Health and Disability White Paper

(Urgent Question): To ask the Secretary of State for Work and Pensions if he will make a statement on “Transforming Support: The Health and Disability White Paper” published by the Government.

Yesterday, the Secretary of State published “Transforming Support: The Health and Disability White Paper”. This White Paper is a significant milestone, demonstrating the Government’s commitment to ensuring that disabled people and people with health conditions can lead independent lives and fulfil their potential. It sets out an ambitious policy reform package that will transform the health and disability benefits system, and help disabled people and people with health conditions to start, stay in and succeed in work.

We will deliver action in three ways. First, we will transform the future benefits system so that it focuses on what people can do, rather than on what they cannot, including by removing the work capability assessment. In our new system, there will be no need to be found to have limited capability for work or work-related activity in order to receive additional income-related support for a disability or health condition. We will introduce a new universal credit health element that people receiving both personal independence payment and universal credit will be entitled to, which will enable people to try work without the fear of losing their benefits. We will roll this out carefully from 2026-27, and we will ensure that no one currently on universal credit and with limited capability for work or work-related activity will lose out once they move on to the new system.

Secondly, while de-risking work is one side of the coin in supporting disabled people and people with health conditions into work, we know that we also need to provide more employment and health support for this group. The White Paper sets out how we will introduce a new personalised approach to employment support and engagement, with the aim of helping people to reach their potential and live a more independent life. We are investing in additional work coach time and tailored support. The Chancellor also set out yesterday that we will introduce a new programme called universal support, which will provide wraparound support for individuals and employers, as well as additional money to provide more mental health and musculoskeletal treatment for this group.

Thank you, Mr Speaker, for granting this urgent question.

Although we know that most of the proposals set out in the White Paper will not be implemented until the next Parliament, a significant number of ill and disabled people will be impacted. We see the Government using a carrot-and-stick approach, which will leave many sick and disabled people with the stick and the real threat of the ramping up of sanctions, as indicated by the Chancellor during his Budget statement yesterday. Just this week the Information Commissioner’s Office ruled that the Department for Work and Pensions must release “sensitive” research into its sanctions regime following the Work and Pensions Committee report, which found that there is very little evidence that the sanctions work. Instead, it found that they have a significant impact on the health and finances of those who have been sanctioned. There are real consequences to some of the Government’s actions.

Nobody is arguing that scrapping the work capability assessment is not welcome. However, relying solely on the PIP assessment is not the solution, given the current experiences of PIP assessments, which show that they are deeply flawed; the DWP is losing or conceding in four out of five appeals. Moreover, the Institute for Fiscal Studies said yesterday that up to 1 million people currently on incapacity benefits could lose out as a result of scrapping the work capability assessment and relying on using PIP only. Also under the new proposals disabled people will not automatically be in the “no work-related requirements” conditionality group and will now be subject to the decisions of a work coach.

We also did not hear any additional investment in the Access to Work scheme, so can the Minister say how many people will be impacted and what the cost is of these new proposals? It is estimated that 1 million people will lose out. How are the Government intending to mitigate that? Will the PIP assessment framework change or stay as it currently is? Given the poor decision making on so many PIP assessments, what action is being taken to fix the flawed decision-making process and the assessment itself? How will the DWP ensure that the policy proposals do not remove vital protections against sanctions and risk pushing people further into poverty? Finally, when are the Government intending to publish the sensitive research into the sanctions regime?

I am hugely appreciative of the hon. Lady, who always speaks with great passion on these issues. I welcome the cautious welcome from her about the broad thrust of the reform we are trying to deliver, which is to remove the structural disincentive to work. That manifests itself in the many conversations I have with disabled people and their representative groups, when they tell me that many disabled people would like to try to work, but fear doing so and then losing their entitlement if it does not work out. That is not an acceptable situation, and it is right that we change it. I hope that as a House, as we move forward with these reforms, we can come together and deliver something that achieves that objective, which is plainly the right thing to do.

It was before my time in the House, but I well remember debates in previous years about the work capability assessment. It is welcome that we are scrapping the work capability assessment through these reforms. The reforms also offer an opportunity to focus on quality when it comes to the PIP assessment and on making sure that we get the right decisions first time. The hon. Lady will note, for example, that one of the commitments we have made in the White Paper is trying to match specialist assessors with people’s conditions. That is another thing people have regularly been asking for, and we are determined to test that and see what difference it can make. Again, this is all about being responsive to the feedback we have received.

