Dr Matthew Offord (Hendon) (Con): Last Friday, I was very pleased to visit the NHS Blood and Transplant centre in Colindale to listen to the concerns of management

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and staff. One concern that was raised with me was the low level of blood donations from ethnic and minority groups. That is a particular problem because that blood is used to treat people with sickle cell anaemia. Will a Minister come to the Dispatch Box to advise on how the Government are trying to encourage people from ethnic minority groups to give blood?

Mr Lansley: I agree with my hon. Friend that we owe blood donors a huge debt of gratitude. Each unit of blood donated helps us to save the lives or improve the health and the lives of three people; on average, one donation helps three people. That is important and I hope that everybody will recognise it. He raises an important specific point. NHS Blood and Transplant runs regular donor recruitment campaigns, including those to encourage blood donations from black and minority ethnic donors. It works with the media, particularly those of particular relevance to those communities, and with celebrities who have support in those communities. In addition, the Department of Health has established the National Black, Asian and Minority Ethnic Transplant Alliance, which brings together organisations to tackle the issue of low donor and transplantation rates in those communities.

Alison McGovern (Wirral South) (Lab): Can we not have a debate in Government time on the state of the high street? Now that we understand the shakiness of the Government’s jobs figures, does it not make the Leader of the House’s assertion just now that market forces will prevail look worrying indeed?

Mr Lansley: The hon. Lady may wish to go, with others, to the Backbench Business Committee to seek such a debate. The employment figures are not shaky; they are absolutely robust. They are telling us that a great deal of private sector job formation is taking place, and that is very important. It stands in direct contrast with the situation in many other countries. We know that we are suffering from the economic effects of the eurozone crisis, but in contrast with a number of countries in the eurozone we have relatively robust employment figures. That is evidence of the Government’s support for the private sector.

Andrew Selous (South West Bedfordshire) (Con): The Bedfordshire and Hertfordshire local medical committee, which represents local GPs, has written to me and other MPs to raise its concerns about people coming to this country to access free health care. It says it wants help on this issue, so may we have an urgent debate on how we can offer that?

Mr Lansley: I understand very well the point my hon. Friend is making. The Government have concluded a major review of the rules and procedures on charging visitors for NHS care. It is important that we understand that those who are here, on whatever basis, have access to emergency care, but that there are rules about those who have access to non-emergency care or continuing care beyond primary care. I hope that Health Ministers will be able to make an announcement about the results of that review soon.

Chris Bryant (Rhondda) (Lab): I do not want just a statement on Europe; I want a full debate on Europe in Government time. In the old days, we used to have

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four debates a year before European Councils and four statements after European Councils so that the Government’s policy could be scrutinised by the House. I know that they were pretty tedious affairs, with single transferable speeches delivered time after time, not least by myself. It would be good if we could have a bell fitted behind the Speaker’s Chair, so that every time the word “Europe” is mentioned all Pavlov’s dogs on the Government Benches could start slobbering—




Mr Speaker: There is nothing disorderly about that remark, but I leave Members to make their own assessments on the question of taste.

Mr Lansley: You are absolutely right, Mr Speaker—there is a distinction between what is in order and what is charming, and that was charmless. I also noted that following oral questions earlier, the hon. Gentleman did not take the trouble to apologise for being completely wrong in suggesting that I had incorrectly informed the House about what was in the ministerial code, but be that as it may.

I think it is a tremendously positive innovation that a substantial proportion of the House’s time is not in the gift of Government but is available to the Backbench Business Committee. That includes time that was previously allocated to a range of general debates for such purposes. If the hon. Gentleman feels strongly about the need for a debate on Europe, he should get together with other Members and go to the Backbench Business Committee to seek it.

Tessa Munt (Wells) (LD): The Glastonbury road run is an established, popular and safe annual charitable fundraising event, supported with great good will by our local police and other services. Should the council choose to use the Town Police Clauses Act 1847 because the street is “liable to be obstructed”, local charities lose no funds, but if the council elects this year to use the Road Traffic Regulation Act 1984, the organisers will receive a demand for £1,000, which will have to be paid from charitable donations. Will the Leader of the House raise the matter of clarifying the regulations to separate commercial from charitable street events so that the latter are treated with reason and common sense and not as a county council fundraising effort at the charities’ expense?

Mr Lansley: I am grateful to my hon. Friend for that question and will of course raise the issue with my hon. Friends at the Department. I might be wrong, but I think that in such circumstances the local authority has the discretion to waive those fees in certain cases.

Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op): Despite a 400% increase in the demand for food banks since 2010, the Prime Minister has neglected to give clear answers to me or to my hon. Friend the Member for Rotherham (Sarah Champion) about whether he will visit one. May we have a debate on the subject of food banks in this Chamber so that we can bring the facts to the Prime Minister, if he is unwilling to go and see them for himself?

Mr Lansley: I heard the Prime Minister’s reply during Prime Minister’s questions yesterday, and the hon. Gentleman might recall that during business questions

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last week I made it clear that my hon. Friend the Member for Loughborough (Nicky Morgan) and I have visited a food bank. We rightly appreciate the service that is being provided by food banks and the Department for Work and Pensions operates a food bank referral service that works with them, including, in particular, the Trussell Trust. The Government are also working independently, not least through the Healthy Start scheme, which helps about 500,000 very low-income families across the UK to buy milk, fruit and vegetables as part of a healthy balanced diet.

Guto Bebb (Aberconwy) (Con): According to TripAdvisor, the town of Llandudno in my constituency has some of the best guest houses in the world. However, if they want to increase business by offering a complimentary glass of wine to their residents as part of an evening meal, they face the disproportionate cost of acquiring a licence. May we have a debate on the Government’s proposals, as set out in the alcohol strategy, for reducing licensing burdens on these ancillary sellers of alcohol?

Mr Lansley: Yes. I am grateful to my hon. Friend. If I recall correctly, there was very positive coverage of at least one hotel in Llandudno earlier this week—

Chris Bryant: Over here.

Mr Lansley: Yes. If the hon. Gentleman will allow me, I was referring specifically to Llandudno in my hon. Friend’s constituency for a second. I sometimes wonder, Mr Speaker, whether the hon. Member for Rhondda (Chris Bryant) wants to be in charge of the order of the House. It seems rather impertinent, does it not? If I were disorderly, you would call me to book. I do not need the hon. Gentleman for that to happen.

I can give my hon. Friend the Member for Aberconwy (Guto Bebb) some reassurance. On 28 November the Government launched a consultation on whether to reduce the burdens of licensing on businesses that sell alcohol only as a small part of a wider service. That includes guest houses or bed-and-breakfast accommodation that wish to provide alcohol to guests as part of an evening meal. That consultation can be found on the Home Office website. I encourage him and all interested parties to respond before the closing date of 6 February.

Jonathan Ashworth (Leicester South) (Lab): May we have a debate on Government waste by Departments? Figures that I have uncovered show that Government Departments have produced more than 5,500 circulars, consultation documents and publications since May 2010 at a cost of over £1.3 million, including such exciting titles as “Code of Practice on Noise from Ice-Cream Van Chimes”, “Understanding the relationship between taste and value in culture and sport”, and my personal favourite bedtime reading, “Is your dog barking too much?” Is this really a good use of taxpayers’ money?

Mr Lansley: I do not have comparative data, but I suspect that under the previous Government there were at least equivalent numbers, but probably much larger numbers of consultations taking place, and the hon. Gentleman knows that perfectly well. Our responsibility is to make sure not only that we engage the public by consulting fully and adequately, but that we make effective progress with business. That is why we introduced in the

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latter part of last year a new structure for consultations that means that they will be conducted more expeditiously. We will make more progress more quickly and we will help business, not least as a consequence of that, to get certainty more quickly, and it will help us in the process of reducing the burden of regulation.

Christopher Pincher (Tamworth) (Con): Some 1,080 people from Tamworth started apprenticeships last year. May we have a debate in Government time on the new traineeship programme so that we can explore how we can further help young people successfully to compete for jobs and avoid the welfare trap that all too many of them endured under Labour?

Mr Lansley: Yes, I hope we might find an opportunity, by one route or another, for further discussion of the announcements made by the Minister for Schools. Traineeships are a welcome addition to the armoury, so to speak, to ensure that all young people get access to the right skills and that all employers find young people in this country who have appropriate skills and attitudes in order to go into work. My hon. Friend is right. Since the election more than a million people have started apprenticeships. The budget has been increased, and even where apprenticeships are not appropriate, through the youth contract work experience and other support to the young people who most need skills have been growing under this Government.

Andy Sawford (Corby) (Lab/Co-op): Will the Leader of the House find time for a debate on the uses and abuses of zero-hours contracts, which plague many people in my constituency, particularly the most vulnerable workers?

Mr Lansley: If the hon. Gentleman specifically wants to raise abuses, I am sure my right hon. and hon. Friends at the Department for Business, Innovation and Skills would be interested to hear from him. I encourage them to respond to him about the nature of those contracts. In some cases—for example, in relation to the NHS—I looked at some of those contracts, and they can play a part in the effective management of a work force and may sometimes be in the interests of workers themselves, as well as their employer. It is all a matter of what the appropriate circumstances are. The hon. Gentleman might like to look for an Adjournment debate or some other opportunity in order to raise these issues.

Oliver Colvile (Plymouth, Sutton and Devonport) (Con): In the light of the recent rioting in east Belfast, some have suggested that some of the youngsters involved feel that they are not included in the decision-making process. At what stage does my right hon. Friend think Parliament should assess progress on the Good Friday agreement, especially as far as community relations are concerned?

Mr Lansley: I further remind the House and my hon. Friend of the opportunity to raise such issues with my right hon. Friend the Northern Ireland Secretary and her colleagues on Wednesday next week.

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My hon. Friend will be aware that the 1998 Belfast agreement clearly set out the constitutional position in Northern Ireland and the accountability mechanisms that follow from it. I also say to my hon. Friend that the violence and public disorder in Belfast is completely unjustifiable; I do not think it is justified or excused by reference to any issues of that kind.

Natascha Engel (North East Derbyshire) (Lab): Has the Leader of the House had the opportunity to make a decision about bringing e-petitions fully in-House, so that people are aware that they are petitioning Parliament and not the Government? If he has not yet had a chance to make that decision, will he sit with me and construct a timetable to make sure that it can be done as quickly as possible?

Mr Lansley: As the hon. Lady will know from our discussions and a previous answer in business questions, I am keen for us to make progress on this issue. No decisions have been made, of course; in any case, I hope that such matters would be for the House.

I hope that we can get together and consider how we can take forward what has been a substantial success. There are now a large number of petitions; there have been some 8 million signatures on 40,000 petitions since the e-petitions website was created. We must not prejudice that, but we must try to make it as relevant as we can to the work of the House, and the hon. Lady’s Committee has done a great deal on that. I am very open to further discussions, and we are working on the issue now.

Mr Philip Hollobone (Kettering) (Con): What on earth is going on at the UK Border Agency? It has never had the best reputation in the world for the timeliness of its responses to Members’ inquiries, but in the past two or three months, it seems to have got many degrees worse; many of my constituents in Kettering are awaiting replies to correspondence that is two or three months old. May we have a statement from the relevant Minister to make sure that the UK Border Agency sorts out its correspondence protocols?

Mr Lansley: My hon. Friend will recall that during questions last week and previously I said that the chief inspector acknowledges that the Border Agency still has a great deal of work to do, but that the situation has started to turn around and is now improving. However, I share with my hon. Friend and many other Members a sense that there is still a way to go. There is a huge volume of correspondence, which is why the agency is introducing a national operating model in March, under which correspondence from hon. Members will be managed through a single process. Guidance has been issued to staff, stressing the need for all correspondence to be dealt with promptly. However, I will take up my hon. Friend’s question with the relevant Minister at the Home Office.

