Welfare Reform Bill

Yes, Professor Harrington is currently looking at two areas: mental health conditions and fluctuating conditions. We have received one but not the other. We will clearly take those into account and look at them closely when they come in. To that extent, the debate today is slightly premature. It may not be later in the process of the Bill. To pick up on the point of the noble Baroness, Lady Wilkins, on the medical evidence used, all available evidence, including that from GPs or specialists, is fully considered by the department’s decision-makers. The final decision is with the department. It gets a recommendation from Atos and takes that into account with all this other information. Following recommendations by Professor Harrington, decision-makers are now phoning claimants to ensure that they understand the process and can submit any additional medical evidence that they feel is relevant. However, GPs and specialists are not experts in disability assessment. Often, as advocates for their patients, they are not best placed to make a decision that affects benefit entitlement. We would not want to undermine the role of GPs as advocates for their patients. As a result, the criteria provide a reliable, nuanced and measurable way of assessing limited capability for work. This ensures that a full understanding is gained of an individual’s disability or health condition, the effects of that disability or health condition, how these effects may vary over time and whether it would be reasonable for that person to work or not. The amendment suggests that an additional test with additional criteria is added to the assessment of limited capability for work. However, the criteria suggested are not readily measurable or nuanced. It would, for instance, be impossible to measure the potential excessiveness of any workplace adjustments because they will vary depending on the size and capacity of the employer concerned. An additional test would also not provide an objective or more accurate assessment of an individual’s limitations—and in some instances could hinder it. For instance, it would be difficult to provide strong evidence of whether someone currently out of work could work for 26 weeks without significant time off without knowing the type of job they would be in and their health circumstances at the time. Such judgements are difficult to make and, as a result, the criteria would risk being inconsistently applied. We recognise that concerns have been raised about the current assessment for limited capability for work. Indeed, many in this Room have raised concerns. However, as noble Lords will know, we are committed to improving the work capability assessment through a series of independent reviews led by Professor Malcolm Harrington. He has made clear that the work capability assessment is not broken and that it is the right assessment. One of the great failings of our welfare state is that we have left too many people on the sidelines and written them off without checking what their potential alternatives are. We are not trying to do people down but to assess what they can do, if they have the potential to work, and to help them to find a job. However, we want to make sure that the assessment process is right—a process that, after all, we inherited from the previous Government, as the noble Lord, Lord McKenzie, described. That is why we asked Professor Harrington to review it. Indeed, we were relieved when he said that the process was not broken. He published the first review in November 2010, setting out a series of recommendations. We fully endorsed his review and have implemented all his recommendations, including empowering decision-makers to make the right decision first time, improving communications with claimants and tasking Atos to employ mental function champions across its network. I pick up the points made by the noble Baroness, Lady Wilkins, on registration. All healthcare professionals are registered with a professional body such as the General Medical Council. They must have had at least three years’ post-qualification experience, received comprehensive training—eight days for doctors, 18 days for nurses and 21 days for physiotherapists—and be approved by DWP’s Chief Medical Adviser. The thorough and stringent recruitment process means that only 18 per cent of healthcare professional applicants are successful. Once approved, all are subject to ongoing quality checks through audit, which the department validates. There have been approximately 20,000 checks in the past year. The contract stipulates that less than 5 per cent of reports must be classified as substandard, and less than 1 per cent of reports returned by decision-makers. These targets are consistently met. Professor Harrington has recently reviewed our implementation of his recommendations. He found that, "““real progress is being made””," and he noted a ““real enthusiasm for change”” from decision-makers and officials throughout the department. He is undertaking a second review and, as part of that, is looking in more detail at the criteria for the assessment. I pick up the comments of the noble Baroness, Lady Wilkins, on the rate of successful appeals for claimants. I have to make the obvious point that that rate is lower than under the old personal capability assessment, which was running at 50 per cent. Currently, the successful appeal rate for the WCA is 39 per cent. I should also make the obvious point that if a decision is overturned at appeal, it does not necessarily mean that the original decision was inaccurate. Customers often produce new evidence at their appeal and that is why there is a changed decision—there is no question of a mistake. Clearly, we want to drive down this rate of losing appeals. We have introduced measures to help to reduce appeal rates. These include calls to claimants to explain the decision reached, ensuring that all the available evidence has been submitted in claims, and improving feedback, communication and training between the agencies involved. We are looking forward to these further improvements in the second review, which we hope will keep the assessment fair and effective. We will continue to update the work capability assessment in the light of those reviews and, indeed, the work being carried out by the noble Countess, Lady Mar, who was the original instigator of the amendment. Given those assurances, I urge the noble Baroness to withdraw the amendment.