Welfare Reform Bill

Absolutely. There is a whole range of conditions of which Tourette’s is a very good example. My hon. Friend is right to draw the House’s attention to those problems. I would also make the point that the range of conditions—incorporating hidden disabilities, learning disabilities, mental health problems and so forth—is such as to require a considerable amount of training in order that any assessor or doctor may understand those problems and make an adequate assessment. Let us consider what other organisations say about the problem. Mind says that"““the majority of people who carry out PCAs will be locums. Most will be GPs who have done a day’s work and will do PCAs in addition””." It states that the assessors"““certainly do not have much in-depth knowledge of mental health problems in the experience of our advisors who work with people with mental health problems””." Mind continues by noting that it"““spoke recently to one of our welfare rights advisors. She attended… 50 PCAs with various clients and in only one case did she find the person to have any understanding of what the issues were, to treat””" the client"““with respect, and to conduct the assessment at a pace that could give the person the opportunity to discuss as much as was needed””." Mind’s view is that, as a minimum, assessing GPs should have NVQ level 3 in mental health training. Citizens Advice has particular concerns about the ability of Jobcentre Plus personal advisers to identify appropriately and accurately the support needs of people with fluctuating and unpredictable conditions, or those whose conditions are likely to get progressively better or worse over time. Customers with mental health problems were seen as particularly challenging and even more experienced advisers did not feel confident working with them. As my hon. Friend the Member for Daventry (Mr. Boswell) said to me yesterday, this is not just an academic exercise. Some 40 per cent. of people on incapacity benefit have mental health issues as their primary condition, and if people who have them as a secondary condition are included, the number rises to nearly two thirds. So understanding mental health issues is key to effective reforms of the assessment process. A further concern is the relationship between the medical assessor and the decision maker. In Committee, the Minister said that the decision maker is not there to second guess Atos Origin but to check that procedures have been followed.