concerned that losing the word related to "disabled" would be a problem, because it does clearly identify who it is for. However, I don’t think we have a particularly strong view about that. What is more important is what it contains and how it is communicated.

Geoff Fimister: We have not tested that out. I know it has arisen in the debate on the Welfare Reform Bill in the House of Lords. It has been criticised as a potentially ambiguous name-Personal Independence Payment.

Q115 Harriett Baldwin: The new name?

Geoff Fimister: The new name, because it does not mention disability. So I suppose that is a good point.

Neil Coyle: And it does link to the social care language of personal budgets. Personal Independence Payments and personal budgets: there is a risk of more confusion from the new name than under the former name. I am happy to do some research on this, but our members-365 local and national organisations across the country-would probably support "disability living costs allowance", which I believe is Baroness Campbell’s suggestion.

Q116 Harriett Baldwin: Can you say that again?

Neil Coyle: Disability living costs allowance, or disability living costs budget-something along those lines.

Q117 Chair: What does that work out as an acronym? Nothing rude.

Eugene Grant: I think I draw on Paul’s point that we are not wedded to the name personal independence payment, but much more important than the name itself are the content, how it is delivered and how well it recognises the barriers people face.

Q118 Harriett Baldwin: On a show of hands, who would prefer to keep the name the same?

Geoff Fimister: I think disability living costs allowance is good; I like that.

Neil Coyle: I think the reason "costs" was chosen by Baroness Campbell was because DLA was introduced to help with the high cost of living. It seemed to be missed in some of the discussion of the change that DLA was about the high cost of living, and so people were routinely experiencing high costs. To have something focused on costs would probably get significant support.

Chair: Keep that thought in mind. At the end when we come to look at how well the new benefit is fulfilling what you want it to do, that is maybe something we need to explore further. Glenda, I think you want to come in quickly.

Q119 Glenda Jackson: Actually, it was in relation to something that Paul said before we got on to the change of name, which is part of something that has been presented to the Committee before.

You referred to psychiatric nurses, for example. It seems that there is confusion-and you are presenting a picture that there is major confusion around-about who can claim and maintain DLA. There are so many other areas of the state, which on the surface have no contribution to make here. This is a point we have all been banging on about for some time. These are the organs of state that should be made aware that they have responsibility in the area. The obvious one is health; the other is social services-very often they don’t know. Local authorities are very patchy in this area.

Am I right in presenting this rather bleak picture? Do you think there should be a requirement on central Government to join this up across all the organs of state, so that everybody knows they have responsibility in this area?

Paul Farmer: I completely agree with that. About 18 months ago, I co-authored a report with Rachel Perkins and Paul Litchfield for the DWP, entitled Realising Ambitions. One of the strongest findings was the lack of join-up in terms of the messages people were receiving. People do not live in departmental Government silos; they live in the real world. In that real world, people told us that one week somebody would be telling them that they will never work again, but the next week they would be called for a reassessment of their ability to work. There are huge benefits-and huge savings, to be honest-to come from creating a more joined-up approach. At the heart of that is information, in terms of people’s understanding and knowledge, but it is also an understanding of the individual’s broader experiences.

I think it is very important that this particular review of Disability Living Allowance is seen in that wider context. It has a lot of potential to be an exemplar of a personalised service that is well promoted and enables people to be more independent in their living and in fact to become less reliant on the state. It is dependent, however, on people who are part of the statutory services informing that individual about their rights and their potential ability to benefit. Time and again, we hear from people whose mental health is actually worsened as a result of constant reassessment and constantly being asked to tell their story again, which adds further to their stress rather than enabling them to become more equal citizens in our society.

Q120 Glenda Jackson: So really, changing the name is irrelevant if you do not ensure that the relevant information is out there for everybody concerned.

Paul Farmer: If the name did what it said on the tin, to coin a phrase, that would be great. If people’s understanding of "disability living costs allowance" is precise, that is fine, but if people are unclear about what PIP means and stands for, it adds further to confusion. Fundamentally, it is about what is inside that box.

Q121 Glenda Jackson: It is quite scandalous that people still do not know that it is a benefit that you can claim in work as well as out of work. That is absolutely outrageous.

Geoff Fimister: The question about the awareness levels of various professional groups is something that certainly resonates with me. I ran a local government welfare rights service for 25 years in Newcastle upon Tyne, and part of our brief was to try to provide training and information systems to other professional groups such as social workers and housing staff who were in touch with claimants and potential claimants. It is a complex business.

The counter-argument that people used to put to us was, "The benefit system is so complicated, how can you expect busy staff to understand it?" As far as it goes, that is a reasonable point, but we used to argue that it is essential to have at least a reasonable diagnostic level of knowledge so that you know when there is a problem and you can see that someone is under-claiming. Even if you do not have a detailed knowledge of the system yourself, you at least know that you should be referring that person for a benefits check. That was always our objective: to try to get at least a decent diagnostic level.

We did a lot of work nationally on this as well through the local authority associations and through the social services trade press, and we found a great deal of variation from one local authority to another in the extent to which they took that on board. There is also a link in here with staffing levels, because if you are jostling to try to get welfare rights into a training programme, you are taking up part of the staffing margin that is allocated for training. When you are in a situation of staff shortages, training tends to be one of the first things to go, unfortunately.

Chair: We will move on to Oliver, who also has questions about the need for change.

Q122 Oliver Heald: Just on the matter that we have been discussing, do you think DLA has an image problem? Certainly, when Professor Fothergill was talking to us he was describing the concentrations of DLA claimants as being in post-industrial areas in South Wales, the North and Scotland. He was saying that you are talking about people who are poorly qualified, from manual occupations, who have been out of work for a long time, with formidable labour market detachment and similar household types and housing tenure. Really, there was a flavour of labour market problems in an area, continuous unemployment and people gradually being diverted into benefits of this kind. If that is the image of DLA, you can understand that it might be quite difficult to sell it in areas where there is not so much of a labour market problem, and you would perhaps be talking more about an in-work benefit than an out-of-work benefit. I wondered whether you wanted to comment on the image of DLA.

Amanda Batten: I think in some ways the image of DLA can be quite positive. It is a benefit that people really value because it is about having that money for you to use as you know best, as will best support you. It is one of the benefits that our members would almost value most, because you have that flexibility with it. We were surveying our members’ views and lots of people described it as a lifeline. In some ways, because some people will have applied for DLA for children or have used DLA for a long time, their understanding can be higher than it is about some of the other newer benefits, particularly for younger adults. So I think it is mixed perhaps.

Neil Coyle: I think the image problem is interesting. I would perhaps challenge some of that. If you are out of work for a long time and you have worked in heavy industry, it is not that you are gradually pushed on to claiming something because there is no other potential income, it is probably more likely that you gradually end up meeting the criteria through the deterioration in your health in being out of work for so long. There are other reasons for the uptake being higher in those areas perhaps. But the image problem is perhaps a Daily Mail one, or a misperception of what people are using it for and what it is supposed to help achieve. That comes back to the communications and reaching a better understanding of this or any other benefit. What is it designed to achieve? Is it helping to do that? Is it helping people to meet the costs of living? These issues are all improvable under existing arrangements or with tweaks to the existing system, rather than paying a very hefty sum to introduce a new benefit, which will have a far greater image problem from day one because people will be moving off support on to, potentially, nothing.

Paul Farmer: I am not sure that it has an image problem. It has an invisibility problem in the eyes of many people. We think it is quite significantly under-claimed. Many people do not even know it exists. Although there is a risk of DLA being rolled up with a variety of other benefits, there is a popular misconception or perception about people in the industrial heartlands who have accumulated significant amounts of benefits. Neil is correct. We know that spending long periods of time out of work is poor for your mental health, for instance. It will increase the incidence of mental health problems. So there is a genuine issue around that but more broadly, the media conflate DLA into out-of-work benefits, and those kinds of messages, especially ones that suggest that is easy to claim the benefit, definitely suggest that there is a misconception problem. Anybody I have sat with who has tried to fill in the form will tell me quite how complex and difficult it is to claim the benefit. It is an extremely difficult benefit to claim.

Geoff Fimister: The point about the old industrial areas is very interesting. I thought Steve Fothergill’s argument was impressive and I think he is right. Clearly, with the decline of the old industries a lot of ill health, as Neil says, is due to people being out of work for a long time, but it is partly also because some of those industries are associated with health problems anyway. Clearly if people who have been on a decent wage now find themselves living on very low levels of benefit, it is important for them to be able to maximise their income, not just through DLA but through whatever benefits might be available. It is not a coincidence, I think, that the old industrial areas and some of the poorer London boroughs were also the pioneers of local authority welfare rights strategies as well. What we also found at Newcastle Welfare Rights was quite a lot of low-paid workers who were failing to claim the benefits that they were entitled to, maybe people who had previously been in heavy industry and gone into lower paid jobs. When we did take-up work with low-paid workers, we were constantly finding unclaimed benefits, not just disability benefit, but housing benefit and council tax benefit as well.