Diana Johnson (Kingston upon Hull North) (Lab): From the official figures, which are going to be announced next Wednesday, it will no longer be possible for Members to obtain constituency statistics on the number of jobseekers after each job in their constituencies. That is a real issue in my constituency, which has been top for many months—50 jobseekers after every vacancy. There is no legitimate reason for that statistic not to be provided, so

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may we have a debate on why the Government are choosing to suppress the inconvenient figures that give a real indication and insight into what is happening with local employment around the country?

Mr Lansley: I will, if I may, talk to my right hon. and hon. Friends at the Department for Work and Pensions about that. I am not familiar with the background to the hon. Lady’s point; the availability of statistics through Government Departments is normally approved through the UK Statistics Authority. I will certainly inquire through the Statistics Authority or the Department to ensure that the hon. Lady gets a proper reply, which I can see, too.

Mr David Burrowes (Enfield, Southgate) (Con): The equal marriage Bill will be published next week. Will there be a statement to explain the rush to redefine marriage and will it address the information from the Commons Library that in the past 12 years no Government Bill determined by a free vote has been announced before the Queen’s Speech?

Mr Lansley: My hon. Friend seems to have constructed a very particular question about something that may not have occurred because relatively few Government Bills are conducted on a free-vote basis, but I will gladly look back to see what the precedents are. Let me reiterate what I said in last week’s business questions: we have not yet introduced this Bill. My hon. Friend seems to be more knowledgeable than I am. I do not have a timetable for its introduction; I know that we will do it soon but I have not established a date. When the Bill is introduced, we will of course make it very clear how it is properly to be considered.

Ian Lucas (Wrexham) (Lab): It is

“a terrible time to have the diversion and uncertainty which build-up to a referendum would entail”.

Those are not my words but those of the Business Secretary, reported in the Financial Times as what he is going to say today. Is not the reason the Prime Minister will not come to the House with a statement following his speech the fact that he cannot speak on behalf of the Government he leads because they have no coherent policy on Europe, and that is damaging British business and British interests?

Mr Lansley: I am afraid I simply do not accept a word of that. The Government are very clear about what we are doing. We are conducting a review of competence the purpose of which is to enable this country to engage in a negotiation that would lead to a more competitive and more flexible Europe. I heard the hon. Gentleman’s leader saying on a radio programme this morning that he was in favour of a more flexible European Union and that he believed that there were powers that needed to be brought back to this country. He and his party appear to be willing the end but denying the means.

John Glen (Salisbury) (Con): Will the Leader of the House make time for a statement on the performance of the NHS bursary unit? One of my constituents, Thomas Petch, is among a large number of students who have

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failed to receive the bursary to which they are entitled, causing massive inconvenience as they rely on it to fund their everyday living.

Mr Lansley: My hon. Friend makes an important point on behalf of his constituent. The changes in the NHS bursary application procedure mean that continuing students need to reapply for their bursary each academic year. A large number of continuing students did not reapply as requested, and this has led to a backlog. I know that the NHS Business Services Authority will take every measure it can to reduce and manage that backlog quickly. May I assure my hon. Friend that his constituent, Mr Petch, will receive his January payment in the next week?

Fiona Mactaggart (Slough) (Lab): On 14 February it is an international day of preventing violence against women, and MPs from all parties have supported the notion that this House should contribute to events and debates on that day. If the Leader of the House were to make an early decision and inform the Backbench Business Committee that 14 February would be a day on which it could allocate time, it might allocate it to such a debate. Will he tell the House now that we can have that debate on 14 February?

Mr Lansley: I am afraid I am not in a position to make that announcement now, but I entirely understand the hon. Lady’s point, not least because I heard her and other Members make it to the Backbench Business Committee at its meeting on Tuesday. I will discuss with my colleagues whether we are able to meet her request and the requests of other Members and liaise with the Committee on that.

Kris Hopkins (Keighley) (Con): On Sunday 10 March the Sue Ryder Manorlands 10 km race will take place in Keighley—an event that has raised £120,000 over the past four years. May we have a debate not only celebrating the moneys raised but on how such great events bring communities together?

Mr Lansley: Yes, I am glad to have the opportunity to share in my hon. Friend’s support for the 10 km run, the money that it raises and the good causes that it will be supporting. It is an illustration of something that Members across the House understand from their communities—that this kind of voluntary action enables people to have a great deal of fun, in this particular instance, to be healthier, and to offer a great deal of support to other people who are in need.

Kevin Brennan (Cardiff West) (Lab): May we have a debate on the cost of ministerial travel? Further to what my hon. Friend the Member for Wrexham (Ian Lucas) said earlier, it is clear that the Prime Minister will not be making his speech in Holland as Prime Minister and leader of the coalition Government, as other Ministers have said, but as leader of the Conservative party on what the Conservatives will do in five years’ time in the unlikely event that they will be in government, so should not the Conservative party be paying for this trip?

Mr Lansley: I will say two things. First, I am afraid that the hon. Gentleman is wrong. The Prime Minister will speak tomorrow in the Netherlands as Prime Minister.

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The position is very clear—he will speak as Prime Minister and if, during the course of that speech, he refers to the Conservative manifesto or beyond the next election, he will, of course, be referring beyond the scope of the coalition agreement. That is quite usual—there is nothing unusual about it at all.

I do not have the figures in front of me, but if the hon. Gentleman wants to have a debate about the cost of ministerial travel in this Parliament relative to its cost in the previous Parliament, we would be very happy to have it.

Glyn Davies (Montgomeryshire) (Con): I have raised in previous business questions the potential negative impact on the organ donation system in England of plans by the Welsh Government to change the system in Wales to one based on presumed consent. Yesterday I received a copy of a letter to the Welsh Government from the UK’s foremost expert on the issue, pointing out that the consultation process adopted by the Welsh Government was fundamentally flawed. Will my right hon. Friend arrange an early opportunity for MPs to discuss this crucial issue before damage is done and it is too late?

Mr Lansley: My hon. Friend makes a very important point. These issues do not relate solely to Wales; they also relate to England, because they have direct implications for the organ donation system in England. I made that clear to the Welsh Assembly Government when I was Secretary of State for Health and I know that my right hon. Friend the Welsh Secretary will have done so, too. I do not know what opportunities there may be for a debate on the matter in this House or, indeed, in the Welsh Grand Committee, but I will certainly discuss it with my colleagues.

Yvonne Fovargue (Makerfield) (Lab): This week the Legal Services Commission confirmed a £655,000 cut to the Law Centres Network, the Advice Services Alliance and the Royal Courts of Justice’s citizens advice bureaux service. May we have a debate on what that will mean for those organisations, the organisations they support and, most importantly, the people who will no longer be able to use them?

Mr Lansley: The hon. Lady may have an opportunity to raise that issue at Justice questions on Tuesday 5 February, but if that seems far off and she would like a response on the specific implications, I will gladly talk to my right hon. Friend at the Ministry of Justice and secure it for her.

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Backbench Business

Atos Work Capability Assessments

11.53 am

Mr Michael Meacher (Oldham West and Royton) (Lab): I beg to move,

That this House has considered the matter of Atos work capability assessments.

I warmly thank the Backbench Business Committee for enabling me and cross-party colleagues to introduce this debate on Atos work capability assessments. There is enormous concern about the issue both in the country and in this House, as witnessed by the fact that more than 30 Members wish to speak on a Thursday. To try to ensure that they can all do so, I propose to speak for no more than 10 to 15 minutes. I hope that colleagues will accept that, for reasons of pressure on time, I do not propose to take interventions.

As knowledge of the debate has spread, I have been sent nearly 300 case histories, many of which make heart-rending reading. I cannot begin to do justice to their feelings of distress, indignation, fear, helplessness and, indeed, widespread anger at the way they have been treated. Nor can I easily contain my own feelings at the slowness, rigidity and insensitivity with which Atos and the Department for Work and Pensions have responded—or very often not responded—to the cries of pain that they have heard repeatedly. I have time to cite briefly only three examples which show how extreme is the dysfunction and malfunctioning of the Atos assessments.

The first example concerns a constituent of mine who was epileptic almost from birth and was subject to grand mal seizures. At the age of 24, he was called in by Atos, classified as fit for work and had his benefit cut by £70 a week. He appealed, but became agitated and depressed and lost weight, fearing that he could not pay his rent or buy food. Three months later, he had a major seizure that killed him. A month after he died, the DWP rang his parents to say that it had made a mistake and his benefit was being restored.

The second example, also from the Oldham area, concerns a middle-aged woman who was registered blind and in an advanced stage of retinitis pigmentosa. She was assessed at 9 points—well short of the 15 that are needed—and her incapacity benefit was withdrawn. On review by a tribunal, the Atos rating of 9 points was increased to 24.

The third case—I could have chosen from hundreds of others—also comes from the north-west and concerns an insulin-dependent diabetic with squamous cell cancer, Hughes syndrome, which involves a failed immune system, peripheral neuropathy, which meant that he had no feeling in his feet or legs, heart disease, depression and anxiety. Despite his life-threatening condition, he was placed in the work-related activity group.

Those and myriad other examples illustrate incontrovertibly that Atos’s current work capability assessment system is drastically flawed, and for several reasons. First, Atos is an IT firm and it uses the so-called Logic Integrated Medical Assessment, which is often described as “rigid” and “tick-box” because computer-based systems make it difficult for health professionals to

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exercise their professional judgment. Because such a mechanistic system has little or no regard for the complexity of the needs of severely disabled or sick persons, the British Medical Association and others have condemned the current WCA as “not fit for purpose”.

Debbie Abrahams (Oldham East and Saddleworth) (Lab): Will my right hon. Friend give way?

Mr Meacher: Despite my hon. Friend being my colleague in Oldham, I really must keep strictly to what I said, but I very much hope that she will be called.

Secondly, assessed persons regularly felt that the opinion of their own doctor or of other specialist medical personnel who were treating them was either ignored or overridden. That is all the more serious when Atos’s practices simply do not adhere to the guidance for doctors set down by the General Medical Council.

Thirdly, because of the failure of so many initial assessments, the appeal procedure is grossly overloaded and hugely expensive. No less than 41% of decisions are appealed, of which 38% are won. At £60 million in a single year, the appeals have cost the taxpayer more than half of the £110 million that was spent on the original assessments. Moreover, the National Audit Office has castigated the Department for failing to penalise Atos for what it politely calls its “underperformance” and for not setting “sufficiently challenging” targets.

Fourthly, there are concerns about the responsibility for work capability assessments, in particular that of the Atos chief medical officer. Professor Michael O’Donnell joined Atos from the American company, Unum, formerly UnumProvident, which had a very poor reputation in the US, where it was described as an “outlaw company” by the US authorities, partly because it was regarded as a “disability denial factory”. In that situation, the responsibilities of the Minister and the Secretary of State need to be established clearly.

Against that background, it is frankly not good enough for the Minister to respond to the debate by saying that there have been three Harrington reviews, and that the Department is doing the best it can to improve procedures. The fundamental issue is this: how can pursuing with such insensitive rigour 1.6 million claimants on incapacity benefit, at a rate of 11,000 assessments every week, be justified when it has led, according to the Government’s own figures, to 1,300 persons dying after being put into the work-related activity group, 2,200 people dying before their assessment is complete, and 7,100 people dying after being put into the support group? Is it reasonable to pressurise seriously disabled persons into work so ruthlessly when there are 2.5 million unemployed, and when on average eight persons chase every vacancy, unless they are provided with the active and extensive support they obviously need to get and hold down work, which is certainly not the case currently?

