Order. The sitting is now resumed. The reason for the suspension was because the statement, which under the ministerial code should have been delivered at a minimum of 45 minutes prior to the statement being made, was delivered late; I know the Secretary of State will want to look into the matter and report back to the Speaker.
First, may I apologise profusely to the House that a copy of my statement was not provided to Mr Speaker and indeed those on the Opposition Front Benches sufficiently in advance of my statement? May I also take this as my first opportunity in the House to say how saddened I was by the passing of Frank Field, a true champion of welfare reform who was always prepared to work across party? While we did not always agree on all matters, I share and admire his belief that welfare means transforming lives.
With permission, Mr Deputy Speaker, I shall make a statement on the consultation we are launching today on the changes to the personal independence payment, which aim to create a benefits system that can best support disabled people and people with long-term health conditions to live full and independent lives.
This Government’s priority is to make sure that our welfare system is fair and compassionate: fair on the taxpayer by ensuring that people of working age who can work do work; and fair on those in most need of the state’s help. Welfare at its best is about more than just benefit payments; it is about changing lives for the better.
In recent years the Government have delivered successive reforms to create a system that is fairer and more compassionate while providing value for the taxpayer. We have reformed an outdated and complex legacy benefits system and introduced universal credit—a new, modern benefit that ensures people are better off in work than on benefits. Last year we published a landmark White Paper announcing significant reforms to focus the welfare system on what people can do rather than what they cannot. We are delivering our £2.5 billion back to work plan, substantially expanding the employment support to help more disabled people and people with health conditions to start, stay and succeed in work. Our reforms to the work capability assessment will better reflect the opportunities in the modern world of work and ensure that more people get the support they need to move into employment, while protecting those unable to work, and in February we published the disability action plan to make this country the most accessible place in the world for people to live, work and thrive.
In addition, the Government have provided unprecedented help for the most vulnerable, including by implementing one of the largest cost of living support packages in Europe, which prevented 1.3 million people from falling into absolute poverty during a time of global inflationary pressures. We have increased benefits by 6.7% and raised the local housing allowance, benefiting 1.6 million households by an average of around £800 this year.
Our approach to transforming the benefits system for disabled people and people with long-term health conditions is guided by three important priorities: providing the right support to the people who need it most; targeting our resources most effectively; and supporting disabled people to reach their full potential and to live independently.
I thank the Secretary of State for his comments about Frank Field. Both I and my hon. Friend the Member for Wallasey (Dame Angela Eagle), who is sitting alongside me on the Front Bench, thought the world of Frank. I thank the Secretary of State for his tribute to a person who was completely unique in every way.
With regards to advance sight of the Secretary of State’s statement, I say: apology accepted. Labour will carefully review the detail of the Green Paper, because the country that we want is one where disabled people have the same right to a good job and help to get it as anyone else. We will judge any measure that the Government bring forward on its merits and against that principle, because the costs of failure in this area are unsustainable. The autonomy and routine of work is good for us all, for our mental and physical health—and more than that, for women, work is freedom, too.
I have read the Secretary of State’s gibes about Labour. He says that he does not know what our position is on a set of reforms that he has not set out. The Prime Minister made a speech about this issue two weeks ago, but every single day since then the Government have failed to publish the Green Paper. The Secretary of State wants my views on his, until this moment, unpublished thoughts. What was the problem? Was the printer jammed? Rather, was it that the Prime Minister and Secretary of State realised that, as soon as they published the Green Paper, everyone would realise the truth about the Government: like the Prime Minister who leads them, they are long on questions and short when it comes to the answers?
The Green Paper is not a plan; it is an exam that the Secretary of State is hoping he will never have to sit. The reason he wants to know Labour’s plan is that he suspects he will be long gone before any of these proposals are a reality. Will the Secretary of State tell me where the Green Paper leaves the Government’s earlier half-baked plan to scrap the work capability assessment, given that the idea behind that was to use the PIP assessment? He said that some health conditions can be taken out of PIP assessments. Which conditions was he talking about?
I thank the hon. Lady for her response and the gracious manner in which she accepted my apology, which is much appreciated.
The hon. Lady said that she cannot be expected to comment on the PIP proposals, but I remind her that the work capability assessment proposals went through a consultation, and we still do not know where the Labour party stands on those. We have spoken about fit note reforms, we are setting up WorkWell, and in the autumn we will trial some of those fit note possibilities. We do not know where the Labour party stands at all on those matters.