Eugene Grant: I would pick up on the point about maximising income. It is not necessarily about maximising someone’s income; it is more about recognising that their income takes a significant hit because of the additional costs of being disabled. Those costs and barriers will arise whether you are in a rural area in Wales with a post-industrial job or industry, or in a city such as London. It is very important to recognise that it is about meeting those additional costs, not necessarily maximising one’s income in that way. I definitely second Amanda’s point about DLA being an extremely valued benefit that enables people to participate. It occupies a unique space in the welfare system.

Q123 Oliver Heald: I was not supposed to be asking you about that. When they did the national benefit review in 2004-05, one of the things that they found is that there is a very low level of fraud and error for DLA, but one issue that was identified is that there could be gradual changes over time that are almost imperceptible day by day but that over a period of time lead to overpayments being made of about £0.6 billion a year, which is quite a significant amount of money. Of course, that is the basis for the argument that we need systematic reassessment, otherwise we will have this problem with the budget. What are your comments on that? Obviously some people are not in favour of systematic reassessment, but surely the taxpayer is entitled.

Paul Farmer: In the system as it currently exists, some people will be given an unlimited award and others will be given a time-limited award.

Oliver Heald: Well, 70% are indefinite.

Paul Farmer: There is no reason within the current system why you could not build in some more time-limiting, particularly for those people who might have particular conditions. But it is equally the case that there are large numbers of disabled people for whom their condition will not alter over a long period of time, so it feels unreasonable to expect them to undertake a regular reassessment when their condition is permanent.

For people with fluctuating conditions, you would have to have a system that is suitably sensitive to the nature of their fluctuating conditions. As this Committee will be aware, that is one of the issues on which we have been seeking to work with the Department in the context of the Work Capability Assessment, which in its current form fails to be sensitive to the nature of fluctuating conditions.

So I think there is a balance that needs to be struck between appropriate levels of reassessment and learning lessons from the Work Capability Assessment journey. For instance, with mandatory face-to-face assessment and not taking full account of previous medical evidence, there may be a better way of doing it than simply following the model that is currently being applied in the WCA, which has extraordinary similarities to the current proposals for the PIP reassessment process. There are some very significant dangers in simply taking that template and applying it to this particular benefit for a number of reasons that colleagues have mentioned.


Q124 Oliver Heald: Just to challenge you a bit on that, obviously there are mental health conditions where you can have a period of two years, a very long period, where you are really in quite a good place and then a period where things go badly wrong. Surely you have to be able to reassess a condition like that or it could lead to a situation where you are not paying the right amount.

Neil Coyle: That is possible under the current system. The Department for Work and Pensions can require a review of any DLA payment.

Q125 Oliver Heald: The point that I am making is that it should be a systematic reassessment, otherwise the budget is at risk.

Neil Coyle: Even that is possible under the current system, and we normally have the evidence on, "What is the primary condition? What are the other conditions? Are they likely to change? Would it be sensible to be calling people in for review bi-annually?" Or whatever it might be. The Department for Work and Pensions has that power under the existing arrangements.

Q126 Oliver Heald: But given that, at the moment, 70% are indefinite, that is a very substantial percentage, isn’t it? What is the percentage where you would say, "Well, there shouldn’t be any reassessment"?

Amanda Batten: I am not sure there is a precise percentage, but there is a need for some flexibility and pragmatism in the system. For some people a regular reassessment might be appropriate and achieve the outcomes you are describing, and of course, people’s needs can change and become more complex, so they might need additional support as well as the reverse. But for some people, if you had rigidity in the system and everybody had to go through a systematic reassessment on the same basis, it would be impractical and unnecessary. Somebody with profound autism has autism for life. They are not suddenly going to not have autism. To put them through a regular reassessment every year to find that they still have autism and those needs-there are also cost implications. It seems an unnecessary use of resource. You need to make sure that the system has the flexibility and pragmatism to reassess as appropriate.

Eugene Grant: The idea of a systematic reassessment jars slightly with the Government’s personalisation agenda. As Neil says, a lot of personal information is there. If anything, those assessments should be based on that personal basis, rather than a systematic thing where every two years you reassess everybody.

Geoff Fimister: I think that reassessment can be very useful in both directions. It can pick up where somebody is being overpaid because of changes over time, and also pick up where they have been underpaid because of deterioration in their condition. That is fine. The problem is that it has become a bit of a fetish in the current review. For example, in the sensory impairment context, if you have somebody on the highest rate and they are not going to get any better, what is the point of reassessing them? At the moment, severely visually impaired and deaf-blind people have indefinite awards and automatic entitlement. That seems only sensible. To introduce an assessment for no apparent good reason seems to us to put unnecessary pressure on those people. Also, to pick up the previous point, it is a waste of administrative resources and runs against efforts to introduce more streamlined administration into the benefit system.

Paul Farmer: First of all, I would be surprised if significant numbers of people with mental health problems received indefinite awards. Bearing in mind that it is a relatively small number of the overall category, I would be surprised if it were a significant number, but there are certainly examples where that would be appropriate. For somebody with very severe schizophrenia, for instance, that would be very appropriate. But we are certainly not opposed in principle to the idea of reassessment.

I suppose my point is that we need to take the learning from the WCA process. We know that in the current WCA process, that reassessment is extremely stressful to people. It creates high levels of anxiety and concern. We think that there are pieces of evidence that could be usefully used to make that reassessment process more rounded and effective. In particular, to pick up on the point about the join-up with health, health evidence could make that a much easier process.

Of course, the nature of people’s fluctuating condition is such that sometimes, the benefit is the difference between keeping them well and making them unwell. It is a difficult assessment to make-we completely understand that-but what a number of people tell us is that this is the kind of benefit that makes quite a big difference in terms of people’s ability to live a relatively normal life.

Q127 Oliver Heald: But you do accept that if £0.6 billion is being overpaid, you can’t ignore it.

Paul Farmer: No, and in principle, reassessment is not a problem. The question is about how you do it and how systematic it is.

Geoff Fimister: Just for clarity, I should have said that I was referring to the mobility component.

Q128 Oliver Heald: My next point is about the rigour of the system. Only 6% of the awards are made on the basis of a face-to-face assessment. Do you think that that is not rigorous enough, and that far more effort needs to go into it?

Neil Coyle: I think this is the same point that Paul has just been making. If there is sufficient additional evidence, why would we impose or require a new test that costs money to run that would outweigh the likelihood of finding different information that would result in non-payment of benefit?

Q129 Oliver Heald: My question is more about balance-6% is a tiny proportion. You are right that in some cases it will be clear from other evidence, but should there not be far more face-to-face assessment and a really rigorous approach?

Neil Coyle: Something like 56%-if I’m right-of DLA recipients have four or more health conditions. If they have information to back all that up-clearly, costs are attached to that-56% are already accounted for.

Q130 Oliver Heald: So move up to 44% face to face.

Neil Coyle: That’s four or more health conditions. Within that 44%, I do not know what the figure is-the DWP would be in a good place to say how many people have three conditions. If there is sufficient medical evidence for those, again, the cost of requiring someone to come in for face-to-face assessment-the sheer level of bureaucracy involved-is unhelpful given the limited resources that are being distributed.

Chair: Part of the problem around this argument might be that the Government do not trust the evidence that is coming in. That you cannot trust GPs to do a sick note any more seemed to be suggested this weekend.

Q131 Sheila Gilmore: Perhaps I can ask whether you think it depends what a face-to-face assessment is about in terms of the benefit. Obviously, there are medical reports and so forth. Is it a medical assessment to double-check the information? What do you see the face-to-face assessment-if used-being for?

Amanda Batten: Our primary concern is around the change in the assessment process to introduce really heavy reliance on face-to-face assessments, because we feel that that change will disproportionately impact on people with mental, cognitive and intellectual difficulties. That draws on our experience of the assessments around the WCA for Employment Support and Allowance (ESA), on which there is a very high rate of successful appeals, as you know-certainly around autism.

There is difficulty with the face-to-face assessment. We would love everyone doing those assessments to have really good training in autism, to be able to communicate with someone, to be able to do an in-depth assessment and adapt their questioning to get the information they need, but that is unrealistic in the context of 80% of GPs saying that they do not have understanding of autism-and that is to refer for diagnosis, let alone to do an assessment of that nature.

If face-to-face assessments are done by people with limited training or knowledge, it seems unnecessary to do them if claimants have just had a diagnosis and a comprehensive report from a psychiatrist, or whatever. They might have had a community care assessment and been able to put all that evidence forward. It seems unnecessary to insist on a quite limited face-to-face assessment following that. What is really important is that there is a tiered process to assessment, in which, if you have the evidence on paper, you do not need to go forward. The important context, as you mentioned, is around the very low fraud rates for DLA-it is useful to bear that in mind, but we must also be realistic about how in-depth and effective face-to-face assessments on this scale can be.

Q132 Oliver Heald: Do you think that the criteria have broadened too far, because three times as many people are claiming as a few years ago and four times as much money is being spent. Does that suggest that the level of disability required in order to get the benefit has dropped?