I therefore want to conclude by asking the Minister five specific questions to which I want a specific answer before the end of the debate. First, it is true that Harrington has produced minor adjustments—implemented at a glacial place—but the underlying system remains largely undisturbed. The BMA and the NAO have therefore called for a thorough, rigorous and transparently independent assessment of the suitability of the work capability assessment. Will the Minister now implement that?

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Secondly, will the Minister accept that the current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems? How will he rectify that?

Thirdly, will the Minister provide full and transparent details of the Atos contract? They should not be hidden by specious claims of commercial confidentiality when Atos is the sole provider of what is clearly a public service. Better still, given that Atos has failed so dramatically, why does he not in-source the work back into the NHS?

Fourthly, how will the Minister ensure that the medical expertise of disabled persons’ doctors and related professionals is fully taken into account before assessments are completed?

Lastly, I want to provide a full dossier to the Secretary of State so that he fully understands what is being done today in his name, and to bring a small delegation to see him from some of the excellent organisations of disabled people who have heroically battled to highlight and tackle the distress and pain caused by Atos. Can I please be assured that the Secretary of State will see such a delegation?

I repeat that I am sincerely grateful for this debate, for the co-operation of colleagues from all parties, and for the detailed responses I have received from so many hundreds of victims of Atos, but I assure the Minister of this: the debate is important, but it will certainly not be the end of the matter.

Several hon. Members rose—

Mr Deputy Speaker (Mr Nigel Evans): Order. If everybody could resume their seats, I just want to inform the House that there are 28 Members who wish to participate in this relatively short debate. My responsibility is to protect Back Benchers’ time and get as many Back Benchers in as I possibly can. While we are starting at six minutes, you should start to think in terms of a four-minute contribution if you possibly can, so that as many Members as possible can get in.

12.4 pm

Mrs Cheryl Gillan (Chesham and Amersham) (Con): I offer my hearty congratulations to the right hon. Member for Oldham West and Royton (Mr Meacher). He has long been known as a champion in this area. I listened carefully to what he had to say and I am afraid that my experience, and that of the people I have been talking to, mirrors much of what he is saying.

I would like to address the debate from the perspective of people with autism. There is a great deal of concern on both sides of the House, and among our constituents, about the way this process handles people with autism. The National Autistic Society, which provides advice to so many of us in this House and on which we rely a great deal, believes that the work capability assessment should be delivered differently so that it is fair and appropriate for claimants with autism.

More than 2,000 people have signed a National Autistic Society petition to Atos, which was launched following the “Dispatches” and “Panorama” investigations, with which many of us are familiar, into the company last year. The programme claimed that Atos was working to internal targets on the numbers of people being put into

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the work-related activity group, the support group or as being fit for work. Atos has indicated that it is open to working with the National Autistic Society and other charities, including in the context of this petition, but I have a specific question for the Minister. Will the Minister provide assurances that no such targets are in place?

There have been key concerns with the face-to-face assessment process. The work capability assessment model can certainly prove to be challenging in the context of claimants with autism. Most people with autism have difficulties with social interaction, and some will also lack insight into their difficulties. They may also have difficulty understanding the questions being asked and with communicating a response. Even travelling to the assessment centre and engaging with the process may be difficult to understand and create great anxiety. Therefore, face-to-face assessments may not always result in a fair and accurate assessment of claimants’ ability to work. The NAS has had a lot of inquiries relating to the quality and appropriateness of the WCA for claimants with autism, and that feeds into a broader picture of widespread concern.

There is also concern about the awareness of, and training for, assessors. In the cases of claimants with autism, including high-functioning autism and Asperger’s syndrome, difficulties in the workplace may not be obvious and may not become apparent in the course of a face-to-face assessment. That could be due to the hidden nature of the disability and a desire to appear more able than they really are to an assessor, or to other difficulties with this form of communication associated with the condition. It is therefore a strongly held view that it is vital that claimants with autism are assessed by professionals who have received autism-specific training. That would ensure that assessors have a better understanding of autism and routinely make reasonable adjustments as part of their assessment.

Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op): Will the right hon. Lady give way?

Mrs Gillan: If the hon. Lady will forgive me, I have only a short time to speak.

I think people are pleased that the Government have committed to having mental and cognitive champions, but I believe that people are concerned at the number of champions, their level of training and their expertise in autism. Our understanding is that there about 60 across the UK and it remains unclear what, if any, expertise they have in autism.

On collecting evidence, the NAS has consistently called for a tiered approach to assessment, both in terms of the WCA and the assessment process, for the personal independence payment under the new benefits system. I hope that the Minister, who has met recently with the NAS, Mind and other organisations, has listened carefully, and I am looking for reassurance in his response that all these points will be taken onboard.

In summary, I have a few questions for the Minister. What steps will the Government take to ensure that Atos collects existing evidence relating to a claimant’s capability to work, which would create a more cost-effective and streamlined system? Do WCA assessors receive autism-specific training? If so, of what does it consist?

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How many of the mental and cognitive champions currently operating at Atos assessment centres have specific autism training? How will he monitor the effectiveness of the introduction of those mental and cognitive champions?

I am sorry I could not give way to the hon. Member for Hackney South and Shoreditch (Meg Hillier), because I know she has a great track record and a special interest in this matter, but I hope that she will make her own speech. I hope that I have reflected in my contribution the widely held concern about this process among those least able to speak for themselves, and I hope that the Minister will respond positively.

12.10 pm

Natascha Engel (North East Derbyshire) (Lab): I pay tribute to my right hon. Friend the Member for Oldham West and Royton (Mr Meacher) and thank him for bringing this debate to the Backbench Business Committee. We were delighted to schedule it, and the number of Members present from both sides of the House demonstrates the importance of this issue mainly from a constituency perspective. I, like all other Members, have received a huge amount of correspondence about awful, tragic cases of individuals who have been badly treated by Atos during their work capability assessments.

The fault lies not with Atos, but with its employer, which, in this case, is the Department for Work and Pensions. When we look at the other employers for which Atos works, such as Royal Mail and the NHS, we see numerous cases of people who have been signed off work—not just their current work, but for any work ever again, with a recommendation that they be retired from all kinds of work—going back to Atos, but this time when it is employed by the DWP, and being assessed as entirely fit for work. They get no points and are deemed fit for work. As my right hon. Friend said, the number of people who are not just not fit for work but who die after being assessed as fit for work, is a reflection not of Atos but of the DWP. That is where the questions need to be asked.

Ian Mearns (Gateshead) (Lab): I am sure that my hon. Friend will not be surprised to learn that in Gateshead, of the 1,400 cases taken to appeal by the citizens advice bureau, more than 1,200 were successful. I am worried about the CAB’s lack of capacity to deal with other cases that it could have taken but which have been unsuccessful because they were not advocated at tribunal.

Natascha Engel: I am glad that my hon. Friend has made that point as I want to come to that.

The proportion of original Atos decisions that are overturned is shocking—it is about 30% or 40%. I would be grateful if the Minister replied to that point. Precisely how many people deemed fit for work by Atos have their decisions overturned on appeal and are signed off work? I have asked about that in the past. The number is very high, but I would like to have the precise figure.

The welfare rights organisations dealing with the people who are being deemed fit for work—for instance, the unemployed workers centre in Derbyshire and the CAB—are swamped at the same time as they are having their funding cut. Not only are they swamped with

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work, but volunteers are leaving in droves because they cannot cope with the amount of work and the stress of seeing all these cases.

How many people deemed fit for work who do not take their cases to appeal then find work? As has been said, the employment situation, especially the further north we go in the country, gets worse and worse. In my constituency, there are 15 people applying for every job. Is it really for the best to sign people as fit for work when there are no jobs to be had? I would like answers to those specific questions.

We all want people to go back to work if they can, but the welfare state is there to protect those who cannot. People who are not fit for work would love to work if they could, but they cannot. The jobs are not there, but they are being signed fit for work. How many of them are getting a job, and how many of them are just being signed over to destitution?

12.15 pm

Stephen Gilbert (St Austell and Newquay) (LD): I join hon. Members in congratulating the right hon. Member for Oldham West and Royton (Mr Meacher), the Backbench Business Committee and my hon. Friend the Member for North Cornwall (Dan Rogerson) on securing this timely debate.

As the hon. Member for North East Derbyshire (Natascha Engel) said, we need to separate two things. The first is the principle of assessing those on out-of-work benefits to establish whether they can rejoin the workplace. As everyone in the House accepts, that must happen if we are to be responsible guardians of the public purse and if we are to help people who can work to get back into work. The second is the need to look in detail at the practice of how the assessments are being conducted.

Mr John Leech (Manchester, Withington) (LD): I am grateful to my hon. Friend for giving way so quickly. A number of people who have been assessed reasonably recently had their incapacity benefits stopped but then reintroduced on appeal are now being reassessed and found fit for work once again. Surely people who have recently been assessed and won on appeal should not be being recalled by Atos.

Stephen Gilbert: I absolutely agree with my hon. Friend and what he says goes to the nub of the points I wish to make. This debate should focus on the practice of how these assessments are being conducted. He, like me and probably every Member, will have had scores, if not hundreds, of constituents experience a similar problem as they go through the system.

There is a consensus in the House on the principle of making assessments. The last Administration set up the WCA and the Atos contract in 2008, and it was right that in 2007 Liberal Democrat Members pressed for and secured the annual review of how the WCA was being implemented. Over the last few years, as every hon. Member will know, these reviews have revealed a catalogue of errors, and, to their credit, the coalition Government have taken action: there has been increased flexibility for assessors to take additional evidence, not least from consultants; there has been better communication with people undergoing assessment; and new standards have been implemented for descriptors. All that is having

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results. The numbers going into the ESA support group have risen to 26%—from 11% under the last Administration —so fewer people are now being found fit for work.

None of us can underestimate or undervalue the human effect that some of these assessments are having. I would like to read into the record an e-mail I received from a constituent. It is probably similar to e-mails that all hon. Members have received. It reads:

“They never asked about the amount of pain I have to contend with or how tired I get from coping with it. After the interview I was told I was to be disallowed ESA benefit. I could probably go down the route of appeal but I really don’t feel like fighting for a benefit that I have already been made to feel that I do not deserve, neither do I have the energy”

to appeal. If we in this House cannot give voice to these people, who are some of the most vulnerable in our society, I really do not know what we are for.

Steve Rotheram (Liverpool, Walton) (Lab): To illustrate one of those cases, I shall cite a letter I received from a constituent, Janine, in Liverpool. Her dad was thrown off sickness benefit in November after an Atos work capability assessment and was declared fit for work despite suffering from chronic obstructive pulmonary disease. Six weeks later, on Christmas day, Janine’s father died. Does the hon. Gentleman agree that this example clearly highlights the fact that the work capability assessment, run by the DWP, is fundamental flawed?

Stephen Gilbert: As I have said, and as I am sure the hon. Gentleman would acknowledge, the point is not the principle of conducting assessments but the practice—how they are rolled out and how millions of our constituents experience them. Constituents have told me that they find the process dehumanising and degrading and that they are often seen by people who are unqualified to make an assessment of their condition. We have to get the assessment process right. That is right for the individuals concerned, but it is also the decent, moral and humane thing to do.

I am particularly concerned about those with fluctuating conditions such as ME—myalgic encephalomyelitis, or chronic fatigue syndrome—and those with lifelong degenerative conditions, who will never recover from the illness from which they are suffering but who continue to be called in for repeated assessments. The principle is the right one; the practice, however, is failing many millions of the most vulnerable people across the country. Although the coalition has made welcome efforts to get right a system that it inherited from the last Government, much more still needs to be done to ensure that we are doing things in a humane way.

