List of Recommendations
1. As we have taken the relatively unusual step of conducting our inquiry while parliamentary scrutiny of the relevant Bill was under way, we trust that the Government will take our conclusions and recommendations into account in its formal consultation on the revised assessment criteria announced in January and then in drafting the relevant Regulations, which will set out the detailed structure and rules for PIP.
(Paragraph 8)
Policy objectives
2. We accept the argument that DLA requires reform. There is some evidence that the benefit has insufficiently clear criteria and is not always well understood. The complex claim form can also make it difficult for people to make a claim. We therefore support the Government's intention to address these issues.
(Paragraph 42)
3. There is not a proper system for reviewing DLA awards: 24% of working-age DLA claimants have either had no change in or no review of their award for over a decade. While official fraud and error levels are comparatively low, there is evidence that around 11% of awards may be overpaid due to changes so gradual over time that claimants could not be expected to report a change in circumstances. We accept that there needs to be an appropriate, consistent and clear system for reviewing awards.
(Paragraph 43)
4. Some witnesses believed that the necessary changes could have been made within the existing DLA structure. The Government's view is that this would have required changes to primary legislation and that there are advantages to a "fresh start". We agree that introducing a new benefit under a new legislative framework could offer the opportunity to improve support for disabled people while addressing the problems with DLA which the Government has identified. However, we believe the starting-point for reform should be to design a new benefit which meets its objectives in recognising the additional costs which disabled people incur. It is unfortunate that a background of budget cuts has created unnecessarily high levels of anxiety about this reform amongst DLA recipients. (Paragraph
44)
5. We are also concerned that the Government is basing its assumptions for the scope for reducing working-age caseload on the fact that there was growth of 29% in total DLA expenditure between 2002-03 and 2010-11. It is important to bear in mind that a substantial part of this growth arises from demographic change, including the increase in the number of people over state pension age who retain their DLA. PIP will only apply to working-age claimants, where growth is closer to 16% after taking account of demographic changes. We would welcome clarification from the Government on how these statistics can be reconciled with the savings assumption, in response to this Report.
(Paragraph 45)
Media coverage
6. The Government's view seems to be that the negative tone of press coverage of benefit claimants is unsurprising since it merely reflects the public mood about the integrity of the benefits system. However, the Government should not ignore the fact that public opinion can also be positively influenced by the media and we believe it should take the necessary steps to ensure that its own contribution to media stories about benefits is accurate and contextualised.
(Paragraph 53)
7. While we accept that the Government does not control the editorial line taken by the media, we believe it should actively encourage accurate reporting of its own statistics on benefits. Direct quotations from Ministers can give undue credence to inaccurate or misleading reports. We recommend that DWP establishes internal protocols to ensure that significant statistical releases are accompanied by a press release setting out the context and providing background explanatory notes, together with quotations from Ministers where appropriate.
(Paragraph 54)
8. We look forward to the publication of the new UK Disability Strategy. It provides an opportunity to address the apparent growth in negative perceptions about disability. We recommend that it contains proposals to tackle negative reporting of disability in the media and a Government strategy to get the message across that disabled people can and do make a positive contribution to society, very often as taxpayers.
(Paragraph 58)
Communication and consultation
9. The Chancellor of the Exchequer's announcement of the intention to reform DLA made the Government's communications task a difficult one. This difficult beginning was compounded by the poor initial consultation on the Green Paper which was not only shorter than recommended by the Government's own Code of Practice on Consultation but also took place over the Christmas period. The Bill was published before the consultation period ended, and well before the responses could be analysed. The Government's published response appeared not to reflect the full extent of respondents' concerns, and the full responses were not published.
(Paragraph 63)
10. Since then, DWP has taken steps to involve disabled people in the process for devising and implementing PIP and this has proved to be effective to some extent. The Department has listened to many concerns: it dropped the proposals to end payment of the DLA mobility component for care home residents after the Low Review and to extend the three-month qualifying period under DLA to six months under PIP. It is important that DWP now puts even more effort into engaging disabled people in the introduction of PIP and that it clearly demonstrates the extent to which it has responded to their legitimate concerns.
(Paragraph 64)
Payment of DLA mobility component to care home
residents
11. We welcome the Government's decision not to proceed with its plans for withdrawal of the DLA mobility component from residents of publicly-funded care homes. We congratulate all involved in Lord Low of Dalston's review, which established a lack of evidence for the measure and a need for clear guidance to local authorities. We recommend that the Government now issues clear guidance about funding mobility needs and the role played by DLA and PIP mobility. We believe that this sequence of events clearly demonstrates the need for the Government to conduct thorough research, including detailed impact assessments, before the announcement of measures that could have a negative impact on disabled people. However, we accept that the Government listened to the representations of those affected.