Eugene Grant: I don’t think we should necessarily regard the rising caseload and expenditure as a bad thing. We are not talking about an out-of-work benefit; we are not talking about the economy being in crisis and saying, "So many people are out of work and claiming jobseeker’s allowance-this is rocketing." What we are talking about is a benefit that enables disabled people to participate in society, and it is very valued, as my colleagues have been saying. I do not necessarily think that the fact that the caseload has gone up is a bad thing. But if you narrow it down more, we know that people are getting older, more people are surviving into later age and more premature babies with conditions are surviving, so there are demographic reasons for why the caseload might have increased.

One of the interesting things about when the Government talk about their reforms is that they often describe the overall caseload and overall expenditure, but then they are only going to be reassessing working age claimants, so there is a discrepancy in the figures there. I do not think, however, that we should necessarily be automatically assuming the rise in DLA caseload to be a bad thing.

Q133 Oliver Heald: Do you think it is easier to get it than it used to be?

Neil Coyle: It remains the same assessment process, and the eligibility criteria are the same, so I do not think that that is the issue. To flesh out a little bit more what Eugene has just said, I think the 30% figure that was used by the Government at the start of the call for change has been looked at by the Department for Work and Pensions and the working age growth is closer to 13% once you take into account the population demographic change. Some of that is about the fact that it was a new benefit from 1992, as well as the demographic changes and some greater level of awareness that there was a bit of support available.

Geoff Fimister: I entirely endorse both of those-

Chair: I must stop you there. We need to move on, because we actually have not got on to the new benefit yet, so we will do that.

Q134 Andrew Bingham: Question to Neil: the DWP said that you have made an assumption that current lower-rate DLA recipients will not get PIP, and the DWP has said that that is simply speculation because you have no evidence to base that assertion on. Do you think that is a responsible line to take? In Port Talbot yesterday, one or two people were concerned that they would lose the lower rate. It seemed to be a done deal. Do you think that that is a responsible line for your organisation to take without the evidence?

Neil Coyle: Right. The mission statement of Disability Alliance is to break the link between disability and poverty, so it is our charitable obligation to look at anything that risks increasing disability poverty. What we have had in the DLA/PIP announcements is a 20% arbitrary figure being put on what will come out of DLA expenditure without a justification for what that figure is based on ever being provided. Freedom of Information requests that have gone through have said that it would fetter decision making if the process to decide that 20% figure was revealed.

The figure that we have used is based on looking at total low-rate care DLA expenditure for the working-age population, which is £663 million a year. Even if all of those people lost all of the support that they receive, that is just about half of what the Government are looking to take out of the total DLA pot by 2015-16, and the Government’s plans include shifting the three rates of DLA care into two rates of PIP daily living component. The Government’s language has been very strongly about providing support to those with the greatest needs, and, under the DLA model that we have now, those with the greatest needs are those who receive the greatest levels of payment. The group on the lower rate is clearly most at risk, and even if all of them lost all of that level of support that they receive, the Government would still not meet their savings target.

Q135 Andrew Bingham: It is still an assumption though, is it not? You have still made an assumption.

Neil Coyle: I would suggest that it was an estimate of who is most at risk. I would very much like to have had the Department for Work and Pensions provide its own estimate for who is most at risk, and we have been promised that for some time. In the latest commitment, it was supposed to be in the, Personal Independence Payment: second draft of assessment criteria document, which came out last Monday. We were supposed to have in there an estimate for who could lose out in this system. So we are working in a vacuum, and, as I say, I believe that it is our responsibility to highlight who could be losing out and what the potential impact of losing out could mean.

There is something else missing, which is what DLA helps people achieve, what could the cost to Government be and what could the risks to the individuals and their families be of withdrawing support. We are doing that because the DWP is not providing that level of information and therefore generating huge anxiety for disabled people, because if the reduction in expenditure target is 20% and if it is not this group, who is it?

Q136 Andrew Bingham: I will just pick you up there. I am not 100% sure of your wording, but you say the target is 20%. I do not think that it is a target; it is what the Government estimate. We have heard your assumption as to who will be worse off through the introduction of PIP-the people on the lower rate. What is your assumption of who would be most likely to benefit from PIP?

Neil Coyle: Because of the way we expect this to change, and we are not told yet what the levels of payment might be, that is a difficult one to answer. If the levels of payment are the same, we will be requiring two million working-age, disabled people to go through a test so that some people can retain the level of support they have now. So in terms of being better off, I would argue that very few people will be better off. If the new benefit comes with a better communication awareness campaign for what it can help people achieve, both more generally, but also within other statutory services and beyond, then perhaps there will be some people who don’t currently receive support who seek help from the new benefit and they will be better off.

Q137 Andrew Bingham: You’ve not made that assumption?

Neil Coyle: Well, the Government is saying it expects some greater level of uptake but meeting that greater level of uptake would mean other people having to lose out. So, better off? It is probably a little bit difficult to see, more because of how the Government has reached the point it has, where it said this new benefit is about creating independent active citizens. We would all welcome that. But this comes with this 20% target. I think the Government has been quite clear. It is not an estimate. This was in the Spending Review. It was in the October Budget. It is in the Treasury papers. I don’t think there is any question mark over whether this is a 20% target.

Geoff Fimister: It is 20% of projected spend. Those are the parameters that the officials are working within in trying to develop the scheme. That could be achieved either through reducing the number of claimants or reducing the level of the benefit, or both, some combination of the two. We have not been able to establish how exactly they propose to go about it. One of the contradictions we found in the discussions we have had with the officials who are working on this is that they are engaged in an increasingly sophisticated exercise which, it seems to me, could potentially increase the spend on the benefit and yet they have to meet this 20% reduction in projected spend, which is more than £1 billion. Given those factors, it is a reasonable assumption that the recipients of the lower rates of the existing benefit are most at risk. It is difficult to see how it could be otherwise.

Q138 Andrew Bingham: Okay. Just as a wider question to all of you, what is your assessment of the likely combined effects of DLA, incapacity benefit reforms and the time limits on contributory ESA?

Neil Coyle: I think I would add in social care as well. The impact will be profound on hundreds of thousands of disabled people, whichever way you look at the range of reductions in support. Social care is also relevant obviously for councils facing some reductions in their spending levels. Social care is a significant part of any council’s budget. Disabled people are receiving social care service support that won’t be there. There is another risk. We have already seen the tragic circumstances where people feel they cannot access support now. Some of that support will decrease under the changes you have listed, as well as social services retracting further. We have seen councils trying to move very quickly, like Birmingham and the Isle of Wight, and not paying due regard to the potential impact on disabled people. That is where they have been hooked on the process, rather than making that change and cutting support.

If Birmingham and the Isle of Wight had gone through the right process they could legitimately have cut care support to critical needs only, which would have meant even more disabled people not being able to access support. Of course, the Dilnot review pointed out that if current benefit levels remain the same, which would include lower rate care, care expenditure, demand for care services would be at a particular level. Removing lower rate care, causing the escalation of need and the higher demand for services will put even greater pressure on other public services. So not just the profound impact on disabled people but the profound impact on other areas of Government expenditure that is being under-analysed by the Department for Work and Pensions and the Office for Disability Issues across Government.

Q139 Sheila Gilmore: I have a very quick question about the overlap there with social care. Are you aware of what proportion of local authorities take into account DLA income in setting charges for care?

Neil Coyle: All councils can claim against DLA for some of the support they provide. Again, where individual disabled people lose entitlements, then councils would also lose. It is a slight generalisation, but if you are getting lower rate care DLA, you are probably less likely to qualify for council care services anyway; there are separate pots there. But if people lose DLA, then councils lose the ability to reclaim the costs of providing services to disabled people, so there is a dual cost there for councils.

Eugene Grant: Unfortunately, I do not have the number off the top of my head. Earlier this year, Scope commissioned the think-tank Demos to do a piece of work on local cuts to local authority budgets and how that would impact on disabled people. That took into account which councils do take people’s DLA into account, and it was quite a significant number, which I do not know off the top of my head.

It is really important to stress when we talk about DLA and social care that they are completely different things and are for very, very different purposes. One is about the prevention of risk to a person’s own well-being and making sure that they can participate in their community and get support, such as for eating and things like that, while DLA is very much a participatory benefit about additional costs and barriers. They are very different things.

Geoff Fimister: It is a conundrum for local authorities, which the more thinking local authorities are aware of, that if you can encourage people to claim DLA and then charge against it that obviously helps you to provide services, but if you charge too much and leave people with very limited disposable incomes that makes it more difficult for them to cope in the community, and therefore they are more likely to need services.

Q140 Karen Bradley: I would like to turn the conversation to the required period condition. The DWP has said that it is going to extend the qualifying period to six months in order that the definition of long-term disability for PIP is the same as it is in the Equality Act. First, what are your thoughts on whether you agree that that is necessary and, secondly, what do you think will be the consequences of a six-month qualifying period?

Eugene Grant: I think it is a regressive move. When you are looking at a benefit that is specifically designed to help people cover the additional costs of disability, someone who has a sudden onset of a condition-a stroke, for instance-will now be made to wait longer before they can access the support they need. For want of a better word, someone who has a condition like that has a kind of "start-up" cost, if you will, of adapting to that change in their life, having to adapt their house and having to meet other additional costs, and they will have to wait longer to get the support that they will be entitled to.

