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Work & Pensions Committee - Minutes of Evidence1493
Taken before the Work and Pensions Committee
on Monday 12 December 2011
Dame Anne Begg, in the Chair
Examination of Witnesses
Witnesses: Maria Miller MP, Minister for Disabled People, Dr James Bolton, Deputy Chief Medical Adviser, and Simon Dawson, Deputy Director, Independent Living and Office for Disability Issues, Department for Work and Pensions, gave evidence.
Q178 Chair: Minister, thank you very much for coming along this afternoon. Something exciting is happening in the Chamber this afternoon, and some Members are still there trying to catch the Speaker’s eye. Perhaps that helps to explain why we are slightly thinner on the ground than we might have been, but thank you very much for coming along anyway. I understand that you have a very brief opening statement to make.
Maria Miller: Thank you, Dame Anne. I would like to thank the Committee for the opportunity for my colleagues and me to come along today to discuss Disability Living Allowance (DLA) reform. We remain committed to supporting disabled people and focusing on helping those who experience the biggest barriers to leading an independent life. Across Government we spend some £40 billion a year to provide support and services for disabled people. DLA is one of the most important ways we support disabled people, and we feel that it is no longer working in the way it should. You have heard evidence from others to that effect. The eligibility criteria are outdated, reflecting society’s understanding of disability of some two decades ago; awards are inconsistent, and therefore can lack credibility. Of those cases that go to appeal, some 40% of decisions are overturned. This has damaged people’s confidence in the system. There is also a high number of nugatory claims. Less than 45% of DLA claims are successful, and we feel there is over-reliance on a very complex self-assessment questionnaire with no systematic review of benefits built into the system, with awards becoming therefore inaccurate as changes in circumstances are not routinely picked up.
The Personal Independence Payment (PIP) has been developed with independent health, social care and disability experts to take better account of modern views on disability, including cognitive, mental and sensory impairments. We feel the new assessment is fairer, as it focuses on needs that have arisen as a result of a condition. It is more consistent, as the criteria are more clearly defined, and more objective, as individuals have had the opportunity to talk to a health professional about their condition and how it impacts on their day-to-day life.
We will make sure that people receive the right level of support through a personalised approach, and more active, systematic reviews based on the likelihood of their health condition or impairment changing. Most importantly, we will ensure that we continue to involve disabled people in the design and implementation of this important new benefit.
Q179 Chair: Thank you very much. In all of that you have not mentioned money at all, and yet one of the major reasons the Government have given for changing DLA and introducing PIP was to cut 20% of the DLA budget. What evidence do you have that increased DLA expenditure and caseload is due to a widening interpretation of the eligibility criteria, or how much of it is due to a growing awareness that the benefit exists, or demographic changes?
Maria Miller: I think I should set out from the start that the reform we are undertaking here is very much a principled one. We are all aware of the statement of the Chancellor. How we undertake that reform of Disability Living Allowance and the introduction of the Personal Independence Payment is absolutely rooted in making sure we have a benefit of integrity, and it has behind it principles that will deliver good support for disabled people. To us, there is very clear evidence that there are problems within the system as it currently stands. We know from research carried out in 2004-05 under the National Benefit Review that there were significant problems with incorrect awards. There were some £630 million of overpayments, and the figure for those people not receiving enough support was £190 million. There is evidence there of inaccuracy within the system.
With regard to people who claim the benefit and their awareness, the fact that we get such high levels of nugatory claims-almost half of the claims we get are from those who do not have basic eligibility-suggests that the problem is not necessarily that people don’t know about the benefit but that they are coming forward without the required eligibility.
Q180 Chair: But that confuses me, because that means they don’t get it. The criteria must be quite tight if a large number of people who apply don’t get it, so why bring in a completely new benefit with new criteria in order to cut down on the caseload?
Maria Miller: It is about basic eligibility, as opposed to an assessment of more detailed needs. I don’t know whether Simon wants to comment on that.
Simon Dawson: My name is Simon Dawson, and I am Deputy Director with responsibility for Personal Independence Payment and DLA policy. To add to what the Minister said, only one third of the growth in DLA in the last eight years can be attributed to what might be called demographic factors, the remainder being accounted for by average receipts per head.
Q181 Chair: To stop you there, your Department still published the statistic of an increase of 30% in those claiming DLA, and that was used as a justification for getting rid of it completely and bringing in PIP instead.
Simon Dawson: We would argue that the current benefit is not very well understood. People don’t understand when they might not be entitled.
Q182 Chair: The Minister has been very clear that it is not well understood. My question is: how can it be better understood when you bring in something new? Possibly one of the reasons why the caseload of DLA has gone up is that it is now better understood 20 years on-more people know about it. We have questions on that. The original statistic used was that the caseload of those applying for and receiving DLA had gone up by 30%. You have just said that a third of that was probably due to demographic changes. The move from DLA to PIP will not remove those demographic changes, unless you say that PIP will not continue after the age of 65. I understand that is not the case. Is that true?
Simon Dawson: It is true.1
Q183 Chair: Therefore, those demographic changes will continue and that proportion will increase. Some of the increase was because of demographics. That is not taken out by the move to a new benefit. Some of it is the result of a better understanding of the benefit, but in that case the new benefit might do that because people won’t know about it. I don’t want to get into that, because I know we have questions on it. The question I am asking is: what evidence do you have that the increase in the uptake of the benefit has anything whatsoever to do with a loosening of the criteria?
Simon Dawson: The fact that the growth in caseload itself has broadened the eligibility criteria-
Q184 Chair: But that has brought in people, perhaps the blind and others, who did not get it before, but are you saying that the groups that have been taken into the criteria for DLA in recent years will be automatically excluded from PIP?
Simon Dawson: No. The National Benefit Review statistics show that about £630 million of expenditure is accounted for by unreported changes of circumstances due to people’s conditions changing, which clearly suggests something about a loosening of the criteria.
Q185 Chair: Surely, the answer to that was to put some periodic reviews into DLA.
Maria Miller: At this point I think it is important to restate the case for change here. At the risk of making a very simplistic statement, if it was as easy as making some small changes to DLA then the previous Administration would have undertaken that. A lot of the changes we have been looking at in trying to bring the assessment into the 21st Century, and making sure we have a tighter gateway into the assessment so there is more certainty that those with the greatest need are receiving it, require us to look at a new legislative structure. It is very difficult to achieve those sorts of changes under the current DLA, because so much of the detail of the Bill is enshrined in primary legislation. I can perhaps understand why it was done at the time, but it has meant a real lack of flexibility within DLA to adapt to changes. We know that from the problems to do with the blind and the measure that had to be the subject of primary legislation.
The answer to your question is that there is absolutely a need to reform the benefit very fundamentally; that there is clear evidence to suggest that only a third of the growth over the last eight years-it is, I think, 38%2 growth-can be attributed to demographic factors; and the remainder will be linked to the problems of the slippage in gateway. The fact that half of the people who apply for DLA-55%-are rejected at stage one tends to suggest that lack of knowledge about DLA is not necessarily a problem across the board.3
Q186 Chair: Do you not accept that it might be a good thing if the caseload of DLA has gone up because more people know about it and therefore more people are applying, which may explain why you have a larger number being rejected at the first stage? Again, that is not a good reason for sweeping away all of the existing benefit and replacing it with something new.