Annette Brooke (Mid Dorset and North Poole) (LD): Does my hon. Friend agree that most people were extremely pleased that Professor Harrington convened his working group to look at the descriptors for fluctuating conditions? However, whatever has happened has not solved the problem for people with ME, multiple sclerosis or mental health conditions. It is therefore imperative that the DWP get on with this and make the system work for those people.

Stephen Gilbert: I could not have put it better. This is not about the principle of assessments; it is about how they are conducted in practice. We owe it to some of the most vulnerable people across our country to ensure that we get this right.

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12.22 pm

Pamela Nash (Airdrie and Shotts) (Lab): Nothing has shocked me more as the Member of Parliament for Airdrie and Shotts than the sheer scale of anxiety and hardship caused by the flawed work capability assessments, which is apparent in the number of people visiting my office every week. I am sure that that experience is replicated across the House and that we will hear many such stories today. I have had a frail lady sitting in my office who had only recently finished chemotherapy but had been told she was fit for work. I have had a lady who suffered 90% burns to her body—she spends every day in severe pain—and was told that she was now ready to join the Work programme. I could list hundreds of others—sadly, these are very familiar stories. These people are having their lives ruined by a system that was designed to support them.

Last year the whole country came together to celebrate the Paralympic games. I have to say that the vast majority of the country joined those booing in the Olympic park when the Chancellor took the spotlight, but he was not the only unpopular person at the games. Atos’s sponsorship was also widely condemned, leading to protests throughout the country, including by our very own Team GB. Unfortunately, the Scottish Government have not listened to the Scottish people on this. In fact, our Deputy First Minister has welcomed Atos’s sponsorship of the Commonwealth games next year. She has tried to wriggle out of it by saying that Atos is only carrying out the will of the UK Government. However, the Scottish people disagree not only with the structure of these work capability assessments but with the incompetence with which they are being carried out.

As I have such limited time today, I will restrict the rest of my comments to the recording of work capability assessments, which I have raised before on the Floor of the House. I know that there has been a pilot of recording work capability assessments as a result of Harrington review. The result was that the majority of those being assessed do not wish to have their assessments recorded. However, recording should continue to be offered to everyone being assessed, and the reason for doing this—the huge number of assessments whose results are overruled when they go to appeal—should also be explained to every claimant.

Caroline Lucas (Brighton, Pavilion) (Green): The hon. Lady is making a powerful case. Does she agree that the Atos assessment process is not only humiliating and demeaning for those involved—and often plain wrong—but counter-productive, in the sense that it adds to the stress they are under, making sick people even sicker?

Pamela Nash: I thank the hon. Lady for that contribution. I am sure she has had the experience, as I have, of seeing people who have claimed employment and support allowance as a result of a physical disability or illness ending up with mental health problems owing to the stress of going through the system.

Wayne David (Caerphilly) (Lab): Does my hon. Friend agree that it says a great deal about the nature of the work capability assessment that not only do many people win their appeals but that so many are appealing that this can lead to delays of up to 25 weeks for them to be heard?

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Pamela Nash: I completely agree with my hon. Friend. We have heard that one in six of those claiming ESA ends up eventually winning their appeal, but in North Lanarkshire—the local authority area that I live in—60% of appeals are being won by those lodging them.

To return to the recording of assessments, the Minister’s predecessor, the right hon. Member for Epsom and Ewell (Chris Grayling), made it clear in a Westminster Hall debate last September that he felt that Atos

“should make recording available on a voluntary basis”.—[Official Report, 4 September 2012; Vol. 549, c. 42WH.]

However, not a single constituent of mine who has come to see me about work capability assessments has told me that they have been offered the prospect of having it recorded. In fact, one constituent told me that she had asked for her assessment to be filmed, following her previous assessment, which resulted in a report that bore little resemblance to that assessment. On that occasion she was found fit for work, but she subsequently won her appeal. She was informed that recording would indeed be possible, but that she would have to pay for a private, independent company to come in to record her assessment. Equipment was not made available to her. She had hoped to take a family member in to film the assessment, but was told that this would not be allowed or appropriate. How on earth is a person living on benefits—living on the breadline—supposed to be able to afford to pay a private company to record their assessment?

The Minister’s predecessor also stated in that debate that additional audio recording machines had been ordered for work capability assessments. I hope that the Minister can today update the House on the progress made on that and on whether visual recording equipment is being purchased for that purpose. I would also like clarification on the right of the claimant to request a recording. If claimants have that right, will the Minister make it clear whether Atos is obliged to provide a recording? Will Atos reschedule an assessment date if the person concerned is told that equipment is not available on the original date? In the event that a claimant refused to go through with an assessment without a recording, would they be sanctioned in terms of their benefits?

This is an important issue to raise in the House today. Not only does it affect those going through the assessments directly, but there is a huge cost for the taxpayer, as my right hon. Friend the Member for Oldham West and Royton (Mr Meacher), who has brought this matter to the House today, illustrated in his speech. This process has cost £60 million in the last tax year, which is more than half the original cost of the contract with Atos to perform the work capability assessments.

12.28 pm

Robert Halfon (Harlow) (Con): I supported the right hon. Member for Oldham West and Royton (Mr Meacher) at the Backbench Business Committee and I congratulate him on securing this debate.

Briefly, I want to make three points. Britain is rightly generous to its disabled people. That is a good thing and something that unites the whole House. That said, there have always been problems with Atos. As a major contractor, it has repeatedly failed to inspire confidence and needs shaking up. Thirdly, whatever the party politics,

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we must clear our minds of hyperbole and focus on the evidence and the facts. People are always fearful of change. Whatever our differences on this issue, we must focus on the politics of fairness, not the politics of fear. It was suggested in the other place that disabled people were facing “ghettoisation”. I think that is a trivialisation of the real evil of the holocaust, which is why I say that how we use our language and the facts that we set out are so important.

Debbie Abrahams: Like many Members here today, I feel very strongly about this issue on behalf of the hundreds of constituents who have come to see me with heart-rending cases and told me about the dehumanising process that they have been put through. Why does the hon. Gentleman think the Department for Work and Pensions and Atos have been unable to accept the recommendations of the British Medical Association and the Royal Colleges for more specific diagnostic tests that would make the assessments more appropriate?

Robert Halfon: I am here today because I care about this issue as much as the hon. Lady does. The fact remains, however, that it was the previous Government who signed the contract with Atos that led to all the problems and started the work capability assessment. This Government have accepted in full the recommendations of the Harrington review.

The disability living allowance was first introduced by John Major’s Conservative Government in 1992 as a way of helping people with the cost of their care and mobility needs. It is partly because of that reform that we now spend £50 billion a year on support for disabled people, which is one fifth higher than the EU average. I am glad that the coalition has rapidly expanded the access to work budgets, helping more than 30,000 people to retain and enter work. By this April, the disabled worker element of the working tax credit will have risen by £285 a year since the Secretary of State started in his job in 2010. The element for the severely disabled will have risen by an extra £125 a year on top of that. The Minister has said before that Britain is acknowledged as a world leader in its support and care for disabled people, and that that is something we should all be proud of.

I have initiated and signed early-day motions on these matters, and hon. Members will know that I have been an outspoken critic of the French multinational Atos in this House since November 2010, because of its treatment of a number of my constituents in Harlow, and I will go on to talk about that in a moment. I want to emphasise that this Government are expanding on what subsequent Labour Governments did after 1997.

Mr Dave Watts (St Helens North) (Lab): Will the hon. Gentleman give way?

Robert Halfon: I want to carry on for a moment.

The Labour Government were right to introduce the work capability assessment in the last 18 months before the 2010 election. The right hon. Member for Stirling (Mrs McGuire), the shadow Minister for disabled people, was also right at the Labour conference to defend the idea of testing in the personal independence payment, when she said:

“The principle of an arm’s-length assessment is not wrong.”

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Whatever party politics might be involved, there is consensus on the principles and on what our aims should be, and that is welcome.

Mr Kevan Jones (North Durham) (Lab): The hon. Gentleman is correct in saying that the first contract with Atos was introduced by the previous Government, but why did the present Government renew and extend that contract even though they knew about all the problems that he and others have raised in the House?

Robert Halfon: This is where I agree with the hon. Gentleman. I was very disturbed when Atos got the contract for the personal independence payments.

Mr Jones: That happened under this Government.

Robert Halfon: Yes, that is what I am saying. The reasons that were given included the fact that the infrastructure was already in place, and the cost of changing the contractor.

Mr Watts: Will the hon. Gentleman give way?

Robert Halfon: I have given way twice; I need to carry on.

As I have said, Atos has not covered itself in glory. It was the main contractor when the coalition came to power, but the problems are significant. For example, the Atos benefit assessment centre for my constituents in Harlow is in Romford, 20 miles away, and it has been a source of complaints and genuine disappointment to many. I have met Ministers several times to make these points and, to be fair, they have listened to and acknowledged them. I have also made a trip to an Atos centre in London to try to understand what occurs there.

I welcome the changes that have been made by putting in place champions with expertise in mental, cognitive and intellectual conditions, but the objections from many Harlow people are not about the principle of testing, but about how it is done. We have to remember that whenever a disabled person goes for a test, that creates an enormous amount of fear inside them, because they worry that something that they rely on might be taken away. Their objections are simple ones, but the problems have massive implications for ordinary people.

The problems include centres that are inaccessible, and a long distance away. It can be difficult to travel to them, and there might be no parking there. There are sometimes no rails on the walls. People might have to lose a whole day’s earnings to attend, or use up a day’s annual leave. Some centres are on the second floor, with no proper lift. The testing centres can be hard for people in wheelchairs to get into. Some of my constituents tell me that they have been tested by doctors who do not even speak English properly. All of that is totally unacceptable, especially when people are going to those centres in fear and apprehension that that their benefit will be taken away.

I accept that, because of the contractual history, it is difficult to unwind the arrangement. What matters, however, is that we should learn lessons from what has happened to people who have been tested by Atos and use that information for the future. It is essential that those people who are tested for the new personal

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independence payment should go to a local centre and not have to travel far. I can understand why people should not be tested by their own doctor, but I do not understand why they cannot go to another surgery in their area to be tested. It is unacceptable that they have to travel so far, as those journeys take up an enormous amount of time. I urge the Government to look at radical localisation, and to consider the use of spare rooms in local buildings, including jobcentres.

The people who bring their complaints to me do not have an axe to grind. They just expect a public service to be as good and professional as the private sector. Given the experience of my constituents, it seems that the system that Atos has set up is still not good enough.

Several hon. Members rose—

Mr Deputy Speaker (Mr Nigel Evans): Order. The time limit on Back-Bench speeches is now five minutes.

12.36 pm

Mrs Madeleine Moon (Bridgend) (Lab): My caseworker, like those of many Members, is inundated with cases that are tragic and heart-rending. The telephone line to my office is often clogged with crying people. They often ring several times a day, as they are unable to cope with the stress that they are facing. Many have mental health problems, and are unable to cope with the paperwork. They are unsure what to do with it, and they ring me to ask for help in the most tragic and personal way.

Meg Hillier: My hon. Friend raises the issue of people with mental health problems. Does she agree that that is an area of great concern, along with other conditions that can fluctuate, such as HIV and AIDS? Such conditions are difficult to assess in a 15-minute interview. Does she also agree that it is the framework of the assessment that is at fault, and that Atos might have something to answer for as well?

Mrs Moon: It is absolutely clear that the framework of the assessment is unable to clarify realistically whether someone is able to work. The assessment is not valid for the purpose for which it was set up, unless that purpose was deliberately to deny people access to benefits.