Paul Farmer: I would agree with that. It is so important that when people are experiencing a problem that they are able to get help as quickly as is reasonably possible. Particularly thinking about those people who are in work, we know that that period is often one where people can very easily slip out of work and, as a result of that, find themselves on benefits and costing the state significant amounts more of money. We understand the issue around the Equality Act, but a 3:9 split is a better one than a 6:6 split.

Geoff Fimister: I would agree entirely with those points. For people with sudden onset conditions-for example, in sight loss, for somebody who has suddenly lost their sight for some reason-it is a time at which they are facing huge problems, and having to wait six months for financial support in that way is just worrying. We are very strongly opposed to that.

Q141 Karen Bradley: Three months is okay for people at the moment, is it?

Geoff Fimister: Obviously, the sooner the better as far as the individual is concerned, but three months is obviously a lot better than six months.

Neil Coyle: The point has been made that to make the change-to make the qualifying period longer-would undermine people’s early intervention. Given the evidence on getting support to people quickly, particularly those in work-the Government have a very strong agenda about supporting people in work-to change this and prevent people accessing support in work would risk employment.

Q142 Karen Bradley: But there is general acceptance that the definition needs to be consistent across the Equality Act and PIP, or whatever it gets called?

Geoff Fimister: The arguments about six months fitting in with the Equality Act we took to be a bit of an ex post facto rationalisation for what is a financial saving.

Q143 Harriett Baldwin: If you are in employment, is it possible that your needs might be to some extent covered by your employer? Does that ever happen?

Neil Coyle: You might get reasonable adjustments from your employer; obviously, there are legal obligations. If you have, for instance, a sudden spinal injury, it can take a very long time to get support in work, even through Access to Work. I am sure we all have sorry tales about how difficult it can be to get a disabled employee Access to Work support. It is about personal support, such as suddenly needing an adapted vehicle if you have spinal injury. An extreme example, which might not be suitable, is trying to get a suitable wheelchair, although that is perhaps not the best example. The employer will only need to provide an adjustment for you to be able to do your job, so that is once you are in work-in a physical building. There are other personal considerations, such as transport. I am not sure whether I have given the best examples.

Q144 Chair: You seem to be arguing that the shorter time period is appropriate, but only in some circumstances-somebody who is suddenly blind, who is not going to recover, or somebody who had a cataclysmic accident and is suddenly a paraplegic, who is not going to recover. Surely the Government are trying to make sure that the benefit only goes to people who have got a long-term condition. Blind and paraplegic are long-term conditions, and you know from day one that they will be, but most other conditions are not. Aren’t the Government quite reasonable to say that in the generality there is a much longer period? What you are arguing for is in specific situations-this point was certainly made at the meeting yesterday-three months is too long, and it should be no waiting time. Is that what you are arguing, or are you saying it should be a short time for everybody?

Neil Coyle: Geoff mentioned three and nine, so it is not that the entire qualifying period would change. You would still have to be experiencing something for 12 months. Most of the people who would be eligible, we would imagine, would have experienced something for longer anyway. When you approach DLA you would have had that experience for a significant period. The points that we are making have all come about because we have all been active in working with the Government to try to look at who could be most negatively affected by changing the qualifying period. That is why we used the sudden impact examples.

Q145 Karen Bradley: But aren’t they still affected by the fact that they have to wait three months? Is there not a case for reform that a sudden impact, as the Chair has said, which is clearly going to last more than 12 months, should not even have to wait three months?

Geoff Fimister: You could certainly argue that, yes.

Paul Farmer: The point you are making is about recognising that the condition is going to be for a period of more than 12 months. The question then becomes at what point you make the assessment. There is often a need to allow a slightly longer period of time to understand whether that will be a very long-term condition. For people with mental health problems, for example, it might take a little while to understand exactly how long that condition will last, and of course it is not always possible easily to tell. However, I think in many cases there are sufficiently clear signs that will indicate-that is why taking medical evidence is important-how long a condition is likely to last. I am thinking, for instance, about a young person who may be experiencing a diagnosis of schizophrenia or bipolar disorder for the first time. It is pretty clear that they will experience that disability for a reasonably long period, probably for the rest of their life. We know that getting somebody help as quickly as is reasonably possible gives them a better chance of recovering and being able to play an active part in society, so there is a good argument for getting the help as early as possible. Waiting for too long-at the moment, the proposal is six months-can elongate the length of time before a reasonable recovery is possible. I think there is a balance to be struck here, isn’t there?

Q146 Glenda Jackson: I have a constituent who has a gradually debilitating disease. She has a very understanding employer, who wants to keep her. It is a physical deterioration. The problem is that he is going to have to change her physical environment, which will take some time. So is she going to be in or out of this kind of system? There is going to be a point where she cannot actually get to work, but that is not her fault; it is because the employer has not brought about the necessary changes to enable her to work there. Obviously she can do part of the work, which at the moment she may be able to do at home, but that in itself is a difficulty because, of course, her own home is going to have to be changed.

Chair: I am not sure about that, because it is far more to do with Access to Work and employers.

Glenda Jackson: The point is that she is claiming it at the moment. Do you see what I mean? That suggests there is not just a sudden impact here.

Chair: I think some of that will be assessment, and we have questions on that to come.

Q147 Harriett Baldwin: I just wonder whether if what we are picking up here is that there is a capital need-you might have adaptations or equipment that is a one-off-and then there is an ongoing living cost need for the additional costs. Is it possible that, as part of this reform, the Government ought to consider breaking the allowance down into those two elements: an up-front cost and an ongoing cost?

Eugene Grant: I would say no. I think there is a real risk with assuming that certain costs are one-off, because really they are not if you look at them. We are in contact with people daily who tell us about powered wheelchairs, for instance, which can cost up to £8,000, but when they break down, you have a battery that costs £600 and tyres that cost £70. The maintenance of what you thought was a one-off cost has significant knock-on effects, so it is very difficult to break it down from a one-off cost to an ongoing cost of living. The same goes for housing adaptations and for those big chunky costs that often throw disabled people because they do not have the financial stability to meet them, which is what something like DLA will provide.

Neil Coyle: It would have been helpful if the Government had engaged with organisations before presenting certain proposals, because looking at costs would have been preferable. With the Government agenda of coming back to work, making additional payments to help cover the higher costs of entering work could have been very useful within the context of this benefit and helped to tackle some of the misperception that this is not a benefit designed to support you in work as well.

We would have quite welcomed a focus on helping with higher costs at specific times, as well as routine ongoing costs at whatever level they may be. Focusing purely on costs: it is a very low percentage, but there are disabled people who have told us that DLA more than covers their routine costs. It is 2% or 3%, but there is a figure. Having different levels of payment could have generated some savings for the Government while also allowing higher levels of payment for those with even higher costs of living. We are not in a situation with Government where there are clear proposals on the table, and we do not expect it to include variations on levels of payment based on the sudden impact of a change or more routine costs.

Eugene Grant: I think one of the most difficult things about what we are looking at is that, with both DLA and PIP as it stands at the moment, it is very difficult to pick up on many of the costs that disabled people have because they come from social-environmental things-barriers to disabled people-rather than just their impairment or the limitations arising from their body or their cognitive, physical or mental impairment. It is actually very difficult to try to flag these costs because we do not, as of yet, have an assessment process that tries to see those barriers from which disabled people incur extra costs, such as from their housing and those kinds of things. It is very tricky.

Q148 Karen Bradley: Is this an opportunity for the Government, by making it a personal independence payment, to make it personalised? If it is sudden onset, it is a quicker payment that might involve some form of capital up-front expenditure that is required because of the condition and then an ongoing payment. It should be personalised to the individual.

Neil Coyle: There is some space for that, but the message from the Department for Work and Pensions has been very clear that one of the reasons for scrapping lower-rate care was to simplify so that there are fewer mixtures of payments and that there are only certain boxes of support that you could fall into. I am not convinced that the Department for Work and Pensions is in a place where it thinks there will be that variation in the levels of payment. That is not what it seems to be seeking in the drive for simplification, which seems to overrule such a flexible, personalised approach.

Geoff Fimister: The other factor is that, although I can see a case for looking at the immediate situation and the possibility of higher payments for some claimants in those circumstances, in a context of significant spending reductions, there is a danger that that might be paid for by reducing the ongoing benefits. That would obviously also have negative implications.

Neil Coyle: We see that in ESA, where there is a commitment to pay more to the Support Group-though there is no time frame for that; it is an aspiration of the Government-while at the same time taking a significant number of other disabled people out of out-of-work benefits altogether through time-limiting contributory ESA. We fear we are not seeing a more generous system being introduced.

Q149 Karen Bradley: Linked to that, from the evidence there appears to be a difference of opinion between organisations about automatic entitlement. DWP has said it does not want to give automatic entitlement to specific medical conditions, because it says it effectively labels disabled people, and it wants PIP to be more personalised. I know the Disability Alliance disagrees with that. Neil, could you elaborate on your concerns about that, and then the rest of the panel let us know their opinions?