On the issue of sanctions that the hon. Lady mentioned, I know that the legal case she touched on is under consideration by Ministers elsewhere in the Department at the moment. No doubt we will come forward and say more about that in due course, but I want to be clear that it is not my intention or the Department’s intention to force anyone to do something that is not right for them. We are committed to personalised, tailored support that meets individual needs and aspirations. The Secretary of State will talk about that in more detail during the Budget debate later. A lot of that will be voluntary. I would hope that people will want to engage with universal support and will want to engage with Work Well, because this is about trying to help and support people. For people with health conditions, for example, this is a way in which we can work harder and tirelessly with them to help them get better. Work is of course an important determinant of better health outcomes. The White Paper is explicit in saying that we will move forward with this in a way that is appropriate for individuals. For those where work is not appropriate, they will not be expected to do it.

I warmly welcome the announcement of the Government’s new universal support programme. Does my hon. Friend agree that it will help disabled people in my constituency find an appropriate job, backed by £4,000 of resources per person? It will further enhance the exceptional work done by Disability Confident and the Barnstable Jobcentre Plus. Might he come to visit and see for himself?

I commend my hon. Friend for the work she does on the ground in her constituency, working constructively with the jobcentre and employers to help facilitate employment opportunities. I am really excited about the opportunities universal support will bring. We know from existing schemes that where people are supported in taking and then retaining roles, it is hugely powerful and effective in bettering their health and employment outcomes. That is precisely what we are doing through universal support with those 50,000 opportunities. I am excited to work with my hon. Friend on implementing that in her area, and I would of course be delighted to visit and see more of what is going on on the ground.

I call the shadow Minister.

No one will mourn the passing of the work capability assessment; Labour has been calling for reform of that for a long time. It needed to change, because people’s lives do not fit neatly into a binary system of work or no work. However, disabled people and those with serious health issues want and deserve support and reassurance in work and out of it, and what people fear, understandably, is that under the guise of reform their lives will be made harder and vital financial support might disappear.

The devil is always in the detail, so I have a few questions for the Minister. The PIP assessment is designed for a totally different purpose from the WCA; how will he reconcile those completely different systems? What will happen in future to those people who do not currently receive PIP—those on the limited capability for work and work-related activity element of universal credit, and particularly those with short-term and fluctuating conditions? Unless it is the Minister’s intention that some 750,000 people will lose £350 a year, an alternative needs to be in place; what will that alternative be?

Do the Government believe that it is fair that the hundreds of thousands of people with disabilities that prevent them from even engaging in work-related activity should receive less financial support through UC than people who are entitled to PIP, and if so what is the basis for that justification? If the intention is to allow work coaches to use discretion in all such cases, how will we ensure consistent decision making and decision making that is based on a proper understanding of serious health conditions and their impact on daily life? What provision is made within the Department to ensure that capacity for that is in place?

As transparency and openness are so essential in building confidence, will the Minister now publish the report on the operation and effectiveness of sanctions? By publishing the White Paper, the Government have started this debate; the minimum we need now is openness and clarity about how those ideas are intended to work in practice.

May I first welcome what I think is a cautious welcome from the Opposition for the reforms that we are seeking to advance? I think it reflects some of the utterings that we have heard from Labour Members over recent weeks and months about the direction of travel they want, recognising that there will be people for whom work is not appropriate. I repeat the point that, where that is the case, we will not be expecting people to engage with this support, but it is right that that structural impediment to work is removed from the system, that those who want to work are supported in being able to do so, and that we make sure that we have a system that is responsive to that and that also has health as a focus. I hope we can move forward on a cross-party basis on those terms.

On the specific point about PIP, again it is important to recognise that we will look very carefully at whether those individuals who are not currently in receipt of PIP meet the PIP criteria, and we will act accordingly. Also of course, anybody who thinks they may be eligible for PIP is able to apply for it. I would always encourage people who might be eligible for any given benefit to apply for it.

On the point about the health top-up, I can confirm that the award rate for the new UC health element will be at the same level as is currently awarded to those who have LCWRA. I again make the point about the approach that we intend to take: the reform will be carried out on a staged geographical basis, beginning with new claims in 2026-27. Of course, legislative steps will need to be taken to bring this reform to fruition, but there is much to welcome and I hope we can come together. On the point about the legal case, as I said earlier, colleagues elsewhere in the Department are considering next steps and will come forward in due course.

