Welfare Reform Bill

My Lords, I completely concur with the noble Baroness’s view that benefit recipients should never be directed to undertake medical or surgical treatment to fulfil their conditionality, and I agree that we should have consistency across the legislation in this area. That has always been our policy intention. Nevertheless, we have listened to the invaluable debates that we have had in this House and we have decided to move this safeguard into the Bill. That is the purpose of our Amendments 16, 28, 36, 42, 43, 49 and 50. Amendment 16 amends Clause 2F, which covers income support customers, to ensure that a direction cannot specify a medical or surgical treatment as the only activity that in any person’s case is to be regarded as being work-related activity. Amendment 28 to Schedule 1 ensures that this extends to customers on modified JSA. Amendment 36 is to Clause 8 and extends this safeguard to ESA customers. Amendments 42 and 43 are to Schedule 3 and extend this safeguard to problem drug users on JSA. Amendments 49 and 50 are to Schedule 3 and extend this safeguard to problem drug users on ESA. Where individuals have a health condition that in itself is a barrier to them returning to work, we believe that they should receive appropriate help and support to make a return to work possible, such as counselling or physiotherapy, if that is something they think is appropriate for themselves. The effect of the government amendments is such that it will remain permissible for customers to undertake such medical or surgical treatment to meet their work-related activity requirement voluntarily and with informed consent. However, under the noble Baroness’s amendment, that would be impossible. Whether it were in an annex or in the agreement itself, it would amount to the same thing. This would prohibit an adviser from entering such activities on the action plan—activities that the customer might want to undertake and which might be very beneficial for that person. We will ensure that customers are not penalised, if they changed their mind about this voluntary decision, by allowing them to fulfil their requirement to undertake work-related activity by completing another activity on their action plan. We have deliberately not defined medical or surgical treatment in the Bill, but we will produce detailed guidance for advisers on what are and are not appropriate activities to direct customers into. We would never, for example, direct customers into treatments such as physiotherapy, psychotherapy, a condition-management programme, or a diet or exercise regime. We are also confident that healthcare professionals will not deliver anything that constitutes treatment against a customer’s will. This would be against medical ethics and codes of practice. I hope that our government amendments will allay the concerns that noble Lords have expressed about this issue in previous debates, and will demonstrate in primary legislation our determination to ensure that people cannot be coerced into medical treatment—the same concerns that the noble Baroness has sought to address through her amendments. I commend Amendments 16, 28, 36, 42, 44, 49 and 50 to the House, and I ask the noble Baroness to withdraw her amendment.