 House of Commons |
Session 2005 - 06 Publications on the internet Standing Committee Debates Welfare Reform Bill |
Welfare Reform Bill |
The Committee consisted of the following Members:John
Benger, Chris Shaw, Committee
Clerks †
attended the Committee Standing Committee AThursday 26 October 2006(Morning)[Mr. David Amess in the Chair]Welfare Reform BillClause 10Work-focused
health-related
assessments 9.10
am Danny
Alexander (Inverness, Nairn, Badenoch and Strathspey)
(LD): I beg to move amendment No. 31, in
clause 10, page 9, line 17, at
end add ‘who
has undertaken such training in work-related needs and support as may
be
prescribed.’.
The
Chairman: With this it will be
convenient to discuss amendment No. 261, in
clause 10, page 9, line 17, at
end add— ‘(9) A health care
professional will not be approved by the Secretary of State unless he
has undertaken such training in disabilities and health conditions as
the Secretary of State may by regulation
prescribe.’.
Danny
Alexander: Thank you, Mr. Amess. It is good to
be under your chairmanship today. The weather has somewhat improved
since our previous sitting, and long may that continue. I gather from
the radio this morning that I will be confronting storms, snow, ice and
all sorts of other things when I return to my constituency this
evening, so I hope that the atmosphere in the Committee this morning
will be more in keeping with the atmosphere outside than with that in
my constituency this
evening. Both
the amendments would introduce training requirements into clause 10,
which relates to work-focused health-related assessments. Amendment No.
31 specifies training in work-related needs and support. Amendment No.
261 refers to a health care professional having
“training in disabilities and
health conditions”. Both
amendments seek to probe the Government’s intentions regarding
the training of those who will carry out work-focused health-related
assessments, and I gather that the Under-Secretary of State for Work
and Pensions, the hon. Member for Stirling (Mrs. McGuire),
will respond to the debate, so my comments are addressed to her. I
raise the issue because it was suggested in our previous debate that
the assessments could sometimes be undertaken by different health care
professionals from those who will carry out the limited capability for
work and the limited capability for work-related activity assessments,
and we had a good debate about the training needs of those
involved.
My key point
is that it is important for Ministers to make it clear that they will
ensure that those who carry out these important work-focused
health-related
assessments—we have discussed their functions before, so I do not
need to go into them again—have a proper understanding of the
wide range of disabilities, impairments and health conditions that
those they are talking to might have. That is the burden of amendment
No. 261. If they have that understanding, they should—this is
the burden of amendment No. 31—be able to understand such
conditions and impairments and make health care recommendations that
might enhance people’s ability to undertake work-related
activity. With those few remarks, I ask the Under-Secretary to set out
the Government’s intentions.
Mr.
Jeremy Hunt (South-West Surrey) (Con): May I, too, welcome
you back to the Chair, Mr. Amess? I look forward very much
to serving under you as we discuss all the issues before us.
I want briefly to add to the
comments made by the hon. Member for Inverness, Nairn, Badenoch and
Strathspey (Danny Alexander). When we discussed training earlier, the
Under-Secretary gave us an assurance that people would be provided with
all the training necessary to ensure that what is envisaged in the Bill
happens. However, I wonder whether she could respond a little more
fully on that issue, because there are widespread concerns among
disabled people and the organisations that represent them about the
level of training to be given to those who do the assessments and to
Jobcentre Plus staff. I know that the Under-Secretary takes a great
interest in this issue, so could she say a little more specifically
about what training will be undertaken to ensure that people understand
hidden disabilities? People with learning disabilities, for example,
are concerned that those disabilities might not be understood because
they are not visible.
There is widespread concern
about these issues, and I know that the Department will have the right
intentions, but with the greatest respect to Ministers, it has not
always delivered to the highest standard. Will the Under-Secretary
therefore give some reassurances in that
respect?
The
Parliamentary Under-Secretary of State for Work and Pensions
(Mrs. Anne McGuire): Like my colleagues, I am
delighted to be here and to be under your chairmanship, Mr.
Amess. It must be lovely to be the Chairman of a Committee, by the way.
I do not know of any other group of MPs who get so many compliments so
early in the morning—and sometimes even late at night; but I
shall not go down that road.
