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Lord Swinfen moved Amendment No. 7:

After Clause 4, insert the following new clause:

("Serious underlying medical condition

.—(1) Regulations made under section 20(4) and under paragraphs 8 and 10 of Schedule 1 shall provide that a vulnerable person shall be entitled to income-based jobseeker's allowance from a prescribed date.

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(2) Regulations under subsection (1) may in particular provide for a person to be treated as vulnerable if they have a serious underlying medical condition.
(3) The following are examples of circumstances where regulations may prescribe that a person be treated as having a serious underlying medical condition—
(a) as a result of an existing physical or mental condition, the person's health is likely to deteriorate if benefit is not paid;
(b) the person's physical or mental health is such that the non-payment of benefit will put the person at risk of excessive physical or mental distress.
(4) Where a person is seeking to demonstrate a serious underlying medical condition, any costs incurred in obtaining medical evidence shall be borne by the Secretary of State.").

The noble Lord said: My Lords, the purpose of the amendment is to put on the face of the Bill a definition of "serious underlying medical condition" which would enable a hardship payment to be made immediately, and for any cost of verification of such condition to be met out of public funds.

The amendment will put into the Bill some examples of the meaning of "serious underlying medical condition" which builds on one of the categories of "vulnerability" for the purposes of making a hardship payment. Those payments can be made where a person has been unable to show that he satisfies the conditions for claiming jobseeker's allowance or where a doubt has arisen as to his entitlement.

The Government have already accepted the need to define the key conditions of "availability" and "actively seeking work". Yet there is no indication of the circumstances when hardship payments can be made. As someone is at risk of being without any form of benefit, it is crucial that claimants and staff know precisely what is intended.

At Report, the Minister stated:

    "We wish to allow the adjudication officers discretion to consider individual circumstances and therefore we do not propose to set out a list of specific conditions which could exclude some claimants and not take account of the severity of the condition".—[Official Report, 16/5/95; col. 463.]

Given that many illnesses and disabilities are hidden, it is not always easy for staff to make quick but comprehensive assessments about a claimant's condition. How will they decide who is vulnerable when faced with the variety of chronic or fluctuating disabilities? Under the current discretionary system, fewer than half of those applying for hardship payments in 1993 received them. Discretion alone may not be enough to protect the most vulnerable, as is indicated by the department's own research reports (Nos. 8 and 9) into the operation of the discretionary social fund which offered little evidence that those given awards had greater needs than those refused.

Ensuring that sick and disabled people are covered in vulnerable groups is important because only vulnerable people will have access to hardship payments immediately, or once an adverse decision has been made. The Minister has indicated two categories of "vulnerable" which concern ill health and disability. The first is entitlement to a disability premium. However, that helps a minority of unemployed sick and disabled people, as the premium is payable only to those registered blind or receiving disability allowance—which itself covers only care and mobility needs. Other

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needs such as heating, diet and communication are not met. Indeed, the Policy Studies Institute has estimated that fewer than half the people with health-related needs would have been eligible for the disability premium when it was introduced in 1988.

The second category is "serious underlying medical condition" which the Minister has indicated can include people with dietary needs. However, it is important that someone with a condition like diabetes is considered as having a serious condition for hardship purposes. I understand that one unemployed client of a citizens advice bureau with diabetes was unable to follow a fat and sugar free diet as advised by her doctor because of lack of money. That could have meant that her condition would have deteriorated.

With at least 150,000 sick and disabled people having their incapacity benefit withdrawn and having to sign on, there is concern that many of those people could find difficulty in fulfilling the conditions of the jobseeker's allowance and therefore could have the possibility of hardship payments as their only source of income. Many of those people could have conditions which might deteriorate rapidly if subsequently they were unable to receive hardship payments.

Factors such as possible deterioration in condition or risk of distress are obvious matters which should be taken into account when assessing whether a person falls into that category of "vulnerable". Such matters are already in regulations concerning good cause. Stress brought on by money worries can exacerbate conditions such as mental health, digestion or respiratory problems, and can in turn make it far more difficult for the person to cope with financial problems.

It is equally important that any medical or other evidence required in support of the claimant's contention is free of charge to the claimant. When a hardship payment is being considered, the claimant should not be placed in the position of having to borrow or go into debt—or indeed into greater debt—in order to obtain a letter from his doctor. The amendment ensures that any costs relating to the medical evidence are not borne by the claimant.

During the Committee stage, the Minister stated that discussions between the Department of Health and the Department of Social Security were under way concerning the costs of medical evidence generally. When the Minister replies, will he state whether the discussions have been concluded, and, if so, what was the outcome.

Finally, the Minister has stated that there has to be a balance between claimants' obligations in return for benefit, and protection for the most vulnerable. As hardship payments are reduced by up to 40 per cent. of the basic rate, which currently amounts to only £27.90 for a single person, access to such payments is unlikely to be sufficiently attractive to undermine the conditions of the jobseeker's allowance. I believe the amendment ensures that the Government's own definition truly protects the most vulnerable. I beg to move.

Lord Carter: My Lords, I was pleased to add my name to those on the amendment, and from these Benches we support it. The noble Lord, Lord Swinfen,

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explained its purpose extremely well, so I can be brief. It is to ensure that the term "serious underlying medical condition" is interpreted broadly in order to protect anyone whose state of health is such as would make them vulnerable, were their income to be removed. The amendment would ensure that claimants are not faced with additional financial burdens of paying for the medical evidence they require in support of their claim.

We can all foresee that there could be problems for the Benefits Agency in deciding whether someone is vulnerable because of sickness. Potentially large numbers of people will not be eligible for the disability premium, as the noble Lord said, but will nevertheless be in poor health and will seek to demonstrate a serious underlying medical condition.

The intention is to ensure that when considering whether a person suffers from such a condition the staff at the Benefits Agency take a broad approach. The amendment therefore provides that an indication be given on the face of the Bill as to the circumstances which should fall to be considered, as well as ensuring that claimants who have to provide medical evidence to confirm their health problems are not financially penalised.

It is clear that the provision of medical evidence to support an argument that someone is suffering from a serious underlying medical condition would be necessary. We presume that the Benefits Agency staff will require such evidence. Perhaps the Minister could comment on that when he replies. There could be problems for claimants in obtaining such evidence. There is increasing evidence that GPs are insisting on charging for medical reports which people need in connection with benefit claims. We feel that that adds yet a further problem to the situation in which such people find themselves.

The people in need of hardship payments on the grounds of vulnerability will need to have their claims dealt with by the Benefits Agency swiftly and thoroughly. It is therefore important not only that a claimant is able to provide proof of their circumstances but also that no delay is caused by arguments over the cost of medical evidence. The amendment therefore provides for any cost to be met automatically by the DSS in that situation. That could be easily implemented through the use of a single form for all claimants to fill in and forward to their GP.

It is an important amendment and we hope that the Government will see the strength of the argument. These people need help and we feel that the words should be on the face of the Bill so that this help can be provided swiftly and efficiently.

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