I welcome the announcement in the Budget. As my hon. Friend will recall, I wanted to introduce the universal support package alongside universal credit. Its purpose was to intervene and help to change people’s lives, which was what was missing for all those years and needs to be there now. It was intended to replace what has been a very difficult benefit, originally introduced by Labour along with the work capability assessment. Throughout that time, I wanted to see universal credit together with universal support to help people get over their difficulties.

According to a recent survey on sickness benefit, 700,000 people want to find work, but the limits to what they can do seem so difficult that they fear losing their benefit. This measure, hopefully, should change that. However, I urge the Government to do the final bit, which is to bring in the other group who are still receiving employment and support allowance and not yet receiving universal credit, so that the interventions can help them and we can have a progressive, positive way of helping people with sickness or disability to fulfil their potential and lead productive lives, because work is a health treatment.

My right hon. Friend speaks with passion and authority on these issues, and he has a wealth of experience of delivering meaningful change in the welfare system that has improved the lives of millions of people. This is the next chapter—the next step in that journey—and one thing I know for sure is that I shall want to draw on my right hon. Friend’s experience and expertise and hear his ideas about how we can get this right. Like him, I am excited about the opportunities that universal support can provide in matching people to roles and supporting retention, with all the wraparound care and support that goes with that. There is a great deal of best practice from which we can learn. I was in Tower Hamlets yesterday, and saw a fantastic example involving NHS talking therapies. I want to ensure that more people are able to engage with that sort of support.

I call the Scottish National party spokes- person.

Why do this Government intend to expose more disabled people to the punitive benefits sanction regime? It does not work, and the automation of sanctions will make the position even worse.

Why was there no guidance in the White Paper on statutory timescales for reasonable adjustments to enable more disabled people and those with long-term conditions to work? The SNP and many stakeholders continue to call for urgent improvements to end the payment gap. Why is there no mention of that? Why will the Government not ensure that flexible working is a day one right by default, rather than the onus being on the worker? Why is there no uplift for legacy disability claimants who were missed out during the pandemic? PIP assessments are already failing many disabled people and forcing them into challenging decisions which are ultimately overturned. Why is more being added to PIP assessments?

Will the Minister consider using dignity, fairness and respect as the White Paper proceeds into legislation, as the Scottish Government do?

I would argue that dignity, fairness and respect underpin all the work that I do as Minister for Disabled People, Health and Work, all the work of my colleagues in in the Department for Work and Pensions and, of course, all the work of our officials, who approach their responsibilities with real seriousness and want to help and support people in a way that is appropriate for them. That goes to the heart of these reforms.

This is about a tailored approach, whereby people are helped into work when that is appropriate for them. When we can improve people’s health outcomes, we ought to be doing so in a joined-up way. No one will be forced to do anything that is not appropriate for them. As I said earlier, I want people to feel that they would want to engage with the employment support we are offering, and that is reflected in the fact that so many disabled people tell us that they wish to try these opportunities, but fear losing their support if it does not work out.

The PIP journey is now down to 14 weeks, but there is more to do in that regard. I am not complacent about it, and I want to drive forward work on digitalisation. Let me also say that I have a very constructive working relationship with the Scottish Government Minister with responsibilities in this area, and I absolutely commit myself to working with him as we deliver this reform. I know I am set to meet the hon. Lady next week, when we may be able to follow up some of these points.

The Government’s initiative to emphasise the need to improve health outcomes is fundamental to this. May I draw my hon. Friend’s attention to today’s edition of the Daily Express and its Justice for Jab Victims crusade? A two- page article describes the problems that thousands of people are experiencing as a result of receiving covid-19 vaccines that have not worked out in the way they had hoped.

I appreciate my hon. Friend’s welcome for our proposed reforms. I have not seen the article to which he refers, but I will certainly have a look at it once I have left the Chamber, and I shall be happy to speak to him separately about it.

I call the Chair of the Work and Pensions Committee.

There are very welcome measures in the White Paper, although a lot of the detail is still missing. The work capability assessment is to be scrapped, starting in three or four years’ time, and replaced with

“a new personalised health conditionality approach”

to assess entitlement to what the Minister just referred to as the “health top-up” in universal credit. That sounds like a new assessment of some kind. Can he tell us what it means?