Maria Miller: For clarity, we are not sweeping away the support that is available but putting in place a very modern approach to supporting disabled people, which has been designed working directly with disabled people and their organisations right from the start. I am not sure I agree it is a good thing to have so many people who don’t have basic eligibility applying, because there is a cost associated with looking at each assessment form. You will always have a level of misunderstanding about what a benefit is, and some people who apply do not have eligibility, but to have this scale of problem is something the Committee should be concerned about. It shows a basic lack of understanding, or perhaps a feeling that there is such a vague notion of who is eligible for DLA that many will apply just to see whether they are eligible, and perhaps that is not something the Committee should be satisfied about.
Chair: We have questions about how the Treasury managed to arrive at its 20% figure.
Q187 Sheila Gilmore: One of the habits of politicians is to say that we need to modernise things without putting any content into it. You have talked today and on previous occasions about bringing the benefit into the 21st Century. Can you give some examples of what you mean by that?
Maria Miller: These are things that were touched on by organisations that have given evidence to the Committee previously. One particular area I give as an example is the current problem with Disability Living Allowance, fully recognising the problems of mobility faced by people with severe learning difficulties. The higher rate Disability Living Allowance is very focused on individuals who have a physical impairment, and I think it is widely accepted that it is less able to deal adequately with the real needs of people with a learning difficulty or mental health problems. We experienced some of the limitations of the structure of the DLA primary legislation when changes were made to do with the blind or those with severe visual impairments.
First, in terms of modernising, this is a benefit on a very practical level that recognises the real needs of people with learning difficulties, but second, it is modernising the structure within which the legislation operates so it is more flexible to accommodate changes over time. I am sure the Committee would agree with me that our understanding of disability and how we can support disabled people is evolving over time, and it is something I am hoping to look at in more detail as part of the disability strategy that the Government are undertaking at the moment. I don’t know whether Dr Bolton wants to add anything to that.
Dr Bolton: My name is James Bolton. I am the Department’s Deputy Chief Medical Adviser. I have been leading on the development of the assessment. There are a number of ways in which, as we have gone through the current criteria for DLA, we have looked at ways to modernise them. We have been working with a group of independent people representing health, disability and social care and also with disabled people and representatives of disabled people’s organisations. That group has been working in a co-produced way to look at the existing DLA criteria. They were allowed to start with basically a blank sheet of paper and come up with ways they think it could be better. That is where the assessment criteria of PIP have evolved from. We have already heard the example of how Disability Living Allowance, particularly if you look at higher mobility, focuses on individuals with physical health conditions, yet for individuals with mental health problems the barriers in terms of what they can do and their ability to get out may be very similar. Those are the sorts of things we are looking to address.
Another example of what we have been looking at is that DLA is very focused on care and mobility, which are the criteria in primary legislation. We have had representation from various disabled people’s groups on things like communication, which is something DLA does not look at. What we have come forward with in our proposals is quite a complex scheme that looks not just at how an individual is able to communicate and what may be the barriers and costs associated with that but also social engagement, so there is also a nuance to some of the barriers to communication that can be created. What we have brought forward in our proposals, which we are co-producing and working on in a very consultative way, is much more holistic and broader than Disability Living Allowance. The other advantage of being able to specify this in regulation is to allow us a lot more flexibility. As part of the Welfare Reform Bill we have a review built into the process, and this is something we can keep constantly under review. As things change we have the flexibility to update it and reflect modern views and changes in society and medical care.
Q188 Sheila Gilmore: I have some difficulty in understanding where we are going with this. I don’t think anybody would say you should not have criteria that are more holistic and broader, and the examples the Minister has given are quite helpful. Clearly, if those are not covered by DLA currently and yet they give people a problem in engaging in their social or working environment, or whatever it is, we want to include that. That would suggest the new criteria and benefit will cover more rather than less people, against the backdrop from the outset of a forecast reduction in expenditure of 20%. How was that arrived at?
Maria Miller: As to the number of people who will be in receipt of the benefit, we have not yet finalised all of the assessment. The Committee will be aware that we published a revised set of assessment criteria with a weighting associated with it, but we have not finalised all of that and so we are not yet able to give you complete details as to who will receive the benefit in future. Keeping that in mind, what we have been trying to do throughout this process is take a fundamental look at who most needs support to live an independent life.
Q189 Chair: I am sorry, Minister. I am conscious of the time. We understand all that, but the question Sheila Gilmore asked was: given all of that, where did the 20% figure come from? If you don’t know the number who will qualify for the benefit, how could the Treasury say there would be a saving of 20%?
Maria Miller: I said right from the start that our starting point is a principled reform.
Q190 Chair: But that flies in the face of a flat 20% off the DLA budget.
Maria Miller: The Treasury looked at the Work Capability Assessment (WCA), which suggested that introducing a face-to-face assessment would reduce expenditure on DLA by about 20%. In response to the challenge from the Chancellor, we said we wanted to take a fundamental and principled look at DLA. It is not the first time the Government have done this; perhaps it has been done in the past, but we thought this was a great opportunity to be able to modernise a really important part of the support system for disabled people.
Q191 Sheila Gilmore: Therefore, you still have a savings target of 20%?
Maria Miller: Members of the Committee will be aware of what is in the Budget, and as Ministers in a Government that has inherited one of the worst budget deficits in recent years we have to make sure that the support we offer to some of the most vulnerable people in our community is sustainable in future. I think people would expect us to do that.
Q192 Sheila Gilmore: If you are to extend the new benefit to people who hitherto have failed to qualify because the criteria did not match them, are not a good number of the organisations who have given us evidence right to suppose that a lot of people will lose benefit altogether as a result of the changes you are proposing?
Maria Miller: I would urge the Committee to look at the figures and facts. The facts are that, at the end of the Spending Review period, we will be continuing to spend the same on PIP as we did last year on DLA. That is after eight years of significant increases amounting to around 30%,4 two-thirds of which is not to do with demographics. Therefore, rather than put in place a very different regime in which to operate, we will be operating with the same budgets in 2015 as we did in the last fiscal year. I think that would give the Committee some confidence that what we are trying to do is to keep that rate of increase more in line not only with what the country can afford at this time but also with the fact that we are not seeing an increased incidence of disability in our communities.
Q193 Sheila Gilmore: I presume you are assuming that the current rate of inflation will rapidly reduce; otherwise, in real terms spending will be considerably less than it was last year. Aside from that, are you not really still saying, if you want to take on new people, as well as holding down expenditure-presumably, there will be some inflation-that a number of people will no longer get a benefit? Do you have any assessment of what those numbers are in reaching your financial conclusions?
Maria Miller: As I said earlier, we have not finalised our figures because we have not finished the assessment yet; we are still working with disabled people and their organisations, and it would be wrong for me to prejudice that. You are right to say that there are tough choices to be made and I do not shy away from that, but what we are trying to do is make sure those are fair choices and that there is consistency in the way the benefit works in future, in the way there has not been in the past. You may agree that inconsistency itself is not fair to disabled people if individuals with similar conditions may or may not get the benefit support they need because of problems to do with a self-completion questionnaire, which is perhaps as good as the person who helps you fill it in. That is no way for us to run a £12 billion benefit-one of the biggest we have in this country-with a budget that is larger than the entirety of the Department for Transport.
Q194 Sheila Gilmore: Some of my colleagues may want to ask whether or not it is just a question of people filling in the form. There is quite a lot of dispute as to whether it is fair to say that is all that goes on here. As to the financial position, a lot of people were very pleased to see you have changed your mind about the removal of mobility allowance from people in residential homes, which is something people have campaigned against from the time it was proposed. That also had a savings implication because a reduction of some £160 million was in the financial estimates. Is your Department still expecting to find additional savings from the migration from DLA to PIP that now will not be found from removing mobility allowance from people in residential care?
