My Lords, I am grateful for the deliberation noble Lords have given to the Bill today. It has been the House at its very best. I will seek to address the specific points raised. Before that I will take the opportunity to welcome the degree of consensus that has already been built up on the overriding principles behind the Bill, which has been evident throughout today’s debate. I acknowledgethe concerns expressed about practicalities, about resourcing and expertise—and I note that we will have some interesting debates about the shared room rate and housing benefit sanctions.
I will go through as many of the specific points as I can in the 20 minutes allotted to me, while recognising that when we get to Committee stage pretty much everything we have discussed today will feature again. The noble Lord, Lord Skelmersdale, asked whether this was all about fears of harassing people with mental illness back to work. It demonstrably is not. This is about people we know want to work and helping them to break down the barriers that prevent them working.
A question was asked about existing customers. People already on incapacity benefits will have their cash benefits protected. Over time we will migrate existing customers to the employment and support allowance to bring all customers under the same system, helping to smooth administration and reduce complexity.
The noble Lord asked whether a claimant with mental health difficulties would be able to bring an intermediary to the assessments. The answer is yes, we would encourage customers to bring a representative to medical assessments. It is most important that the entitlement is based on decisions that have the correct evidence. The noble Lord, Lord Skelmersdale, asked about regulations. Regulations relating to Clauses 12 and 15 have not been prioritised and are not in the release later this week. I hope that regulations relating to Clauses 8 and 10 will be informative and help our deliberations in Committee.
I was asked whether the terminally ill will go on to the main phase immediately. The way we treat people with terminal illnesses is obviously a very sensitive issue and I am conscious of the arguments put forward in favour of shortening the assessment phase for this group. We continue to look at how best to support terminally ill customers and will return to the House at a later date with our response. The issue about people undergoing cancer therapy was raised by the noble Lord, Lord Skelmersdale, and my noble friend Lord Morris of Manchester. There will be no automatic process on to the support group. We donot want to write anyone off, so the criteria for entitlement to the support group are based on the functional limitation that the individual has as a result of the condition.
On local housing allowance, the question was asked whether landlords would pull out of the market. It is true that there was initially a lot of opposition from landlords to the local housing allowance, but the pathfinder evaluation has revealed that while some landlords have left the market others have joined and there has been no impact on overall supply. One of the benefits of the local housing allowance is that the landlord will not necessarily know that the tenant is on the housing benefit so that will remove some of the difficulties that may currently be encountered.
A number of noble Lords—the noble Lords, Lord Addington, Lord Skelmersdale and Lord Low—asked what is being done directly with employers to ensure their engagement with people with mental health conditions in particular. The Government are committed to supporting employers and tackling discrimination, but we need to work on the good work of organisations such as the DRC, which works to raise awareness of disability issues with employers. The DWP has recently launched a major campaign aimed at employers, especially small and medium-sized enterprises—the point pressed by the noble Lord, Lord Addington—to help them recognise their obligation under the DDA as well as the benefits that that can bring.
In October last year, the Department of Health launched a new initiative, Action on Stigma: Promoting Mental Health, Ending Discrimination at Work. At Budget 2006, the Chancellor announced a cross-cutting review of mental health and employment outcomes which would look at existing best practice, holes in provision and options for the future. The review, which is ongoing, will provide recommendations for practical solutions and we hope that it will be completed by Budget 2007.
The noble Lord, Lord Oakeshott, raised the issue of psychological therapies and of CBT in particular. I agree that psychological therapies, such as CBT, can often play an important role in helping many people with mental health problems to manage their condition and return to work. As such, we are exploring ways of increasing access to those therapies. The Department of Health established the Improving Access to Psychological Therapies programme, which aims to develop a service model for delivering a range of evidence-based interventions. There are two national demonstration sites, in Newham and in Doncaster, one of which was referred to by the noble Baroness, Lady Meacher. While we believe that cognitive behavioural therapy has a role to play, we must remember that one size does not fit all and psychological therapies may not be appropriate for many of our customers. We need to consider a range of support for people with mental health problems, and I refer again to the Treasury’s review of these matters.
