Welfare Reform Bill

My Lords, before I start, I would like to record my most sincere gratitude to the Minister for the courteous way in which he has engaged with me on many occasions to discuss all my amendments, but particularly this one. I found that our meeting was courteous, and he showed a clear understanding of the issues, so I thank him for that. I was, of course, disappointed that the other House decided to overturn my amendment, particularly one that I thought was fairly modest, as Amendment 18 simply sought to protect cancer patients from the impact of time-limiting employment and support allowance. If the impact of the time-limiting proposal on cancer patients is to be mitigated, the Minister’s words in his summing up today will be of particular interest. During the previous debate I indicated very briefly what it is like for patients to be on chemotherapy for prolonged periods of time, sometimes for as long as two years. I could not do enough justice to the description of how a patient feels, so I would rather use the actual words of a patient. Jenni Russell, a reporter, wrote an article in the Sunday Times, and she had this to say: "““Everyone knows that cancer patients are likely to spend a lot of time being made to feel really … ill … I almost died of malaria in my twenties””—" I had malaria in my teens, and I can still remember what it felt like— "““but I have never felt as appalling as I did on chemo. The point of chemotherapy is to load the body with sufficient poison to kill the cancer without … killing the patient. It is crude medicine and, because we understand so little about genes or cancer pathways, it is unpredictable. I had assumed I would overcome it with a bit of willpower. Instead I had vomiting, nausea, headaches, muscle weakness and an inability to tolerate bright lights. For the first four days in every fortnight’s treatment, I couldn’t eat, speak, read, listen to the radio or get out of bed. My white blood cell count sank so low that I needed injections to boost my bone marrow production. For the next six days I was too weak to want to walk upstairs. There was no fight left in my body. … I could not conceivably have held down an ordinary office job over those months””." This is despite the fact that she had had a lot of support. She goes on: "““The fact that working was a choice, not a fearful necessity, made a huge psychological difference. … I have no problem with the principle that people who can work should work””." I think she is right. The vast majority of people with cancer who are out of work because of their condition want to work. For cancer patients, getting back to work is a crucial step forward in getting their lives back after cancer, but people with cancer often experience debilitating physical and psychological effects from the disease and its treatment. As I have described, these can be quite severe. For the majority of people with cancer who need ESA, 12 months is simply not long enough to return to work. We hope there is consensus that cancer patients awaiting and undergoing cancer treatment should be in the support group. The Minister already referred to this, and I am grateful for that. I understand that following my discussions with the Minister and others, the Government are in discussions with Macmillan about how this process can be reviewed. Progress is being made, and I appreciate that very much. However, the primary concerns about the impact of time limiting on cancer patients have been that those who still experience the long-term effects of treatment will lose their benefit before they are ready to return to work. I hope the Minister will say something about that. I am glad, however, that the Government are seeking to ensure that these people are given more time in the support group, where they will not be impacted by the time limit. If we are to protect cancer patients who are suffering from the debilitating side-effects of their treatment through the work capability assessment, it is crucial that the views of healthcare professionals—the oncologists, the GPs and the specialist nurses—are taken on board, and their evidence ought to suffice. I hope that the Minister will refer to that. Patients often deteriorate after treatment is completed, hence my amendment, which says that those suffering from the effects of treatment should not be included. A system would be based on the presumption—and that word is important—that the cancer patient leaving the treatment phase would remain in the support group of the benefit if they needed it. Evidence from a healthcare professional would consist of confirmation that the cancer patient continues to experience side effects that limit a claimant’s capability to work, and therefore should be placed in the support group. I agree that this assessment could be reviewed after a suitable period—even after six months—to see how the claimant’s situation has changed. I therefore sincerely hope that the Minister will be able to think of ways of meeting this amendment, and I look forward to hearing them.