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Earl Russell: My Lords, hardship payments under the Bill are rather like baths under the rule of St. Benedict. According to the rule of St. Benedict, the old may have baths, and the sick, but to the young and especially those in good health they shall be seldom permitted. That is precisely the situation with hardship payments. To the young and especially those in good health, they shall be seldom permitted.

To be eligible for hardship payments, you have to be established as being in a vulnerable group. That is the point of introducing the phrase "serious underlying

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medical condition". I think I am right in saying that that was the Minister's own phrase, used in the first day of Committee. So he has to take some responsibility for it.

The kind of thing which, as I understand it, should be covered by the amendment is asthma—which is increasing so distressingly fast—hypertension or depression, which is a particularly common illness among those on benefit. All those make people vulnerable. They are all the kind of things which being totally without benefit might cause to worsen, possibly to the detriment of the person's employability for life. It seems sensible to include them.

The amendment also provides assistance with fees for medical certificates for those conditions. This appears, as a result of the market tendencies inside the health service, to be a rapidly growing problem. For example, there is the case reported by a CAB in Suffolk of a single parent whose son suffered from asthma thought to be caused by mites in house dust. She applied for a grant for a vacuum cleaner. The Benefits Agency, reasonably enough, asked for a doctor's confirmation of her son's asthma. The charge for the report from the doctor was £9.50. She could not afford the fee, so she did not get the vacuum cleaner, so the asthma continued. We do not think that that is in the public interest.

5.15 p.m.

Lord Zouche of Haryngworth: My Lords, I wish to support the amendment of my noble friend Lord Swinfen. The Government's current narrow definition will exclude many people in poor health, particularly those with chronic illness or in a state of poor health. Those are the very people who need our help and support.

I should like to give an example from a citizens advice bureau in the south west. It reported the case of a widower who was receiving medical treatment for depression. He was told by the jobcentre that unless he accepted the offer of a part-time job as a driver, paying £2.30 an hour, with no work during the school holidays, his income support would be stopped. Accepting the job led to a number of problems which worsened his state of mental health. He was earning too little to pay national insurance contributions—a situation which worried him greatly. When he visited the bureau, his housing benefit had been withdrawn—it was subsequently reinstated, due to his low income—and he feared that he would be made homeless as a result. He told the adviser that he was contemplating committing suicide by throwing himself into the river.

We should all think long and carefully before rejecting my noble friend's amendment because, if your Lordships reject it, a large number of people who are not severely disabled enough to qualify for incapacity benefit but who nevertheless are in poor health are in danger of failing to meet the jobseeker's test as a result of being deprived of even a minimum income.

Lord Moyne: My Lords, there is an additional point to be made here, following what my noble friend has just said, and it is perhaps a slightly more cynical one. If the amendment is not passed, cases will be brought up by the tabloids in a way that will be highly damaging to Her

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Majesty's Government. Therefore, serious consideration ought to be given to the matter before the amendment is rejected.

Lord Mackay of Ardbrecknish: My Lords, the amendment deals with the definitions of the vulnerable groups which will have access to hardship payments following the imposition of a sanction under Clause 19, or failure to meet the availability or actively seeking work conditions for receipt of JSA, or who have not agreed a satisfactory jobseeker's agreement. I think it is helpful to be clear at the outset about something perhaps not made entirely clear during the course of the debate: that is, the groups we are dealing with and the fact that the claimants involved have either failed to meet the necessary conditions for benefit or have made themselves unemployed or failed to pursue an opportunity to take themselves out of unemployment.

I have made clear on many occasions that we accept that there is a need to provide in these circumstances for claimants whose circumstances mean that they, or others for whom they have responsibility, are particularly vulnerable to hardship. We have set out the basic groups who will have access to payments if they demonstrate they would otherwise suffer hardship. I have also said, and must say again, that we do not accept that claimants should automatically have access to benefit at all times irrespective of their actions and choices. In the case of single, healthy claimants, we believe they must meet the basic conditions of entitlement if they wish to receive JSA.

That is the Government's basic approach to these issues. We intend to set out in regulations the detailed definitions of the vulnerable groups, and the factors which an adjudication officer will have to take into account in reaching a decision on whether hardship will arise. These are sensitive matters which may need fine-tuning in the future. They are therefore best dealt with through secondary legislation.

