Welfare Reform Bill

My Lords, I thank the noble Baroness for raising this amendment again and for giving us the opportunity to discuss the matter on Report. The amendment seeks to probe our intentions for passported benefits within ESA. The noble Baroness also asked about the comparison between those on the contributory elements of both ESA and jobseeker's allowance. As I said previously, we understand the importance of income-related benefits to our customers, both for the income they provide in and of themselves and because they often also allow the customer to qualify for other benefits. As I made clear in Committee, we expect to bring existing passporting rules into the income-related strand of employment and support allowance, allowing access to the same range of benefits as offered by income support. The range of support includes free prescriptions and remission from other NHS charges, such as optician and dental costs, benefits such as free school meals, school uniform grants and cold weather payments, milk tokens and vitamins for young children and expectant mothers. In addition, customers receiving the income-related strand of ESA will be passported on to the maximum level of housing benefit and council tax benefit. As noble Lords know, that can make a huge difference to the income of families, particularly those in greatest financial need. Customers receiving only contributory benefit are not currently passported automatically, as we discussed, because the schemes in question are targeted support meant for those most in need, and entitlement to contributory benefits is not based on household income. However, someone on a low income who is in receipt of incapacity benefit or, in the future, contributory ESA, may still qualify for additional help through the low-income scheme. Noble Lords will understand, therefore, that there is no financial disadvantage regarding prescription charges between contributory jobseeker's allowance and employment and support allowance, as those on low income will qualify for help whether passported or otherwise. We accept that this scheme requires additional forms to be completed and we recognise that that is an issue, but it provides valuable access to free prescriptions and is designed so that no one on a low income need be unable to afford prescriptions. Additionally, from 2004, people have been entitled to full remission of NHS charges on more generous terms. Previously, people were entitled to full help through this scheme only when their income was equal to, or less than, their statutory requirements. From 2004, people became entitled to full help if their income exceeded those requirements by up to 50 per cent of the prescription charge. This means that people whose income is only marginally above income support level are now entitled to full help. Again as I advised noble Lords during Committee, as part of their response to the report of the Health Select Committee on NHS charges, the Government undertook to explore the possibility of accessing free prescriptions without the need to make a separate low-income scheme claim—a significant point. This will be looked at as part of the overall review of prescription charges. The noble Baroness, Lady Thomas, highlighted the complexity of prescription charge exemption. Looking at the list that she took us through and at all the different exemptions, it is clear that a significant review needs to be undertaken, and the Department of Health is undertaking such a review. However, when doing this, we need to be mindful of getting the balance right. The challenge is to find a way of identifying those with low incomes and ensuring that our information is up to date as people's circumstances change without being overly bureaucratic or intrusive. The Government will report the outcome of this review by this summer. In addition, as I said in Committee, the Government have agreed that, to make it easier for customers to meet the cost of annual prescription prepayment certificates, they will be available through monthly direct debits from July 2007. At the same time, four-month prepayment certificates will be replaced by lower-cost three-month prepayment certificates, something for which I know stakeholder organisations have been campaigning for many years. I just wanted to pick up on the point about sanctions. If a customer’s state of health or his physical or mental condition prevented him fulfilling a particular requirement and if this was a result of not having a prescription medication, that could count as a good reason for not attending. There is no reason why someone on low income should be unable to obtain a prescription; that is what the low-income scheme is for. In the light of the reassurances that I have given, I hope that the noble Baroness will consider withdrawing her amendment. I appreciate that she is highlighting a very important and complex issue for people with significant health needs. I hope that, through the review of prescription charges, some of these issues can be further aired.