Disability Benefits: Assessments

I beg to move,

That this House has considered e-petitions 593296, 619481 and 620962 relating to assessments for disability benefits.

It is a pleasure to serve under your chairmanship, Mr Mundell. Let me begin by reading out the prayers of the petitions. Petition 593296 reads:

“People with a lifelong illness should not be subject to regular reviews for eligibility for the Personal Independence Payment (PIP) or Employment and Support Allowance (ESA). People suffering lifelong conditions should not have to prove they are still ill every couple of years.”

The petition received just over 29,000 signatures, including 68 from Carshalton and Wallington.

Petition 619481 reads:

“The Government should remove the requirement for people claiming disability benefits, such as the Personal Independence Payment (PIP), to have to go through an assessment process. Claims should be based solely on evidence from medical professionals, such as a letter from a GP or consultant.”

This petition also received just over 29,000 signatures, including 46 from Carshalton and Wallington.

Finally, petition 620962 reads:

“We want the Government to conduct a full review of the PIP process. This should look at DWP policy and the performance of ATOS and Capita, which conduct the health assessments for applicants. We believe the current process is inherently unethical and biased, and needs a complete overhaul.”

This petition received around 16,500 signatures, including 18 from Carshalton and Wallington.

I thank the amazing staff of the Petitions Committee for all the engagement work they did in advance of the debate, and the petition creators for meeting me. I thank the numerous charities, campaigners and organisations that briefed the colleagues we will hear from later, particularly those that shared particularly harrowing stories. They were brave enough to come forward and share those stories so that we can share them. It was clear from my conversations with the petition creators, charities and other stakeholders that it is absolutely time for reform and change. I hope that change will go some way towards restoring trust in the PIP process, which is shown by the conversations I have had to be severely lacking. We owe it to the claimants, who see the system as confrontational and judgmental, to change.

After all, applicants should not be made to feel as if the system is against them even before they have begun to engage with it. They should not feel like an assessor is trying to catch them out, and they should definitely not feel that gaining PIP support is not worth what many describe as the emotional, mental and physical costs of the application and assessment process. I look forward to hearing from the Minister what plans the Department for Work and Pensions has to build on its existing reforms.

I want to point out a few scenarios, some given to me by the petition creators and some from my own constituency MP postbag. I am pleased to see how well attended the debate is for a petitions debate, and I am sure we will hear from colleagues what has come through in their constituency casework. My first example is of a PIP assessment in which the applicant was applying on the basis of a mobility-based disability, yet the assessor who was overlooking the case, and who ultimately decided that they should not be entitled to PIP in the first instance, was a dental hygienist. I do not think many people would accept that a dental hygienist is a suitable assessor of someone with a mobility-based impairment, even if the hygienist has undergone some basic general training. It is probably no surprise that, from the word go, the applicant felt neither confident nor assured in their PIP assessment.

I have heard about that issue not once but a number of times in my constituency casework, and many charities and organisations raised it with me in advance of today’s debate. Claimants are being assessed by medical professionals whose field of expertise is either at complete odds with or outside the medical condition being assessed. I would appreciate it if the Minister could comment on that, and explain what the Department may be able to do formally to ensure that the medical expertise of assessors at least correlates with the condition forming the basis of the PIP application.

However, the problems seem to go deeper than that. Indeed, the medical awareness of assessors, and the wider issues of what is taken into account as part of an assessment, lead to my next point: the role of those medical professionals who best know a PIP applicant’s situation, illness or disability and how it affects their day-to-day life. In most cases, that will be their GP. It became clear from conversations—and from the appeal process, which I will come to shortly—that GPs and their understanding of the claimant should play a more central role in the initial application stage for PIP applicants.

Claimants I have spoken to do not believe that their applications and assessments are as strong as they could be if GPs took more of a role in the process, giving greater input and putting their weight behind it. They argue that the current situation, where GP insight is requested only when it is thought to be needed, gives only a partial glimpse of their situation. That is especially the case given the importance of on-the-day assessments, as a number of effects of illnesses and disabilities are more acute on some days than on others.