Kevin Brennan (Cardiff West) (Lab): The head of Atos was recruited from Unum in the United States. Is it not disturbing that the lieutenant governor of California has stated that Unum was operating “claims denial factories” for working men’s compensation? Does not that disturb my hon. Friend?

Mrs Moon: It disturbs me a great deal. Quite honestly, the lieutenant governor was right to say that, because that is what we have found in this country too.

I want briefly to describe some of the cases that I have been dealing with. I shall start with 53-year-old Mrs E, who was employed as an accounts officer. She was a very able and capable woman. She suffered a vicious sexual attack, and was diagnosed with post-traumatic stress disorder. Her health problems caused her difficulties with working, and she was forced to take redundancy. She started claiming employment and support

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allowance, and attended her Atos assessment. The doctor who saw her is well known to me. I have received many complaints about him. I regularly receive complaints about his rudeness, arrogance and total lack of compassion towards the people whom he is assessing. He made unprofessional remarks to Mrs E, and bluntly told her carer to shut up, saying that he did not want to hear from him.

An official complaint was made, but Mrs E was found fit for work. An appeal judge overturned the decision maker’s decision and she was placed in the support group. Three months later, she faced another Atos medical, and it was decided that she would be fit for work in six months. She was then placed in the work-related activity group. A month later, because of the stress, her mental and physical condition had deteriorated, and medical advisers told her to apply for disability living allowance. DLA was refused because of the original Atos report. When it was pointed out that the report was negative, but had been overturned on appeal, a reconsideration was requested. The DWP insisted that the information from the first Atos assessment was sound and that the only option was to appeal to the first-tier tribunal.

My constituent then faced two tribunals. We should remember that this is a lady with post-traumatic stress disorder. She faced two appeals. The first was for DLA. The decision to award the lower rate for mobility and care was backdated. Since then, another DLA application has raised the mobility and care components to the higher rate. The second appeal tribunal was for the employment and support allowance. She was placed in a support group and her benefit was backdated.

That was not the end of this lady’s trauma. Her mental health had deteriorated to the extent that she attempted to take her own life. Her carer has to remain constantly vigilant. A few months later, she received a letter saying she had been transferred back to the ESA work-related activity group from the support group. Payment for the ESA support component was stopped. Following some investigation, the DWP apologised and said that that was a random “administrative error”, but it affected the lady very badly and her mental state became even more fragile.

Despite that, incredibly, on Christmas eve last year the same “administrative error” occurred. My office was contacted, and I have to say that we were extremely angry. The additional stress was placing this lady in a suicidal position again. The application process started again, and yet again there has been an apology for an “administrative error”. This lady is being hounded by the state: there is no other way of describing it. There is no excuse for this behaviour. This is a company that is not playing fair by this country’s most vulnerable people.

Nic Dakin (Scunthorpe) (Lab): Will my hon. Friend give way?

Mrs Moon: I am afraid I cannot; I have only a short time.

Atos received £112.8 million in 2010-11 for its DWP services. About 60% of all claims are judged fit to work; 41% of those people appeal, and 38% of those appeals are successful. Last year, appeals cost £54 million.

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How can that be seen as value for money? How can this be seen as evidence of a supportive and caring Government in action?

Here are my questions to the Minister. We are told that specific support staff for mental health will be provided. Are they in place? Are they aware of the trauma of post-traumatic stress disorder? Is sensitivity training available, because it has certainly not been made available to the ex-GP who works as an Atos assessor in my area? Has the DWP looked at the cost—to Members, to citizens advice bureaux and to welfare rights organisations—of fighting this iniquitous system?

12.43 pm

Annette Brooke (Mid Dorset and North Poole) (LD): I rise to make just a few comments, particularly on fluctuating conditions. I have received many representations from people with mental health conditions, as have other Members. Some of the individual cases and stories that sometimes come from mothers with adult daughters about what has happened during the assessment process have been absolutely heartbreaking.

Let me read out a few comments from one of my constituents, who says:

“I do not believe that the WCA is working for people with mental health problems. Too many people are found fit for work when they are not, and are becoming trapped in a distressing and expensive cycle of appeals and reassessments. Too much of the decision making is inaccurate and too often the WCA and related processes worsen people’s mental health.”

Mr Watts: Does the hon. Lady agree that, given that everyone in the House knows that Atos is not fit for purpose and given that we know the Government have taken no action on it, we can believe only that the Government are supporting Atos as long as lots of people are getting signed off and put back into work?

Annette Brooke: I think we are here today to point out that there certainly are problems, and I await to hear the Minister’s response to them. We need to remember that a great deal of improvements to the system have been made since the Labour Government set it up in the first place. That does not mean, however, that the situation cannot be improved. I think it is right and proper for us to point out where we feel improvements should be made.

Margot James (Stourbridge) (Con): I have visited my local Atos and have sat in on an appeal at the local tribunal, but I do not share the universal condemnation of Atos that I have heard in this House. Does my hon. Friend acknowledge that Professor Harrington reviewed the system three times with particular reference to mental health and that he concluded that the improvements were starting to have an impact so that, in his view, no fundamental reforms were needed to the current work capability assessment?

Annette Brooke: I thank my hon. Friend for her intervention, and reiterate that it was a positive move by the coalition to ask Professor Harrington to do this work.

I would like to refer briefly to the issue of ME—myalgic encephalomyelitis. I understand that although the discussions on ME were very productive, the changes

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that we all want are not coming through individually. What we are looking for today is a means of unlocking some of the frictions that are causing the individual problems.

I am chair of the all-party parliamentary group on ME, so I have obviously received many representations on this matter. I would like to draw the Minister’s attention to a survey on the work capability assessment carried out by the charity, Action for ME. It had 203 responses. I commend the report to the Minister and hope he will read all the conclusions. I shall refer only to several of them as I do not want to take up too much time.

The conclusions included one to the effect that

“all face-to-face interviewees should be automatically given a copy of the Atos medical report”,

which I understand is not always happening. That is an area where the Minister could intervene to make sure that it does happen. Another conclusion was that

“more efficient communication is needed between the DWP and Atos”—

and that is almost certainly true. I believe we can have a positive and constructive debate when we look at those sorts of points. One further conclusion was:

“Atos healthcare professionals who carry out the face-to-face assessment should receive specialist training about fluctuating conditions, developed in consultation with organisations that support people with M.E. Training needs to be as frequent as the staff turnover at Atos requires”.

Those are really important points to which I would like the Minister to pay some attention.

We had a meeting in the House this week, but it was not possible to get a Minister to attend it. I would like to request that the offices of the all-party group be used for a meeting to talk about ME, the work capability assessment and fears about the personal independence payment in the future.

12.49 pm

Valerie Vaz (Walsall South) (Lab): It is always a pleasure to follow the hon. Member for Mid Dorset and North Poole (Annette Brooke). I also pay tribute to my right hon. Friend the Member for Oldham West and Royton (Mr Meacher) and the hon. Member for North Cornwall (Dan Rogerson) for initiating the debate, and to the Backbench Business Committee for agreeing to it.

We are all here today because constituents have come to us and told us their stories. Constituents have come to me in their wheelchairs with their carers because they have wanted me to know about the difficulties that they are experiencing. They cannot understand why, in the face of overwhelming medical evidence, they are still being called in for interviews. Some cannot understand why they have been told “If you make it to this interview, you must be fit for work.”

Nia Griffith (Llanelli) (Lab): Does my hon. Friend share my utter despair at the sheer amount of money that is wasted on calling in people whose well-documented histories clearly show that they suffer from conditions which, sadly, will not improve in any way, rather than being spent on trying to find ways of helping those who are in a better position to go back to work?

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Valerie Vaz: I agree with my hon. Friend.

My constituents cannot understand why, although 40% of appeals are upheld, the Minister’s predecessor said that the system works. When I asked him, in a written question, how many people in Walsall South had been declared “not fit to work”, his response was:

“Please note that constituency information on the work capability assessment process is not available.”

It is no wonder that the Government have no idea why my constituents are suffering, but I will tell them now.

SD has cancer and is undergoing radiotherapy; she has been declared fit for work. SH suffered seven strokes, and also suffers from type 2 diabetes and a liver condition; she has had to appeal against a decision. KH was placed in a work-related group; she has incontinence of bowel and bladder as well as diabetes, and is partially sighted. CS has received zero points despite having a spinal disc prolapse. SA suffered a stroke and is blind, but has still been declared fit for work. LM has arthritis of the spine, and has had to appeal against a decision. Stephen Nye was so angry that he came to see me on behalf of his father, and said “I want to let you know what is going on. Sick people are being persecuted: the assessment system is flawed, and they are being harassed by the jobcentre.”

Meg Hillier: Does my hon. Friend agree that the tenor of the debate about “strivers and skivers” says a great deal about what the DWP intended when it set up the assessment system—as do my sheaf of papers relating to constituency cases and the list of cases that she is reading out?

Valerie Vaz: I entirely agree, and I do not subscribe to the “strivers and shirkers” nomenclature.

MD came to see me with her husband, who is blind and deaf. They told me that the work capability assessment did not take account of the issues faced by blind and partially sighted people. I wrote to the Minister’s predecessor, who replied that Professor Harrington had had considerable engagement with the Royal National Institute of Blind People, Sense, and Action on Hearing Loss. However, that was only at the time of the professor’s third review—it should have happened before the assessments had even been devised—and only at the time of his second review did he suggest the introduction of sensory descriptors and an additional descriptor addressing the impact of generalised pain and/or fatigue.

I am pleased to say that, at their annual conference, GPs called for the scrapping of the computer-based work capability assessment. They should know: they make the medical assessments every day, and they see the sick and the vulnerable every day. There is no common sense in these assessments, and there is no humanity or dignity for the most vulnerable members of society. I urge the Minister to listen to those who have to undergo these assessments, and to instruct Atos to start again.

12.53 pm

Jeremy Lefroy (Stafford) (Con): I congratulate the right hon. Member for Oldham West and Royton (Mr Meacher) on securing the debate, and the Backbench Business Committee on enabling it to take place. I am pleased that the Minister is present, because I entirely agree with his statement last year that there must be

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“continuous improvements to the process to get the right outcomes for claimants”.—[Official Report, 5 September 2012; Vol. 549, c. 136WH.]

I want to mention a few improvements that I should like to see implemented immediately—I am glad that the Minister is listening to this—all of which were brought to my attention by constituents. The first relates to the frequency of recall for people with long-term medical conditions. Last year the Minister wrote to me:

“A claimant for whom a return to work is considered unlikely within two years will be reassessed after two years.”

I want to be sure that these decisions are being monitored, and that people are not being recalled more frequently even than the DWP has suggested.

Secondly, as we heard earlier from my hon. Friend the Member for Manchester, Withington (Mr Leech), there are cases in which people have had to wait for up to a year before winning appeals and then immediately face another work capability assessment, so the whole process starts again. Why cannot such people be given at least a considerable period of grace? Surely that would be possible.

Andrew Stunell (Hazel Grove) (LD): Would not speeding up the appeal process also relieve stress and bring about certainty much more quickly?

Jeremy Lefroy: My right hon. Friend is absolutely right.

Thirdly, there is a category of people who are being considered fit for work although they have had, for instance, a severe stroke or are awaiting a back operation. One constituent was told that if people could move an empty cardboard box, they could go to work. Do the health care professionals employed by Atos always take account of the fact that people have to get to work in the first place, or that, while they may be able to perform an action once, they may not be able to perform it repeatedly when it causes severe pain?

Mr Charles Walker (Broxbourne) (Con): Does my hon. Friend share my fear that the reputation of Atos may be so damaged that it can never really be effective? Perhaps the time has been reached when we need to park Atos and move on in a different direction.

