Welfare Reform Bill

My Lords, I shall speak also to Amendments 23 and 35. These amendments complement the Government’s amendment to Clause 8, which ensures that a direction by the Secretary of State may not specify medical or surgical treatment as the only activity which is regarded as work-related activity in an individual case. The government amendment reflects the Government’s agreement that medical treatment cannot be regarded as an activity, which, if the claimant fails to accept it, is subject to sanctions. In other words, compulsory treatment under the threat of benefit sanctions does not belong in this or in any other government legislation. I am not suggesting that the Government are saying that compulsory treatment does not belong in any other legislation—those are my words—but their amendment on this issue shows their commitment, at least, in relation to this piece of legislation. I have tabled these three amendments because I believe that the government amendment on its own leaves a loophole. If a claimant agrees to include medical treatment in their action plan, perhaps under duress—none of us can be sure about that—and if they fail to undertake that part of their action plan they may be subject to benefit sanctions. We know that some 50 per cent of claimants are failing the test which could qualify them for employment support allowance. Therefore, they are placed on jobseeker’s allowance, as I understand it, even if they have mental or physical disabilities as long as those are not assessed as preventing them taking a job. It is therefore important that the clarification that medical treatment will not be a sanctionable work-related activity is included within the Bill in relation to the various benefits covered by the Bill. These three amendments do just that. There is an issue here. For many people, psychological treatment or a rehabilitation programme may be very important in preparing them for a return to work. It would therefore make sense to include those treatments within an action plan. My point is that these treatments must not be sanctionable. If someone does not feel able to enter treatment for some reason at a particular time, they should not be forced to do so. There are four powerful reasons for that. First, treatment without consent is a breach of civil liberties and a potential breach of the European Convention on Human Rights. Secondly, such treatment is not efficacious. Any treatment, but most particularly psychological treatment which is likely to be applicable to many of these claimants, will not work effectively without the client's commitment and engagement. One has only to think about it to realise that if someone is forced to go along to some CBT therapist, they may miss a session, they may turn up late, they may not concentrate and the whole thing will be thoroughly unhelpful. Thirdly, such treatments would be a waste of resources. There are not enough therapists available to deal with the people who desperately want that help. If a therapist takes on a claimant who is there only to ensure continuation of their benefits, the therapist will almost certainly be wasting their time, time which could fruitfully be devoted to another claimant who wants that help. Fourthly, and very importantly for the Government and the rest of us, legislation in one department should be consistent with legislation in another. Therefore, the Welfare Reform Bill should be consistent with the Mental Health Act 2007. I shall not go into detail on that. Suffice it to say that someone can be given treatment without his consent only with the most rigorous safeguards under the 2007 Act. For example, if somebody has a severe mental illness and two senior clinicians and a nurse or social worker have signed to say that he has such an illness and that that illness might result in him being a threat to his own life or somebody else’s, he may be detained in hospital and, for a period of three months, given treatment without his consent. None of that is reflected in this Bill, and I do not think any Government could justify that inconsistency between the rigours of the Mental Health Act 2007 and the apparent relaxation in relation to treatment without consent that one is confronted with in the Bill. I understand that the Government accept these arguments. I propose that any medical treatment needed by a claimant should be included in an annexe to the action plan that would not be sanctionable. I do not want the idea that psychological help, which may be very important to the claimant, should not be included in any way in an action plan. That would be unhelpful. I wait with interest to hear the Minister’s response. An important related point is that under the Mental Health Act regulations and guidance, it is made abundantly clear that the term "medical treatment" includes habilitation and rehabilitation and, most particularly, includes psychological treatment. I ask the Minister to assure the House today that the regulations to be issued with respect to the Welfare Reform Bill will use the same definition of medical treatment as that used in the regulations and guidance under the Mental Health Act. I beg to move.