Welfare Reform Bill

I oppose the Question whether Clause 12 shall stand part of the Bill. My remarks will apply also to Amendment No. 74. Clause 12 envisages that claimants of employment and support allowance will undertake work-related activity as a condition of continued entitlement to the full amount of benefit for which they have been assessed as being entitled. My purpose here is to draw attention to the almost certain failure of the new employment and support allowance scheme in reducing the number of people with mental health problems who are dependent on the new benefits. I emphasise that I am one of those people who sincerely want the Government to succeed. I regard my top priority as the chairman of a mental health trust as ensuring that we introduce the sort of initiatives that will enable people with mental health problems to get into work and to lead as normal a life as possible, as their condition permits. So I am not opposed but in favour of the objectives of this legislation. However, we all know that this matter is far from straightforward. As the Social Exclusion Unit noted, the barriers to employment for people with mental health problems are considerable. They include low confidence, limited earning power and, thus, the fear of loss of income. That is a crucial point for these people. Initially, many of them will not work for more than perhaps 12, 14, 15 or 16 hours a week on low pay. So the income level is a serious matter for them, given tax credits and so on. Also, there are low expectations among jobcentre staff, which we know about; and there are the attitudes of employers, which is a huge problem. When I attended a recent meeting of employers, a director of human resources said, ““My job is to make sure that we do not employ any of these people””. I guess that that is a fairly common attitude. All of that is in addition to the overwhelming fear of destitution if people move from benefits into work and it does not work out for them—they then have the problem of restoring their benefits. The best guide to the likely success of the welfare reform programme is, as we discussed earlier, the Pathways to Work pilots. They were relatively well resourced and included the work-focused interviews. Some 12 per cent of those claimants had the benefit of so-called ““condition management””, a term which, I understand, was applied to different kinds of support that could help a person become suitable for employment. It is of particular interest that, even with condition management, Pathways did not achieve a significant improvement in claimants’ job prospects if they had a mental health problem, as I think we came close to clarifying earlier. If the Pathways pilots failed to make a significant impact on the employment of people with mental health problems, we can be quite sure that the less-well resourced scheme proposed by the Bill, in which the work would be contracted out, where there would be payment by results and incentives for contracted firms, will not help this substantial group. This system cannot work. The question is: does this matter? Yes, it does. First, people with mental health problems comprise about 50 per cent of incapacity benefit claimants. However well the scheme functions for physically incapacitated claimants, the Government will not achieve their target of reducing by a million the number of people dependent on ESA. Then there is the cost of human failure. We know that people with mental health problems are the most stigmatised and excluded of all disabled groups. It would make an enormous difference for many families and others if half a million people who are currently dependent on benefits could be supported back into work. Also, if people with mental health problems in employment were, through the right approaches, helped to maintain themselves in work, that, too, would save so much misery for so many families and individuals. All of this is within our grasp—that is the whole point of this debate. We can do it. I found myself in the rather strange position of paying tribute to my noble kinsman, Lord Layard—that is certainly a new term of endearment that I shall use on special occasions. It is he who has brought together the evidence to show that, as a nation, we can make a significant impact on the employment of this stigmatised group, thus saving billions of pounds for the Exchequer and for the economy. The DWP will of course be the main beneficiary from all of this. So what are we proposing? We propose that people suffering depression or other mental health problems, whether as employees struggling to hold on to a job—and that is important—or as benefits claimants, should be offered up to 16 sessions of evidence-based psychological therapy. NICE guidelines point firmly in the direction of CBT as the therapy likely to have most benefit. The guidelines also indicate that self-help and computerised CBT could be helpful for some people. I was pleased to note that NICE recommended family therapy, given that I practised it many years ago and I am very aware of the power of that short-term and, therefore, inexpensive modality. If the Government’s welfare reform package is to succeed, contractors and jobcentres working with this client group must have access to local, evidence-based psychological therapy services, so that anyone with mental health problems and, no doubt, other problems, can be referred for effective help as soon as they apply for the new benefit. Better still, a GP should be able to refer people as soon as they stop work and go off sick. Ideally, an employer should do so before that; as soon as someone comes forward and says, ““I am struggling. I have anxiety and depression””, it should refer them, and on they go. That will require a national programme to increase the availability of staff trained in evidence-based psychological therapies. In the absence of such support, it is fanciful to imagine that the Welfare Reform Bill, by placing conditions on entitlement to benefit, will magically drive people with mental health problems into employment. The purpose of this clause stand part debate is to highlight the risk of failure, and to seek an assurance from the Minister that he will urge the Department of Health and the Treasury to finance a nationwide evidence-based psychological therapy service to ensure the success of this vital policy. If successful, the Bill could play a significant role in implementing the Government’s social inclusion agenda. All these things hang together. If, however, jobcentres are not able to refer claimants of ESA for evidence-based therapy, I urge the Minister to consider whether Clause 12 should be replaced by a clause that makes clear that people with mental health problems, even relatively moderate mental health problems, should not be involved in the conditional approach to benefits. The point here is that the symptoms of depression, anxiety, schizophrenia or other disorders which render that person of limited capability to work will also affect their capability to undertake work-related activities. You have to do exactly the same sorts of things; answering letters, turning up on time and so on. If the person is too unwell to answer letters and phone calls or to arrive at an appointment on time, they are likely to fail the conditions outlined in Clause 12. That is the fundamental point that we have been discussing on and off today. We are all after the same ultimate objective: to enable people with mental health problems, as well as those with physical problems, to work, when possible. I hope that the Minister will agree to do all in his power to ensure that the crucial evidence-based therapy is made available, and that he will make sure that regulations are drafted to ensure that claimants with crippling symptoms, whether physical or mental, are not unjustly penalised by the conditionality that is so central a part of the Bill.