Welfare Reform Bill

Perhaps I could ask one or two questions. The Minister is doing extremely well explaining a very difficult set of circumstances, so she should not feel held back in any way. I think that we are all struggling with this. Incidentally, she provoked in my mind a question which, although it refers to Clause 8, is none the less important. I refer to the derogated authority and duty given to the personal adviser to make the decision. In some of the early models—way back in the ONE programme, the original pilot back in the late 1980s for Pathways to Work—consideration was given to outsourcing this element of the programme all the way down to the personal adviser level. You could use the word ““privatising”” if you wanted to use slightly more pejorative language. Some of the Bill’s later provisions contemplate making substantial and challenging changes. Are the Government suggesting that this responsibility will be discharged by personal advisers who are anything other than fully paid-up and signed-up civil servants in Jobcentre Plus offices? The advisers will be performing a very onerous and important duty. I am asking questions under this group of amendments for the following reason. If we disaggregate the different aspects of the PCA and address them under Clause 8, on capability for work, or Clause 9, on capability for work-related activity, the danger is that the psycho-social dimension will be lost to the medical assessment although it is so important in making the change work. I understand all this talk about ““health professionals”” and agree it is better if they are doctors. But whoever is trained and asked to discharge this duty and consider these questions should not—and must not if this is to succeed—be restricted to a medical assessment per se. There must be a much more broadly based assessment of what is going on. If Clauses 8 and 9 are separated, I think that the psycho-social dimension goes down the middle. There is a real danger that, if this is compartmentalised and it is all done by healthcare professionals who think that they have to address restricted areas of the overarching question, then the very important and ground-breaking work will be lost. I refer to work that is done, for example, at the unit at Cardiff University run by Mansell Aylward. The department knows him well because he used to be the medical director and so he should know a thing or two about some of this stuff. He has been doing very important work that underscores the importance of a holistic approach and not one where everything is separated out into different little bits and allocated to health professionals, who all think that they are doing the right bit according to the British Pharmacopoeia or whatever. You lose the overarching importance of getting the totality of the question confronting the individual properly addressed in the original information-gathering process.