I can offer the Opposition
considerable reassurance. I understand the reason for their concern and
for their wanting matters to be spelled out in Committee. As currently
happens with Atos Origin doctors, all the health care professionals who
will be involved in the process will undergo training specified and
agreed by the Department’s chief medical adviser before being
approved by the Secretary of State to carry out assessments. That will
ensure that health professionals who carry out the work-focused
health-related assessments will have been trained to the standard that
the Secretary of State expects and thinks appropriate. A health care
professional who has not been trained to that level will not be
approved.
Alison
Seabeck (Plymouth, Devonport) (Lab): I am reassured by
that. Will the Under-Secretary further reassure the Committee that the
number of trained people will be sufficient to provide capacity in the
system to manage any surge that might happen at the beginning of the
roll-out, such as was described by my hon. Friend the Member for
North-East Derbyshire (Natascha Engel) with reference to pathways to
work in her
constituency?
Mrs.
McGuire: I can give my hon. Friend that assurance because
we have set quite exacting targets for the gateway process and in our
expectations of the health professionals. It is in everyone’s
interest to make sure that that works properly, and that will be part
of the continuing discussions with Atos Origin. We also need
flexibility to change the training requirements,as may be
necessary in the future. That is one reason why the amendments are
unacceptable—although I appreciate that they are probing
amendments. I
particularly want to reassure the hon. Member for South-West Surrey
(Mr. Hunt) that hidden disabilities will be one aspect of
the training for the relevant health professionals. I hope that the
whole Committee will accept our commitment: the training currently
prescribed by the Secretary of State requires each practitioner to have
a personalised continuous development plan, which includes models
relating to a wide spectrum of medical subjects, including specific
conditions. Practitioners must, in addition, undertake a series of
modules on non-medical subjects such as cultural awareness. They may
have to work with broader issues than just the medical side in their
capacity as health professionals undertaking such important
assessments. I hope
that that reassures the Committee, and, in particular, the hon. Member
for Inverness, Nairn, Badenoch and Strathspey, so that he will feel
able to withdraw his amendment.
Danny
Alexander: I am grateful to the Under-Secretary for those
remarks. She has given the reassurance that I wanted, so I beg to ask
leave to withdraw the amendment.
Amendment, by leave,
withdrawn. Question
proposed, That the clause stand part ofthe
Bill.
Danny
Alexander: With your leave, Mr. Amess, there
are some broader issues about the conditionality regime in the Bill
that I should like briefly to draw to the attention of the Committee,
and on which I should like to seek some assurances from the
Under-Secretary of State. Those considerations pertain not just to
clause 10 but to clauses 11 to 13, all of which come under the heading
“Conditionality” in the Bill. I hope that discussing the
matter now may help us to expedite proceedings on those
clauses. In our
sitting on Tuesday afternoon the Minister of State entered into a quite
lively discussion about the level of funding for pathways to work. I
should like to return to that. It is important to put it on the record
that the Bill, understandably, and, provided that the reassurances that
I seek are given, justifiably, makes it clear, as he said in language
that I would endorse, that
it is based on the idea of responsibility. It is based on the idea that
provided the support for individuals is in place and they are part of
the work-related activity component, they have some degree of
responsibility for availing themselves of that support. The Bill dwells
at length on the individual’s responsibility, which is again
understandable, given the nature of legislation in this area, but it
does not dwell on the Government’s responsibilities.
I wish to press Under-Secretary
of State a little on the reciprocal responsibility that exists on the
part of the Government in exchange for the responsibility that
individual claimants are being asked to undertake under these and other
clauses relating to conditionality. I am sure that the Ministers would
agree that it is important that the Government fully carry out their
part of the bargain. It has been described as a something-for-something
package: claimants are asked to give something in terms of
responsibility and the Government undertake to provide something in
terms of support to get them back into work. That is a reasonable
proposition. It is
important to say that the Government have a particular responsibility,
although it is not stated in the Bill, to reassure the Committee on a
number of points. The first relates to funding, which we debated a
little on Tuesday afternoon. I have carried out further work on that,
partly as a result of the Minister of State’s prompting,
building on written answers that he and his colleagues have provided to
me over some months. I examined what the costs per claimant in the
pathways regime were, and what they might be expected to be, given the
predictions of the onflows on to incapacity benefit over the next few
years, in the two-year period for which the £360 million has
been allocated. I do
not wish to go through all the references in all the parliamentary
questions on which this is based. However, if one takes into account
all the different available elements in the pathways pilot areas within
the choices package, the number of people who have been helped and the
percentage of people who have been participating in the different
elements of pathways, one comes to an estimate of the annual cost per
claimant within the pathways project of £571 a head. My
calculations, which are based on the figures that have been provided in
answer to questions about the expected onflows on to IB—in other
words, the new claimants to whom initially this is devoted—
suggest that, even if the full £360 million were to be devoted
entirely to the roll-out of pathways, which I shall come on to in a
second, the annual funds per participant allocated for the national
roll-out of pathways to work would be less than £327 a
head. I would be happy
for Ministers to correct my figures or to give their own estimates. If
the entire £360 million is to go to pathways, and one is talking
only about new claimants over this period, on those calculations, there
is a funding gap of £268 million.