Maria Miller: As you would expect me to say, the Department has very clear commitments to the Treasury in terms of the spending it is able to undertake in the spending review period. The answer to that question is, very firmly, that we will have to find the funding that was associated with the mobility component for people living in residential care, but we will not find it from within the Disability Living Allowance.
Q195 Sheila Gilmore: From within PIP?
Maria Miller: Yes.
Q196 Sheila Gilmore: So, it will be found from elsewhere in the Department’s budget?
Maria Miller: From the wider Department budget, and, as I am sure you are aware, that is a very sizeable amount of money; it is £158 billion in total.
Q197 Stephen Lloyd: What was the Department’s rationale for not retaining DLA but having face-to-face assessments? Obviously, it costs a considerable sum of money to transfer and bring in something completely different. I think most fair-minded people recognise that DLA needed a level of face-to-face assessment rather than paper, with some possible exceptions for very specific disabilities. Maybe one way we could have saved a few hundred million pounds was to retain DLA and have face-to-face assessments. Why was that never really considered?
Maria Miller: I will defer to Simon Dawson in a moment because he has a lot more of the detail on this than I have. It was considered. All options as to how we could make sure that the support we gave to disabled people was delivered in the most effective and cost-efficient manner were considered. There is a very strong case to be made that it would be impossible to deliver that within the framework of Disability Living Allowance because of the structure of the primary legislation. So much of the structure of the benefit is enshrined in primary legislation rather than regulations. Therefore, the ability to make those changes, which perhaps to you and I would seem very obvious things to do, would require changes in primary legislation, which led us very clearly to the need to move to a new benefit, not only in terms of the face-to-face assessment but the fact there is no inbuilt, systematic review either. To make those sorts of changes was very difficult within the structure of DLA. Perhaps Simon wants to come in.
Q198 Stephen Lloyd: Before he does so, I hope the new legislation includes a certain amount of flexibility so that if, in a few years’ time, whichever Government is in charge-hopefully, the Coalition or whatever-wants to change something again, it does not have to go down the route of primary legislation. That happens so often and is fantastically inefficient and very difficult for many disabled people.
Maria Miller: You are absolutely right, and we are structuring the new benefit to give us that flexibility in future.
Simon Dawson: To add to what the Minister has said, the cost of introducing more systematic, or face-to-face assessments, into the existing DLA, along with the associated IT, training and communication changes, would not have been far short of the cost of introducing a new benefit in its entirety. For example, the cost of the assessment would be about one-fifth of the overall cost of implementing the Personal Independence Payment, so introducing the sorts of changes that other witnesses have described into DLA would have resulted in, broadly speaking, the same sorts of costs as for Personal Independence Payment.
Q199 Stephen Lloyd: Moving on, I want to look at assessing the impacts of the reform. A number of disability organisations have been concerned that the change to two rates of the PIP daily living component, rather than the three of DLA care, will result in the current 650,000 working age lower rate DLA recipients losing support. I am sure you appreciate the anxieties there. Minister, you have said that this is simply speculation but, as I understand it, as yet we do not have a clear response from you as to exactly who is likely to lose out.
Maria Miller: I think the important point is that the reform we are putting in place is not as simple as removing the lower rate of DLA. The new assessment criteria are a more fundamental reform of the way we are supporting disabled people. The number of individuals who will benefit from that and those who will see changes to their awards will be forthcoming in the next few weeks as we finalise the assessment criteria and their weightings in discussions with disabled people and their organisations, and then put in place thresholds. Therefore, I cannot directly answer that question today.
Q200 Stephen Lloyd: I understand. Once you have made an assessment of what you think those numbers are, I would be very grateful if the Select Committee could get some information from you about the number of people you believe are involved. That would be very helpful.
Maria Miller: Perhaps I may reassure Mr Lloyd that is exactly the work that will be ongoing as soon as those assessments are finalised. Indeed, we have given a very clear undertaking to their Lordships in the other place that that information will be available prior to debate of this stage of the Bill in the Lords. That will be forthcoming shortly, and I am sure it will be helpful for the Committee to see that. I am sure officials will ensure that information is forwarded to you.5
Q201 Stephen Lloyd: Thank you for that. Many of the people who will be affected by DLA reform will also be affected by the Incapacity Benefit reassessment. What assessment has the Department made of the cumulative impact of IB and DLA reform on the capacity of disabled benefit claimants to meet their living expenses?
Maria Miller: This is something of which we are very conscious. There are many different changes being undertaken. We are mindful of the fact that, whether it is disabled or non-disabled people, there will be overlaps in terms of the impacts of these changes. That is something we are looking at very closely. When we have finalised the impact of the changes to DLA through the introduction of PIP we will be looking at that, but until we have finalised that it is difficult to provide a direct answer to your question. I reassure you that that is something of which we are very mindful. Of course, there are also some practical issues around that.
Q202 Stephen Lloyd: The next thing that slightly surprises me, from my own constituency casework, is that you and the DWP have rejected the argument that these reforms will have knock-on impacts on the NHS and social care budgets. In your judgment, does not DLA play any preventative role in this respect?
Maria Miller: You ask two different questions. One is whether or not the changes will have any direct effect on the amount of money people have to support themselves, and the other is whether there is a preventative effect. I am sure DLA, and soon to be PIP, has a very clear role in helping people continue to live an independent life both through working age and beyond retirement as well. From speaking to people who are recipients of DLA, that is absolutely the case. To reassure you, I see that continuing in future, but there are some issues about local authorities’ ability to take into account DLA. I don’t know whether Simon wants to comment on that.
Simon Dawson: As the Committee is probably aware, local authorities have always been able to charge against receipt of someone’s disability-related income, including the DLA care component, if they are receiving local authority-provided social care support. Equally, some local authorities choose not to do that, and where the benefits are taken into account councils should be guided by the overriding principle that charges do not reduce the user’s net income below basic levels of income support plus 25%, and do not result in the user being left without the means to pay for any other necessary care, support or other costs arising from their disability. Obviously, that will continue going forward.
Q203 Stephen Lloyd: Presumably, the DWP is liaising with the Department for Communities and Local Government (DCLG) and the Department of Health, because clearly there will be occasions when they will impact either on the local health service or local authority.
Simon Dawson: Both the Department of Health and DCLG are members of the crossWhitehall personal independence working group set up last year-there was a meeting of it today-to discuss issues related to the interaction between DLA or Personal Independence Payment and other services provided to disabled people, including passported benefits sponsored by other Government Departments.
Q204 Sheila Gilmore: If people who currently have social care lose eligibility for benefit, and that benefit is properly taken into account in assessing their fees, with all the safeguards you have suggested, is there not a knock-on consequence to local authority budgets?
Maria Miller: If an individual was deemed not to be eligible for the Personal Independence Payment, it would be because they would not have the need for that level of support, so by definition it would mean that individual was not in need of that level of support.
Q205 Chair: But it is a different assessment. The council will have gone in and done its assessment and assessed the person as needing X level of support. Today, that person probably has DLA care and uses it to pay for the council-provided care. If they don’t qualify for the new PIP, the council may still assess them as needing that care.
Maria Miller: The individuals who would be in need of that level of care would be assessed under the Personal Independence Payment as needing a level of care to remain living an independent life.
Q206 Chair: But it is a different assessment. The point is that the assessment you make in order to qualify for PIP is not the same as the assessment that a care manager will make of an individual in the community.
