Welfare Reform Bill

My Lords, I would like to start by responding to the noble Baroness, Lady Grey-Thompson, on her Amendment 86ZZZUA. Obtaining the right evidence for assessors and decision-makers will be a key part of the assessment process for personal independence payment, enabling us to make the best decisions regarding an individual’s claim. Such evidence might come from a range of sources, but in particular from the healthcare professionals involved in supporting disabled people on a regular basis. This may sometimes be the individual’s GP, but in other cases will not be. Many individuals, particularly those with longer-term conditions, may not have not seen their GP for some time and another professional might be much more relevant. This is why we want individuals to tell us who we should be seeking evidence from, as they will know best. We will encourage individuals to provide this evidence to support their claim or, if they cannot, to let us know who it would be best for us to approach directly. We do not wish to create a two-tier system, as feared by the noble Baroness. However, I do not necessarily think that we need to gather such evidence in every case. In some cases what the claimant has already told us, or provided alongside their claim, will be sufficient. In other cases, information from a health professional might be likely to add only limited value. We must remember here that what the condition or impairment is, or its severity, is often not critical in the assessment; it is the impact of it that matters. The gathering of additional evidence should be decided on the merits of individual cases. The noble Baroness referred to learning from the work capability assessment used in employment and support allowance. Although it is important to be clear that ESA and personal independence payment are very different benefits paid for very different reasons, we are seeking to learn from the experience of delivering the work capability assessment. As part of this we are looking closely at the findings of the independent review of the assessment carried out by Professor Malcolm Harrington to see where we can improve the design of the personal independence payment claim and assessment processes. For example, we recognise the need to ensure that these processes are empathetic, that we gather the best possible evidence and that assessors are given the training and support they need. I turn now to the amendments tabled by the noble Lord, Lord Touhig, and the noble Baroness, Lady Gardner. Evidence will also enable us to make the best decisions about how an individual's claim should be dealt with, including whether a face-to-face consultation is necessary. We recognise the importance of the assessment process being carried out sensitively and proportionately. We have made it clear that we believe that face-to-face consultations should form part of the claim process for most individuals. Consultation will play a key role in creating a fairer, more objective and transparent assessment, providing individuals with the opportunity to put across their views on how their impairment affects their everyday lives. However, where there is already sufficient evidence on which to make a decision on entitlement, we completely agree with noble Lords who argue that a face-to-face consultation should not be required. In such cases, entitlement would be considered on the basis of paper evidence only, and we have the flexibility in legislation to allow for that. In doing so, we are ensuring that we will have a tiered assessment—as recommended by the National Autistic Society, and referred to by the noble Baroness, Lady Healy and the noble Lord, Lord Wigley—a process where we consider evidence provided by the claimant first, then any additional evidence gathered and then carry out a face-to-face consultation only if needed. However, we do not agree that there should be different rules or processes for different groups of people, and especially not on the basis of impairment type. Exempting individuals from the face-to-face consultation on the basis of their impairment would undermine one of the key principles of the new benefit, which is to treat the individual as an individual. The noble Lord, Lord Touhig, argued the point well when he said that when you have seen one person with autism, you have seen only one person and that no two people with autism are the same. The only exception to that principle is where individuals are claiming under the terminal illness provisions, whom we will not expect to attend face-to-face consultations. I am sure that all noble Lords will accept the need to make an exception under those circumstances. Picking up the point made by the noble Lord, Lord Wigley, on the frequency of reassessments, we will take a personalised approach to setting the length of awards, varying the frequency and formats of awards and reviews depending on the individual’s needs and the likelihood of the impact of their health condition or impairment changing. Some people will have short-term awards; others longer; and some will receive ongoing awards. It is also important to state that reviews may not always necessarily involve face-to-face consultation. We recognise that it will be important to ensure that the review process is applied sensitively and appropriately. Having discussed the need for face-to-face consultation, I feel that this is an appropriate juncture at which to turn our attention to my noble friend Lord German’s amendment regarding the attendance at a face-to-face consultation of a suitable person alongside the claimant. We