Sickness Benefits: In-person Interviews

Question

Asked by

To ask His Majesty’s Government whether they plan to reinstate in-person interviews for all applicants for sickness benefits.

My Lords, we already undertake a number of face-to-face health assessments for people applying for sickness benefits. However, as announced in the Pathways to Work Green Paper, we are planning to increase the number of face-to-face assessments while preserving alternative health assessment channels in order to meet the specific needs of people who require a different channel, for example, as a reasonable adjustment.

I thank the Minister for her Answer. This problem goes back a long time. I saw in the Times on 28 June that assessors in the department are apparently paid a bonus on interview numbers—the higher the number, the higher their bonus. This may or may not be reasonable but, at a time when there is a need to reduce expenditure on benefits and we know that in-person interviews tend to lead to a stricter application of the rules, would the Minister consider reintroducing in-person interviews before new benefits are awarded or existing benefits are confirmed?

My Lords, face-to-face assessments were stopped during Covid, as they clearly could not happen on public health grounds. They resumed in mid-2021, but the fact is that the levels have been left far too low. In the middle of last year, just 7% of assessments were face to face across PIP and the work capability assessment. That said, the assumption that the benefit bill will automatically come down if we change everything to face to face is not straightforward, based on the available evidence. I assure the noble Lord that, as he may know, in our Pathways to Work Green Paper, we committed to doing more face-to-face assessments while preserving alternative health assessment channels, because those who will not be able to do that will need a reasonable adjustment and another alternative. We will increase them as fast as possible and do it in the right way in order to make sure that we can recruit enough people and provide a good service. I am pleased to tell the noble Lord that that is our plan.

My Lords, I am all in favour of face-to-face interviews, but they would be made a lot easier if we had not seen the closure of many jobcentres prior to 2024. In the last round of closures around eight years ago, 11 Jobcentre Plus offices were shut in London alone. Many of those closures contravened the Government’s own guidelines, and it was purely a cost-cutting exercise.

My Lords, most assessments are done in assessment centres. Many of those are conducted by providers because we have to have health providers to do them. My noble friend may be glad to know that we have specific, clear rules about what an assessment centre must do. For example, it must be appropriately accessible and reasonably easy to get to—so that someone can get from their transport to the front door—as well as DDA-compliant in terms of ramps and areas of ground-floor space, et cetera. There are specific assessment centres designed to be suited to this purpose.

My Lords, can the Minister expand on the purpose of a face-to-face assessment? Is this to help people get the sickness benefit they want and need, or is it in some way to make it more difficult for people to get sickness benefit? What is the overriding reason for such attendance at an interview?

There are various ways in which you can do an assessment. The starting point is that assessments can be done on paper where there is clear medical evidence of somebody’s diagnosis and functional needs. Some of them are really straightforward. It may be for somebody who is nearer the end of life or somebody who, for example, engages a lot with a physiotherapist or a rehab team after a stroke or a brain injury, where there is clear evidence and a clear track record. There are other people where there is not any evidence for a range of reasons. In those cases, there would need to be an assessment. It can be done on the telephone, by video or face to face.

There are different reasons for different people. Some people are unable to get to a face-to-face assessment. They may be bed-bound or may suffer from a severe mental health affliction, but they can perhaps do a video interview. Some people prefer face-to-face interviews; they feel that they will be seen better and understood better. Our aim is to try to keep all channels available and to get the right balance, both to make sure that we get the right conditions for the claimant and the right decision for the Government and to make sure that we have all the people we need there in order to try to move as fast as possible on assessments.

My Lords, how does the Minister explain some of the following statistics, all of which come from government sources? The number of people expected to go on to long-term benefits will rise from 3.3 million to 4.1 million over this Parliament. Some 3,000 people are signing on every day. In our second city, Birmingham, one in four working-age adults is not working. That is higher than it was during the great depression. In those days, it was considered the greatest problem in politics; now, we just shrug. I think it was Charlie Munger who said, “Show me the incentive and I’ll show you the outcome”. What does the Minister plan to do to switch the incentives for some of the people who are choosing to go on to benefits when they are capable of working?