Maria Miller: The use of DLA, or in future PIP, is a way of assessing individuals, not just through social care but things like blue badges. People have used eligibility for DLA as denoting some level of care and need for support. That is for individual departments to consider.
Q207 Stephen Lloyd: I will give you the example of a case I am dealing with at the minute. A constituent had a wet room installed because her husband is on higher rate mobility DLA. For instance, if a few years down the line, for whatever reason, someone in that situation loses DLA, does it mean that the local authority removes the wet room, to give a slightly hyperbolic example? The real point we are looking at is that there will be changes and some people will lose. Presumably, there will be a system that then allows the local authority to reassess it, and remove the funds or make up the difference. That is where your conversations with DCLG will be very important.
Maria Miller: You are absolutely right-it is important that all of these knock-on effects are fully taken into account. That is why, as Simon Dawson has already outlined, we have a cross-Government group looking at these issues. It really is up to other Departments how they look at eligibility for benefits as a way for pegging eligibility for funding streams they may offer. Disability facilities grants are an area where the Government has increased expenditure, as I am sure Mr Lloyd is aware, and it is something to which we are very committed. It is for DCLG working with local authorities to look at eligibility for that income stream.
Q208 Chair: But they won’t get the facilities grant if, as a result of your changing the criteria that allow them to get PIP, they no longer get the equivalent of the higher rate mobility DLA. The wet room is a good example, because the criteria change. Someone who is a very active self-propelled wheelchair user needs a wet room in the same way that someone with profound disabilities needs a wet room, but one will get the 15 points and the higher rate because they have profound disabilities and the active wheelchair user does not, but both still need the wet room. You cannot say that passporting the benefits is up to other Departments. If you are changing the criteria on which they base a lot of their decisions, which saves them money because they do not have to reassess continually, surely that is of huge concern to your Department.
Dr Bolton: One of the things we have done within the assessment is recognise that individuals with wheelchairs will have significant extra costs. There are a number of points associated with requiring wheelchairs. I don’t think the example of the person who can walk and the person who cannot and is in a wheelchair necessarily works.
Q209 Chair: The active wheelchair user will get only 12 points. Will 12 points be the equivalent of the higher rate mobility DLA?
Dr Bolton: We have made no decisions yet about what the entitlement thresholds are, because we are continuing to work with disabled people and their groups on the weightings to be applied.
Q210 Chair: But this person does not get the wet room if that is not so.
Dr Bolton: To go back to the Minister’s earlier point, the key is that individuals with a level of disability we can recognise within the assessment will continue to receive PIP at either the standard or the enhanced rate. That is the key thing about it. The people who will not be receiving PIP are individuals who either have got better or, if they are new claimants, just do not meet the eligibility criteria in the first place.
Q211 Stephen Lloyd: I hear that. What we are saying-I am sure you are hearing us-is that there needs to be some very close integration on this; otherwise, there will be unintended consequences.
Maria Miller: To address that point directly, this is why we are working extremely closely with individuals in other Departments. I have had a meeting at ministerial level on this very issue as well. Passporting is an extremely important issue not just for disabled people but many other groups. I underline the point that it is for other Departments that may provide support to consider whether PIP is the right gateway to the support they offer in the future. There are clear examples, particularly if you look at the blue badge, where it is not just through entitlement to DLA that individuals receive a blue badge; there are other statutory measures, and local interpretation that can be put in place to guide the award of that particular very important passported benefit for disabled people.
Q212 Stephen Lloyd: One area where I have a lot of concern, which is shared by a number of different disability groups, is the qualifying period. Currently, there is a qualifying period of three months, with the extension to six months for the prospective test, and we are looking to move the qualifying period to six months. I have real concerns about people with fluctuating conditions, or even cancer for that matter. I know a number of different disability groups have made application to the DWP. They understand where you are coming from, but rather than changing from a three-month to a six-month qualifying period, which could be a long time for someone with a sudden onset illness, why not compromise by sticking with the three months but having the prospective test and stretching that out to nine months? My first question is: does the Minister accept that, when you have a sudden onset illness, six months before you can receive any DLA is a long time, and not a lot of people have six months’ money in the bank, to be perfectly honest? Second, what is the Minister’s view about the possible compromise of extending the prospective to nine months rather than six, but retaining three months?
Maria Miller: I would like to underline the fact that we have been meeting and listening very carefully to the concerns of a wide range of organisations on this issue at both official and ministerial level. My noble friend Lord Freud has also listened very carefully to the concerns raised in the other place about this. For the clarity of the Committee, it is important we remember that DLA, and in the future PIP, is there to support people with long-term conditions. I think there is general agreement that it is there to support people who have a disability that will last for 12 months or longer.
As he rightly says, the issue for individuals who have a sudden onset illness is how to get the balance right. Obviously, we have means-tested benefits to support people in the very short term who might find it very difficult financially. We want to make sure we retain the integrity of the benefit and it is there to support people who have long-term conditions. As I am sure Dr Bolton would want to say, it can be very difficult to understand the full impact, or perhaps ongoing impact, of a condition in the initial period, and there needs to be a period in which that condition can settle down. With stroke, for instance, for the first few months the individual may be in a very different situation from six to 12 months later, so we have to make sure we get the right balance between putting awards in place in a timely manner and the time when an individual really does understand the true impact of the condition on their day-to-day life.
Dr Bolton: Probably there is not a lot I can add to that. Stroke is a very good example. The first few months are often very critical; individuals can be in hospital for that period of time, having intensive investigations, rehabilitation, treatment and so on. The clear picture in many cases can be quite difficult to know early on. One of the other things we know from DLA is that many individuals tend to claim quite late on for their condition; they often do not claim at the start.
Maria Miller: For completeness, the Committee will be aware that we are minded to take forward the provisions within Disability Living Allowance to make sure there is immediate access for individuals who are terminally ill. We would make sure that was the same in the future.
Q213 Stephen Lloyd: Does not the proposal of extending the prospective test to nine months cover stroke?
Maria Miller: You make a very important point. We have to get that balance right. We are continuing to look at the detail and, as the debate progresses in the Lords, we will continue to make sure we get the balance right.
Q214 Stephen Lloyd: I appreciate that you are continuing to look at it. Though I do understand part of the rationale of the DWP, the CAB6 has come up with what I think is a rational compromise for extending the prospective test to nine months. I congratulate the Minister on listening to the concerns about the mobility component of DLA in residential centres and care homes and revisiting it. I am grateful for that. The Minister knows that I and others have lobbied on that frequently over the last few months. However, I want to ask about one matter that caused an awful lot of concern. Why did the DWP not do the research before the decision was taken because, as you said last week, the evidence of the overlap in funding is patchy at best?
Maria Miller: I understand the point you make absolutely. I would also like to pay tribute to the work Lord Low has done in this area, which has helped to improve people’s understanding, on top of the work that the Department has done. As I have said from the beginning, there is a very clear theoretical overlap in the payments made in social care and DLA mobility for individuals in care homes.
The intention to make the change was made known in October of last year, and, as soon as we started to hear the very real concerns of people on the ground, we looked immediately at what was happening in practice. That is where my comment about patchy practice on the ground comes from. We acted on that very quickly to provide reassurance to people that we would be looking at that in more detail. When we said in February that we would not remove the mobility component of DLA from October 2012, we also said we would look at the practice on the ground. We have spent the time since then looking at the very different ways that local authorities deal with this measure. What I did not want to do was pre-empt any recommendations or thoughts coming from Lord Low, so it was absolutely right that we waited for his report before we made any further comment on that. I agree with him that it would not be the ideal order in which to do it, but, given the necessities of a new government, that is where we were.