The noble Lord, Lord Oakeshott, asked whether these resources were affordable. Over the next two years, we will be investing a further £360 million on our welfare reform Green Paper proposals, which include extending the Pathways to Work programme nationwide by 2008. The department is working through the implications of the spending review settlement for its employment programmes and is working closely with HM Treasury to ensure that spending plans between 2008 and 2011 support departmental aspirations. The question was asked whether we can deliver pathways while cutting staff. That is a question of prioritising resources. We have announced that the remaining 60 per cent of pathways will be rolled out using primarily private and voluntary sector participants.
The noble Lord, Lord Oakeshott, and the right reverend Prelate the Bishop of Leicester asked about the anti-social behaviour processes and the withdrawal of housing benefit. The Government have a wide range of measures to tackle anti-social behaviour as well as the provisions in this Bill. The court’s decision to evict a household is often taken for the whole household and is dependent on robust considerations relating to the needs of the wider communities and the individuals concerned.
A question about safeguards was raised. There will be safeguards to protect the vulnerable. Each case will be considered on an individual basis before a local authority pursues a housing benefit sanction. It should take a decision about whether a sanction is an appropriate tool to use or whether a different route could be used. For example, if there are serious mental health issues, a referral to mental health services might be a more appropriate route. We intend to pilot the Clause 30 provisions for two years only and will fully evaluate that before any decision to roll out the scheme is taken.
The right reverend Prelate the Bishop of Leicester raised concerns both about children and about the creation of homelessness. We recognise those concerns. It is not the policy’s intention to sanction large numbers of people. A sanction is not a punishment; it is an encouragement to accept an offer of support to households in crisis.
The right reverend Prelate the Bishop of Leicester asked what happens if support is not available. If support is not available either because the local authority does not have support structures in place or the programmes are full, then no sanction could be applied.
Why are we targeting people on housing benefit? Well, we are not specifically. No one is suggesting that anti-social behaviour is confined to those in rented accommodation or to those who claim state benefits. We do not see this measure as the primary tool for tackling anti-social behaviour; rather, it is one measure that can assist in that.
The noble Lord, Lord Oakeshott, asked how we are rolling out Pathways to Work whether it works. Pathways to Work already covers 40 per cent of the country. The remainder will be rolled out in two phases and delivered by providers. Phase 1 will be up and running by October 2007, with phase 2 by April 2008. Again, the issue of resources was raised. We have repeatedly committed to funding a national pathways service and there is no question of doing that on the cheap. This is not a cost-cutting exercise, but obviously we have to live within the spending review settlement.
My noble friend Lord Morris of Manchester, who I know was struggling to be able to stay for the whole of this debate, spoke with authority as usual. I acknowledge his expertise and welcome the benefit of his wisdom in the weeks and months ahead. He spoke, as others did, about employer resistance, which is a hugely important factor. He did say that sanctions do not work and asked why we needed them, as not many people have sanctions imposed on them. It is entirely right that, in return for our offer of Pathways-style help and support, we ask customers to engage with us. Research with Pathways customers found that sanctions are an important factor for some in maintaining their attendance at work-focused interviews. The success of this approach is demonstrated by the fact that only 1 per cent of customers in Pathways pilots have had sanctions imposed on them.
The noble Baroness, Lady Thomas, asked whether personal advisers have discretion if someone with a mental health condition misses a work-focused interview. Yes, they will have that discretion. We have introduced a series of safeguards to ensure that no sanction is imposed in cases where someone hasa mental health condition until a face-to-face discussion has been held with the customer to ensure that they understand the requirements. The noble Baroness also asked about the participation of GPs and whether they are effective. Procedures are in place to identify doctors who do not provide reports when asked. I can provide more information in Committee or otherwise if the noble Baroness so wishes.
A question was asked about investing more in mental health services. In 1999, the Department of Health published a national service framework that set out our vision for mental health care. Between 2001-02 and 2005-06, the NHS and local-authority planned expenditure on mental health services has increased in real terms by 25 per cent, and there are50 per cent more consultant psychiatrists, 75 per cent more clinical psychologists and at least 20 per cent more mental health nurses than there were in 1997.