One would have thought that given the central role that PIP plays in the welfare system in our society and country, the Labour party would have some kind of view on that benefit. But we hear precisely nothing on that matter because the Labour party has no plan. The consequence of that will be that, as under previous Labour Governments, the welfare bill will continue to spiral out of control. That will fall to hard-working families up and down the country to pay, by way of higher taxation.
The hon. Lady asked about the abolition of the work capability assessment, which, as she said, is set out in the White Paper. Those measures will not be due to come into effect until 2026. We will take into account the conclusions that may be drawn as a result of this consultation when we consider that matter. She raised numerous other questions, many of which are included in the consultation. I am sure that she will actively take part in the consultation as we work towards the answers to those questions.
I was rather surprised that the hon. Lady raised the NHS. This party is spending more on the national health service than at any time in its history, with a 13% real-terms increase in spending over the last couple of years, 21,000 additional nurses and 7,000 more doctors in the last 12 months alone, and from next year £2.4 billion additional spend on mental health services, to which she referred. That is on top of the additional £4.7 billion that the Chancellor previously set aside for more mental health treatments and, at the last fiscal event, 400,000 additional talking therapies within the national health service.
A constituent who has cerebral palsy has been in touch with me this afternoon to outline how he currently uses PIP. It gives him the freedom to live independently and work full time, as he uses it to buy mobility aides such as hoists and wheelchairs. His concern is that any changes to PIP might push those costs on to the NHS and reduce his flexibility to choose what to spend the money on and when. He does not want to be pushed into a cycle of renewal that may be too rapid and therefore cost the NHS more money. What reassurance can my right hon. Friend give that this consultation will enable those sorts of concerns to be highlighted and that, in the long term, it will give more choice and not restrict my constituent’s freedom?
I thank my right hon. Friend very much indeed for that question and for raising the issue of her constituent. The reassurance I can give her is that we are aiming for the best outcomes. There will be a number of ways in which those best outcomes may be achieved—that is the purpose of the consultation—but it is reasonable to at least explore the issue of whether cash transfer payments are always the right solution, particularly given the growth in mental health conditions we have seen in recent times. The final point I would make is that we are absolutely interested in examples of situations where people have lifelong regressive illnesses from which, unfortunately, they are not going to recover, and to ask whether, under those circumstances, it is right to require them to go through re-assessments.
Following today’s statement, the announcement made a couple of weeks ago and all the proposed changes, people are scared. They are scared because they rely on these payments, which have changed their lives. They have been able to access support that they otherwise would not have been able to get. It is very clear that the announced changes are not being created by disabled people, with disabled people at their heart of the decision-making process. This is a Government consultation and then people are being asked to input into it. It is totally different from the situation in Scotland, where the adult disability payment was created with disabled people in the room talking about the best way to make the payments work and the best way to have assessment processes. Basically, the answer that came back was, “Do not do them anything like the assessment processes for PIP.”
Everybody should have the income to live with dignity, whether or not they are able to work. I am massively concerned by the comments that the Secretary of State and the Prime Minister allegedly made about people with mental health difficulties only facing the “ordinary difficulties of life”. It is very clear that anybody who is able to say that has not suffered from depression, and has not felt that absolute energy-sapping that comes alongside suffering depression or anxiety. These are real conditions. These are real things that people are struggling with. And the lack of the ability to work is just as serious for people with mental health conditions as it can be for people with physical health conditions.
I have a couple of specific questions. In relation to universal credit, it is a gateway benefit. Will the Secretary of State assure us that any changes that might be made to eligibility criteria around universal credit will be fully consulted on and fully discussed, particularly with anybody who administers benefits that are allowed through those gateway benefits?
I thank the hon. Lady for her response to my statement. I reassure her that disabled people will be very much involved in the process and the consultation. It will be a 12-week consultation and of course we will take them, their comments and representative organisations extremely seriously.
The hon. Lady’s comment about the importance of recognising that many, many people unfortunately suffer from very serious mental health challenges is extremely well made. I am absolutely determined that whatever conclusions we draw from the consultation, they should lead us to a position where the Government are better able to support people who are in those circumstances.
On whether there will be questions in the consultation on the passporting of PIP into other benefits, the answer is yes. That is something we are most certainly consulting on.
On the Scottish equivalent of PIP—this is, of course, a devolved matter—yes, the Department has been in discussions with the equivalent officials in the civil service and the Scottish Government. We are looking forward to considering, as I know the Scottish Government will be, the independent review of that benefit, which is being conducted at the present time.