(Paragraph 71)
Assessment of the impacts of the introduction
of PIP
12. We believe that the Government cannot fully assess the potential knock-on impacts of DLA reform on other providers of services for disabled people. There is evidence to suggest that DLA plays an important role in helping recipients to manage their conditions, thereby reducing the need for other services. If a DLA recipient is found ineligible for PIP, yet still needs support, we would not agree with the Minister that there is already an adequate alternative package of support available to all current working-age recipients of DLA who may be affected by these reforms.
(Paragraph 75)
13. DLA is unique in providing a universal benefit specifically designed to contribute to the extra costs of disability. If it is removed from some claimants who still have these extra costs, they are very likely to need to draw on services provided by other public agencies. We recommend that the Government carry out more detailed assessment of the wider impacts of DLA reform and consult further with local authorities and the NHS on the implications for their provision of services for disabled people, now that the updated impact assessment has been published.
(Paragraph 76)
14. DWP has described other organisations' projections of the likely impact of DLA reform as "simply speculation". However, accurate analysis by interested bodies has been extremely difficult and claims have been made devoid of any factual basis in the absence of DWP impact assessments. Until very recently, the information released by the Government included no estimate of the number of people likely to be affected or any scenario modelling to indicate the likely impacts on different groups.
(Paragraph 93)
15. The fact that Government information has been released at a late stage, and the consequent "speculation" by interested bodies, has also exacerbated public concern about the likely impacts of the introduction of PIP and worked against the Government's aim of reassuring disabled people that reform is intended to be a positive step for them. It is important that the Government and interested bodies learn from this. In future, major benefit reform proposals should be accompanied by detailed and comprehensive analysis of the likely impacts as soon as practicable.
(Paragraph 94)
16. We are unable to ascertain, from the latest figures released by DWP in January, from which DLA rate combinations the projected PIP caseload reduction of 500,000 claimants will come and therefore which current DLA recipients are likely to have their benefit withdrawn altogether. We recommend that, in its response to this Report, DWP sets out further case studies to show how the introduction of PIP is likely to affect current working-age recipients of each rate combination of DLA.
(Paragraph 95)
Qualifying period
17. We welcome the Government's decision to support a three-month qualifying period for PIP rather than extend it to six months. However, there is evidence of significant financial hardship caused during the current three-month DLA qualifying period, particularly for those with sudden onset conditions such as the loss of limbs after a car accident. We see no reason why claimants with sudden onset conditions, which medical evidence can show to be likely to last at least 12 months, should not receive support immediately. We recommend that DWP implements a facility for early eligibility which could operate in the same way as that for terminal illnesses.
(Paragraph 102)
The draft PIP eligibility criteria
18. We welcome the changes made to the first draft of the PIP assessment criteria. We believe they demonstrate that the Government has listened to concerns expressed by disabled people and their representatives. DWP deserves credit for the way it has involved them in the "co-production" approach it has adopted to the development of the PIP criteria.
(Paragraph 128)
19. We fully support the Government's intention to ensure PIP is fairer, more consistent and takes a more holistic, "social model" account of the impacts of disability. One of the Government's declared aims for PIP is to improve on the assessment used for DLA. So far, mobility descriptors still concentrate heavily on ability to move a fixed distance and do not include barriers to accessing public transport, or the difficulties of some locations for individuals where routes to shops, public transport etc are particularly hilly or stepped. The PIP assessment criteria, as drafted, tend towards the medical model of disability. We recommend that, as part of the consultation with disability representative organisations on the second draft of the criteria now under way, the Government considers how activity descriptors could take account of the impact of such factors as housing, access to public transport and hilly locations.
(Paragraph 129)
20. We recommend that the Government undertakes a further trial of the assessment criteria once they have been revised following the consultation and that the results of the trial are published before the criteria are laid down in Regulations under the Welfare Reform Bill.
(Paragraph 130)
PIP eligibility assessment
21. We were encouraged by the language used by the Minister in describing the PIP assessment as a "conversation" between claimant and assessor. It is vital that the PIP assessment does not take the same mechanistic approach, based on an inflexible computer system, originally adopted for the WCA in 2008. We believe that healthcare professionals administering the assessments should take an empathetic approach that allows claimants to describe the impacts of their disabilities or health conditions on their everyday lives. We recommend that DWP sets out this principle in the published guidance for healthcare professionals on the assessment process. This approach will have implications for the time allowed for face-to-face assessments, which in turn must be reflected in the contract arrangements with the third party providers of the assessments. We would seek assurances from the Government that this will be taken into account in the contracting process.
(Paragraph 139)
22. We agree with the Government that more reassessment of claims is necessary than has been the case with DLA. However, too frequent reassessment risks wasting public money and causing stress and anxiety to disabled people. The personal interview should play a part in assessing many PIP claimants. Face-to-face assessment should include the option for home visits where this is agreed to be appropriate. These steps may help to avoid cases going to appeal, with the accompanying costs and delays in resolving claims.