Turning now to the amendment, I should like to deal first with the issue of vulnerability on medical grounds, which is the subject of Amendment No. 7 and which is also covered in Amendment No. 8. We have already made clear that claimants who have a serious underlying medical condition that means that the removal of benefit would make them particularly vulnerable to hardship will have access to payments.

We will wish to look carefully at how to define that condition in the regulations. Taking physical conditions first, we have made clear that we do not believe it right to list specific medical conditions in regulations. It is important that the adjudication officer should be able to use his discretion to consider the claimant's individual circumstances as a whole, and the severity and effects of the illness in his particular case. Claimants applying for a hardship payment will be asked to give details of any serous illness from which they or a family member suffer and to explain how this affects them. In particular, they would be expected to give details of any essential costs associated with the condition—for example the costs of treatment and dietary or other needs. The basic test will be whether the illness is such as to make the claimant vulnerable to hardship, and the adjudication officer will be free to take into account any factors which he feels are

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relevant to this decision. We will be giving careful thought to how far we can or indeed should go in guiding adjudication officers to look at particular factors here, given the complex nature of the judgments involved. We believe that the number of cases will be extremely small, given that many serious conditions are controllable through medication, which is provided free of charge, and people on low incomes can receive free prescriptions which will ensure that they can maintain their normal level of treatment. We also believe it is right that any factors that we list should be circumstances which must be taken into account and not circumstances in which a claimant must be treated as in hardship in order to allow for the necessary flexibility to cope with each individual case. I should emphasise again that the presence of a medical condition will not of itself automatically provide access to benefit; the adjudication officer must decide that there is a clear risk of hardship arising.

We have also considered carefully whether the provisions should apply to mental disorders. I have to say that at this stage I am not convinced that they should. The new incapacity test should ensure that no one with a serious mental health problem has to claim JSA. Indeed, they will be exempt from the "all-work" test. Where a claimant's mental illness is mild or moderate the test will be applied but if it is clear from the questionnaire and medical evidence from the claimant's GP that he is not capable of work, then again he will not be required to attend a medical interview and incapacity benefit will be awarded. If the test is applied fully and the claimant does not reach the necessary points score, it is still open to the Benefits Agency medical officer to consider whether, despite the scores, the nature of the clamant's disorder is such that there would be a substantial risk to the physical or mental health of the person if he were found capable of work. Those arrangements—and in particular that final provision, which looks specifically at the risk to the health of the claimant whatever his score—represents a substantial safeguard to claimants with mental health disorders. Any claimant who scores on the mental health aspects but is still found capable of work has been judged capable of undertaking work in the normal labour market. I am not convinced that JSA will be dealing with claimants whose mental condition means that they are significantly more vulnerable to hardship than the average claimant, although I am happy to consider any arguments that have been made in that regard.

My noble friend and the noble Lord, Lord Carter, mentioned in particular medical evidence. Amendment No. 7 deals with the provision of medical evidence required by the adjudication officer to support the application. In many of the cases concerned we do not believe that special medical evidence will be required. As I explained, the claimant will be asked to provide details of his condition and of how it affects him or, as the case may be, his partner. If the claimant has taken the incapacity benefit "all-work" test, evidence from that test will be available to the adjudication officer, as I mentioned before, provided the claimant has given his consent. In a small number of cases the adjudication officer may wish to seek additional factual medical evidence before reaching a view. We are still considering how that evidence might best be provided, but I can

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provide an assurance that the claimant—if, for instance, factual evidence was requested from a GP—would not be required to meet the costs.

I listened to the examples quoted, and in fact read them myself this morning in the briefing. I should say that there is no compulsion on a doctor to make a charge for such letters. If the doctor wishes to give a letter to his patient free of charge, then he is free to do so.

I have spoken at some length on these issues, even though we addressed them on a number of occasions at previous stages of the Bill. I hope that noble Lords will agree that their importance merits a detailed reply. Since two of my noble friends have entered the debate for the first time, I hope that they will accept that I have explained carefully and in detail how we intend to deal with the particular problems. I believe that they can be dealt with satisfactorily. Having given my assurances once again to my noble friend, I hope that he will be able to withdraw his amendment. However, if he does not see fit to withdraw it, I hope that my other noble friends will support me in the Lobby.


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