Social Security (Disability Living Allowance) (Amendment) Regulations 2002

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Mr. Boswell: I fully understand the Minister's commendable wish to make matters clear for the decision makers, but she mentioned inconsistency with earlier tribunal decisions. My understanding was that that particular tribunal hearing, which involved several social security commissioners, was a test case to establish the basis on which future decisions should be taken. It was not some maverick, oddball decision; it was central to consideration of the import of the regulations.

Maria Eagle: I would never accuse any commissioner of making an oddball decision. The commissioners always do the best they can in the circumstances and on the facts before them, but that does not mean that we always end up with consistent case law to help our decision makers to reach the correct conclusion in individual cases. Decision makers must be clear about the circumstances in which fear and anxiety might count, and that is the purpose of the regulations.

There is no doubt that that tribunal decision created the risk of an unintended widening of the entitlement gateways. We are not narrowing the gateways, but trying to keep them where they have always been, because disability living allowance lower rate mobility component exists to assist people who are severely mentally or physically disabled, not to assist those who do not have such a disability. I see the regulations as a way of keeping the gateways where they have always been, because we want to ensure that benefit expenditure goes to those who need it.

Mr. Prisk rose—

Maria Eagle: I shall give way to the hon. Gentleman, but then I want to make some progress.

Mr. Prisk: Is the Minister saying that the change introduced by the regulations will take us back to the situation that existed before the case to which she referred was decided? Furthermore, can she assure the Committee that no one will be worse off as a result of the regulations?

Maria Eagle: I shall come to that latter point. Certainly, the tribunal of commissioners, which intended to clarify the law, created the problem by taking fear or anxiety into account when it was an indirect effect of disability, although that had never been done before. That is how the problem arose.

I want to move on to say something about what the regulations will do. They will remove the uncertainty that was created and the associated risk of an unintended widening of the gateway. They do so by making it clear that fear and anxiety can be taken into account for entitlement to the lower rate mobility component only if that is a symptom of a mental disability and is so severe that it prevents a severely disabled person from walking alone out of doors, on an unfamiliar route, without guidance or supervision from another most of the time.

I now want to say something about what the regulations do not do, before trying to answer some of the specific issues raised by hon. Members.

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Mr. Boswell: The Minister just said that the allowance was designed to deal with the situation in which fear or anxiety relate to a severe mental disability. Is not the whole point of the head provisions, from which the regulations derive, to consider both physical and mental disability, which, admittedly, must be severe to trigger an entitlement? What matters is whether the fear or anxiety is entirely contingent on the disability, because whether the cause of the disability is physical or mental, the fear or anxiety can be just the same.

Maria Eagle: Those who currently qualify for lower rate mobility component on the grounds of having a severe physical disability will not be affected by the regulations, so someone who is prelingually deaf has a physical disability, and the clarification will not affect that person's entitlement. We are not saying that anyone with a physical disability must also have a severe mental disability to qualify. There has been misunderstanding in that respect, and understandable fear among groups that campaign and assist disabled people. Social security law is complicated and open to many different interpretations. Even commissioners, who are familiar with it, interpret it in various ways, so it is easy to grasp how misunderstandings have arisen, despite our best efforts. That is why I welcome the chance to clarify the matter.

I want to deal with the specific conditions that hon. Members raised and explain what we are doing. Will hon. Members please bear it in mind that DLA is by nature a subjective benefit? It is not awarded on the grounds of disability, in that one is entitled to benefit on the basis not of a named disability but of the effect that the disability has on the individuals' ability to care for themselves, in respect of the care component, or to get around, in respect of the mobility component. Inherent in the benefit is a subjectiveness, which none of us can change without changing the entire design of the benefit. I ask hon. Members to bear that in mind.

People will continue to qualify if they are blind or deaf, and their deafness is so severe that they can communicate with others only with difficulty, or if they suffer from severe agoraphobia, have head injuries or learning difficulties and need someone with them when they go out on an unfamiliar route. Those people have a physical disability. The law has always applied to a severe mental or physical disability, and the regulations do not change that. Those with severe physical difficulties will continue to qualify and will be unaffected by the regulations.