Q215 Teresa Pearce: Minister, I was going to ask why the Department believed it was necessary for most individuals to have face-to-face assessments, but in an earlier answer you said that experience of the Work Capability Assessment had led the Department to the conclusion that such assessment would reduce the DLA spend by 20%. Is the reason why most individuals will have face-to-face assessments just to reduce the budget?
Maria Miller: No. That was I believe the rationale put forward by the Treasury. My rationale is that I want to make sure disabled people have the right to be able to talk to somebody about their condition. Many, if not most, disabled people have more than one condition with which they are dealing. To be able to sit down and discuss that face to face with a health professional, and talk about the impact it has on day-to-day life, is a very valuable part of the new PIP assessment process. But it is only part of the new assessment process, because there will also be an application and an ability for people to be able to give professional evidence of the impact of the condition on day-to-day living. I believe it is important for disabled people to have that face-to-face assessment, but it is only part of the assessment process.
Dr Bolton: Over the summer we did some testing of the assessment criteria. One of the things it involved was G4S going out to do face-to-face assessments and gather information for us. At the end of that they did a survey; they sent out a questionnaire to the individual. Of those that came back, 92% were very positive. We had comments like, "It was very helpful to have someone who understood what I was explaining, such as the medical terminology and how certain symptoms affect my lifestyle as well as physically and mentally." We have a whole number of things like that. Huge numbers of people found this very positive and useful; they could tell their story and had a chance to show and explain. All of these were carried out in individuals’ homes, so the assessors were also able to see the kind of adaptations and changes that disabled people needed and were able to gather a very useful amount of information as well to help inform our development and testing.
Maria Miller: Indeed, I think it came out in previous evidence to this Committee that sometimes people find the very negative nature of the current DLA assessment form a very difficult thing to deal with, looking at their own condition in a very negative way, and to be able to discuss their condition with a professional will be incredibly beneficial.
Q216 Teresa Pearce: I am interested in what Dr Bolton just said, because that description of the process is not something that this Committee would recognise from the Work Capability Assessment. As we all acknowledge, the Work Capability Assessment had significant flaws, and yet the PIP assessment is designed along very similar lines. The lines you have just described are not the same as the work capability assessment. Can you tell me how much it will differ? One of the main problems under the work capability assessment was that they may be before a health professional but that health professional would have no experience whatsoever of the condition, whereas what you have just described is almost like matching the professional to the condition. Would that be possible?
Dr Bolton: In the testing we did we used predominantly occupational therapists. We don’t use occupational therapists for the work capability assessments. They have a skill set that has been very well adapted to this, and we gave them specific extra training on a number of conditions as well. Regarding the Work Capability Assessment (WCA), we have been very grateful to Professor Harrington. We have now had two independent reviews from him. His first highlighted that the WCA was the right assessment and it was not broken, but he did highlight that it was impersonal and mechanistic, and he put in a whole number of suggestions for us to help improve it around better communication, explaining things, improving the empowerment of decisions makers and so on. All of those things we have done. In his second independent review, published the other week, he noticed that things had noticeably changed for the better and came up with a series of further suggestions, such as more internal communications between decision makers and the work programme, engaging representative groups, greater auditing and so on.
The key point is that Harrington has shown us so much in both of his independent reviews. We have established an implementation development group that involves disabled people and their organisations to look at how we set up PIP and make it work. Central to all of that are the lessons we have already learned from Harrington. Therefore, when you talk about the WCA and doing something different on PIP, yes, absolutely. We are already doing something different on WCA, and it is important we learn all the lessons from it and do something different in PIP as well.
Q217 Stephen Lloyd: Are you stating absolutely that the improvements and changes that have happened last year in the WCA will be carried over into PIP? That is very important. There have been some improvements, but they have to be carried over.
Maria Miller: We are making sure that any relevant learning from the WCA is carried forward to PIP. Officials are very close to both projects, so that will be absolutely critical. It is also worth underlining for Ms Pearce that there is a fundamental difference between the WCA and the PIP assessment. The former is about whether you can work; the latter is based very much on a social model approach, which is, "What are the barriers to your living an independent life?" and using the assessment criteria as proxies for that assessment process. There are some fundamental differences but some learning that is common to both, particularly the point Ms Pearce raises about the importance of training those people and access to expertise for those who are undertaking the assessment.
Q218 Teresa Pearce: That is an interesting point, and that is why I am concerned the Treasury has come to the decision that it can reduce the budget by 20%. If the PIP assessment works correctly you might increase the budget, but that is a separate point. Organisations like Sense and the RNIB are concerned that the descriptions used at the moment for people who will go to face-to-face assessments mean that it will apply to most individuals, whereas they believe there are certain conditions, such as blindness or deafness, that will not get better and would not need those face-to-face assessments. A parent came to the Committee’s public meeting in South Wales. She talked about her 22-year-old autistic son who required observation over a two-week period to be assessed, so a short face-to-face interview would not achieve anything in those circumstances. Is there any chance that you will be looking at various conditions so people will not have to go to these face-to-face assessments, or are you still of the opinion that it will be almost everybody?
Maria Miller: I reiterate the point that the face-to-face assessment is only part of the way we would assess somebody’s requirement for support, so for the individual you are talking about, who has very complex needs requiring some time to disentangle or to understand fully, obviously evidence can be put forward from specialists or an individual he is dealing with on a very regular basis.
Q219 Teresa Pearce: But would a face-to-face meeting add anything to that? Surely, that would be sufficient information.
Maria Miller: What the face-to-face assessment as part of the overall assessment will add is the ability for an individual to come forward and talk about their condition to make sure that they do not have to face a self-assessment questionnaire by themselves.
Q220 Chair: With all due respect, I think the point that Teresa Pearce is trying to get at is that there must be some conditions where any doctor’s letter will say, "Because of this condition, the person is profoundly disabled." Therefore, why on earth do you need a face-to-face interview? Perhaps Dr Bolton can tell us the results of the pilot when the deafblind could not go through the assessment because translators could not be found for them. If you need a translator in order to interpret the assessment, surely that is the best illustration you need of the extra expenses associated with their disability.
Maria Miller: Just before Dr Bolton answers that, I was about to say that there will be individuals where there is sufficient evidence and there will not be a requirement for a face-to-face assessment. It would not be a good use of either that individual’s time or taxpayers’ money.
Dr Bolton: In the testing we worked with Sense, who represent people who are deafblind. They provided us with 41 volunteers, so we had a huge amount of information that was incredibly useful. They also did a report for us afterwards, which contained a number of very useful lessons that we are feeding into the development and delivery of all of this. That has been incredibly useful.
Q221 Chair: We have got the report and I was on the radio programme with one of the deafblind people. But what was your conclusion with the deafblind if you could not find translators for them even to do the assessment?
Dr Bolton: Indeed. I think it highlighted a series of very practical issues. We set it up during a short period and it ran over a relatively short period of time. I think at times we did fall short, and we recognise that.
Q222 Chair: But, surely, if somebody who is profoundly deaf has to come to an assessment with a translator, that is evidence of an extra cost, and PIP is about meeting extra cost as a result of disability. Here is an example of people who clearly have extra costs as a result of their disability because even to get through the assessment they must have help from somebody else.