There is also the mental health aspect. Many applicants talk about the toll of the preparation needed for an assessment, whether mental, physical or emotional, depending on the individual and their circumstances on the day. It is only exacerbated if they find that the person assessing their application does not have any expertise in their condition.

There have been many calls from those I have met for greater involvement—known involvement—of a GP or specialist who is more familiar with the claimant within the process. That will enhance their readiness to engage with the system, as well as give any conclusions greater grounding and create an environment where claimants feel listened to, believed and empowered.

The hon. Member has made some fantastic points. Figures show that only 11% of applicants are successful in challenging the PIP award as part of the mandatory consideration process. Applicants who take their appeal to tribunals, where a judge makes a decision, are awarded their enhancement nearly 80% of the time. Does that not say that judges are becoming the doctors? Surely that is the wrong way round.

I am grateful to the hon. Lady; she makes a good point. She has glimpsed a bit further into my speech, but if she is happy to bear with me I will certainly cover that point.

Without adding too much to the list of asks for the Minister, what does he think about giving a greater role to specialists who are more known to the claimant?

I want to move on to talk about the assessment process and the wider system. Often, claimants, faced with something with which they have previously had little or no contact, will talk about a sense of interrogation or mistrust between them and the assessor—I have heard those words from claimants many times. As I say, almost every conversation I have had with a constituent or one of the petition creators has been prefaced with a line about nervousness, stress or other emotions in the lead-up to the assessment, alongside any physical or mental difficulties that a claimant may have. All too often, perhaps unintentionally or unwittingly, they are left feeling like they are a case number rather than a person.

Let me bring up another example, which is also about a PIP claimant with mobility-based problems. They turned up for their assessment and the lift in the assessment centre was broken. Despite their mobility issues and fearing that if they were not able to attend there might be consequences, they attempted to climb the stairs. After a significant amount of time, they managed to arrive for their assessment, but it had caused them a great deal of pain and a lot of stress, and the fact that they were able to get up the stairs was then used against them in the report.

I concur with the point that the hon. Member made about the sense of interrogation that many of our constituents feel when going through a process that can be very degrading. In the case of one of my constituents the assessor dropped a pen, and when my constituent bent down, picked it up and handed it to the assessor, that was used against them in their assessment. Such stories are not uncommon. We need urgent and radical reform to make sure that people are not treated like criminals for trying to seek help with their living costs.

I am grateful to the hon. Lady for that intervention. Her point about her constituent is well made and chimes with what we have heard from the creators of the petitions.

To return to my example, the lift was broken and the PIP claimant had no option but to attempt the stairs. That case is echoed elsewhere, as the hon. Member for Warrington North (Charlotte Nichols) has just described. The strongest arguments made by the petition creators, whom I met before today’s debate, were about how the assessments are conducted, the time taken to conduct them, where they are conducted and who they are conducted by. In a report on the PIP assessment process, Mind, the mental health charity, found that people felt the process tries to catch them out. I am sure the Minister will agree that if that is the perception, that needs to change; we need to listen to the claimants to figure out why that is.

We have seen some alternatives offered, which I am sure we will hear more about from colleagues from Scotland. I will not steal anything from their speeches, so I will move on.

I am delighted that the hon. Member is willing to give way. I will be making a substantive speech, but on the point about Scotland and the system that we have built, it is based on fairness, dignity and respect for claimants. I spoke to a sufferer of Crohn’s disease earlier today. She told me that her experience of trying to get PIP, very like what he has described, was traumatic and the person she spoke to had no understanding. Conversely, when she engaged with the Scottish system, the person came out and spent time with her in her home to see how she was living her life. Perhaps that is something that the UK system should do more of.

