Welfare Reform Bill

Clearly, the system will be elaborated and developed, and we are at an early stage. Although the WCA is a very different test from the PIP assessment, one of the useful lessons that we have drawn from Professor Harrington’s recommendations for it is that mental health champions are available on site for assessors. That is the way in which that test has developed, and there are some valuable lessons there for when we look at how we elaborate the PIP assessment. If we were to go with the full social model assessment along the lines suggested by Scope, looking at the full range of factors that potentially cause barriers and cost, it would require a very long, intrusive and costly assessment, putting significant cost burdens on the state and, more importantly, very large burdens on the individuals involved. They would also inevitably require much more regular assessment, as the social factors that would be taken into consideration would change more regularly than the impact of a health condition or impairment. You might, for instance, get to the ludicrous position where every time a local bus service changed, you would have to do a reassessment on that model. In meeting after meeting with noble Lords, I have been left under no illusion that having too many reassessments is one of the things that they dislike the most. We will try to provide later on some reassurance that there will be decent gaps wherever possible between reassessments. The situation could go very dramatically the other way and lead inevitably to inconsistency, with factors considered varying from person to person and affected by local factors or service provision. With PIP, we are looking at something that is universal and where entitlement is based on the same criteria wherever individuals are and whatever their circumstances. This discussion carries echoes of our ring-fencing debate earlier today in relation to the Social Fund. If we move to a kind of local needs-testing, which is what the amendment implies, it would be at odds with how we deliver a national benefit. Clearly, we could do something else. We could localise it as a benefit, but then it would be a very different benefit. I suspect that many noble Lords would be very concerned about moving in that direction. Most importantly, we think that a social-model approach would be more subjective. Benefit entitlement needs to be based on clearly defined and transparent criteria which we need to be able to set down in legislation and apply to individuals consistently, whatever their circumstances and wherever they are in the country. If you cannot do that there would be a level of unfairness and uncertainty, high levels of appeals and a system in disrepute. Under the type of assessment proposed, it would be harder to define the criteria that individuals would be assessed against and less clear whether they had met the thresholds for entitlement. Finally, we do not think that an assessment along these lines would allow us to control expenditure and keep that benefit spend sustainable, making sure that it goes where it is needed most. I do not think that I can really reach a figure on how much it might cost, but our estimate is that it would be very substantial. Although the social-model approach is superficially attractive—and I emphasise that we support it in many ways—we have decided that it is not the right way to go with this assessment. We have not gone for the medical model; we have gone for the biopsychosocial model. That model has now garnered very significant academic support, as those noble Lords to whom I sent that very interesting piece of research will recognise. It recognises the diverse range of biological, psychological and social factors that impact upon an individual and cause variation in need. We think that approach—of looking at activities and outcomes—matches the requirement.