My Lords, I am sure that, if the noble Lord tracked those statistics back, he would see when the numbers began to rise—it was not under this Government. I know that he is making not a partisan point but a broader point; I fully accept that.

The good news is that, as the noble Lord may have noticed from the last labour market statistics, for the first time ever, we have managed to stop that growth in economic inactivity related to sickness and disability. We have a long way to go to bring that down. He is absolutely right to raise this as a major issue. We have seen such a significant rise in the number of people claiming sickness and disability benefits. Broadly speaking, one in 10 of our working-age population is claiming a sickness or disability benefit, and our population is ageing.

In terms of what we will do, it is partly about incentives. The noble Lord will be aware that we recently changed the incentives in the then Universal Credit Bill. For example, we halved the amount of money that someone gets on the standard allowance for sickness and disability and increased the standard allowance overall to reduce those incentives. The truth is that there will be some people who just do not want to work. There are an awful lot of other people out there who would love to work but either cannot find the right job or do not have the confidence, skills, opportunity or support. Our job is to tackle this on all of those fronts. We are trying to transform the whole of employment support so that it is tailored to give people the chance to get into a job, to move up in a job and to get the skills they need, which will serve them and the British economy.

My Lords, the Health Minister has reported concerns about the over-medicalisation of normal human emotions such as sadness and anxiety and the labelling of those as mental health conditions. I am sure that the Minister will know—indeed, I am sure that the whole House will be aware of this—that that is behind much of the rise in the numbers of sickness and disability claims. In the Minister’s excellent work, on which I commend her, in bringing back these face-to-face assessments, will she review the process of assessing these mental health conditions so that this can be targeted at the people who are in genuine and serious need?

The noble Baroness is absolutely right: there is no doubt that there has been a growth in people claiming support and not being in work as a result of mental health conditions, but also because of other conditions as well. There are other clear patterns, such as musculoskeletal conditions and a range of other things. That is partly about changes in our population and about trends in society.

Our job is to invest in trying to tackle those early enough. One thing that the Government have done is invest money in putting mental health support into schools. In the case of young people, let us tackle those questions early. We consulted in the Green Paper about what we will do in future, but we have announced that we are going to have a youth guarantee. We have a Question tomorrow on youth unemployment. For those who are aged 18 to 21 and are perhaps heading for sickness and disability benefits, let us find a transition phase for them where we find out what the challenges are, figure out how we can support them and then, hopefully, get them on to a path. Sadly, some people will never be able to work, but, for many people, the evidence is that good work is good for their physical and mental health—we just need to help them get into it.

My Lords, can the Minister set out how increasing in-person assessments, which we on these Benches fully support, will help reduce fraud and error, thus protecting taxpayers’ money, while ensuring another thing that we on these Benches support—that those who can work, do, and those who cannot, get the support they need? Will the Minister encourage her colleagues and the Secretary of State at the DWP to take up the serious and mature offer made by the leader of the Opposition to work with the Government in order to help them cut and reduce benefits?

The noble Baroness asks an interesting question. I do not know whether it was on her watch but she may remember that, in 2022, under the previous Government, the department ran a trial to evaluate whether health assessments conducted by different channels led to different outcomes—that is, did it matter if you did it by video, on the telephone or face to face? The trial data showed no substantial differences between work capability assessment and PIP award rates, lengths or average amounts.

Having said that, my observation is that that does not tell us whether the outcomes of individual claims were affected by the channels used. Also, at the time, there were so few face-to-face assessments being conducted that I do not think it can tell us whether the move to remote assessments under Covid had an impact on the volume of claims. Of course, behaviour changes over time, too. We have committed to increasing face-to-face assessments while preserving the alternatives; we can look carefully at whether that makes a difference.

On the noble Baroness’s broader point, there may be some way to go before the leader of the Opposition in the Commons gains the trust of her opposite number, given what has happened recently. However, I am always very happy to work with the noble Baroness; we can talk about these things day to day.