I am grateful to the hon. Lady for that intervention. I received a lot of information from my colleague and former Minister in this space, my hon. Friend the Member for North Swindon (Justin Tomlinson); I am sure he will have more to say when he gets up to speak, but I am grateful to the hon. Lady for raising the issue.

I know that the DWP has been looking into the issue for some time, so I would appreciate an update from the Minister on where the Department is. For many, the PIP assessment is not the end. It is just the start of a very long process—unless they give up completely after finding it so difficult.

My last point is about appeal tribunals. My hon. Friend the Member for North Swindon, a former Minister in this space, might be able to correct me on these statistics, but from October to December 2022, 69% of PIP applications that went to tribunal were overturned in favour of the applicant. In 59% of the appeals won by the claimant, the tribunal had reached its conclusions based solely on evidence already provided to the DWP and not on anything new. The numbers are concerning and chime with the concerns that many of us have. I know that the Government are looking at the sheer volume of education, health and care plan assessments that are overturned at tribunal; I hope that the Minister can shed some light on why the Department thinks that this is the case for appeals, what is fuelling their sheer scale and how the matter is being looked into.

As I am sure we will hear from plenty of colleagues who recount their constituents’ stories, reassessments and appeals can be incredibly draining and stressful experiences, especially if a person’s initial contact and assessment was less than satisfactory. Such apprehension leaves many feeling that there is no point in making any further appeals or requesting reconsiderations, so we simply do not know the true number of people affected. I see in his place the Chair of the Work and Pensions Committee, the right hon. Member for East Ham (Sir Stephen Timms), and I am sure we will hear from him later. That Committee’s “Health assessments for benefits” report, published earlier this year, noted that some claimants

I am grateful for the chance to speak in the debate, to the Petitions Committee for having arranged it, and to the hon. Member for Carshalton and Wallington (Elliot Colburn) for opening it. He kindly referred to my Select Committee’s report on health assessments for benefits, which was published in April, and my speech will draw on what we said in that report. We also published the Government’s response to the report in June, since when I have been in correspondence with the Minister about some of the key points that arose.

The annex to our report is well worth a look. It is based on a survey of 8,500 people, who told us about their experience of using the system and going through the assessments. They included people with lifelong conditions and people with experience of the use of medical evidence, both of which are topics covered in the petitions.

I will not comment in the debate on the adequacy of the benefits—the Select Committee has an inquiry under way on UK benefit levels that is focused on that—but I must say that over the summer a good deal of concern continued to be raised about the benefits we are talking about not meeting claimants’ extra costs, as they are intended to.

The Government have recognised the need to transform the system, including in their White Paper. I welcome many of the reforms that have been announced—including, to pick up on a point made by the hon. Member for Carshalton and Wallington, in respect of the testing of the use of specialist assessors—but the problem is that they are going to take years to implement. We need to take further action, given the gravity of the problems that we have already heard about in the debate.

A very important recommendation in our report was that assessments should be recorded by default. They should always be recorded, unless the claimant chooses to opt out of having their assessment recorded. The Government have said no to that recommendation, presumably because it would cost a little more, but I really think that is a mistake. All the assessment providers that are contracted by the Department support the recommended change, as do many of the respondents to our survey. It is the only way to get to the bottom of why things go wrong so often.

Will the right hon. Member give way?

I will gladly give way to the former Minister.

It is a difficult and fine balance, because the counter-argument is that the current approach allows people, before they turn 18 and therefore become fully responsible for their own living costs and housing arrangements, to know exactly where they are. So it is not a black and white issue.

The hon. Member is right: these are often difficult judgments, but I would like to know what discussions the Minister has had with Ministers in Scotland about how things have worked in practice there. I would also like to know what progress the Department has made on plans for 16 to 18-year-olds in work in the severe disability group. I take the point that there are often quite fine judgments to be made, but the unanimous view of the Work and Pensions Committee was that it would be right to move to a system where applicants were not required to move on to PIP until the age of 18.

