Welfare Reform Bill

My Lords, this Bill seems to have been an awfully long time on the way, so to speak, but I am as pleased as the Minister that it is here at last. A few points give me concern. I hope that they will be clarified by the Minister at this stage—or, perhaps, he can write to me, because I have many questions—and that we will be able to improve the Bill during its passage through this House. For many years, I have been concerned about the manner in which claims for incapacity benefits from people with a diagnosis of CFS/ME, fibromyalgia, organophosphate poisoning, multiple chemical sensitivities and other diseases that are multi-symptomatic and difficult to define have been dealt with by the Benefits Agency. Despite an enormous amount of peer-reviewed scientific evidence from researchers and clinicians from all over the world, the view persists in this country that they are psychosocial behavioural problems and that there is no need to look too closely at causation or for biological signs of organic illness. Recently, I have been a member of a panel, led by Dr Ian Gibson MP, which inquired into the current state of research into CFS/ME in the UK. We heard evidence from many sources, perhaps the most distressing of which was from sufferers of CFS/ME who were severely ill and who had been sidelined by the social security system because nobody would believe that their illness was real. Such people are usually bed-ridden, often living alone and isolated from the community, and the aids that they need are unattainable. We were told that that had resulted in at least one death and several suicides. This is a welfare reform Bill. I do hope that the reforms made will take into account the seriousness of an illness that far too many men, women and young people in this country suffer, and that will offer them the security of knowing that at least the most basic of their needs will be provided for. I will confine myself to Clauses 8 to 15. I am most concerned about the very large number, at least 27, of applications of the Henry VIII clauses, which will make it extremely difficult for either House to reject major secondary legislation that will affect the lives of many disadvantaged citizens. As the noble Baroness, Lady Thomas of Winchester, said so strongly, and as stated often in this House, that is not a satisfactory way to legislate. Experience has taught me that, unless those responsible for the examinations are sympathetic, it is very likely that claimants suffering from the illnesses that I have listed will be given short shrift. I have written frequently to the Minister’s predecessors and have challenged them at the Dispatch Box—that includes the noble Baroness, Lady Hollis, who I am pleased to see in her seat, the noble Lord, Lord Hunt of Kings Heath, and even the noble Lord, Lord Skelmersdale, who resisted pulling my leg this evening. Inevitably, original decisions on claims have been overturned. I cannot immediately recall the proportion of refusals overturned on appeal, but my noble friend Lady Murphy said that the figure was70 per cent, a huge figure. It leads to an enormous amount of stress for claimants and is a huge waste of public money. If the new system can be rationalised to reduce both those factors, I, for one, will be delighted. It grieves me that I receive many communications from frightened and anxious people or their carers. Clause 8(2)(b) states that regulations will, "““define the assessment … [of] the extent to which a person who has some specific disease or bodily or mental disablement is capable or incapable of performing such activities as may be prescribed””." Most of the illnesses that I have mentioned involve symptoms that fluctuate in severity and duration. Some sufferers get better, others do not. It is known that claimants will prepare themselves for an interview or medical examination by resting beforehand, and it may be that they perform well at the time. However, it is extremely likely that they will suffer a setback which may involve several days of serious disability. How are those who are to make the determinations to decide whether the claimants are lying in bed because they are lazy or because they have one of those ill defined conditions? Most of the people in this group whom I have encountered have been very distressed about their illness and keen to get back to work and to lead a reasonable social life. They are frequently frustrated by the relapsing nature of their illness. In fact, it is their eagerness to get going again that often leads to such relapses. Clause 8(3) requires evidence to be provided. I would be grateful if the noble Lord could indicate what that evidence might be. Under the current system, the evidence of the patient’s GP or consultant is frequently disregarded. Whose evidence will the assessors believe? Will the Minister kindly explain the need for two almost identically worded provisions, subsections (1) to (4) of Clauses 8 and 9? Will he explain also the difference between ““limited capability for work”” and, "““limited capability for work-related activity””?" As regards Clause l0(1)(b), I have sought in vain for a clear definition of a, "““member of the support group””." That phrase has been used several times this evening. What is that support group, and will the Minister consider defining it in Clause 23? Will he explain more fully what the Government have in mind in subsection (2)? Is it the Government’s intention that the healthcare professionals mentioned in subsection (7) will be appointed on the same basis as they are currently; that is, that the work will be subcontracted to a private company? What type of training will the professionals receive and from whom? One of the current problems is that examining doctors do not always have a good grasp of English, particularly when a patient has a strong regional accent. As the noble Baroness, Lady Murphy, said, often those doctors are not capable of distinguishing between different sorts of illnesses. Perhaps a computer would be better. Can we be given an assurance that that will not be a problem in the future? Regarding Clause 11(2), what will be the qualifications of the people responsible for conducting the work-focused interviews? Subsection (7) states that an interview will be conducted by the Secretary of State, but I am sure that that cannot be the case. Who will it be? What would be the position of one of the Secretary of State’s officials who, under this legislation, persuaded the claimant against his better judgment to take up a work-related activity which resulted in a serious deterioration in the claimant’s condition? I ask that because I am aware that, under some circumstances, cognitive behavioural therapy and graded exercises are recommended for people suffering from depression and chronic fatigue syndromes—with some success. That is not necessarily the case regarding people suffering CFS/ME, because, although they may be depressed and fatigued, they may have also a number of other symptoms that may not be picked up in a medical examination, and which can be exacerbated by exercise. Clause 13 provides for an action plan in connection with work-focused interviews. Subsection (3) makes provision for them to be provided to the person who is subject to a requirement to undertake work-related activity. Are those plans to be agreed with the person involved? I have read and re-read Clause 14(1) and cannot understand its meaning. I would be grateful if the Minister could translate it into plain English. The Bill is both necessary and timely. The system for paying benefits to people who are sick or out of work has become much more complex than it was when I worked in the Ministry of Pensions from 1959 to 1962. In those days, it seemed that everyone got two pounds and 10 shillings a week, whatever their condition, and the pension was two pounds and 10 shillings a week as well. I look forward to the Bill’s progress through this House.