Jeremy Lefroy: The Minister has definitely heard what my hon. Friend has said. I would only add that even if that is not the case, Atos is in the last chance saloon.

Fourthly, as the right hon. Member for Oldham West and Royton pointed out in his excellent opening speech, there are people whose conditions fluctuate. They may be all right on one day, but completely incapable on the next. At least two of my constituents have made that point.

Fifthly, there is the disregarding of expert medical opinion. I understand that there are marginal cases, but I have seen cases—as, I am sure, have all Members—that bear absolutely no relation to the WCA reports. Because I always make a point of visiting constituents at home if they have a problem with Atos, I see for myself that in some cases the reports bear no relation to the reality. I believe that appeal tribunals that overturn such reports should highlight blatant instances of that, because it clearly constitutes a misuse of public money when the reports are written so badly.

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Finally, there are people who are not considered fit for work—for instance, those who are awaiting operations with no idea of the time scale—and who are put into the work-related activity group although they cannot work. That strikes me as a contradiction in terms.

Nic Dakin: Will the hon. Gentleman give way?

Jeremy Lefroy: I hope that the hon. Gentleman will forgive me if I do not. I am about to end my speech, and I know that others are waiting to speak.

I know from past experience that the Minister certainly listens. I welcome his willingness to make those

“continuous improvements to the process to get the right outcome for claimants”,

and I urge him to do so.

12.58 pm

Jonathan Edwards (Carmarthen East and Dinefwr) (PC): Atos and the work capability assessment should be seen in the broader context of the UK Government’s assault on, and demonisation of, disabled people. We have seen first the reduction in the disability living allowance and then its replacement by the personal independence payment, about whose workability we have grave concerns.

Many disabled people’s groups say that the reductions in benefits have had a catastrophic effect on recipients, and there have been a number of reports of suicides and untimely deaths brought on by immense distress. In my surgeries, I have heard several harrowing and very sad accounts from constituents who have been subjected to impersonal and inhumane work capability assessments by Atos. One has been diagnosed with an aggressive brain tumour, which cannot be completely removed because that would leave her paralysed. In August and September of last year she had radiotherapy to slow down the growth of the tumour, but in October she was told that it would grow back even more quickly, and that she would have to have further radiotherapy or she would die. I should add that this lady also has polyarthritis and asthma. Why has this lady been placed in the work-related activity group? Her doctors and consultants have specified that she should be placed in the support group as she is fighting for her life. Her only concern should be winning that battle.

Robert Halfon: The hon. Gentleman said the disability living allowance has been reduced. Can he explain that, because benefits went up by over 5% last year and are not subject to the 1% increase this year?

Jonathan Edwards: I was speaking about my constituents’ experiences, and I think I should concentrate on that in the limited time available to me.

Another constituent contacted me who had been ill for two years and was eventually diagnosed with cancer following a serious bout of pneumonia. Prior to her illness, she had an unblemished employment record. She was certified as unable to work by her GP and had attended many DWP hearings about the employment and support allowance, with the final one being in April 2012. She won her tribunal hearing against the Atos decision. She had not received a single penny in state benefits from before April 2012 until she died at the end

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of November. She faced immense distress and was denied any financial assistance at a time when she was vulnerable and in desperate need of assistance.

As with a lot of current UK Government policy, this is a matter of completing the job left by the last UK Government; it is another example of the Labour-Tory tag team in action. Labour introduced WCAs in 2008 and signed up Atos. As a Welsh nationalist and a socialist, I believe an independent Wales would choose a different path, where Governments do not offer contracts to private companies to make profits from inflicting misery and suffering on the most vulnerable people in our society. We would treat people who need support with the dignity and respect they deserve.

1.1 pm

Dan Rogerson (North Cornwall) (LD): I pay tribute to the right hon. Member for Oldham West and Royton (Mr Meacher) for leading the effort to secure this debate. I was happy to accompany him and the hon. Member for Harlow (Robert Halfon) when they appeared before the Backbench Business Committee, and I am grateful to the Committee for having found time, in what is a busy schedule, for a debate on this issue. It is of great concern to many Members and, more importantly, to those who have been assessed under the WCA system and those who work to support them and are inundating us with case studies.

We have heard a lot about the history of this issue, so I will not rehearse what has been said on that. I am pleased that an annual review of the system is in place and that it is highlighting the concerns, which we are then able to address in this House. The coalition Government have moved to tackle some of the concerns, but they need to do more, such as by addressing the issues raised by Professor Harrington.

I remember a case that arose during the last Parliament—when this system was introduced—involving a constituent of mine from one of the north-coast villages. He was told he had to attend an assessment, and printed information on how to travel to the assessment venue by public transport was sent to him. The suggested journey involved an overnight stay on a railway platform. It was hardly helpful to send such a suggestion to someone who was travelling to attend a WCA.

We have moved on a little since then. As we have heard, however, people attending WCAs are often nervous and fail to get across all the points they want to make, and they frequently feel that, as a result of the process, they are railroaded into responding in a certain way. As we heard from the hon. Member for Bridgend (Mrs Moon), the people who accompany them are sometimes shut out of the process, too, even though they can perform the valuable role of giving their companion the confidence to represent themselves thoroughly.

The hon. Member for Airdrie and Shotts (Pamela Nash) raised the important point that the process is recorded. As we all know, telephone calls to many organisations are routinely recorded and people, including those undergoing WCAs, should realise that the recording of proceedings is for their benefit as well as that of the organisation concerned. Those undergoing WCAs can get a copy of that recording, too. That point was raised with me by a woman whose son had to wait for seven months to get his assessment, which serves to highlight

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that we must also speed up the process. Work needs to be done to help Atos understand the problems that might be leading to those delays.

Sarah Newton (Truro and Falmouth) (Con): Does my hon. Friend agree that we must make Atos understand that in remote rural constituencies such as those we both represent some people have to travel long distances? That problem is leading to a lot of no-shows at the Truro Atos centre, which in turn is leading to lots of delays in assessments, thereby causing a great deal of anxiety.

Dan Rogerson: That is also a common problem in respect of visiting district general hospitals. I have repeatedly asked hospitals to make sure that people travelling long distances are seen in the middle of the day, rather than early in the morning. Sensible decisions like that would help.

A constituent who would rather I did not reveal her name also raised the issues of delays and recordings, and others have mentioned the lack of expertise. If Atos has practitioners with different areas of expertise—some in physical disability, others in mental health issues, for instance—it should arrange assessments in such a way as to utilise that.

The language that is used and how people are treated are also important issues—some Members of this House could probably moderate the language they use in discussing this subject.

Ian Lavery (Wansbeck) (Lab): We are, in effect, trying to put a sticking plaster on a gaping wound. Atos and the WCA are not fit for purpose. Does the hon. Gentleman agree that we should bin them both, and start again with the idea of looking after disabled people, rather than the opposite?

Dan Rogerson: The problem with that suggestion is that all the people who have been through the process and have won appeals will have to go back to square one. I am therefore in favour of improving the current system. Every time we renew a system, we go back to square one. Those who have been through an assessment and an appeal and have finally got the right result should not be sent back to square one. The hon. Gentleman articulates the anger that is felt, and there are clearly problems with the process, but I do not think scrapping it and going back to square one is the best way to proceed. Professor Harrington has not suggested that course of action, either. What he has said is that there are problems that need to be resolved.

Guto Bebb (Aberconwy) (Con): Will the hon. Gentleman give way?

Dan Rogerson: No, I want to conclude so that others can have a chance to speak.

There are certainly questions to be asked about the company operating this process. The hon. Member for Stafford (Jeremy Lefroy) said it was drinking in the last-chance saloon. We have heard in other contexts that people can remain in that saloon for a long time, however, and this debate serves to show the Government that we are taking this issue very seriously.

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There is another issue, too. Those who are found capable of work even after an appeal should be supported into work. We must do that properly. I hope we will address that issue on another day, as it is the second part of this process and there are problems to be solved.

1.7 pm

Mr Iain McKenzie (Inverclyde) (Lab): I congratulate my right hon. Friend the Member for Oldham West and Royton (Mr Meacher) on securing this important debate. There is a huge groundswell of discontent about Atos and the work capability assessment. It is deplorable that our sick and disabled constituents are experiencing immense hardship after being deprived of benefits having endured an Atos WCA. We all recall last year’s television programmes exposing the way people are treated across the country by Atos, and I have heard from a number of my constituents who have been badly treated—treated without care, compassion or understanding.

Ian Mearns: I am sure that, as a Scot, my hon. Friend will share my concern about the fact that Atos will now be carrying out the personal independence payment assessments as well. The Government have already determined the outcome of those assessments. The Minister for disabled people, the hon. Member for Wirral West (Esther McVey), told this House that by October 2015 560,000 claimants will have had their assessments, and 160,000 will get a reduced award, 170,000 will get no award, and 230,000 will get the same support. How can we know the assessments are valid when we have had such a prediction?

Mr McKenzie: I could not agree with my hon. Friend more. The accuracy of assessments is essential, as I will go on to discuss later.

Let me outline briefly some of the cases that have been brought to my surgeries, on the back of a recurring issue now being referred to by my constituents as the “Lazarus letter”. This is a letter they receive instructing them to make their way to Glasgow for assessment and containing many connotations about what will befall their benefits. A constituent who suffers from severe cerebral palsy and could not travel was refused a home visit and told to go to Glasgow to be tested. Another constituent who was recovering after being seriously injured in an accident was advised to attend an Atos assessment in Glasgow. Both those constituents could not possibly travel because they were in so much pain, and I had to get involved and ask for a home assessment for them. It does not end there because they then had their benefits cut or stopped because Atos sent the assessment forms to the wrong address. If it cannot get the address right, what chance does it have with assessments?

Clearly many of my constituents have not been treated with the fairness and decency they deserve. Although I realise that we need to see whether people can work, we need a system that is humane and fair, not one that causes fear and loathing. It is time the Government realised that they are driving many sick and disabled people into poverty. What does the Minister think of Citizens Advice’s detailed year-long study “Right first time?” on the controversial work capability assessment run by Atos, which has revealed evidence of widespread inaccuracies in the medical reports that help to determine

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whether individuals are eligible for sickness benefits? Citizens Advice also tracked a group of people through the process of claiming employment and support allowance and looked at how their claims were handled. The report’s conclusions are stark: 37 individuals were tracked and had their reports examined, with serious levels of inaccuracy revealed in up to 43% of the reports. That level is significant enough to have an impact on the claimant’s eligibility for benefits—surely our sick and disabled deserve better than this.

The low rate of accuracy is worrying because the reports are used in deciding entitlement to other benefits. Is it not better to have an accurate, fair and just system of medical assessment, one that claimants know will treat them fairly and with the humanity they deserve, rather than a system that is, frankly, unfit for purpose and that uses a company, Atos, that instils fear and loathing in people, resulting in a system where people are continually appealing against decisions? We have already heard that the success rate against the decisions is about 60%.

Pamela Nash: Although the Department has made much of the fact that Atos does not actually make the decisions, with that being done by decision makers in the job centres, I have never seen evidence of the decision makers taking account of any evidence apart from the Atos assessment and the questionnaire, unless the case goes through appeal or reconsideration. Does my hon. Friend agree that decision makers should in every assessment be seeking the opinion of the person’s GP and of other professionals who are offering the person care at that time?

Mr McKenzie: I thoroughly agree with my hon. Friend on that point. It is ridiculous to have people making an assessment based on a tick-list that looks like it should be used for an MOT on a car.

We need to ensure that the people who are going through the system are treated well, justly and fairly. The British Medical Association has called for the work capability assessment to end immediately and be replaced with a system that does not cause harm to some of the most vulnerable people in society. I call on the Government to change course and look again at this process.