Maria Miller: But we want to make sure that the appropriate support is in place, and that individual may not just have communication needs.
Q223 Chair: Hold on, Minister. You are not putting the appropriate support in place; that is something for the local authority, or whatever. All you are deciding are the proxies that will give this individual extra money for them then to decide how they will purchase their support.
Maria Miller: But the proxies are both in daily living and also mobility. To take a step back, the reason we think it is important to look at people on a case-by-case basis is that we are trying to adhere to a more social model approach to assessment rather than simply pigeon-holing somebody based on their condition. If we are going to take that through to its logical conclusion, which I think we should, each individual needs to be looked at on a case-by-case basis. Clearly, there will be some individuals for whom face-to-face assessment is wholly inappropriate. If I go back to those who have terminal illness, or some who have particular conditions that can be corroborated through medical evidence, nobody will be advocating unnecessary meetings, but if we are to take a more social model approach here, it is important we look at people on a case-by-case basis.
Q224 Sheila Gilmore: I am finding it hard to reconcile that with your earlier statement that one of the problems with DLA was inconsistency, in that people with similar conditions could receive different outcomes. Surely, what you have just said will again produce exactly that, which may indeed be a good thing because people’s needs do not necessarily derive directly from their condition but from all the circumstances. The social model is precisely about seeing that people’s circumstances are different, so you will get different outcomes. Therefore, you will still have a lot of different outcomes.
Maria Miller: Not for individuals who face similar barriers. That is where we want to get consistency.
Q225 Sheila Gilmore: Not where people have similar medical conditions but face similar barriers, because earlier you talked about people with similar medical conditions or disabilities receiving different outcomes.
Dr Bolton: I think that is the key. Because what we are looking at within the assessment are different activities. Any given medical condition or impairment will affect individuals in a different way. We do not know what that is. One of the advantages of face-to-face assessment is that you can see exactly; the individual can tell you in their own words and demonstrate to you, if necessary, how conditions affect them. One thing I would like to make clear about testing is that this was not a pilot of how we would expect to run things once PIP went out; it was about information gathering to help inform the development of the assessment. There may have been people involved in the testing who had very clear problems and who you may never want to see because their level of disability is very clear and it would be unnecessary to do that. The testing was to go out and try to gather broad information on a whole range of impairments to help inform the development of the assessment.
Stephen Lloyd: I think testing is good and the social model is spot on. My advice is that, even when you are doing something right, like the social model, have some flexibility, because to test the deafblind is demented. Have some sort of flexibility, even if it is having five reports from their GPs, medicals or what have you. The social model is absolutely spot on and I heartily approve of what you are doing, but, if you do not have any or inadequate flexibility, there will be some people with very specific and profound disabilities where it is almost criminally insane to do a face-to-face assessment. That is my advice.
Q226 Teresa Pearce: I have a final question about delivery of the assessment and whether or not you believe there are sufficient companies with the experience to deliver the assessment so there would be proper competition. One thing we discovered with atos and the work capability assessment was that the contract was drawn up on the basis they would be paid per assessment and there was no penalty for incorrect assessments; it was just for processing people. There is nothing about the standard. As for this particular group of people, what happened in the Atos contract was that, if people did not turn up, nobody followed up to find out why that was. For these people it will be very important to follow up why they do not turn up, because it could be something extremely serious. What is the number of companies out there that you think would be able to deliver this? It is very complicated.
Maria Miller: Perhaps I may deal with the first part of the question and then leave the officials to deal with the more commercial part of it. We are already working with disabled people’s organisations on delivery. We know about the work capability experience and Professor Harrington’s comments about making sure the claim and assessment process is a good and positive experience for claimants. We know that from WCA experience, but also, from the basic principle of making things work properly, we need to make sure we listen to and coproduce the claims and assessment process with disabled people. That is already an ongoing piece of work. In terms of the organisations who may deliver this, the Committee will be aware that we have already started the commercial element of the procurement process so there is not a lot of detail on which I can comment. Perhaps Simon wants to assist.
Simon Dawson: As the Minister said, the formal competition for the independent assessment provider is ongoing, so it is probably not appropriate to be discussing details of potential bidders or to speculate on the outcome, but I can reassure the Committee that there has been a considerable level of interest at this stage from a range of suppliers. We are fairly confident that there will be a sufficiently robust competition for us to be able to complete this piece of work. We have fairly recently commissioned some research into the health professional resource in the marketplace. That has now concluded, and we will use the outcomes of that research to inform both the commercial approach and the way in which we include that in the overall design of the Personal Independence Payment.
Q227 Chair: Will one company get the contract, or will there be competition within the contract as there is in the Work Programme, or will it all land on Atos 2 or whatever?
Maria Miller: At the moment, we are looking at the details. We will make sure that our commercial strategy is informed by all the feedback we get from the market.
Simon Dawson: It is something we are considering in terms of the commercial approach.
Q228 Chair: On a practical note, who will go through the migration first? Will you start with a soft approach? Will it be new claimants first, or will you bring in a particular age group? What time scale is involved in all this? Who will you hit first, and how will you decide the order in which people will be called in for interview for the new assessment?
Maria Miller: The details will be set out in the new year. I think we will undertake consultation on this, but our starting point is that we would look very much at new claimants and then build up from there, but any order of migration is something we would want to look at in detail through consultation.
Q229 Chair: I advise you to make sure that is very clear. I speak as someone who was elected when the Benefit Integrity Project suddenly exploded on the scene in 1997 and was aware of the fear and alarm it caused to exactly the same group who would be getting reassessed under the new PIP criteria.
Maria Miller: I understand there is a great deal we can learn from the previous administration about changes to DLA. There were considerable problems to do with that.
Q230 Chair: It was something the previous Conservative Government left to explode in the face of the new government. When you are sending out these kinds of letters to people who have profound disabilities, which is the cohort of the group who will be affected by this, it can have a destabilising effect on them and their lives.
Maria Miller: We would always want to make sure that migration to the new benefit is handled in a fair and transparent manner to avoid some of the past problems to which you allude.
Q231 Harriett Baldwin: I suppose that in terms of communications one of the things we have heard from a range of different sources is how widely it is thought DLA is just an out-of-work benefit. To what extent is one of the goals of rebranding DLA as Personal Independence Payment to try to help reduce that misperception?
Maria Miller: That is perhaps one issue, but there are many other reasons why we made a conscious decision to name the new benefit the Personal Independence Payment. For me, one of the most important reasons is that people felt the word "disability", although broadly understood and accepted, was not always seen as related to people who had mental health conditions or other conditions; it was felt to be more directly linked to people with physical disability. In trying to press forward with a modernised view and benefit, it was absolutely entirely right to go for a name that talked about the overwhelming objective here, which is independence, and not put anybody off from claiming it because they might not label themselves as a disabled individual.
Q232 Harriett Baldwin: Are there any specific steps that you would take differently to ensure that the new benefit is well understood, in particular the point about it being available whether or not you are in work?
Maria Miller: Absolutely. We will be working with disabled people and their organisations to make sure there is a clear understanding of the role of the benefit and, very importantly, to try to continue to work with the media, who often conflate Incapacity Benefit, Employment and Support Allowance and Disability Living Allowance into one big pot and can create some confusion there as well. I think that across the board it is a matter of making sure people understand the system and, hopefully, as a result of the introduction of the Universal Credit, some of those complexities that perhaps caused the confusion will also disappear, which I think will be helpful.