A question was also asked about the backdating of claims. We have decided that additional support should be provided at the end of the assessment phase. For many customers, this is an increase compared with the existing system in which customers must wait for up to a year before receiving the higher rates of benefits. We must strike a balance between the needs of our customers and the need to simplify the system.
Several questions were asked about the computer system for the PCA, and whether it would be flexible enough to take non-standard answers. Yes, it will.The LiMA system is there to support healthcare professionals carrying out the PCA assessment, and a healthcare professional remains in full control and can override the system wherever appropriate.
The noble Baroness, Lady Thomas, and the noble Lord, Lord Low, asked whether there was a conflict of interest in the work-focused health-related assessment being carried out at the same time as the PCA. We do not believe that there will be. The work-focused health-related assessment is an integral part of the revised PCA. It is a forward-looking assessment of health interventions that will help to break down the barriers to entering or returning to work. However, we will pilot the work-focused health-related assessment later in the year, and will then review its timing.
The noble Lord, Lord Low of Dalston, reminded us quite powerfully of the scale of the challenges that we face if we are to stimulate and facilitate the aspirations particularly of people with mental health problems. He also asked whether the PCA should reflect socio-economic factors in deciding limited capability for work. Of course these factors have an impact on the rehabilitation of people with a disability and on their confidence and ability to enter or return to employment. Entitlement to benefit must be defined in a way that applies nationally and consistently, not in a way that is dependent on local conditions such as the availability of transport or the attitude of prospective employers.
The noble Lord asked how we will ensure that contracts do not encourage providers to help only those people with fewer support needs. That theme was picked up by others, including my noble friend Lady Hollis. The bids for Pathways to Work contracts for potential providers should include details of the skills and experience that they have that enable them to address the specific needs of all customers and the barriers against them, and the bids will be assessed against that information. Contracts do specify that a provider should not discriminate against anyone on the basis of their disability. If providers ignore those with complex or longer-term needs, they will clearly breach this requirement and will have to remedythe situation, or ultimately their contract may be terminated.
The noble Lord, Lord Kirkwood, asked about the ““work first, benefits second”” approaches which my noble colleague the Minister of State referred to in a speech. This does not represent a change in direction from the current agenda in welfare reform. The concept of promoting work over benefits has been at the heart of the Government’s agenda since 1997. The Minister of State discussed this matter at the first seminar of a series of seminars on the future of welfare in the next decade. The seminars are about exploring and discussing ideas for the future of welfare, rather than about representing specific policy proposals. The noble Lord referred specifically to the benefit process in Galashiels. Perhaps I should write to him separately on that matter.
The noble Lord also talked about the use of Section 82 and how it did not work satisfactorily before. I hope that the lessons have been learnt from that. It is very important that the resources are in place so that we get the IT systems fully up and running and tested before we press the button. There is a long lead time to that, which is why we need to go through these processes.
My noble friend Lady Hollis, in a typically thorough analysis, asked whether providers will ignore those who are harder to help: will they cherry pick under the contract facility? In any programme based on results, we can never entirely eliminate the risk that providers will cherry pick. Therefore, as part of contract management, we will need to monitor outcomes and regularly review providers' performance to ensure that any problems are dealt with early. She asked whether we can help former employers re-employ disabled people. We do not believe that that is financially viable. Our approach is about working with employers so that they understand the benefits of employing disabled people and ensuring that people are incentivised to go into work.
The noble Lord, Lord Kirkwood, asked about the details of the IT and BPRP situation. Perhaps I can cover that in correspondence in due course.
The noble Baroness, Lady Greengross, asked about permitted work for those who will never move to full-time work. We recognise the importance of part-time work to well-being and to developing self-worth and are looking at the best ways to continue to enable people who are currently far away from being able to work full-time to take part in work or work-related activity. People in the support group will still be able to undertake permitted work.