Nigel Mills (Amber Valley) (Con)
May I ask the Secretary of State about his comments on the one-size-fits-all model not working if people incur very different costs from their disabilities? Surely he is not expecting people to send in invoices to prove how much support they need, so is he looking at having more tiers of award? For example, disability living allowance used to have three tiers, rather than two. Is that one of his options for trying to reduce costs?
By mentioning “one size fits all”, I am saying that we should explore whether the approach we have at the moment has the best outcomes. We have much to learn from the experience of countries around the world that have a similar benefit but go about its organisation and application in a different way. New Zealand makes payments based on invoices for equipment submitted by those who receive the benefit. Norway does not have assessments in the way that we do; it relies more on evidence provided by medical practitioners. We should go into this with an open mind. Bear in mind that there has been no fundamental review of PIP for over a decade.
PIP assessment providers confirm that worsening delays in NHS treatment are a big factor in the increase in the number of people applying for PIP. The Secretary of State has confirmed this afternoon that the work capability assessment is to be scrapped and replaced by PIP assessments. There are people who are too ill to work, but not disabled, and so not eligible for PIP. How will their support be assessed in the absence of work capability assessments?
As I have set out, we will need to look at the conclusions that can be drawn from the consultation in the context of the replacement of the work capability assessment and PIP becoming the gateway to future universal credit health benefits, as the right hon. Gentleman mentioned. These are questions that are being asked in the consultation.
Ruth Edwards (Rushcliffe) (Con)
In the spring of 2019, before I was elected, I was diagnosed with an anxiety disorder. I was extremely ill with it, and could not work for several months, so I know for myself how debilitating that can be, but I also know that with treatment and support, you can lead a fulfilling career and a normal life that is extremely rewarding. I would have been devastated to have been out of the workforce for the long term. How will the reforms in the Green Paper help anxiety sufferers to get the treatment and support that they need to return to work, and also to take back their life?
I thank my hon. Friend for a powerful and moving contribution to today’s statement. I am pleased that she is in such fine form nowadays, knowing her as well as I do. The answer to her question lies in the consultation, and the recognition that the one-size-fits-all approach is not necessarily right. Those whom she describes may well be better served by receiving treatment, rather than cash transfer benefits. That is not a preconceived outcome that I have in my mind, but it is one of the possibilities on which we are seeking opinions.
The charity Sense has criticised the Government’s narrative around disability benefits, highlighting the divisive and deeply damaging language used, which further stigmatises some of the most vulnerable people in society. Disabled people have told Sense that they are sick with worry about whether they will lose their personal independence payments, which are vital—a lifeline—for them. Given the Tory cost of living crisis that we have been living through for multiple years, does the Secretary of State not think that disabled people need more support, not dangerous rhetoric that casts them as undeserving?
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Although we have made significant progress, the disability benefit system for adults of working age is not consistently providing support in the way that was intended. It has been more than a decade since the introduction of the personal independence payment. The intention was that it would be a more sustainable, more dynamic benefit that would provide better targeted support to help disabled people with the extra costs arising from their disability. However, the nature and understanding of disability and ill health in Britain has changed profoundly since then, and the clinical case mix has evolved in line with those broader changes, including many more people applying for disability benefits with mental health and neurodivergent conditions.
Since 2015, the proportion of the caseload receiving the highest rate of PIP has increased from 25% to 36%. Some 7% of working-age people in England and Wales are now claiming PIP or disability living allowance, which is forecast to rise to 10% by 2028-29. In 2022-23, the Government spent £15.7 billion on extra costs disability benefits for people of working age in England and Wales, and the Office for Budget Responsibility has forecast that the cost will rise to £29.8 billion in nominal terms by 2028-29. There are now more than 33,000 new awards for PIP per month. That figure has almost doubled since the pandemic.
With almost a quarter of the adult population now reporting a disability—up from 16% in 2013—I believe that now is the time for a new conversation about how the benefits system can best support people to live full and independent lives. Today I am launching a consultation to explore changes that could be made to the current PIP system to ensure that support is focused where it is most needed. These options include: making changes to eligibility criteria for PIP; redesigning the PIP assessment to better target it towards the individual needs of disabled people and people with health conditions, including exploring whether people with specific health conditions or disabilities can be taken out of PIP assessments all together; and reforming the PIP assessment so that it is more linked to a person’s condition. We are also consulting on whether we should make fundamental changes to how we provide support to disabled people and people with a health condition.
We know that any additional costs arising from a disability or health condition, which PIP is intended to help with, can vary significantly and are unique to the individual’s circumstances. Some people on PIP may have relatively small one-off costs, such as walking aids or aids to help with eating and drinking, or ongoing additional costs related to their disability or health condition, such as help around the home or running a ventilator. Some claimants’ costs will be fully covered by their award, while others may find the current system does not provide enough support to meet their needs, yet the current system operates a one-size-fits-all model and does not channel people towards bespoke support tailored to an individual’s needs. We recognise that better, more targeted support could be provided by other local services.