Q233 Harriett Baldwin: Will you be using other arms of Government-I am thinking of employment service providers perhaps on the Work Programme, and NHS staff-to help communicate the fact that the benefit can be claimed irrespective of whether you are in or out of work?
Maria Miller: We would accept any help and support on this, but particularly what is already offered through Jobcentre Plus, our specialist disability employment advisers and also our general employment advisers, who have training and knowledge of when individuals are able to claim benefits. But, first and foremost, it is a matter of making sure we have an understanding among the general public that this is something available to people with a wide range of disabilities, and building on that to say that it is also an in-work and out-of-work benefit.
Q234 Harriett Baldwin: We have heard that Baroness Campbell has proposed changing the name to "disability living cost allowance", or perhaps "disability living cost payment", which is felt to reflect its purpose quite effectively. Has the Department test-marketed the phrase "Personal Independence Payment", or any of these other possibilities?
Maria Miller: I think that the debate in the Lords on the name was very important because, as some of the individuals who have given evidence to the Committee have quite rightly said, what is most important is what it does rather than what it is called, but what we call things also has a resonance with people and it communicates what something is there for.
We undertook a series of focus groups to look at this in some detail well before we put the name Personal Independence Payment out into the general domain. Looking at some of the other ideas you have just talked about, we got some important feedback. Individuals felt that the word "disability", although it was understood, related to physical disability, and that perhaps the idea of an allowance was a little paternalistic. In trying to project a very modern benefit for the 21st Century and supporting people to live independently, I was at great pains to make sure we did not have something that echoed the past and was in any way seen to be paternalistic or old fashioned in its views or demeanour.
I realise this is a somewhat subjective area, and I am sure there are companies up and down the country charging great amounts of money to decide on names for products. I can assure the Committee that the Government did not spend great amounts of money on deciding on the name Personal Independence Payment, but it did draw on some important insights into some of the real issues that many disabled people feel they face. They do not necessarily call themselves disabled and yet they would be eligible for this benefit. We have to take these things into account.
Q235 Harriett Baldwin: One thing that has struck me most when I have met disabled groups in my constituency is that, because of the name change, there is a perception out there among some of the most vulnerable people that DLA is going, whereas it is being replaced with a different benefit. What are your thoughts on that communication as well?
Maria Miller: You are right in the comments you make. What is important here is that we are continuing not just with the Personal Independence Payment but also the £40 billion a year support for disabled people and a real commitment across Government to support people. Perhaps some of the coverage around this change has been unhelpful in suggesting that support is evaporating or disappearing in some way. That is absolutely not the case. I would hope that, as we move forward, organisations we are working with will be able to reassure the people they represent that this is not the case. It really is not helpful if people live in fear of something happening that may not happen, which includes some of the speculation about the future number of people who will be supported by the benefit. I think that until things are finalised it is important that we talk in facts as opposed to supposition.
Perhaps I may give the Committee a thought on that. We are very much committed to working by a method of coproduction with disabled people on the development of this benefit. It is the right thing to do, but it brings with it some problems. The problem it brings is that you often have to talk to people about things before you know all the answers, so we bring out a draft assessment framework before we know exactly how this is going to work because we want to involve people in that conversation and dialogue, listening to their thoughts. In the case of the assessment, my colleagues, under the guidance of Dr Bolton, have done a fantastic job in listening and acting on those concerns. But sometimes bringing forward that method of co-production raises more questions than answers. It is really important that people resist the temptation to fill in the gaps with conjecture, because it is not helpful.
Q236 Harriett Baldwin: Another angle on the communication side is the decision taken about 20 years ago to move to a form to assess DLA. The fact that the majority of claimants for DLA have been assessed on the basis of a form is not what we would think is a news story, but the Daily Mail ran a story about a "staggering" 94% of new claimants of DLA receiving their payments after only filling in paperwork, as if this was a shocking piece of news, yet that is the process at the moment. Again, communications around that, as we said in our report on Incapacity Benefit migration, are so sensitive, not only because it is a very sensitive area but because a lot of those who make these claims are some of the most vulnerable people in our communities. I just wonder whether you have any thoughts on how DWP can make sure the message gets out in a clear way that cannot be exaggerated by the Daily Mail. It is probably wishful thinking by politicians.
Maria Miller: I think the point you raise is a very important one. Through a desire to be transparent in the way we operate and by wanting to make sure people understand the facts and figures, we publish a great deal of information sometimes on an ad hoc and sometimes on a very structured basis; indeed, many of the national statistics are available through a tabulation tool on the DWP website that allows people to have access to the data. Obviously, they need to use that information responsibly. We have an excellent press department that provides context for people who contact us, but it requires people to contact us to be able to give them the context in which those data might be best viewed. It is very difficult for us to control the way the media choose to interpret information. Obviously, we would always do everything we can to ensure that information is put out there in the right context. But perhaps a much deeper point is that the press perhaps are reflecting a mood that we need to make sure our benefits system, whether it is DLA or elsewhere, has the integrity it needs and confidence of people to support the people who need that help. Perhaps we also need to take that into account. That is another reason why the development and launch of PIP, which I think has much stronger integrity, will be such an important thing for disabled people.
Q237 Stephen Lloyd: Minister, I am very glad to hear that. It is an issue about which I have spoken a great deal. On the back of what you have said, may I have a commitment that once this change has happened the DWP and you, if you are still the Minister for Disabled People, will go out and proactively sell how this is working and how people in receipt of it have disabilities and they are perfectly entitled to it? It has been a bit of a firestorm over the last year. I don’t accuse you, because I think you have handled it very sensitively, which I respect. I don’t think all Ministers have, but you have. When those changes do come through I would really like to see the DWP and the Ministers be very positive, on the front foot, about how important and justifiable it is for disabled people to receive PIP.
Maria Miller: I would underline that we take the issue of the language we use very seriously-all Ministers do-and we are clear it is the system that has trapped people into a spiral of welfare dependency, and it is the system that needs to change. Mr Lloyd is absolutely right that we have to make sure people not only understand what PIP is designed to do but that we are promoting it as a method of support, because it is important support. We want to see more disabled people being able fully to participate in our communities, whether that is in work or in other ways, and it is through the support of things like DLA/PIP that they can achieve that. We also have other strategies in place. Access to Work is another. I would reassure him that the strategy we are currently co-producing with disabled people will pick up many of these points and will definitely also serve to underline the points he is making.
Q238 Harriett Baldwin: Will part of the goal of achieving a new UK disability strategy be to show how the Personal Independence Payment is helping many disabled people to make a contribution, including as taxpayers?
Maria Miller: To take a step back from that, it is all about making sure people understand the importance of disabled people’s role in our society and breaking down some of the very real problems people face in contributing to our society today and reaching their potential. Of course, one way of disabled people being able to reach their potential in society today is to make sure they have the right support in place and access to it.
Q239 Karen Bradley: I apologise for my late arrival-the Prime Minister’s statement went on for longer than anyone anticipated. On the subject of the draft assessment criteria, we have had evidence of concern that the way they are currently designed means it assesses an individual’s impairments rather than the additional costs of disability. One example given is that the moving around descriptor awards 12 points to someone who cannot move themselves up to 50 metres without using a wheelchair propelled by themselves, but you get 15 points if you need another person to push you, or a motorised device. The evidence we have been given is that those two people may have exactly the same additional costs of disability, even though their impairments may be slightly different. Perhaps you would comment on how the draft criteria were established, with particular reference to the additional costs and the aids and appliances involved.
Maria Miller: The criteria are all about trying to identify relevant proxies for the sorts of additional costs that disabled people face. When it comes to these more technical questions, I look to my right.