Neil Coyle: We have already touched on some of the reasons. To take one relatively small group but with significant barriers to inclusion: deaf-blind people. There is medical evidence to back up the condition and it is unlikely to change. Your cost of living is unlikely to change over a significant period. Why would we require an ongoing assessment, of however long? Why would we insist on the costs of running such an assessment process, when those circumstances are unlikely to change?

Geoff Fimister: This is the point I made before, where you have a situation such as higher-rate mobility being automatically available to deafblind people and people who are severely vision impaired. It seems totally pointless not to have an automatic entitlement system there. It seems a more unnecessary administrative process. I don’t think anybody is arguing that there should be large numbers of automatic entitlement categories, but there are certain categories where it seems quite clear-cut.

Q150 Karen Bradley: You would like to see automatic entitlement for certain specific conditions, but accept that there are other conditions where there are differing levels of need and support required, and therefore a personalised approach is more appropriate.

Geoff Fimister: Yes. As I said before, it cuts both ways. You can identify underpayments as well as overpayments, where assessment is appropriate.

Neil Coyle: Perhaps I should say that Disability Alliance is not saying automatic entitlements for everybody. That is worth adding, I think.

Q151 Glenda Jackson: My question is on the personalised approach. I do not quite know how that is going to be delivered. Do you have any ideas? We could look at the present systems of assessment. We have been talking about face-to-face reassessments, and we know that doesn’t happen even now. One face is usually looking at the computer screen and not the applicant. Do you have any ideas of how that personalised approach could actually be delivered, given what we know up to now?

Neil Coyle: There are mixed messages on this. If we look at the draft assessment, the message is very mixed. While the Government say they want a personalised system, they say there also has to be consistency in awards.

Q152 Glenda Jackson: There is a paradox there.

Neil Coyle: Absolutely. What the consistency appears to be based on is certain people with certain impairments or health conditions getting the same level of payment, which totally contradicts the idea of having a personalised system. It is a very confusing position to be in.

Q153 Glenda Jackson: That is the outcome. My concern is the initial assessment. Do we have any idea about these personalised assessors, the people who are going to do a one-to-one? How is that going to be delivered? It is not happening now.

Chair: I think Glenda is asking whether it is going to be Atos.

Glenda Jackson: No, I wasn’t.

Neil Coyle: I think 37 different organisations have put in initial bids to run the assessment process.

Q154 Glenda Jackson: So it is going to be the same old system, but with a different acronym.

Neil Coyle: It could be. I suspect it won’t be Atos for a mixture of reasons, but there are also organisations looking to involve disability organisations in the process at some point. We think the Department for Work and Pensions is quite keen to explore that further, but exactly what it looks like we do not know yet.

Eugene Grant: There has not been a huge amount of detail yet as to the delivery of the Personal Independence Payment and who the assessors will be. I think it is quite clear that if you look at the policy objectives around DLA reform, which is to ensure that disabled people who face the greatest barriers to independent living have support, you are going to need assessors who understand those barriers and that not all of them will come from medical impairment. Many of them will come from other things in the same person’s life-their social barriers, practical barriers-so whoever does the assessment needs to have a good understanding of the barriers that disabled people face.

The roll-out of the personalisation agenda really helps with that, so you are seeing people with expertise in support planning and things like that-a much more personalised, holistic approach rather than a strict medical tick-box assessment. I think that really has to be kept in mind.

Paul Farmer: For that reason, we would really support a very gradual pace of transition, if that were to be the ultimate outcome. We have learned a lot from the WCA system, where we have seen the reality of that being applied over a couple-of-years period only to new claimants. That is all very well documented; I won’t go into that in great detail now.

There are significant risks in getting this assessment process badly wrong. So taking it gradually, recognising that there is actually quite a lot that you can do to make the current paper process a little bit more effective, taking into account other forms of evidence to enable people to be able to make the right decision feels like an approach that you could take.

There is an assumption being made that face-to-face assessment is automatically a good thing, and I think we would challenge whether face-to-face assessment is automatically a good thing. Good-quality evidence being provided and being assessed by well-trained and well-understood assessors can be just as effective a tool. There may be a need for face-to-face assessment, but the current plans suggest an extremely speedy migration of current claimants across. Particularly at this particular time, there is a very strong argument for that migration being phased in in an appropriate way. The damage that has been caused as a result of the WCA process, in terms of many disabled people’s trust in these kinds of assessment systems, should not be underestimated.

Chair: However an assessment is done-whether it is face to face or on paper-it will be based on the criteria, which is our next set of questions, so we will go on to that with Sheila.

Q155 Sheila Gilmore: Eugene, you have mentioned the use of social and environmental factors and, indeed, your organisation has produced a paper, in conjunction with others, with a different way of perhaps carrying out assessment. Isn’t there a danger that if you do that you produce something that is going to be even more subjective-that has been one criticism of the current system-and actually quite cumbersome, both in terms of what people would have to fill in by way of forms and the information they would have to provide?

Eugene Grant: There is a real danger with this that we are getting a lot of talk about something that is objective and subjective. None of the assessments we have been talking about today are objective. What we have been saying is not only that if the Government are to fulfil their obligation to ensure that the same people who face these barriers to independent living get support, they need to understand those barriers-by way of a personalised approach, it has to be relatively subjective in that sense-but also that the Government have made a commitment to the social model of disability, which understands that many of the barriers disabled people face come from society. To fulfil that commitment, they need to take into account those kinds of barriers as well.

While we understand the Government’s concerns about subjectivity, there is a risk that the emphasis on objectivity is being used to justify a more simplistic approach that focuses much more on medical impairment than the actual barriers that a disabled person faces in their everyday life, which will come through different factors. The important thing is to accept that there will be two people with the same impairment who will have different barriers, who could then be entitled to different levels of PIP. I think we support that, because it should be about the barriers that they face, not necessarily their impairment. Some barriers will come from their impairment, but some will come from other sources.

Q156 Sheila Gilmore: If the factors that you suggested should be taken into account to amplify the assessment happened, would that not broaden eligibility to more people and therefore defeat the object of reducing expenditure?

Eugene Grant: Not necessarily, because there will be some people who have impairments but very low barriers. When we did this research with Demos a year ago, we found that many of the barriers that disabled people faced came from housing, transport and similar issues. You could have somebody who would have a certain impairment, but who lived in appropriate housing that was perfectly adapted, had a Motability car-not that that does not come without costs-and had a great network of support and informal support. The barriers that they faced would be lower than those faced by somebody who has what would be seen as a low-impact impairment or a less visible impairment, but who faces very significant barriers.

Q157 Sheila Gilmore: We have just had another set of draft criteria published, and the Department feels that it has built on the views that were given through the process by disabled people and organisations. What is the response to the new draft?

Eugene Grant: Could I just jump in on that? To quote from the new draft, the broad principles of the criteria remain the same, so we have seen little change from the first draft to the second draft. There have been some tweaks and edits here and there, which are quite welcome, such as including recommended medication-we know that that has significant costs-and not just prescribed medication. Generally, the overarching principle underlying both assessment criteria is about the definition of ability: an individual’s ability as defined by their cognitive, mental or physical impairment. As we have been saying today, that only gives rise to a certain number of those barriers and not the whole picture. Until you begin to include wider factors, the assessment criteria will only help assessors so much in establishing what barriers disabled people face.

Geoff Fimister: In the specific context of sight loss, we feel that the second draft indicates that DWP officials have been listening to what we have been saying. We think it is more sophisticated than the original set, particularly in the areas of communication and social engagement. The DWP has taken that on board, and as far as it goes we are pleased with that. The big worry is that we still know nothing about thresholds. Until we know that, we do not know what the impact is going to be. Having a more sophisticated set of descriptors is not going to help us if the points system and the thresholds still rule people out of entitlement.

Neil Coyle: We have significant concerns, and we will respond to the Department for Work and Pensions. It is welcome that the Government have moved a little. The Department for Work and Pensions has improved the test, but it also acknowledges that the initial test was pretty poor. One of the biggest fears we have is that the Government are not allowing themselves enough time to get the test right. Although they acknowledge that the first test was poor, the results of testing that test on 900 people will form the basis for rolling out the entire new test to two million working-age disabled people. Although we still have some opportunity to improve it, there does not seem to be the time, space, energy or commitment to ensure that whatever new test is finally developed is trialled sufficiently to avoid some of the situations we have seen under the Work Capability Assessment. We are due another set of recommendations as to how to improve that further, three years after it came into operation, after £80 million has been spent on the tribunal service in the past two years to try to pick up some of its faults.

Amanda Batten: I agree with both those comments. The first set of descriptors were very disappointing and very limited. The second set are significantly improved, from an autism perspective at least. They much better capture difficulties around social interaction and communications, so there is real progress there. It is always hard to capture a complex disability like autism in 12 descriptors, or whatever it is, and I think the assumption is that some of those descriptors would act as proxies for other difficulties. So, for example, there is a new descriptor on making financial decisions, but not on being able to manage a household, tidy up and keep things clean, which are two areas that we were concerned about. The assumption is that if you can manage financial issues, you might be able to manage those practical household management issues, too. Obviously, for a condition like autism where people have a very spiky profile, it does not necessarily follow in that way. The new descriptors certainly reflect autism better than the first set of descriptors and perhaps better than the DLA form, but the nature of the system means there is no scope for that "any other information" box that people use at the moment. It is certainly not perfect.