Our plans include exploring how the welfare system could be improved with new approaches to providing support, such as: moving away from a fixed cash benefit system, so that people can receive more tailored support in line with their needs; exploring how to better align the support PIP offers with existing services and offers of support available to disabled people and people with health conditions; and exploring alternative ways of supporting people to live independent and fulfilling lives, which could mean financial support being better targeted at people who have specific extra costs, but could also involve improved support of other kinds, such as respite care or physical or mental health treatment, aiming to achieve better outcomes for individuals.
Crucially, we want to explore whether we can achieve our aims within the current structure of health and disability benefits, or whether wider change is needed. We are consulting over the next 12 weeks to seek views from across society, including disabled people and representative organisations, to ensure that everyone has a chance to shape welfare reforms that will modernise the support provided through the benefits system.
We know that these reforms are significant in their scale and ambition, but we will not shy away from the challenges facing our welfare system today. We owe that to the millions of people who rely on it and to the hard-working people whose taxes underpin it. That is what the next generation of welfare reforms is all about. These proposals will help to create a benefits system that can better support disabled people and people with long-term health conditions to live full and independent lives, and they are a crucial part of my mission to ensure that the welfare system is fair and compassionate and that it provides the right help to those who need it most. I commend this statement to the House.
PIP was the creation of a Conservative Government, so where is the analysis of what has gone wrong? PIP replaced DLA, and now we are hearing that PIP is the problem. How many more times will we go around this same roundabout? Do the Government’s plans involve treating people’s mental and physical health differently? Can he explain the legal basis for doing so? Importantly, on health itself, is this Green Paper not a huge admission of the Tory failure on the NHS, in that it takes as its starting point the fact that people today simply cannot get the treatment and care they need? What will the costs of any new system be, in particular those of any extra support of the kind he mentioned? Will we see a White Paper before a general election?
I am standing in today and for the next few weeks for my hon. Friend the Member for Leicester West (Liz Kendall), who believes that health and work are two sides of the same coin. That is the insight that the Government are missing today. I ask myself how we got here. The country today is sicker—that is the legacy of this Government. NHS waiting lists are longer than they have ever been—that is the legacy of the Secretary of State’s party. If he does not know how bad things are in mental healthcare, he needs only to ask my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). There are 2.8 million people who are locked out of work due to long-term sickness. That is the Conservative legacy: like ice on our potholed roads, the Tories have widened the cracks in our economy and society, making them all much worse.
With respect to mental health, in recent weeks the Secretary of State has decided to speak out of both sides of his mouth. On the one hand, he says,
“I’m grateful for today’s much more open approach to mental health”,
but with the same breath he goes on to say,
“there is danger that this has gone too far.”
He wants it both ways. He thinks that openness about mental health is good, but then he says the very thing that brings back the stigma.
Every time the Secretary of State speaks, he makes it less likely that people will be open about their mental health. On behalf of all of us who have ever had a panic attack at work, or worse, can I say that that stigma stops people from getting treatment, it makes getting help harder, and it keeps people out of work, not in it? A Labour Government will take a totally different approach. We will not only ensure more appointments but have an extra 8,500 mental health staff. The last Labour Government delivered the highest patient satisfaction on record, and that is the record on which we will build.
The issue that we are discussing is bigger than just health; it is also about work. Because of our commitment to serve working people, we will make work better, too. We will have the new deal for working people, improving rights for the first time in a generation, and we will drive up employment in every region because we will devolve employment support and end the tick-box culture in jobcentres. We will tear down the barriers to work for disabled people and provide help for young people. That will get Britain working again.
Harold Wilson said that unemployment, above all else, made him political. Those of us who grew up seeing people thrown on the scrapheap in the ’80s and ’90s feel the same. Every young person out of work today will never forget whose hand was on the tiller when these Tories robbed them of hope. It is time for a change, and a general election.
The hon. Lady concluded by referring to Harold Wilson’s comments on unemployment. I simply refer her to the fact that under every single Labour Government in the history of this country, unemployment has been higher at the end of their term of office than at the beginning.
Has the Secretary of State spoken to the Scottish Government about the creation of the adult disability payment with disabled people in the room, ensuring that at the forefront of every decision is dignity and respect? Those are the two key columns of the Scottish benefits system. The Secretary of State could learn a lot from that approach.