(Paragraph 152)
23. We consider that there is a case for automatic entitlement for some claims. The WCA is being carried out annually in a number of cases, which can cause considerable stress for some people. The case for annual assessment is less compelling for PIP than for WCA which is judging people's ability to re-enter employment. We recommend that there should be flexibility in the frequency of PIP reassessment and that the Government monitors the impact of this.
(Paragraph 153)
Face-to-face assessments
24. Once the initial assessments for PIP have been completed in the first geographical area, we recommend that the Government looks again at the value of face-to-face assessments for PIP claims where the condition is severe and unlikely to change. The Government should reconsider whether, in many cases, reliance on medical evidence gathered over a period of time and based on detailed knowledge of the claimant would have more validity than the snapshot of a claimant's condition and its impacts on their ability to participate in society which can be gained in a relatively short interview with a healthcare professional who is not an expert in their condition.
(Paragraph 154)
Contracting
25. We recommend that DWP contracts with private companies for delivery of the PIP assessment directly link the payment of public funds to the production of reliable assessment reports that are "right first time". We welcome the framework approach which has now been adopted for benefit assessment contracts and request further details about how it will operate, in response to this Report.
(Paragraph 159)
26. Experience with the Work Capability Assessment has demonstrated the need for large Government contracts with private suppliers which involve sensitive health and disability assessments to be properly monitored. We therefore request further information on how the Government plans to oversee and regulate the contracts for the PIP assessments. We would also like to see the contractors' communication with individuals who are deaf-blind reflecting their communication barriers.
(Paragraph 160)
Implementation of PIP
27. The high number and cost of appeals in the original WCA process highlights the risk in introducing a new benefit assessment without full consultation and thorough testing. The challenge of accurately assessing DLA/PIP claims is arguably greater than incapacity benefit claims. The WCA simply assesses capacity to work. The PIP assessment will need to provide an accurate indication of the impact of complex conditions and combinations of conditions on participation in society in a variety of life contexts. It is therefore essential that DWP allows itself sufficient time to get the assessment right and to be able to convince disabled people and their representatives that this is the case. Implementation timescales should not be driven by artificial deadlines set by HM Treasury before the details of the reform were known.
(Paragraph 165)
28. We welcome the Minister's confirmation that DWP does not intend to press ahead with a "big bang" approach to implementation of PIP and his commitment to begin with new claims only from April 2013. We note that the Government plans initially to introduce new PIP claims in one geographical area. The area should be selected on the basis of carefully defined criteria. The period prior to national roll-out should be used to prepare a methodology for monitoring the early lessons to emerge from implementation and to ensure that recommendations for changes can be made quickly, in consultation with interested bodies.
(Paragraph 166)
29. We welcome the Government's decision to bring forward the first independent review of the PIP assessment to within two years of the assessment Regulations coming into force and to have a second independent review within four years of that date.
(Paragraph 167)
Reassessment of existing claims
30. As has been shown with the WCA/ESA process, reassessment of existing claims is even more complex and challenging than dealing with new claims. We therefore believe that reassessment of existing DLA claimants should only proceed once the Department is confident that the assessment is accurate.
(Paragraph 168)
31. The phasing in of the reassessment for Personal Independence Payment should take account of the timing for individuals of the Work Capability Assessment for Employment and Support Allowance. There is likely to be a significant overlap between the two groups of claimants and many disabled people may already have had one or more WCAs by the time the PIP reassessment is introduced. The cumulative impact of frequent reassessment on a vulnerable group of people should not be underestimated.
(Paragraph 170)
Motability
32. We
recommend that the Government clarifies, in response to this Report,
which rate of PIP mobility component will confer eligibility for
the Motability Scheme. It should also clarify whether a three-year
lease for a Motability car, signed when the claimant was a recipient
of higher rate DLA mobility component, will be terminated if that
person is found ineligible for the Motability Scheme under PIP.
We believe it is important for the Government to provide certainty
on these issues before reassessment of the working-age DLA caseload
commences. (Paragraph 172)
Child and young adult recipients of DLA
33. We welcome the Government's decision not to include child recipients under 16 years of age in the current DLA reforms. We believe that DLA for children should not be considered until the reassessment of working-age claimants has been completed and fully assessed. For clarity, we recommend that the Government give a commitment that it will conduct a full and separate consultation on any future changes to DLA relating to children.
(Paragraph 176)
34. We welcome the work DWP is undertaking on the specific needs of young disabled people aged 16 to 25. We recommend that this cohort should be the last to be migrated to the new benefit. We also believe there is a strong case for 16 to 18 year-olds to be treated as a distinct group from the rest of the "working age" population. One option which should be explored is for the reassessment at the time of the migration to PIP to take place in, and with the assistance of, the young person's school or college.
(Paragraph 177)
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