Paul Farmer: That links to the point Eugene was making about allowing greater account to be taken of people’s experiences and circumstances. I agree with colleagues that it is certainly a step in the right direction, but there remains an underlying principle that this is still an overly medical approach to the overall way of assessment. We would support an approach, perhaps a box or the proposals that Scope is making, that allows people to describe their circumstances more effectively.

We share the concerns about the thresholds. One of the examples, for instance, is that at the moment, under these new proposals, planning and following a journey will need to cause "overwhelming psychological distress" in order to meet the threshold. That feels like a pretty high threshold for people for whom we know getting around is a key part of helping them to live an ordinary life, as opposed to being stuck at home and being very fearful of going out. "Overwhelming psychological distress" feels like a pretty high threshold.

Eugene Grant: One of the concerns, drawing on what Neil was saying about pushing out this test very quickly, is that we have already seen prospective scores on this assessment when there are still big problems with the assessment itself. It is almost as if the debate is being moved on very quickly with very little opportunity to interject and comment. The second criteria were officially released about two hours before the House of Lords debate, so we are seeing very fast movement. There is a real worry about suddenly pushing it too fast, too soon without proper consideration of what PIP is about, what it should be about and whether the assessment and the resulting benefit will be designed properly to meet the Government’s objective, which, when you look at it, is to ensure that disabled people have support to overcome those barriers. That is actually a very progressive idea.

Neil Coyle: The Government is not giving itself enough time to consider the impact: the impact on disabled people is immediately obvious; the impact on health care and social care, which we have talked about to some extent; the impact on disabled people’s ability to work is another issue we have touched on; but, beyond that, there will be an impact on the need for informal care to step in if people are to lose support. It is really important to trial the assessment and make sure the descriptors ensure that, when it is finalised, the impact on the whole family is understood better because we have a very high rate of informal care provision in the UK. There is economic inactivity as a result of informal care provision. Any removal through the new assessment process of support for disabled people will require even more women, particularly those aged 46 to 64, to withdraw from work altogether or to reduce working hours. That impact really needs to be taken into account by Government, but the time-frame does not seem to allow any sufficient analysis of how the test will be implemented.

Q158 Sheila Gilmore: Is it your understanding that this is not going to be re-tested, or do you not have any information on that? It is on draft two.

Neil Coyle: We have had the test of draft one on 900 individual disabled people. At the Disability Alliance conference yesterday, the Department for Work and Pensions said that it felt that that was enough of an evidence base to push forward to finalise the test.

Geoff Fimister: They have said that they are going to consult again on the new set of criteria.

Neil Coyle: That is public consultation.

Q159 Chair: Can I ask about the criteria on moving around? A distinction is made between people who can push themselves in a wheelchair quite a bit and those who can’t. Regardless of whether you are an Olympic athlete in a wheelchair or you are me, you still need the same ramps, the same lower kitchen, the same adapted bathroom. You still can’t get to lots of places because of flights of stairs, you can’t use the Underground, regardless of your ability to manipulate that wheelchair. Yet, the difference could be between 10 and 15 points.

Karen made points about the capital expenditure required, for which many people will use their DLA. Often people will borrow from the bank to do the adaptations-because they can’t get it through the local facilities grant-knowing that they have the DLA as part of their income and banks will lend on that. There seems to be no recognition of that in the descriptors. That comes back to you, Eugene, and the barriers. It looks at the person not the barriers.

Eugene Grant: Exactly. It looks very much at the person. The descriptors have changed and some of the activities have been broadened, but again it focuses on the principle of ability as defined by your impairment. It takes no account of the barriers that society puts in your way. One of the descriptors is the ability to plan and navigate a journey. You might be able to do that fine, but if you are in a wheelchair you can’t access public transport and have to pay significant costs. Some people pay £20 a time to use a cab to do their shopping.

Q160 Chair: Buying food and shopping were in the original descriptors, but not the new ones.

Geoff Fimister: That is a specific point that we were going to query. We have a list of specific points and that is one. We don’t know why that has come out.

Q161 Chair: We don’t have time to explore all of those today. Presumably, you are doing a piece of work where you are comparing the original descriptors to the new ones, and what you would like to see. That would be very useful for us as a Committee, if we could have that analysis of where the Government have got it right and listened-and you have said they have in many cases-but where gaps are.

Neil Coyle: There is still one very big risk. While taking into account some of the aids and adaptations that are used and are clearly visible, there is still an assumption that it is reasonable to take into account adjustments, aids and adaptations that are not being used. Given that we have seen the rise in disability hate crime and harassment of disabled people-caused, some believe, by some of the media language used around benefits claimants-there are reasons why people may not want to use a particular aid or adaptation, such as a walking stick. The assumptions behind the assessment are that it is reasonable for the assessor to take into account aids and adaptations that could be used.

Geoff Fimister: This question of aids and adaptations we think is very important and we have engaged with the DWP over it from the outset. It seems to me that the crucial point is that if someone is using an aid or adaptation that enables them to be more independent and gets them out and about more, that is going to increase their costs, because they are going to be more active. It raises all those issues, for example, about travel costs. It is not just a question of the ongoing expenditure on the adaptation or aid itself, it is the fact that it makes you more independent and therefore will increase your costs. We do not want to see a dilemma created, a sort of better-off problem, in which people are worried about exploring the aids and adaptations available to them in case it reduces their benefit.

Q162 Chair: There is also a limitation on the definition of aid and appliance, for instance, if someone needs an aid or appliance to bathe. I reckon I do, because I can’t into a normal shower and I can’t get into a bath at all-unless I have an expensive thing that goes up and down-but that is not included in this. Someone like me would get no points. Have I read it correctly?

Neil Coyle: That is certainly the kind of thing we are nervous about. Even there, is the expectation that the assessor will then not just have to have a face-to-face assessment, but actually turn up at the individual’s home to check what aids and adaptations are being used? Where does the level of assessment end?

Eugene Grant: It is very important to consider where these aids and adaptations come from and the cost of purchasing and maintaining them. The assessment is centred on your physical, cognitive and mental ability. But how does that aid or adaptation help you bathe? Those aids and adaptations often come from a very small set of suppliers at significant cost to purchase and maintain. We know from our research and from our conversations with people daily that that is a significant additional cost for disabled people. It needs to take account of that.

Q163 Sheila Gilmore: Does some of this depend on the interrelation between a test and other aspects of the system? One of the criticisms of the WCA process has been the apparent almost entire reliance-at least until the Harrington review, and we are not quite sure what has happened since-on the test. Even things like that box that people could fill in with their personal statement are not necessarily being taken into account. How do you see the relationship between those two aspects of the whole?

Amanda Batten: That is a really important point to raise, and it goes back to the need for a tiered assessment. As you know, disabled people go through multiple assessments in their lives. They go through their assessment for PIP, they go through the WCA and we have a community care assessment for some people. The idea that you need to have a totally separate face-to-face assessment, rather than take into account all that evidence and pull in all the reports and evidence that are available and make a decision on that basis, calling for face to face if necessary, seems really inflexible to us. The description of the assessment process as personalised is a little bit of a misnomer based on the proposals at the moment. Personalised is taken to equal face to face in how the Department is talking about the assessment. Just making it face to face does not make it personalised in any way.

Geoff Fimister: The DWP has said that it wants to take into account evidence from a variety of sources including professionals who are in touch with the individual concerned. We would also argue that input from the claimant is important as well, and of course from carers. What the DWP has not indicated is the different weight that it would attach to these different sources of evidence. On the face-to-face point, colleagues have made this point before but there is a certain level of skill and knowledge needed, which in some cases is a very high level, for example with a deaf-blind person. One would not want to see that handled without the necessary level of competence.

Paul Farmer: That question is about ensuring a really effective join-up between different systems and really making them work. Amanda is absolutely right that many people are asked to undertake many assessments when there is no shortage of evidence that exists to inform an accurate decision. The problem is often that that evidence is not put in front of the right people at the right time. If the proposal is to introduce face-to-face assessment, it is another argument for taking that process pretty gradually and slowly so that, as with the WCA, we can learn from a real-world application of it. I do not think that the current relatively small numbers of people who have been tested on a previous version really gives a strong enough evidence base for a wholesale roll-out, which in itself, of course, is quite costly.

Q164 Chair: So what happens now? Is draft two the final version, or is the consultation period still ongoing? Do you as organisations have a chance to comment on this and change it again? What happens from now?

Eugene Grant: I believe we do have a chance to comment on the second draft.

Q165 Chair: What is your timescale for that? Do you know?

Eugene Grant: I do not think there is one.

Neil Coyle: I think the Department for Work and Pensions said that there would be a full, formal, public consultation on the final draft. That will not be ready until next year but it will run for more than the recommended period for consultation, which is 12 weeks. There will be other opportunities to improve, but it is still based on an initial draft that is acknowledged to have been very poor.

Geoff Fimister: We are down to a level of discussing detail now-to be fair to the DWP officials, they have been pretty accessible, in our experience-rather than larger structures.