appreciate that some individuals will be able to participate in a face-to-face consultation only with the additional support of someone whom they know and trust. It has always been our intention that individuals should be advised that they can bring with them another person—be it a relation, friend or professional who supports them—in order to help them or to remove any anxiety that they may feel in undertaking a face-to-face consultation. Indeed, the Minister for Disabled People made that exact point during debate in the Commons. That will apply to all claimants. I agree with my noble friend that the suitable person should not just be a bystander to proceedings. They should be able to play an active role in supporting the claimant and ensuring that they understand the assessor’s questions and requests in order to help them to answer them on their own. Where the claimant is not able to speak for themselves as they should, with the claimant’s consent, they should be able to engage with, and respond to, the assessor directly to ensure that they are provided with the necessary information—particularly in the context of all of our concerns with the community on the autistic spectrum. I hope that that reassures my noble friend and noble Lords more generally on this critical point. This important measure does not need legislation. We have already made a clear commitment to it and are building it into our processes, guidance and within the commercial framework with the successful assessment supplier. The sensitive and proportionate approach we are trying to build will only work if the training is right. This brings me to the amendment of my noble friend Lord Addington. We agree fully on the need to ensure assessors have the requisite training to interpret the evidence they obtain whether this be from the individual’s claim form, information from health professionals involved in supporting the individual or from the face-to-face consultation. Assessors will be required to have a broad training in disability analysis as well as training on specific impairments. As part of this we intend to ensure that they have sufficient training in mental, intellectual and cognitive impairments, such as autistic spectrum disorders, and will stipulate this in our contracts with the eventual provider. However, it is not our intention to make assessors experts in every condition—rather, it is to enable them to deal effectively with the full range of individuals that will apply to personal independence payment. It is important here to state that the assessment will not be a ““medical assessment””, requiring the assessor to diagnose a condition and recommend treatment options. Instead it will require the assessor to look at the impact of conditions and impairments on individuals’ everyday lives. This requires a very different skill set from assessors than, for example, those involved in the treatment of individuals, with a lesser need for more in-depth knowledge into specific conditions. Picking up the point made by the right reverend Prelate the Bishop of Blackburn on fluctuating conditions, we are committed to ensuring that assessment works for people with fluctuating conditions. After all, most conditions fluctuate to some degree. However, assessing fluctuations is probably the hardest part of assessing disability. We propose that the assessment should not be a snapshot of any one day but should consider ability to carry out activities over a period of time—we are suggesting a year—and will consider impacts where they apply on more than 50 per cent of days in this period. I know that noble Lords have heard this before in relation to other assessments such as the work capability assessment. We are determined to learn from previous experience—and indeed failings—so that we get this right. For example, I would like to explore ways for organisations such as the National Autistic Society to play a role in helping ensure that training is of a sufficient standard. We also recognise that there may be occasions where assessors may need to access more specialist support in the course of assessing individuals. We are therefore looking closely at opportunities for giving assessors access to, and support from, individuals who have a greater knowledge of specific conditions. This is in line with the recommendations made by Professor Harrington during his review into the work capability assessment, which I know the National Autistic Society supports, where he called for there to be mental, intellectual and cognitive ““champions”” available to support assessors. However, we believe that assessors should use their own professional judgment as to when they need to seek further input in this matter, rather than constrain them through legislation. Picking up the questions from the noble Lord, Lord McKenzie, on the numbers of assessments, I cannot give him the figures now as we are currently working up the specification for the invitation-to-tender phase of the procurement, which will be published in December. Therefore, some of the details he asked for are simply not in a shape for me to provide. Meanwhile, any figures will be dependent on us finalising the assessment criteria and modelling the impact so they may indeed need some subsequent revision after that work is complete. I hope that I have reassured noble Lords that the assessment process will be sensitive, proportionate, personalised, based on sound evidence and delivered by individuals with the right skills, training and support. On this basis, I urge the noble Lords and the noble Baroness to withdraw their amendments.