Welfare Reform Bill

My Lords, in supporting this amendment, I thank the Minister for our very helpful discussion. I believe that we are all of one mind in wanting evidence-based psychological therapies and good employment placement support to be available to people with mental health problems and others who would benefit significantly from such help. The overwhelming economic arguments in favour of government funding for those services were well rehearsed in Committee and we do not need to repeat them. We also understand the challenge for the DWP in pressing the Department of Health to ensure that it plays its part in maximising the success of the welfare reform policy. Nevertheless, this amendment would be a valuable lever at local level to generate pressure from Jobcentre Plus on primary care trusts and mental health trusts, such as my own, to provide high-quality CBT and job placement services, which they should be providing to honour the Government’s manifesto and their social inclusion commitments. However, we know that mental health is always a Cinderella service that picks up the morsels left under the table once the demands of cancer, heart, paediatric and A&E services have been met. The logic is overwhelming. If the Government succeed in reducing by 1 million the number of people dependent on employment and support allowance, that will save billions, some of which could no doubt be spent on acute medical services. If the Government do not make the investment in the first place, they will be shooting themselves in the foot. We know from all the research studies that 50 per cent of people with depression and anxiety—the majority of the half of incapacity benefit claimants—who receive evidence-based cognitive behavioural therapy will recover. As the noble Baroness, Lady Thomas, has suggested, the case for spending £750 per person is irrefutable. How would the amendment achieve the Government’s objective? If Jobcentre Plus could not apply sanctions at any stage of the process to a claimant assessed as needing CBT or other interventions that would enable them to become capable of work, surely it would enter into negotiations with its local PCT and mental health trust to ensure that the relevant therapies were provided. That detail cannot be included in the Bill. Therefore, without wishing to ask too much, I hope that the Minister will support this amendment. I also hope that he will assure us, first, that regulations will specify that the work-focused health-related assessment will include questions designed to identify whether each claimant suffers from depression, anxiety or another diagnosed mental health problem; secondly, that the assessment will specify whether the claimant has received CBT and, if not, recommend that it should be offered; and, thirdly, that the assessment will identify those claimants with mental health problems who should be referred for individual job placement and support. That term refers to specific evidence-based support in identifying suitable jobs and preparing for interview, and support through the process of returning to work. I would be happy to make available to the Minister the research evidence showing the cost-effectiveness of that approach. The answers to questions (a) to (c) would trigger the protection from sanctions until the evidence-based psychological therapy or other support had been made available to the claimant. Anyone not familiar with mental health problems could regard such safeguards as excessive. I suggest that the results of the Pathways pilots underline the need for evidence-based interventions with the 50 per cent of claimants who suffer from mental health problems, if the Government’s welfare reform policy is to be a success. I hope that the Minister will be able to support the amendment.