Q166 Harriett Baldwin: When I have met people with disabilities and mental disabilities in my constituency, one of the things that has really concerned me is that they all seem to have the perception that DLA is just going-that it is just ending-and has gone completely. I just wondered, in terms of Government consultation and communications strategy, what the Government could have done with its communications to prevent that perception from occurring.

Eugene Grant: I think it is an ongoing process. In advance of the roll-out of PIP, there needs to be a very, very widespread communications campaign about it. We are speaking to disabled people who still do not know about ESA, and that was rolled out three years ago. This will be a massive change-let alone the introduction of Universal Credit on top of that-so there really needs to be a very far-reaching, concentrated effort to reach disabled people to make sure they are up to speed on what is happening. It would be very difficult to get any way around instilling fear in some people, but I think that they have to be informed.

Q167 Harriett Baldwin: Change always causes concern. Obviously, in this particular example we are dealing with people who might be thought to be particularly vulnerable or worried about change.

Paul Farmer: Most people would recognise that particularly the early stages of the communications around this were not handled well. It seemed to appear in the first instance in the context of the financial situation, which I think immediately created a link with the financial need to reduce the overall bill and others.

There was a relative lack of information at the early stage. Of course, we understand that that is the nature of the process-you start with a policy intention and then you develop that over time-but there could have been greater clarity about, for instance, the numbers of people affected and the basis for having a new benefit. As many people will be aware, there has been a significant debate about the whole mobility component question, which we have not really touched on today. I think that has raised significant concerns, and that could have been handled a lot better.

It is fair to say that in the more recent stages of the process, as colleagues have mentioned, the engagement with the Department has been better. However, there is a still an undercurrent of media focus on this which is really deeply unhelpful. On occasion, some of the data which are press released by the Department for Work and Pensions is feeding that particular misconception.

Q168 Harriett Baldwin: I will get to that in a moment, if I may. I want to ask Neil, specifically, a question. Obviously, the Department has said that it is putting disabled people and the organisations that represent them very much at the heart of the development process, in terms of the descriptors for PIP and the consultation on the proposals. Yet you have expressed such dissatisfaction with the consultation process that you have threatened legal action. I just wondered why you felt a legal challenge to the Welfare Reform Bill and this particular process was justified.

Neil Coyle: It is almost going back one step. The Government announced the abolition of DLA for working-age disabled people. It will be abolished, so those people who are concerned are perhaps right to be concerned about what comes next, and there is still an opportunity to change that. Our members and trustees obviously took the decision to press for issuing a letter of claim to the Department for Work and Pensions. It was not just about-

Q169 Harriett Baldwin: Issuing a-sorry?

Neil Coyle: A letter of claim. A letter of claim is pre-judicial review, so you issue a letter of claim to lay out the nature of your concerns. Our concerns were focused on the process of choosing to target this particular benefit in this particular way-for a clear 20% reduction in expenditure on the working-age group. Why was it not a different percentage? Why was it not the full DLA take-up, for example? We have legitimate questions about how the Government reached the decision to do this and how they consulted on how they would undertake that process, based on whether the Department for Work and Pensions was meeting its own legal obligations under the Equality Act to promote equality of opportunity for disabled people and for carers, for some of the reasons I outlined earlier.

The Government suggested that there was 20% slack to come from this without necessarily analysing the potential impact. We have talked about a lot of this today. What happens to disabled people who could have accessed DLA, whether or not they do now, and are removed from being eligible for support by a new benefit? What happens to families? What happens to the public services? We have seen the level of anxiety among disabled people. Our member organisations and the people who contact us are very concerned about what could happen.

Q170 Harriett Baldwin: I totally respect your role in the democratic process, but abolition of DLA versus what is being proposed are two very different things. Do you think your role could have been exacerbating the perception among recipients that this is ending completely?

Neil Coyle: That is a very fair question. Were we scaremongering-I think that was one of the terms used by the Department for Work and Pensions? I would have to say no. The reason we chose even to investigate the legal option was because, in the initial period, particularly the first 12 months from the announcement of the 20% reduction, there was a total-I would not say exclusion, but engagement and consultation was not bearing any fruit at all. The Department had 5,500 responses to its own consultation, and 1,750 individual disabled people and others got in touch with us to talk about it. All of the concerns, and all of the questions we were asking about whether people had looked at what this could mean for x, y and z, were being totally ignored in the drive to implement the 20% cut.

That is not to say that the Disability Alliance just sat back and said, "Oh, we’ll wait for this and go for judicial review." We facilitated several meetings between the Department for Work and Pensions and groups of our member organisations to make sure that we were still part of that process. We have been on the PIP assessment development groups, which have been looking at implementation, how to communicate with disabled people and how to make sure that people understand what is about to happen. We have been participating in all of that dialogue. We have been involved in the consultation, as I have mentioned, on behalf of ourselves, NCIL2 and Radar, and all our members. We bring our members into the debates we have on Government policy.

On the back of not having any explanation for the Government’s agenda, rationalisation for the 20% cut or analysis of the impact on disabled people and carers in particular, we said, "Look, we are not getting anywhere through consultation and engagement." So at that point-this was on 1 July-we issued a letter of claim. We said, "These are our significant concerns. We would like you to address them. You still have time to address these concerns before we have an Act and regulations." You cannot legally challenge a Bill in Parliament; you have to wait until you have an Act and regulations. If we still felt that our concerns were unaddressed and that significant numbers of disabled people, carers and others were at risk and would be denied the promotion of equality of opportunity, and if we felt that the Department for Work and Pensions had not met that legal obligation, we could still approach judicial review. Would we like to? No. We are a very small charity, and it is a massive undertaking to challenge the Government through the courts. It is not where we want to be. We are still participating in the dialogue and consultation. We hope to see more significant improvement.

Q171 Harriett Baldwin: Okay, I am going to open it up to the more generic points that Paul was beginning to bring up earlier. In the context of changes from DLA to PIP, but also in terms of the Incapacity Benefit migration to ESA that is happening at the same time, what should we be saying in our report to the Department? In our previous report on ESA migration, we asked the Government to take great care to provide context on any statistical releases. The majority of people who claim Incapacity Benefit will be claiming DLA, but there will be lots of people who receive DLA who are not on Incapacity Benefit. What should we be saying in our report to try to ensure that when the Government communicate in either of those areas that they really try to be as clear as possible? Should they put in more or less context? Do you agree that it is an area rife with potential for inaccurate reporting?

Paul Farmer: I think it is absolutely an area rife for inaccurate reporting: we have seen an awful lot of that already. Someone gave us an example in our consultation work about the value of DLA. The value of DLA is a message that has been totally lost in this process. There are very positive stories to be told about the way in which people are able to contribute to society with the support of the benefits system, including DLA. That side of the story is wholly lost in what appears to be a focus on fraud, error and bureaucracy. Nobody wants fraud or error and most people do not like any more bureaucracy than is absolutely necessary in the system. However, there are some significant opportunities to present a much more positive approach to the contributions that disabled people can and do make to our society.

In a broader policy context that is seeking to support people with disabilities to work, the message that the average employer currently receives about disabled people and, more broadly, people on benefits-because unfortunately those two communities are being conflated-is that these are people on the scrounge and not entitled. The message is, "Don’t employ them because they’re lazy." I am sorry to use such strong language, but that is a message that many people tell us they receive when they try to find work. There is a huge job to do for disabled people who already experience significant barriers in finding work, which is currently not being helped by some of those messages.

There are a couple of very specific things. People in receipt of benefits are, of course, on a database within the DWP. I think there are significant opportunities to communicate with those individuals about some aspects of the process, and to be reassuring about the nature of the process. People are concerned that they are going to be reassessed immediately. I think some clarity about timeline would be helpful. People are concerned, as you have said, there are other issues happening at the same time. Some understanding about those processes and recognising the distress that this can cause, and getting that right, could be really important. There is a real opportunity here to get this process right, but if it is rushed and is insensitive to the needs of disabled people it could be badly wrong.

Q172 Harriett Baldwin: I have one final point on language. At the end of this process, we will have gone from a situation where someone could be labelled as on incapacity benefit with Disability Living Allowance-which seems loaded linguistically with fairly negative connotations-to having Employment and Support Allowance and Personal Independence Payment. Does that linguistic journey help in any way in terms of communication and what you aspire to for the groups that you represent?

Amanda Batten: It certainly could. There is a real onus on the Department when it is releasing statistics around both of those benefits, to provide more explanatory notes and context. It can inadvertently fuel quite misleading reports in the media. The kind of language that you used there-the names of the benefits-is not filtering through to media reports. I was struck by some research by the Strathclyde Centre for Disability Research, looking at media reporting around disability, comparing coverage in 2004-05 with the last year. It found that articles on disability benefit and fraud had doubled in that time and that there had been an increase in pejorative language around disability. I think that is filtering through, because in the focus groups that they did as part of that research, the participants thought fraud was much higher than it is around disability benefits and cited the media as evidence for that. Many people suggested things like 70% fraud levels on DLA when it is 0.5%.

