Welfare Reform Bill

My Lords, the noble Baroness is seeking to ensure that the assessment for PIP reflects the social model of disability, which would mean that assessors would not just consider the impact of impairment on an individual, but also the social, practical and environmental barriers they face. On the question raised on the support we have, I should say that we have the Assessment Development Group whose role is to advise on the detail of the new criteria we are developing, so the group is necessarily technical in nature. However, the members of the group have a wide range of experience in working with and supporting disabled people, including two representatives of disabled people and disability organisations. Several of the group members are disabled people. The group includes individuals from a range of professions including occupational therapists, psychiatrists, physiotherapists, expert social workers and GPs. We also have representatives from RADAR and Equality 2025. We know it is important to hear wider views, which is why we have been talking to disability organisations throughout the development of the assessment and why we will continue to do so. The amendment reflects a commonly held view that the assessment we are developing is a medical assessment. I am pleased to have this opportunity to state that that is not the case. The assessment is not fully based on the medical model, with the impairment or health condition that the individual has or its severity determining the entitlement. Indeed, the type of condition or impairment an individual has is of limited relevance as this assessment focuses on the activities essential to daily living and on outcomes. By looking at holistic activities and participation outcomes, this assessment will better reflect the social model of disability than did previous assessments. I do accept that it is not a full social model assessment; it is not intended to be. However, neither is it a medical model. The reality is that it is somewhere in between. It is perhaps more of a bio-psycho-social model. That is not a term that I have coined; it was coined by Professor Gordon Waddle whose work in the field of health and disability we have discussed in this House before. It recognises that there are biological, psychological and social factors to disability, which we have tried to capture in the assessment. I should like to take the opportunity to provide more details on why we decided to do the assessment in this way. It does not include some of the additional factors to which the noble Baroness referred and which have been included in the alternative assessment proposals developed by Scope. I should add that we have a shared objective with Scope, which accepts that DLA is in need of reform: the need to overhaul this outdated benefit; assessing people as individuals, not as impairments; and ensuring that support is targeted on those who need it most. Its report contains some interesting proposals, for example, on how to support people through the claims process. We want to explore these further with Scope and others. However, it is not administratively feasible to assess every aspect of disabled people’s lives, every barrier they face or every cost they might incur. Long, intrusive and costly assessments would be required to do so. We therefore need to focus the assessment in a way that enables it to be a summary of the overall level of an individual’s need. DLA looks at care and mobility needs to establish this. In this case we have chosen to look at the ability to carry out a series of everyday activities, all of which are essential for participation. We could have looked at other factors, such as those to which the noble Baroness referred. Whatever measure is used, however, it is important to assess need objectively and ensure that there are clear criteria against which to measure it. We must do it consistently for all disabled people, whatever their circumstances and wherever they are in the country. That is where I think a fully social model assessment is flawed. If we were to consider every social, practical or environmental barrier that individuals face, we could not develop clear criteria against which to assess people, nor could we ensure that there was consistency in how it was applied. Taking into account housing or transport, for example, could lead to very different outcomes for individuals across the country, depending on levels of standards of provision. We believe such an approach to be unfair and at odds with how a national benefit should be paid. Access to personal independence payments should be universal. We do not want effectively to create a form of local needs testing. I mentioned earlier that considering these wider factors was likely to require longer, more intrusive and more expensive assessments as assessors would need to cover much more ground. They would also be more likely to require more regular reassessments as these external factors could be liable to change more often than the impact of impairments themselves. While we want to review circumstances more frequently in the new benefit, we do not want more assessments than are necessary. Considering that these factors might also lead to an increase in uncertainty around entitlement for individuals and to appeals as people might have very different views about how these external barriers affect them, we are keen to avoid this both for the stress this causes and the cost of handling appeals. Therefore, while I understand the noble Baroness’s position, we do not think that including social factors in the assessment is workable. We want it to be simple, objective and consistent. On that basis, I urge the noble Baroness to withdraw her amendment.