The Minister will know of concerns that were raised over the summer about pre-application screening questions in the new online PIP application form, which is being developed at the moment, and of the fears being expressed that people will be wrongly put off claiming by those questions, which have not been a feature of the application process before. In winding up, will he say something about those concerns and update us on progress with the online claims system for PIP, which, in principle, is something I very much welcome.

At the moment, claimants have 20 days to return ESA and universal credit forms and a month for PIP forms, and of course they have to send all the supporting evidence in at the same time. Each of those forms runs to tens of pages. The Association of Disabled Professionals told us that this deadline is very difficult to comply with. The deadline starts from the date on the letter, not the date the letter was received. The Association said:

“it is extremely rare for a letter to reach the claimant within five to seven working days of the letter being sent.”

In the pandemic, claimants had three months in which to return the forms. I think there were considerable advantages to that. Mind told us that extending the deadline could

Is my right hon. Friend as concerned as I am about the safeguarding of our most vulnerable claimants when they apply for PIP or have a work capability assessment and about their inability in some cases to complete that process? As a consequence, we are seeing an increasing number of prevention of future death reports from coroners that are directly related to work capability assessment or the PIP assessment process?

My hon. Friend is absolutely right, and she has done a great deal of extremely valuable and important work on this subject, both on our Select Committee and in the Chamber. I do share her concerns and, as she knows, because it was substantially at her instigation, we are undertaking an inquiry specifically on the safeguarding of vulnerable claimants to look at these issues. I do share her concerns, and they are reflected in our report. The point about the time people have to send the forms back is important for people who are struggling, for the kind of reasons she sets out, to complete the forms within the very tight deadline that is set at the moment.

Shortly before we published our report, the Department published its long-awaited health and disability White Paper. The Minister knows, because he has kindly given me the opportunity to tell him about it, of my concern that people may miss out on support under the new system because they will not meet the eligibility criteria, although they do under the current system. Quite how that will be resolved is not yet clear, but can the Minister provide reassurance today that claimants and groups representing them will be involved in developing the new system?

There is much more I could say based on our report, but it is absolutely clear—it is already clear from this debate—that these assessments are not working well. We need significant changes to make them work better in the future, and I hope that, before too long, more of the recommendations in our report will be accepted than have been as yet.

It is a pleasure to serve under your chairmanship, Mr Mundell, and to follow the Chair of the Work and Pensions Committee, who is very proactive and thorough in his work. I know from my time as a Minister that the Department takes his views very seriously and constructively. I pay tribute to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) for leading the debate, which is of particular interest to many thousands of our constituents, who will be watching it closely, particularly as it comes just ahead of the White Paper.

Before I turn to the assessment process for disabilities, I want to support the point from the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) about supporting the most vulnerable. This is a very complex issue, and there is a huge amount of work to be done. I welcome the fact that the Committee will look in detail at the issue, but there is one very easy fix that would help with all applications. Whether someone is on universal credit or is going through the work capability assessment or PIP process, they should have—if they wish—a named, trusted third party. If, for any reason, they have not returned forms or telephone calls by a certain time, there could be an automatic message to the trusted third party to say, “We haven’t heard back from this person.” In some cases, that may help. There is much more that needs to be done, but I wanted to flag that point.

Turning to the coming White Paper, which this debate is well timed for, there are many lessons that can be learned. We have to be careful about some of the requests we can be tempted to make. If we contrast today’s PIP to DLA—the original legacy benefit—DLA was, in effect, all on the claimants. The forms are still long and complex now, but they were much longer and more complex, and it was all down solely to the claimant. For many people that was fine, but for many others it did not cover all their challenges.

That would be particularly useful for people who have fluctuating conditions that may vary from day to day or manifest differently—somebody with ME, for example, can have very different symptoms, experiences and health from another person with the same condition. I endorse the hon. Member’s point; I suppose if I had to ask him a question, I would ask whether he thinks it would be valuable for those people.