The only claims for the lower rate mobility component that are affected by the regulations are those made on the basis of fear and anxiety alone, when that does not amount to a severe mental disability. The Government consulted both the SSAC and the DLA Advisory Board before introducing the regulations. The hon. Member for Northavon was honest in admitting that he had not read what the DLAAB said. Those advisory boards are necessary because the area is complex. The SSAC is well known—many hon. Members have consulted it and examined its deliberations. The DLAAB may be less well known, but it focuses especially in the benefit that

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we are debating. I shall not read out the board's comments in detail but, if hon. Members want to read them for themselves, they will find them on page 24 the Command Paper. The board believes that

    ''it is fundamental to an award of DLA that there should be an underlying mental or physical condition directly causing the disability and subsequent care or supervision needs.''

The board believes in taking a much more medicalised look at the workings of the benefit; it also believes that the regulations are necessary. Although it is true to say that the SSAC expressed the concerns to which many hon. Members referred, the DLAAB, which we consult on changes specifically relating to the allowance, came to the opposite conclusion. The board thinks that we should not only proceed with the regulations but consider making a closer causal link between a recognised and diagnosed disability and its effect. Therefore, it is unfair to say that our regulations were universally condemned.

Mr. Webb: I am grateful to the Minister for drawing our attention to that section of the report, but the DLAAB goes on to say:

    ''There is a serious difficulty, in our opinion, with the use of terms such as fear and anxiety''.

The regulations put those terms on the statute book for the first time.

Maria Eagle: That is true. Unlike the SSAC, the DLAAB is made up mainly of medical people. It has a view, which I do not necessarily share, that we should have a much more medicalised way of dealing with DLA, involving causal links between recognised diagnoses of physical or mental disabilities and an award. We take such things into account and consider everybody's views. We are half way between what the SSAC and the DLAAB say about the regulations.

Mr. Boswell: It is nice to know that the Minister is pursuing the middle way. My serious point is that the DLAAB emphasises in its report that there needs to be a greater emphasis on diagnosis than is usually the case for DLA claims. My hon. Friend the Member for South-West Bedfordshire demonstrated that there is no psychiatrist on the staff of the medical section of the Department. Given the need, which I know from my experience in rehabilitation, for an active involvement in the psychiatric component and given the fact that this is a difficult area for diagnosis, is the Minister confident that her Department will be up to the major task of appropriate diagnosis in such difficult cases?

Maria Eagle: I want to say a little about medical services and the fact that the Department is concerned more with social security, with giving income to people in need and with pursuing various statutes than with diagnosing people's medical conditions. However, the benefit requires a certain fusion between the two. I shall explain how we do that, as concern has been expressed by Opposition Members.

It is not the case that a decision maker must have a medical report before coming to a decision. Sometimes a decision maker requires only information about diagnosis of a mental health condition. It is generally better in such circumstances for that to be requested

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from a treating clinician or from a community psychiatrist. It is not necessary for us to employ psychiatrists to examine the person applying for the benefit. In some circumstances, requests are made for an examination, and it is possible for us to comply. However, it is not the case that everybody who has fear and anxiety or a mental disability needs to be examined by a psychiatrist employed by Schlumberger-Sema in order to receive benefit.

The doctors whom we use in the cases in which an examining medical practitioner is required are recruited from clinical specialties. All are trained in benefit-specific assessment for the various sickness and disability benefits, in mental health assessment and in customer care and disability awareness. All are trained, in carrying out examinations, to cause minimum distress or discomfort. That does not mean to say that we do not receive complaints. I would be fooling hon. Members, as they know from their own postbags, if I said that there are not sometimes complaints about the way in which doctors examine people who are applying for benefit. However, we have ways of dealing with that, and we think that we do a decent job in obtaining the information that we need to determine the benefit claim. That will continue; there is no reason why it should not.

 
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