Are we going to increase the £85 limit at which deductions from the contributory allowance for pension payments start? No, we keep the figure under continual review but have no plans to increase it because we think that that is an appropriate level. The treatment of occupational pension payments is one of the most generous income disregards in the benefits system.
The noble Lord, Lord Best, asked how many claimants have a shortfall between rent and benefit in the local housing allowance pathfinders. In the pathfinders, about 39 per cent of claimants have a shortfall under the LHA, the average shortfall being about £17 a week. He referred to a switch in the average from mean to median rents. The median rent basically takes the point in the middle and therefore should address unrepresentative low or high rents at either end of the scale. Perhaps we can pick up the outcome of that when we return to the matter in Committee. On the shortfalls under the local housing allowance shared room rate, in the pathfinder areas, the average shortfall for those assessed under the single room rate has fallen from £30 per week before the LHA was introduced to its current level of £27 per week.
My noble friend Lord Morris of Handsworth spoke about the importance of the legislation and said that he was in favour of welfare, not workfare and it is certainly not about workfare. He asserts that the Bill should get full scrutiny and I am sure that that is right.
The noble Baroness, Lady Murphy, asked whether we would continue to monitor how the revised PCAs are implemented. The answer is yes. The Minister for Welfare Reform has given an undertaking that we will continue to monitor the revised PCA for the first years after its introduction. She asked about health care professionals carrying out the PCA and whether they will receive training in assessing mental health. The answer to that is yes. I am sure that we will return to that in Committee.
I was asked about access to LiMA software and why we cannot scrutinise it. LiMA software is the commercial property of Atos Origin, so it is exempt from disclosure.
The noble Countess, Lady Mar, referred to sufferers from CFS/ME. We fully recognise that CFS/ME is a genuine condition that can be very disabling. Each individual will be assessed on the functional limitation that he or she experiences as a result of their condition. She raised issues about the personal capability assessment. The personal advisers carrying out work-focused interviews will be able to defer an interview if the person is unable, on account of their condition, to attend on the appointed date. She raised a series of other questions which we shall have a chance to pick up in Committee—specifically on the detail of the regulation.
My noble friend Lord Young of Norwood Green referred to the demise of the term incapacity benefit. That encapsulates the change in ethos that the provisions are intended to introduce. I agree that this is a positive piece of legislation.
The noble Baroness, Lady Meacher, asked about linking rules. We intend to bring forward the current rules that apply to incapacity benefit to contributory ESA, including the more generous two-year linking rule for work and training that came into force in October 2006. We are seeking to bring the short-term linking rule for income-related ESA into line with the rule that applies to income-related JSA and income support; that is, a 12-week provision rather than eight weeks.
It has been suggested that we are rolling out the Pathways to Work programme on the cheap. I think I have dealt with the point: we are certainly not. It needs to be effectively resourced if it is to achieve its objective. The noble Baroness also asked about further evidence and whether the GP is always the best person. We fully intend that further medical evidence will be sought from the most appropriate source, which might well be someone other than the GP.
The noble Lord, Lord Addington, raised a range of issues about the practicalities, including questions about whether the resources are going to be in place, and if proper training will be available. The provisions in the regulations will help in some of that, but no doubt we will return to these points in Committee.
In 1997 we set out on a journey. Throughout that journey our values have underpinned our reforms and driven our agenda, but there is still more to do. Where discrimination still exists and where the right to work is still not truly open to all, we have to rise to the challenge and be radical to stay on track to deliver. That is why this Bill is so important. It is absolutely fundamental to our agenda. It promotes opportunity, it breaks down barriers to work, and it will deliver another blow in our fight against poverty and social exclusion. It will take us another step along the road of creating a welfare state which rather than foster dependency will facilitate aspiration. It is founded on a positive can-do attitude as opposed to the defeatist mentality that nothing can be done.
On Question, Bill read a second time.
Welfare Reform Bill
Proceeding contribution from
Lord McKenzie of Luton
(Labour)
in the House of Lords on Monday, 29 January 2007.
It occurred during Debate on bills on Welfare Reform Bill.
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