1.13 pm

Bob Blackman (Harrow East) (Con): It is an honour to follow a thoughtful contribution from the hon. Member for Inverclyde (Mr McKenzie). It is fair to say that the mark of a civilised society is how it treats the most vulnerable people who live within it, so it is important that we have this type of debate in order to review how we are treating vulnerable people. I add my congratulations to the right hon. Member for Oldham West and Royton (Mr Meacher) on securing the debate and to the other hon. Members who have contributed so far.

In 2006, I was serving on the Greater London assembly and we carried out a report and review on the huge number of people consigned to permanent disability—they were written off by the previous Government as not being capable of working. The one key issue is the sensitivity in determining whether someone is capable of work and therefore should be employed or seeking employment, or is clearly not able to work and is therefore in need of the maximum support.

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Sheila Gilmore (Edinburgh East) (Lab): It is important that we acknowledge that we now have to look at how this test is working. After all, it is not good enough for us just to trade insults and say that the previous Government left people to rot, because the system was actually introduced by the previous Tory Government. We could therefore pass these comments backwards and forwards, but the important thing is to ensure that if we are going to test people, we get it right.

Bob Blackman: I share that view, and I was coming on to discuss some of the issues raised in my constituency about the tests and some reforms that we could reasonably request the Minister and Atos to implement.

My constituency has a relatively low unemployment rate, but I have received a succession of complaints from constituents who have been put through the work capability assessments and clearly believe they have been treated unfairly—I agree with many of them. My hon. Friend the Member for Stafford (Jeremy Lefroy) described how he visited his constituents at home, and I have had a similar opportunity to visit some of my constituents at home to see the position they are in and the lives they lead. These people are and should be entitled to full disability benefits, yet they have been denied them.

I want to discuss one specific example, that of a constituent who came to see me in late 2011 to make a complaint against her employer. She suffered from a degenerative spinal condition and struggled to stand for long periods of time. She had asked her employer to split her two eight-hour shifts into three four-hour shifts so that she would be able to continue to work. After some discussion, her employer eventually consented to changing her shift pattern. The point is that this woman was committed to work for as long possible and in a job that she could clearly do. After receiving higher rate mobility allowance and lower rate care allowance for several years, my constituent had her claim reviewed as part of these reforms. Following an Atos work capability test, all her benefits were suspended and she spent the following year appealing the decision. She got full support from me and my office, and I am delighted to say that after the appeal process and a successful tribunal she had her benefits fully restored. Of course, the pain and suffering for a full year was outrageous.

It is worth pointing out some of the medical conditions from which my constituent suffered. She has had a disc removed from her spine, and I understand that its removal caused a mid-posterior annular tear. Those conditions have brought a lifetime of mobility problems and associated side effects, amounting to a debilitating spinal injury. When we add that information to my previous comments about her keenness to work, we see that this is not someone who seeks fraudulently to claim benefits; she seeks only what she is entitled to. At the original work capability assessment my constituent was assessed by a physiotherapist. I have no doubt that the physiotherapist was reputable and qualified, but as an assessor they were clearly not sufficiently qualified to understand the complex medical needs of my constituent. Having had the opportunity to review some of the cases brought to me, I can say that it is clear that Atos and its employees do not have the required expertise.

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Ian Lavery: I totally agree with the hon. Gentleman. We have a situation where the likes of physiotherapists are assessing people with acute mental health problems. Does he agree that that is wholly unacceptable?

Bob Blackman: I agree. One reform we could quite reasonably ask the Minister and Atos to introduce would involve ensuring that the assessor was qualified to assess the type of problem from which the individual suffers. That could take the form of a referral by the Atos assessor to a proper medical professional in a given field where there was expertise. That would save the individuals from the trauma of the appeals process and would save money as it would mean that the medical professionals could properly undertake an appropriate assessment. I urge the Minister to consider that as a way of improving the system.

It appears to me that there is a tick-box mentality among the Atos assessors. I could refer to a stream of cases in which people have conditions that come and go and have good days and bad days. When Atos assessors make the assessments, those people can often be having a good day and the tick boxes do not allow the right decision to be made.

Meg Hillier: Will the hon. Gentleman give way?

Bob Blackman: I will not, because I have given way twice and I want to conclude.

The clear point is that there needs to be a fundamental reform of the process. It is right that we should assess people to see whether they are capable of work, but the people subjected to horrendous trials and tribulations as a result need further support and deserve to have the whole process reconsidered so that it can be improved for the benefit of all.

1.20 pm

Austin Mitchell (Great Grimsby) (Lab): The number of MPs who want to speak today and the passion that has been shown are testimony to the fact that the system has not worked, is not working and ought to be scrapped. I hope that the Minister is listening, because that is clearly a strong concern on both sides of the House.

The key weakness of the system is the perfunctory, mechanical, inhuman and rushed process of assessment. I have to point out to the Minister that as the system has been handed to the private sector, the more perfunctory the process of assessment, the greater the profit made by Atos and the assessors.

Meg Hillier: Other Members have raised the issue that Atos is a private company. I am sure that my hon. Friend will agree that it would be helpful if the Minister could reveal the profit margin, as this is public money being spent by a private company, which one would expect to make a profit. Would it not also be useful if the Minister could tell us whether there has been any change in the profit in the years for which Atos has been doing the assessments?

Austin Mitchell: I am grateful to my hon. Friend for that intervention. That was one of my concerns as a member of the Public Accounts Committee and it was to have been part of my passionate penultimate ringing

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declaration when I intended to ask the Government to tell us how much profit has been made, but I can now omit that from my speech.

The system is perfunctory and totally inadequate. I will not repeat the cases that have come to my surgery after the assessment—that has been done brilliantly by some of my colleagues—but it is clear that the assessment fails patients with mental health conditions, particularly schizophrenia, which are very difficult to assess and treat. It fails when conditions are intermittent and emerge one day only to fade away the next. It fails on degenerative conditions, too. The system of assessment does not take into account any of its own inadequacies in those areas.

In the Public Accounts Committee, I was able to voice a suspicion that there was a quota for the number of disabled people that should be shaken out in what appears to be an enormous attempt to do that rather than to provide them with the support and help that they need and with encouragement to go back to work. The process is more concerned with shaking them off benefit than with treating their cases properly. We were assured by Atos and the Department that there was no quota, but I think we can guarantee that any medical assessor for Atos who finds that the total or a high proportion of the number of people he is examining are not fit for work will not advance his career in assessment, his career in Atos or his contact with the Department. Inevitably, there are those pressures on the assessors.

As our Committee was told, 38% of the cases that go to appeal—I advise all my cases to go to appeal—are successful in reversing the verdict. That demonstrates its inadequacy and the enormous cost in the reassessment process at appeal, a cost that is not taken into account in the Government’s estimates of the savings produced by the system. Those reassessments are usually done with the help of the patient’s own doctor, so I do not see why their doctor’s view cannot be invoked and used at an earlier stage in the process. After all, the Government are giving more power to the doctors and claiming that they represent the patients. The doctors know the long-term conditions—they are treating the patient—so why are their views not taken into account by Atos at the start?

Our PAC report on the system was pretty damning—one of the most damning we have done. Our concerns included the rate of profit, as my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier) has mentioned. The Minister should tell us the rate of profit made by Atos and what efforts the Department is making to reduce that and to ensure a more efficient service and more efficient assessment processes. We were concerned, too, that this is a monopoly contract with no great risk to Atos. The monopoly is continuously reinstated and Atos is put back in power. Monopoly processes go slack, and if such tasks are going to go to the private sector—I do not think that they should—the companies should be subject to competition and to more regular reviews. The weakness of the assessment system shows that Atos is not working effectively. There should not be a long-term monopoly in this area.

If the Minister reads Twitter at all, as I do avidly—normally to see people abuse me—he will see the widespread concerns about people’s treatment by Atos. If he listens to this debate, he will hear the same. If he listens to the disablement groups, he will hear the same. Instead of backing an inhumane system and refusing to change it

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or tighten the terms and conditions under which Atos operates, it is time that the Minister showed some concern and changed the system.

1.26 pm

Guto Bebb (Aberconwy) (Con): I was not expecting to be called to speak, Mr Deputy Speaker, but I shall say a few words.

The debate has been very valuable and there has been cross-party consensus, which shows that there is a great deal of concern about how Atos is performing against its contract. That is not to say that all the language used today is acceptable, and I feel that some of the constructive changes that have been implemented have been ignored. For example, when I was on the Welfare Reform Bill Committee, one of the key issues of concern for me was how the work capability assessments would deal with cancer patients. It is a fact that more cancer patients now qualify for unconditional support than ever before, yet we have had no mention of that. In the midst of making constructive and, in many cases, justified criticisms of Atos, it is important that Members are careful not to frighten people listening to this debate who might be cancer patients and might feel that they have no hope whatever of a fair hearing from Atos. I also want to highlight the fact that more people—double the number from two years ago—now qualify for unconditional support.

Those two points—about cancer patients and the number of people getting unconditional support—are important reasons why the proposal made by some Opposition Members that we should simply throw the whole system out and start again is dangerous. It does not take into account some of the constructive changes that have been implemented.

Sheila Gilmore: I do not deny that there have been some improvements—although one speaker said that they had happened at a glacial pace, which was probably a fair comment—but we must bear it in mind that the unconditional support is not available without the person being re-subjected to an assessment. One complaint is about the frequency of reassessment, even for people whose conditions are so serious that they have been put in the support group but who sometimes, a year later, still have to come back and go through the whole process again.

Guto Bebb: The hon. Lady’s point is important, because although we all subscribe to the principle of a review, when a condition has been assessed as demanding unconditional long-term support there is a question about whether an annual review is justified. That is an issue that a constituency MP who takes case work seriously would not ignore, so I take her point on board.

There are a couple of aspects that I welcome, but about which I still have concerns. One is the way in which the system deals with patients who suffer from mental health problems. Mental health services are often the Cinderella service of the NHS, but when it comes to people who have difficulty accessing work and feeling confident to do so, the way that Atos deals with such patients has been less than acceptable. I understand that the Department and Atos are putting in 60 champions, but given the number of issues that I have seen in my own constituency, I question whether 60 will be sufficient

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for the whole of the United Kingdom. The way in which we deal with people with mental health problems is not acceptable in the health service and it is not acceptable at this point in time in Atos, even though the problem has been recognised and work is being done to try to deal with it.

The other matter, which has been touched on by several hon. Members, is the issue of people with chronic long-term illnesses. The problem that I have seen in my constituency surgeries is that quite often somebody may turn up at an assessment centre and on that particular day would be capable of a certain type of work, but the situation could be completely different the following day. The problem with the system that we have put together is that it does not take into account those long-term chronic conditions that could result in somebody occasionally being able to take on work, but not on a long-term basis. That is another weakness in the system.

Meg Hillier: Does the hon. Gentleman agree that people with HIV/AIDS, where the side-effects can cause many day-to-day problems, are not properly assessed in the work capability assessment?

Guto Bebb: I entirely accept that point. The same is applicable to cancer patients, for example. However, there is a counter-argument that often people who suffer from HIV/AIDS or who are dealing with cancer would enjoy the opportunity of working. My father, who passed away owing to lung cancer, was working until three weeks before he died, and there is no doubt that being able to work for such a long period was a contributory factor to the way in which he fought the disease. We need to make sure that we do not categorise everybody who has a long-term chronic illness as incapable of any type of work.

