Welfare Reform Bill

My Lords, we are here today to praise the value of work, but I cannot help remembering that some wit said that if work was such a wonderful thing, surely the rich would have kept it all to themselves. Looking around, I see that there are many of my colleagues in the House today. We are addicted to work because it keeps us connected to a community that we share values with. I do not think we are so very different from the people I want to talk about: the 40 per cent of those who are receiving what I call "incapacity benefit"—that is, benefit that people with disabilities receive—who suffer from mental health problems. Most of them have just the same attitudes to work that you and I do. I recognise that it has become very easy for individuals to bottle out of the difficulties and the effort of finding and keeping work, and that has created attitudes that we all deplore. I want, however, to talk about the difficulties that I see in the Bill for those with mental health problems. I apologise if I repeat a lot of what the noble Baroness, Lady Meacher, has already said. I was not here for her speech because I was called away, but we have discussed this at some length, as is often the case with mental health issues. We may be saying the same thing, so please forgive me if I repeat some of what she said. Many people who have mental health problems will be suffering from the sorts of mild anxieties and depressions that mean they will benefit from some kind of positive, supportive coercion. If the Bill were administered well, that would help. However, there are a significant number with moderate or severe forms of mental health problems of an episodic or fluctuating nature that should not disbar them from work when they are well—indeed, for whom work can have a positive effect on their long-term well-being. If sensitively planned, a gradual re-entry back to work after an episode of illness can have a beneficial effect on the recovery process. These people make up a huge proportion of the numbers who are currently receiving benefits. If the Bill fails them, it will fail overall. As well as those people, I also want to talk about the drug-user provisions and the abolition of the Social Fund. At this point I should declare an interest as a fellow of the Royal College of Psychiatrists and, therefore, a member of the Mental Health Alliance, with Mind, Rethink and the Sainsbury Centre for Mental Health. Overall, the aims of the Bill are laudable—to get a high proportion of those capable into work—and I have no quarrel with the principle of conditionality or with the abolition of benefits that are handed out to people with incapacities and disabilities without an attempt to support them into work. That is all very praiseworthy. As everyone else has said, though, it depends on the regulations and on how they are interpreted by the independent providers that will run these schemes, and that is another matter. You do not need to talk to many mental health patients to realise how extraordinarily unhelpful many local jobcentre offices are. The system is extremely difficult to negotiate in practice unless you are highly competent. The Bill extends considerable powers to untrained personal advisers—and when I say "untrained", they are certainly untrained with regard to mental health problems—to direct claimants towards work or work-related activities and to impose sanctions. I have looked very hard for evidence that this has worked elsewhere in the world. A study by Meara and Frank in the United States looked at the effects of similar work scheme conditionality, following the wonderfully named Personal Responsibility and Work Opportunity Reconciliation Act. It was focused on women but did not work with women who had poor mental health or moderate to heavy drug and alcohol use. The Minister’s search engines may be better than mine, but I would like to know what evidence the proposed policy is based on. I accept that, in effect, this legislation contains a sunset clause which will enable people to review it, but two and a half years on can be chaotic, to say the least. Let us take, for example, the imposition of sanctions on people who fail to attend a workplace or interview after five working days. It seems unreasonable to expect someone whose life is completely chaotic and who may just have chosen to visit a family member to behave like that. I look for safeguards in regulations, but I find none except those that were in the Welfare Reform Act 2007. Where will the safeguards guidance be? I am particularly concerned about the training of advisers; I understand they might get a day, or possibly two, of training about mental health difficulties. This is a ludicrously short time, is it not? Can the Minister provide us with any convincing plans to show that the Government means to take the training of advisers seriously in respect of mental health problems, drug and alcohol use, and learning disabilities? The advisers will, of course, be employed by the private agencies contracted for the work. I would like, as many others have said, to know how the Government will monitor the efficacy of the various contracts in relation to not only those with mental health problems but also other groups that this legislation is intended to help. Clause 9 and Schedule 3, which relate to drug misuse, are profoundly worrying. They affect not only those who are currently dependent drug and alcohol misusers but also those with a "propensity" to misuse drugs. As for a propensity to misuse alcohol, I should think that that relates to quite a number of people in this House. Who does not have a propensity? The wording is extraordinary, because it covers such a wide range of people with a history, or with no history, but a suspicion. It includes a whole range of intrusive provisions: compulsory drug testing, compulsory attendance for treatment, and the sharing of information—which I think might be medically confidential—between police, probation officers and jobcentres. Yet the system is likely to be totally counterproductive and drive more drug misusers underground, and there is no evidence that it will work. Drug and alcohol misuse are complex, fluctuating and episodic. Every user has a different set of issues and problems. Coerced declaration of drug use, the imposition of conditionality and enforced tests and attendance at treatment in exchange for benefits seem to me to be at least morally offensive, if not actually a breach of human rights. I am not a human rights lawyer but, I hope, a practical doctor. It seems strange that drug and alcohol use have been excluded time and time again from compulsory provisions in mental health Acts. It is known to be utterly counterproductive to coerce people into treatment in this manner, largely because there is no effective treatment unless the individual is committed to sticking with it. I am sure there will be a lot more to say about that in Committee. I turn to the Social Fund, which is to be administered by external contractors. I do not like the Social Fund; grants were a lot better, but I realise that they were open to abuse. However, at least there is an independent review service with the current Social Fund. Small amounts of money are provided and you get an answer within a few weeks. It is proposed that dissatisfied folk should go to the Financial Services Ombudsman, who is going to take a long time. It seems like an enormous sledgehammer to crack a nut, just to redress minor complaints. Surely we can come up with a better system than that. Finally, I return to people with mental health problems and why they do not work. I dare say other people have mentioned these figures. We know that 60 per cent of employers will not knowingly employ someone with a history of mental illness; 75 per cent will not contemplate taking on somebody with a history of schizophrenia. I do not blame employers for this: I understand why they do not. It is not simply poor understanding and discrimination, but also the fear that people will work for a short time and then go, and so on. We need is a shift in employers’ attitudes, created by incentives, to support people through the earlier times of recovery and employment. What schemes do the Government feel there could be to encourage employers to take on this group and thereby make these provisions work more effectively?