Dr Bolton: The assessment is not a fully social model, but, in exactly the same way, it is not a medical model at all. We do not really look at impairment as I would define it medically. The example you gave was very helpful, in that it shows some of the discussions we are now having about the weightings. We have only recently published the weightings, and they are, if you like, a first indicative look that we came to after developing that with our assessment development group, which involved a series of independent people. We are now having a series of meetings with different disabled people and organisations to look at some of those data and ask, "Will the costs be any different? Is this a good measure? Have we got these weightings broadly right?" We used the assessment criteria and weightings as we have them against the testing that we performed over the summer. What we have done with this version-there are two-is something that is reliable and valid. We did the same validity and reliability test of the first version, which we published back in May. I have to say they were neither reliable nor particularly valid, and it is all the work we have been able to do through consultation, co-production and working with disabled people that has got us the much better version we have now. We can finish working on some of the fine detail about the weightings before we go on to look at the impact of this and publish further information on that.
Maria Miller: We are finalising the weightings and new assessment right now, and we will come forward with thresholds and go to another round of consultation in January.
Q240 Karen Bradley: That answers one of my questions about when the criteria would be finalised and whether there is further scope for consultation. That is very helpful. The only other point-you have answered quite a lot of the points raised-is the specific reference to fluctuating conditions, and whether there is likely to be any change in the criteria. We have heard evidence that it would be "a nightmare for assessors and claimants" to try to assess the impact of the fluctuating condition being experienced more than half the time over a 12-month period. Is this the sort of thing on which we may see some movement?
Dr Bolton: Indeed. In the second version of the criteria we recently published we again put forward this proposal of a slightly different approach to fluctuating conditions. Instead of talking about the majority of the time, we talk about the majority of days, which I think is something people can probably understand much better and, hopefully, is much simpler in terms of its application. We are very grateful to Lord McKenzie in the Lords Committee who said that the new draft criteria contain welcome recognition of the need to ensure that people with fluctuating conditions are not disadvantaged. It is an area that we have been looking at very closely. Again, going back to our testing, we made sure we had lots of individuals in there with fluctuating conditions, and we have been able to look at that very closely in the work we have been doing. As the Minister has already highlighted, we shall be starting formal consultation next year, and it is an issue we can look at again in our latest proposals.
Maria Miller: When we consider ability we will also consider whether activities can be completed safely, reliably and repeatedly in a timely manner. If they cannot, because of pain, fatigue or risk of an accident, it will be considered that an individual cannot undertake that activity. We are looking at this in great detail. We know it has been an area of real concern. We have been listening to people’s concerns and trying to adapt the way we approach this to give them confidence that the assessment will support them in the way we know it needs to. It is in our interests that we get this right.
Q241 Karen Bradley: Will the criteria be flexible enough to take account of how long a task takes, not just whether you are able to do it or not? We heard evidence in the Committee’s trip to Neath about a gentleman with Parkinson’s taking a bath. He could take a bath but it might take a long time, and therefore he might need extra support to enable him to do that.
Maria Miller: To be clear, it is that activities can be completed safely, reliably, repeatedly and in a timely manner.
Q242 Chair: If there were to be a truly social model on which you operated, you would take into the account the need for adaptations, but they do not feature anywhere in your criteria. Who are you assuming will pay for the adaptations if they are not part of the criteria that will give people money through PIP?
Maria Miller: We are going to deal with aids and adaptations in exactly the same way as they are dealt with under Disability Living Allowance, so there is no change in the way we will deal with that.
Q243 Chair: Remember, you are trying to improve it, and very often it is other things. At the moment, the fact that somebody uses a wheelchair acts as the proxy; it is assumed that they will have extra expense in terms of adapting. You talk about using appliances but not about adapting. That goes back to the "wet room" argument we heard earlier. It operates in that respect, but under the new PIP the use of a wheelchair by itself does not get you the full number of points.
Dr Bolton: To be clear about our approach to aids and appliances, the approach we put out in the first draft of the criteria was slightly different from what was in DLA. We consulted on that extensively. In the second version we have changed our approach. The approach has gone back to that under DLA. One thing I would highlight is that within the criteria we do pick up where there are aids, appliances, adaptations and so on being used. The key thing in all these activities is to look at how the individual is able to do that in a normal environment, if you like. If anything has to change about that environment and it has to be adapted around them, or they need aids or appliances to help them do that, they will move down the descriptors and an appropriate weighting is given for that. Again, part of the work we are doing at the moment is to make sure we have those weightings quite right and having discussions on making sure the criteria reflect those correctly.
Q244 Chair: That is where a lot of the costs for those with physical disabilities arise for which they use DLA. Some of them borrow against the DLA in order to make adaptations to their home, work environment or whatever when they cannot access it through Access to Work or facilities grants. We know that those things are limited. That helps to save government money because people have control over <?oasys [pc10p0] ?>what they put in their house, whereas through facility grants you get what you are given and often that is the expensive thing.
Dr Bolton: Absolutely. Those are the kinds of things we are trying to pick up with the assessment as we have developed it. I have been talking a lot today about the testing. The way in which we did the testing was to get in groups of independent experts to look at our cases completely separate from the criteria and at the information gathered and give an indication of what they felt was the level of need. It was against that that we then made our assessment and the weightings applied and compared the two. There was very good correlation. That is how we know that what we have here is working in a very reliable and valid way.
Q245 Chair: One of our witnesses said to us that in this whole process there are no winners, only losers. What is your response to that?
Maria Miller: I disagree. The approach I outlined when we started this session today clearly states that we want a benefit that better reflects the way we as a society want to support disabled people in the 21st Century rather than two decades ago. I would expect to see people who perhaps in the past have been somewhat short-changed by DLA get proper support in the future, and the groups of people I have outlined in my previous answers to questions have already given the Committee some examples of where we will see real support for people who perhaps in the past have not had the help they needed.
Q246 Chair: And if that costs more money?
Maria Miller: We are being very principled in this approach, but we are, as the Committee knows, clearly living in an environment when we are trying to deal with an enormous deficit, so for everybody’s sake, including disabled people, we have to make sure we have a benefit that is sustainable into the future. We will be spending the same on PIP at the end of the Spending Review period in 2015 as we spent on Disability Living Allowance last year, and that is after eight years of growth amounting to 38%.7 The Government remain committed to Disability Living Allowance, but I think the broader support in the form of the £40 billion we put in every year to support disabled people through services demonstrates we are very committed to making sure disabled people have the support they need to live independent lives where they face challenges in doing so.
Chair: On that, thank you very much for giving us your time this afternoon.
 Individuals in receipt of Personal Independence Payment would continue to be entitled beyond age 65 so long as they continue to satisfy the eligibilty criteria. This age-limit will increase in line with the changes to State Pension age.
 This refers to an increase in overall Disability Living Allowance spendi ng in real terms from 2002–03 to 2010–11 (2011–12 prices).
 DWP, Analysis of Disabilty Living Allowance: Awards , March 2011: http://dwp.gov.uk/asd/asd1/adhoc_analysis/2011/analysis_of_disability_living_allowance_DLA_awards.pdf
 This refers to the growth in the number of claimants on Disability Living Allowance between 2002–03 and 2010–11.
 Ev 111, also see: www.dwp.gov.uk/pip
 Citizen’s Advice
 This refers to an increase in overall Disability Living Allowance spending in real terms from 2002–03 to 2010–11 (2011–12 prices).