Welfare Reform Bill

Perhaps I can come on to the issue of what is required and compulsory in a moment. I hope that I can provide some reassurance to noble Lords on that. Amendments 105 and 113 remove the possibility of including in a rehabilitation plan a requirement for a JSA or ESA claimant to attend an institution for treatment. Instead, they allow a rehabilitation plan to require a claimant simply to attend an initial assessment for drug treatment. Removing the ability to require a claimant to attend an institution for treatment and replacing this with a requirement to attend an initial assessment for treatment is a significant change and is intended to soften the edges of a mandatory approach. In practice, though, it would just duplicate the substance-related assessment that a claimant will have already attended under these proposals. We are aware that some stakeholders have voiced concerns, as we have been told forcefully this afternoon, that we are forcing claimants to undergo medical treatment, and claim that any form of coercion into treatment, such as a benefit sanction, will not work. Let me absolutely clear. We are not forcing people into treatment. It will be possible under paragraphs 6(4) and 6(5) only for a rehabilitation plan to include a requirement that the claimant must attend an institution or treatment centre, as a resident or non-resident, for treatment under the direction of a professional. The nature of that treatment cannot be specified, so there is no requirement for the claimant to submit to any particular type of medical treatment at the institution. If the treatment is residential, the location is entered on the plan. If it is non-residential, the location and intervals are recorded, but that is all. The employment support provider does not need to know the details of the treatment that the claimant is undergoing. The claimant needs only to agree attendance at a treatment centre. If the claimant fails to attend the centre for treatment, they may face the possibility of a benefit sanction and remaining on mainstream provision. But, as with any form of medical treatment, the patient will have the right to be involved in discussions and decisions about any treatment they receive at the institution, and to agree to or refuse medical treatment that is offered. As a further safeguard, the Government intend to include in regulations an express provision that a person cannot be required to submit to invasive forms of treatment, such as a course of methadone, unless they have consented. The Government will also make provision in regulations for the content of rehabilitation plans to be agreed with claimants. In relation to coercion, during the Green Paper consultation many groups told us that most drug users want to get treatment and get off drugs. We are probably agreed on that proposition. Some groups told us that an element of coercion is not a bad thing. For example, Turning Point, while expressing some reservations about some aspects of the scheme, nevertheless said: ""Turning Point welcomes any programme which attempts to engage more people in need into the treatment arena. We also recognise that some of those clients may be reached through an element of coercion, and that this may engage some with treatment who would not alone have had the momentum or support to enable them to stabilise their substance misuse"." Some comparison can also be drawn from evidence from a study in the US. I am not sure if that is the same study that the noble Baroness, Lady Murphy, referred to; I have some more detail that I will come on to in a moment. It found that making benefit receipt conditional on treatment participation appeared to increase treatment participation rates. Amendments 106 and 114 seek to ensure that, for treatment to form part of the rehabilitation plan, a drug treatment practitioner must have determined that the person is susceptible to, and consents to, treatment. The amendments are unnecessary. With regard to the susceptibility to treatment, a drug treatment provider, like any other medical practitioner, should not recommend treatment unless it has determined that a person would be susceptible to it. In any case, as I mentioned earlier, the substance-related assessment will have already determined that the person’s drug problem is susceptible to treatment. On the consent point, I have explained that the rehabilitation plan cannot include a requirement for the claimant to submit to any particular type of medical treatment; it can require the claimant to attend a treatment centre for treatment only under the direction of a professional. Amendments 111 and 112 seek to remove the ability to impose a rehabilitation plan on an ESA claimant, thus making it a voluntary matter rather than a requirement. If a rehabilitation plan were voluntary, as recommended by these amendments, we doubt that many would opt to have one. Inevitably, those who are most in need of support and would gain the most benefit from having a plan would fail to take it up. A rehabilitation plan is not just about a requirement to submit to treatment; it is the gateway to the new drug and employment programme. Claimants will be provided with other support to overcome barriers to work; the noble Lord, Lord Ramsbotham, probed this question. This will include action to address barriers to work such as housing, debt and employment skills. It will also cover soft skills such as building self-esteem and confidence. The amendments apply only to the ESA, but if the intention is to apply it to the JSA too, by choosing not to have a rehabilitation plan, the claimant could continue to be subject to the mainstream job-seeking conditions. These are, as I said a moment ago, inappropriate for many problem drug users. Under current rules, many repeatedly fail to meet them by not signing on or by failing to show that they are actively seeking work, and as a result they face regular benefit sanctions. The intention is that when a rehabilitation plan is in place, these conditions will be lifted and replaced with a more appropriate set of conditions for drug users. This is a key benefit which many claimants would lose if they could opt out of a rehabilitation plan. Any requirements in connection with rehabilitation plans will be introduced by regulations. These regulations will be subject to the affirmative procedure, so before they can come into force they will have to be approved in draft by both Houses and there will be an opportunity to consider and debate them. They will also include safeguards to ensure that the requirements are proportionate to our aims and compatible with the European Convention on Human Rights. Finally, Amendment 115 seeks to restrict the ability to impose a sanction in the event of a failure by an ESA claimant to comply with a requirement to submit to treatment under a rehabilitation plan. Under powers in paragraph 7 of the two new schedules, regulations may make provision for a benefit sanction to be applied where a person has failed to comply with any of the requirements contained in paragraphs 1, 2, 3, or 6. The amendment attempts to restrict the ability to impose a sanction where a claimant has failed to comply with a requirement to submit to treatment as part of a rehabilitation plan. Under the amendment, a sanction could be imposed only where the treatment had been recommended by a person with the necessary qualifications and experience and where the claimant has consented to the treatment. Paragraphs 6(4) and 6(5) already provide that the rehabilitation plan may include a requirement that the claimant must attend an institution or treatment centre, as a resident or non-resident, for treatment, ""under the direction of a person having the necessary qualifications or experience"," so any treatment that is recommended will have been recommended by a qualified person. The noble Baroness, Lady Thomas, drew a distinction between necessary qualifications and experience. I am not sure that I can draw a clearer picture than that, but the paragraph covers people who are knowledgeable and experienced and have a range of particular qualifications to be able to engage in this exercise. As I said, any treatment that is recommended will have to be recommended by a qualified person. This is the only requirement for treatment that can be included in a rehabilitation plan. I have also already explained that there is no requirement for the claimant to submit to any particular type of medical treatment at the institution. It follows that no sanction can be imposed merely as the result of a failure to take up a particular type of medical treatment. Claimants will be expected to turn up to an institution for treatment and to be willing to participate in some form of treatment programme. If the claimant fails to attend the centre for treatment or to agree to any form of treatment at all—for example, if they are unwilling to take up even the offer of counselling—they may face a benefit sanction and remain on mainstream provision. Sanctions in this area will be a last resort. As always, a claimant will be given an opportunity to show good cause for any failure to attend an institution or treatment centre for treatment, but we do not intend Jobcentre Plus to impose a sanction for missing just the odd treatment appointment. The key thing is that the claimant agrees a rehabilitation plan and does their best to make progress against it.