There is a real problem, and we have a lot of calls to our helpline from people who are quite distressed by some of the language. It has quite practical implications for people; there was one caller who had a child with autism, lived in a very rural area and relied on her neighbours for lifts. One neighbour apparently said, "I don’t know why we need to give you these lifts all the time, because you’re entitled to all this stuff-aren’t you being given a car?" That was following an article around how everyone with ADHD3 gets a mobility car. I think it does have quite practical implications for people, and the DWP has a responsibility.

Eugene Grant: I would definitely echo Paul and Amanda’s comments. As well as the wording of the benefits themselves, which is important, what is more important is the social narrative that is in the media and that comes from Government. It is about the release not only of statistics but of case studies, because the case studies that are released dictate the story, and we know that some of these case studies come from the Department. Even though you can have a benefit like DLA, which at 0.5% fraud is much lower than some of the other non-disability-related benefits, all it takes is a statistic and a case study and suddenly you have a Daily Mail headline, or a headline in another publication. The fact that the Government’s objective around PIP is to ensure that disabled people are able to overcome these barriers that stop them contributing is very welcome, and that needs to be strongly communicated. The tone at the moment is quite negative, and there is lots of research from think-tanks that shows the attitudes to benefits and reciprocity is dwindling, so that needs to be combated with a very positive communications campaign.

Geoff Fimister: In Scotland there is a campaign called "Stick Your Labels", which all the main political parties are signed up to. It is campaigning specifically against negative stereotyping of claimants. It would be wonderful if we could have something like that south of the border.

Q173 Chair: Until somebody else mentioned it down here I had never heard of it, and I am not sure whether Sheila knew about it either. So certainly you can have a campaign that does not necessarily have any resonance outwith-or even within-the political sphere. Sorry, I interrupted you.

Neil Coyle: One label that the Department for Work and Pensions press office and Ministers routinely use is "taxpayer". It creates a false divide; in routine articles there is a DWP press officer quoted as saying that we need a welfare system that is fair to the taxpayer. We all agree with that, but where the barrier is drawn is almost suggesting that disabled people are not contributing at all. We talked about it today; DLA is available in work, and people who get contributory ESA have worked, so to use the narrative that disabled people do not pay tax is deeply unhelpful and comes back to the points that Paul has already made.

In terms of building trust, better communications and better information, we also have a role to play. We welcome being active participants in providing trusted information and support to individual disabled people, be it on an impairment basis or pan-disability like at Disability Alliance or Disability Rights UK. We welcome that role, but we also need some resources from DWP in order to be able to fulfil that. That was not made available under ESA for a very significant change. We hope it will be available under plans for PIP or whatever the new benefit ends up being called.

Q174 Chair: Before I lose the Committee completely, because the House is now sitting, can I just ask a round-up of questions on the delivery of the PIP assessments and who will carry them out? Can I just be clear what your position is? You seem to be complaining that there potentially could be too many face-to-face assessments of the same person for each of the different benefits, whether it is for social care, for DLA-or PIP, I should say-or the WCA. At the same time, I think from what Eugene is suggesting, because they are quite different benefits-part of the problem with the press is that they conflate them all as though they were all the same benefit-with, quite rightly, different criteria, you could not cut down the bureaucracy by having just one assessment for all of this. You need different kinds of assessment, but it is a case of not having them all as face-to-face assessments. Is that a fair summing up of your position?

Neil Coyle: We probably have most faith in one locally based assessment, be it for social care, that goes on. There are risks of that approach-lots of different risks-some being that, obviously, if it is just focused on care you are bringing in a means test, which would have to be taken out of the equation, but also that there is a risk to Government, because local authorities might then be more likely to allocate greater national resources and less local resources.

Would we, Disability Alliance-I say we, but I am not speaking for the whole panel here-prefer one assessment? Probably yes, based on the experience disabled people tell us: that they would rather agencies better shared information and that there was one assessment able to take into account in and out-of-work benefits and any social care and other support allocation.

Eugene Grant: I think there is definitely an appetite for reducing the number of assessments that disabled people have to go through. Bearing in mind, throughout these two hours, we have been talking quite a lot about the assessment for one benefit and the difficulties of that, and also the assessment for another benefit-the ESA and the WCA-that shows how tricky it is to get an assessment for one benefit right. To get a single assessment that would lead to multiple benefits would need some very careful consideration.

Q175 Chair: Which leads me on to the next question. We have heard the name Atos, which has become a rude word for disabled people across the country. But there must be other organisations, both in the private and public sectors or from the voluntary sector, I should say, that carry out these assessments. Are you, as organisations, either individually or collectively identifying where those organisations are or speaking to organisations that could deliver a different type of assessment-one that you would be happy with and that would not have all the flaws of the WCA that everybody universally accepts has had a really bad or rocky introduction? Are you working with any of those to find out what that kind of assessment would look like?

It would also have to be an assessment that the Government would be happy about-that would cut down on fraud or error and actually get the right amount of money to the right people-and that would deal with all the horror stories we are hearing in the paper and the case stories of even disabled people saying, "I know there are people who are fiddling the system".

Paul Farmer: I suppose there are two sides to this, aren’t there? One is the creation of the assessment process, whether that is the form or the questions that are asked in the face-to-face assessment. At the moment, those are determined by the commissioner, which in this case is the Department for Work and Pensions.

Within the ESA model and the WCA model, we have identified three component issues, one of which is the flaw of the process. Here, we have a really good opportunity to define that process in a different way from the way in which other processes have been approached. The second, if you are going to go down a contractual route, is around the choice of contractor, and the nature of the commission and the nature of the contract about the way in which that process is delivered.

The third area is about the quality and transparency of the deliverer itself. A lot more building into the contract and encouraging all providers to be more transparent about what is working and what is not working would help significantly. We have relied on the individual experiences of, in our case, people with mental health problems but, more broadly, people with disabilities, who have told us about their experiences of other assessment processes and have told us how difficult they found them. A greater degree of transparency between the commissioner and the provider would have identified that problem a lot earlier on.

The framing of the commission, assuming that that is the route that is gone down, is going to be really crucial. There are different providers who can deliver it in different ways, but there needs to be sufficient flexibility in the commission for that to be possible. So it is a two-sided issue.

Geoff Fimister: I would entirely endorse that. Those are exactly the points that I would have made. It is a question of getting the assessment process right and making sure that the people who you are paying to carry it out are doing a good job of it.

Eugene Grant: Ultimately, it is about what you are trying to do with the benefit. If you are trying to ensure that people who face barriers get support to overcome them, you need to contract people who understand where those barriers come from, as Jane Campbell4 pointed out in her speech. Therefore you will need to contract an organisation, or at least a group of professionals, that will have a broad understanding of that, not necessarily just medical examiners.

Amanda Batten: That is perhaps where organisations such as ours can give support. Our experience of public service contracting indicates that the contract for this would go to a provider that has a national scale on the same sort of lines as Atos. Our organisation and local organisations can help in terms of providing training and support for those providers, because, as a big, homogenous, national contractor, having the expertise and training to be able to differentiate those assessments and communicate with such a wide group of disabled people will be a real challenge.

Q176 Chair: Ultimately, any assessment process will say "No" to some people.

Amanda Batten: Yes.

Q177 Chair: And those will be the people who are unhappy. For them, the assessment process has not been good, because it has said "No". At the moment, we still have 40% of those going off to appeal and 40% are winning, and that is not good. I think that somebody talked about getting the assessment right the first time. Are the Government not suspicious that your organisations would try to widen the criteria to include too many people, which obviously has implications for the public purse?

Amanda Batten: I do not think so. I think that it is about ensuring that the assessment is fair for everybody. If you have a face-to-face assessment with someone with autism who, because of the impairment in their social imagination, does not necessarily have insight into their own needs or is unable to communicate the barriers that they face, that person is put at a disadvantage if the assessment just relies on them being able to do that. It is about making sure that the assessment is adapted, so that disabled people can give an accurate and clear account of the difficulties that they face.

Geoff Fimister: We see the process going in the opposite direction, and I try to resist this, essentially. On the ESA point, you see people found fit for work when they realistically are not going to get a job, and the implications for them are serious. The debate is often conducted as if it is a question of people being got off out-of-work benefits and into work, and that is not what is happening. There are three bits to it. You are first precipitated on to much lower rates of benefit or, if, for example, you are moved from a contributory to a means-tested benefit and you have a working partner, potentially no benefit at all. Although we are entirely in favour of people being given opportunities to work-that is tremendous-we are not in favour of people simply being shunted on to much lower levels of benefit.

Eugene Grant: We are not necessarily saying at all that you need to expand the caseload. We are just saying that if you get the assessment right, you ensure that you have the right caseload. If you have the assessment right, it could be higher or lower. You do not know until you have a fit-for-purpose assessment and then roll it out through a very careful process.

Chair: I think that we could have gone on for much longer. We always get bogged down in the first section. Thank you for coming along this morning. If you feel that there is something that we have not covered and you have a burning desire to write to the Committee, please do, because any written evidence will be included with the oral evidence you gave this morning.


[1] Work Capability Assessment

[2] National Centre for Independent Living

[3] Attention Deficit Hyperactivity Disorder

[4] Baroness Campbell of Surbiton (in the House of Lords debate on the Welfare Reform Bill.)

Prepared 16th February 2012