Welfare Reform Bill

I know that noble Lords and the disability lobby are keen to ensure that we consider both physical and mental health conditions when deciding whether a customer has limited capability either for work or for work-related activity. I hope that during the passage of the Bill to date we have emphasised the importance of both kinds of conditions. Indeed, a key reason for the review of the PCA was to ensure that mental health conditions received the same weight as physical conditions, remedying an imbalance in the existing PCA. I will look at the assessment for limited capability for work first; it is dealt with in Clause 8. During the earlier passage of the Bill there was considerable interest from the lobby on whether we would be combining scores for physical and mental health as part of the assessment of limited capability for work. As the Committee will remember, I announced at Second Reading that having considered this matter further and listened to the arguments put forward by stakeholders, we will allow the point scores for mental health and physical descriptors to be added together. That has been reflected in Regulation 3(3) of the draft regulations for Clause 8, which have been shared with noble Lords. I am very keen to emphasise that point today and to make sure that it is very firmly on the record, if it is not already. The findings of the PCA review on combining scores were inconclusive. One of the findings is that there is no robust evidence base for assuming that a combination of mental and physical functional limitations causes greater disablement of a person in such a way that we should combine and increase physical and mental scores to allow that person to meet the benefit entitlement threshold. It also found that there were differences of opinion on this matter between the experts involved in the review. Given that we currently combine physical and mental health scores when assessing whether someone is entitled to incapacity benefit, we have decided that we would need more evidence to support any decision to change this approach for ESA. The amendments proposed by the noble Lord are unnecessary. The use of ““or”” rather than ““and/or”” does not limit us to considering these conditions separately, allowing us to combine scores should we wish to do so; and, as I said, the draft regulations under Clause 8 provide for the combining of scores. We do not need to change the wording for that to be enshrined in the Bill. I will now turn to the assessment for limited capability for work-related activity, dealt with in Clause 9. Although the Clause 8 and 9 assessments are similar in name and are carried out at the same time, they are concerned with different concepts. The former assesses whether a person has limited capability for work, and therefore whether he is eligible for the benefit; and the latter, whether it is reasonable to require him to take part in work-related activity, and therefore whether he is suitable for inclusion in the support group. The two assessments are carried out in different ways. A person demonstrates limited capability for work if he scores 15 points or more in the test of limited capability for work. As I said earlier, that could include a combination of scores from physical or mental descriptors or both. But there is no direct correlation between a person scoring 15 points or more in the test for limited capability for work and that person being an appropriate candidate for membership of the support group. Limited capability for work-related activity is assessed in an entirely different manner—by the customer satisfying one of 46 functional descriptors found in the schedule to the draft regulations under Clause 9. The levels of functional limitation used in these descriptors, which again relate to either physical or mental functioning, are much higher than many of the descriptors used in the test of limited capability for work under Clause 8. That is because only people who are so severely impaired that it would be unreasonable to require them to undertake work-related activity will be placed in the support group. Only one of the 46 descriptors needs to be met to qualify for entitlement to the support group. This descriptor could relate to either physical or mental functioning. Where customers meet a combination of both mental health and physical descriptors under the Clause 9 test they will of course still be determined as having limited capability for work-related activity, but as there is no point-scoring system in Clause 9, the notion of combining scores of any type—physical, mental or both—is not required in the assessment of limited capability for work-related activity. However, we will of course look at the effects of physicaland mental functional limitations when deciding whether somebody meets any of the support-group criteria. The noble Lord, Lord Skelmersdale, threw in a question about migration and the PCA. People who migrate will be fully assessed by the revised PCA at their first review after migration. I hope that that clarifies that point and that I have reassured noble Lords about our intentions. I believe that these amendments are unnecessary and I therefore urge that they should not be pressed.