Welfare Reform Bill

We strongly support this amendment. As the noble Lord, Lord Skelmersdale, said, it brings us to a discussion about an entitlement to an assessment under the admirable Access to Work scheme for those with a diagnosed mental health problem which impacts—as the amendment says—on their ability to undertake work. Last year the funding of Access to Work was doubled but there is no evidence yet to suggest that it is working particularly well in the mental health field, as the noble Lord has just said, or for people with learning difficulties, although I accept that the latter category of people are not specified in this amendment. What is clear is that far too few employers understand what Access to Work is all about. If there is some understanding about help for those with mobility problems, there is even less understanding about help for those with mental health problems. The amendment would ensure that all ESA claimants in the employment group would be entitled to an assessment with a view to determining the necessary adjustments needed under the Access to Work fund to enable them eventually to find and then keep a job, which is a very practical way of helping both claimants and prospective employers. As MIND has said, Access to Work does not support individuals to "sell" themselves to prospective employers at present as it is not perceived to be part of an individual’s "capital". Often, the slow bureaucracy puts people at a severe disadvantage. Another very important voice in this whole debate is the committee we have just been talking about—the Social Security Advisory Committee, which says that the engagement of small and medium-sized enterprise employers with the whole issue of the reasonable adaptations that need to be made to overcome barriers for disabled people has not been considered in enough depth. In particular, it stresses that the needs of those with fluctuating mental health conditions should be considered more fully. I shall come back to that in a moment. The committee makes the point that engagement with employers is important, as is the education and training provided to personal advisers in providing services to claimants in this position. As I have said before, that has been something of a leitmotiv through this whole Grand Committee. Coming back to the mental health issue, two groups of people with severe mental health problems have been brought to my attention in the past few days, about whom there is great concern. There is a letter in today’s Guardian about it. These are mostly people with schizophrenia and those who are bipolar. These are serious but fluctuating conditions with a wide range of characteristics. It is quite possible that claimants who suffer from either condition will be in the employment rather than in the support group, and will therefore be expected to be on the journey into work by undertaking work-related activity. I could have raised this issue under a Clause 8 stand part debate, but I hope that noble Lords will agree that it is relevant enough to this amendment to raise it here. Others in this Grand Committee know far more about schizophrenia than I do, but I have taken some instruction from my noble friend Lord Alderdice, who is a psychiatrist. He said that when people who have this condition are becoming ill they are not likely to be self-aware and there is a strong likelihood that they could be sanctioned for not undertaking work-related activity. Those who work in the field are extremely concerned about this possibility and, although it is not strictly relevant to the amendment, I hope the noble Baroness will address this concern. As the Guardian letter says: ""We need a system in which people suffering fluctuating conditions are able to move in and out of work without fear of punishment or loss of income. It will require flexibility in a properly funded system, government support for employers, an integration of non-coercive support, therapy and care for people with mental illness. Instead of the Bill contributing to the problem of mental illness in Britain, it could become part of the solution"." The last sentence is important because it demonstrates that the kind of support outlined in part in the amendment is what people are calling for, and not that those with fluctuating mental health conditions should be exempt from seeking work. One scheme which is having some success in the pathfinder project is the condition management programme and I wonder whether there are any plans to expand it under the Bill. An offer for paid-for adjustments through the Access to Work fund would make prospective employees with a history of mental health problems much more attractive to employers. What could this mean in practice? It could mean providing in the short term a potential employee with a personal mentor or a job coach, or, in the longer term, a counsellor or support worker, or even a travel companion to and from work. The more I look at the amendment, the more important I believe it to be. Making the Access to Work scheme fully portable and likely to be available before a person has left the jobcentre would also be a very positive step. I look forward to the rest of the debate and to the Minister’s reply.