On Tuesday,
the Minister of State fairly made the point that the Government would
spend whatever was necessary—that might not be an exact
quote—and sought to make reassuring noises on this important
point. I am delighted to hear reassuring noises from the Ministers in
Committee, but I would be even more delighted and reassured to hear
similar noises from the Chancellor of the Exchequer in his pre-Budget
report about the sums
that will be spent. This is a serious point, because if we are telling
employment and support allowance claimants that they are expected to be
part of a conditionality regime, it is important to make it clear to
them that the promised help will genuinely be available at the promised
levels throughout the country. That is the first point on which I would
be grateful for the Under-Secretary’s response. The equation is
simple: if there are to be responsibilities and obligations, there must
also be opportunities for people to obtain the help that they
need. The
Under-Secretary may want to debate whether my calculations are accurate
and whether the £360 million is insufficient,
but there is a second serious question on which the Committee would
like reassurance. What proportion of that £360 million will be
spent on the pathways to work roll-out—I raised that earlier
but, perhaps due to the temper of the debate, it was not
addressed—and what will be spent on other things? I understand
that Ministers will seek leave to start spending money on implementing
aspects of the Bill in advance of Royal Assent—that is an
established procedure—particularly on setting up the benefit,
which is understandable as there is not much controversy about the
benefit. If that is the intention, will the Under-Secretary explain
what proportion of the £360 million will be spent on benefit
administration—setting up computer systems and so on—so
that the Committee will have a genuine idea of how much will be spent
on providing support and assistance for ESA claimants and how much will
be spent on the necessary administrative tasks that will underpin the
benefits? A third
aspect, which again relates directly to the nature of the proposed
conditionality regime, is the extent to which the pathways to work
regime is successful for all groups of claimants. That was drawn to the
Committee’s attention earlier, but I want to highlight two
groups of claimants. The first is those for whom their first reason for
claiming benefit is mental health, and I distinguish that from learning
disabilities. Secondly, several charities representing older people
have said that there is not much evidence that older workers have
benefited from the pathways to work regime.
It is
important that the Under-Secretary addresses that. Both older workers
and those whose first reason for claiming benefit is mental health but
who do not satisfy any of the 46 descriptors will eventually be subject
to the conditionality regime for recipients of the work-related
activity component. It is important that the Under-Secretary sets out
what steps the Government are thinking about and what ideas they have
to improve the available support within the pathways regime for those
people. Given that the conditionality regime is the same, it is
important that the Government make it clear how they will ensure that
support and assistance is available through pathways. Pathways has been
remarkably successful for some groups of claimants and that should be
welcome on both sides of the Committee, but it has not been so
successful for other groups.
On mental
health, I draw the Under-Secretary’s attention to the work of
Professor Lord Layard on depression and the availability of, for
example, cognitive behaviour therapy services within the NHS. I wonder
whether the
shortage of such services at the moment is one of the causes of the
condition management programme being less successful for people in that
category. Perhaps she will reflect on
that. These
are broader considerations about the fairness of the proposed
conditionality regime and the degree to which the Government are
prepared to play their full part in the bargain. I fully accept the
Under-Secretary’s good intentions, but the spending plans of
some Ministers in the Department are subject to an annual reduction of,
I believe, 5 per cent. over the next two or three years. In that
context, how does the Under-Secretary foresee funds coming forward to
ensure that the available support for ESA claimants is sufficient to
ensure that the full roll-out is available, not just for new claimants
but for existing claimants and members of the support group who wish to
take part, so that the hopes that have rightly been generated as a
consequence of our discussions are fulfilled, and people are not left
disappointed at the end of this
process? 9.30
am
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