On a specifically Welsh issue, despite the promises made by Ministers in the Welfare Reform Bill Committee when I tabled an amendment to allow assessments through the medium of Welsh, I have encountered numerous examples where assessments have been requested through the medium of Welsh but that service has not been provided. An excellent example was that of a young woman in my constituency who had a stroke at the age of 42, I believe. As a result, she largely lost the ability to communicate through the medium of English. Despite numerous requests for the service to be provided in accordance with the promises made by the Department, as yet we have not been able to ensure that she has that service through the medium of Welsh, which is her right under the Welsh Language Act 1993.

I subscribe to the general views expressed in the debate that the system is not performing as it should and that there are real concerns about the way that Atos is performing. However, I believe that what the Government are trying to do is right, as it is important that we recognise that we have a higher number of long-term unemployed in the United Kingdom than any comparable western state in Europe, and we need to question why that is so.

I do not think it is necessarily wrong, harsh or unreasonable to say that people who could work should be supported into work, but we need to do that in a way which recognises the dignity of individuals going through the system. Despite my support for the welfare changes that this Government are making, the examples that

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I have seen in my own constituency surgery leave a lot to be desired. We should not throw out the baby with the bathwater, but we need to make sure that the recommendations that have been made time after time are implemented as soon as possible. We owe that to the constituents we represent.

1.33 pm

Dr Eilidh Whiteford (Banff and Buchan) (SNP): Today we have heard a litany of problems with the work capability assessment, not least the problem that it persistently reaches the wrong outcomes in assessing people’s ability to work.

Aberdeenshire was part of the pilot scheme for the work capability assessment, so ever since I was elected, I have faced a steady stream of sick and disabled constituents, distraught, worried and in some cases angry about the process that they have had to endure. These are not anecdotal or isolated instances. The citizens advice bureau has kept close track of the issues brought by clients over many years, and it has documented the sharp increase in demand for advice and help on matters related to work capability assessments. In the past year alone the Turriff citizens advice bureau in my constituency has seen a 60% increase in this type of case, on top of a sharp increase last year. I suspect that we are seeing only the tip of the iceberg.

In spite of three reviews by Professor Harrington, the work capability assessment still is not working well enough. Too many decisions are being appealed, and 38% of those appeals are successful, rising to a 70% success rate when people are supported by the CAB and other advocacy groups. That system failure is costly not only in financial terms, but in human terms.

One of the things that has disturbed me most over the past couple of years is the way in which disabled people have found the process an assault on their dignity. I am also disturbed by the failure of the Government to take remedial action and manage the contract with Atos more effectively. Public money is being spent on these assessments. There is a substantial body of evidence to show that they are failing to deliver, yet the Government continue to hide behind commercial confidentiality in declining to make public the details of their relationship with Atos. That lack of accountability is not good enough.

As an MP, I am dealing with increasing numbers of constituents who are distressed and desperate because they have been told that they are fit for work when they manifestly are not. The very first constituent who came to me for help and who had been found fit for work was a man who could not climb the stairs in his own house to go to the toilet. He came to one of my surgeries which had disabled access, but he needed help from relatives to do so and it was quite an ordeal. His GP rather euphemistically told me that the man had “a poor prognosis”, and the man has absolutely no prospect of getting back into the labour market. He successfully appealed against the decision, but it emerged in that process that no account had been taken of his GP’s documentation or of the evidence supplied by his hospital consultant.

I have encountered incontinent patients being asked to make four-hour round trips on public transport. I have also encountered constituents who have had to

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make very long journeys by public transport only to find that their appointment is not double-booked, but triple-booked. My biggest ongoing worry, though, is about people who have found themselves placed in the work-related activity group with very little realistic prospect of finding a job. I think of one constituent, disabled since birth, who has wanted nothing more than a job since she left her special school. Now in her 30s, she has been on endless training courses. She has enthusiastically embraced work placements but she has never had a mainstream job, despite her efforts. Possibly, she could work, with the right support in place.

In Aberdeenshire we enjoy levels of employment much higher than the average. It is probably easier to find a job there than anywhere else in Scotland, but jobs still do not grow on trees. Many of the jobs that new entrants to the labour market might have a chance of getting are physically demanding. They require strength, dexterity, co-ordination and a degree of endurance. My constituent could not stand on a food production line. She does not have the balance or the motor skills to work in a retail outlet. Her speech impairment would make telecommunications work difficult. She can type, but not nearly fast enough for a modern office. She will lose her benefit in a few months, even though she has always sought work, and is just looking for someone to give her a chance.

I worry that, instead of becoming independent, my constituent is going to become even more dependent on her ageing parents, who are themselves in failing health. They are not a wealthy family. Bringing up a disabled child often impairs a family’s wealth and erodes their assets and their ability to cope with setbacks. I am worried about the impact of increased caring on her family and on their health and financial well-being.

Finally, I want to say a quick word about the situation facing people with serious mental health problems and long-term fluctuating conditions. There is a world of difference between being potentially fit for work, given the right support, and being an attractive prospect to a potential employer. The elephant in the Chamber today is the fact that many employers will think very long and hard before taking on a member of staff with a serious long-term or fluctuating health condition. Anyone with a chequered work history knows that they are perceived as a risk to prospective employers. Many employers will admit this in private but will not come out and say it publicly. I do not think the Government are being realistic enough about the stigma attached, for example, to degenerative conditions or mental illness. These hurdles are not insurmountable, but we must admit that they exist if we are to challenge them. I hope that today’s debate will inject a dose of realism into the Government and that they will stop hounding and persecuting disabled and sick people for their disabilities.

1.38 pm

Heather Wheeler (South Derbyshire) (Con): I apologise for not being in the Chamber for the beginning of the debate, owing to another commitment. Mr Speaker kindly put my name towards the end of the list for today’s speeches.

Interestingly, the scheme has worked relatively well in South Derbyshire. We have quite a high level of returners-to-work as a result, but equally, issues have come to my

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surgery and I have had occasion to write to the Minister and his predecessor. I welcome the Backbench Business Committee’s decision to hold the debate.

I have had conversations not only with my local citizens advice bureau but my jobcentre, which has highlighted a few points that I hope the Minister will take on board. I hope that he will answer them in his winding-up speech. I heard about a number of harrowing cases—not from the CAB, interestingly, but from the jobcentre, whose staff see people coming back into training and what have you after the assessment. Those staff are incredulous at times at the cavalier approach of Atos to people’s health conditions.

Long-term disabled people have come back into the work arena; unbelievably, within three months of being told that they are perfectly fit for work, they have dropped down dead. I would not like that on my conscience, and I find it surprising. I am sure that such cases are relatively rare, but when do they happen? If the Minister does not know the answer, perhaps he will be kind enough to write to me.

Does anybody go back through the files to check on what happened with Atos? There needs to be a review. Folk in the Chamber know that I used to be the leader of a district council. Our job was to put out contracts and make procurements, but we always had penalty clauses, clawback arrangements and the ultimate option of getting rid of a firm if it was not performing.

One of my early letters to a previous Minister asked about the point when we say that the system is not working; frankly, I have not had an adequate reply. When someone drops down dead within three months of being assessed as being perfectly capable of going back to work, what is the review process for Atos?

We have heard about the Harrington report and the need for mental health champions. Only last week, a constituent, who, frankly, did not know what time of day it was, went through the process. Not only were they not allowed to have their carer with them, but no mental health champion was there.

Mr Kevan Jones: I am sorry, but I do not think the hon. Lady understands the notion of mental health champions. They are not for the clients but to advise the health care professionals doing the assessment.

Heather Wheeler: I do get that point; I am saying that the champions ought to be there when the interviews are taking place. I find the juxtaposition astonishing—according to Professor Harrington’s report, people need that extra bit of care. I find it interesting that we have just heard that there will be 60 champions in the country. Patently and obviously, that is not enough. Perhaps the Minister will advise us that that number represents a pilot and, notwithstanding what we are saying in this debate, it will be increased in short order.

Sheila Gilmore: In Scotland, there are mental health champions in only Edinburgh and Glasgow. This is not a pilot; the Minister has previously said that he has implemented Harrington as far as mental health champions are concerned.

Heather Wheeler: I am sure the Minister has heard every word that the hon. Lady said.

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I finish on two final points because time is short and many people want to speak. People have mentioned the tick-box nature of the interview; my constituents find it hugely frustrating that they cannot expand on an answer. After all this time, perhaps the interview process could be tweaked to allow that. My last point is about the absolute frustration of GPs and consultants who feel that no account whatever is taken of the fact that they take their time to write the letters. That is desperately frustrating and a huge waste of public money.

The Minister of State, Department for Work and Pensions (Mr Mark Hoban): We do ask GPs and consultants to provide medical evidence; we send a form to them. Only 37% of those are returned in time.

Heather Wheeler: I thank the Minister for putting that on the record. I will gladly go back to my GPs and consultants and say that they will be taken into account if they please return the forms on time.

I will finish now, because many hon. Members want to get in. I am delighted that we are having this debate because I genuinely feel that there is an opportunity to get the issue right. The people deserve it.

1.44 pm

John McDonnell (Hayes and Harlington) (Lab): Someone said that what we are debating is a party political issue. Let me be clear: I opposed the system when it was introduced by the last Government and I oppose it now—for the same reason. I see it as a brutal attack on the weakest and most vulnerable individuals in our society and an exercise by private companies to profiteer at those individuals’ expense.

I started raising the issue in Parliament early on. My first constituency involvement was like that of many other hon. Members: it involved someone who was mentally ill, went for the assessment and had a nervous breakdown. That had an impact on the whole family—the mother, in particular.

I was then contacted by a range of organisations, which came together and produced the Spartacus report. I urge Members to read it. In the last debate on this issue, in Westminster Hall, we read some of its case studies into the record. They are horrendous examples of human suffering and what can only be described as abuse by the system itself.

I also refer Members to Calum’s List, which has a website. It is a list of people who have died, including by suicide, as a result of, or where there has been a contribution from, the loss of benefits. The first example on the list was that of Paul Reekie. Some Members may have known Paul, an award-winning writer and poet in Leith, Scotland. He did not leave a suicide note, just two letters on the table beside him. One was about his loss of housing benefit and the other was about his loss of incapacity benefit. He died.

The other example is that of Mark and Helen Mullins from Bedworth. They could not access their benefits. They were walking 10 miles a day to a Salvation Army soup kitchen. They committed suicide together because they could not access their benefits. Read Calum’s List, which has example after example of the brutal effect of the system.

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This is at least the sixth debate that we have had on the issue. The concern expressed by Members about an issue of public administration in all those is unprecedented in recent decades. There is example after example of human suffering on a scale unacceptable in a civilised society. That is why 117 Members of Parliament have so far signed our early-day motion calling for the scrapping of the system.

I have read Mind’s briefing for today’s debate and I urge other Members to do the same. It has put forward what is wrong with the system. Yes, it has recommended improvements, but one of the key factors coming out of its survey of people facing the work capability assessment process was that 51% of them said it made them have suicidal thoughts. Any system involving that level of risk is irretrievable and unreformable. That is why I believe it should be scrapped and why the British Medical Association has said it should be scrapped.

I say the following, and I do not say it lightly: we now know that the system does not work. We know the human suffering that is occurring. The responsibility is now on us to do something about it. We will be to blame for every injury, harm, suicide and other death as a result of the system if we do not scrap it now and bring in something that is fair and based on proper medical knowledge—assessment by a person’s own GP, reinforced by expertise. We need something that gives advice and emotional support for people when they go through the system, not something that leaves them at risk.

Ian Lavery rose—

John McDonnell: If my hon. Friend does not mind, I shall not give way as other hon. Members want to speak.

I conclude by saying that we all have a responsibility to say, “Let’s end the system now, start again and make something fair.” We will be to blame for all the injury and harm if we do not.