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Lord Rowallan: Surely the whole point of the amendment is that such people can attend voluntarily. We do not insist on compulsory measures, but are saying that someone who is mentally incapable of attending an interview at a particular time should be respected and not lose his benefit as a result of ill health.

Baroness Hollis of Heigham: The debate has been most thoughtful and at times moving. Our difficulty is that we are not dealing with a particular category but with a range of people who may have moved on to incapacity benefit for reasons of stress or depression, which is alleviated once they leave the job, through to manic depression, schizophrenia and severe states which even with drug therapy do not permit a person to re-enter the labour market.

We are dealing with a wide sweep of people, which is why I find the amendments difficult. I want to support their intention, but I do not believe that they can do what they seek. Mental illness may range from relatively mild stress, which makes it impossible for someone to work, to severe schizophrenia. The full range of people, including those with modest learning difficulties, would not be expected to attend an interview.

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We are trying to avoid categorising people or stereotyping them on the basis of the benefit that they would normally get or their type of disability or handicap. We want to move away from that rigid categorisation because it does not give us the capacity to treat people holistically.

When a claim is first made, we will not necessarily know whether the claimant falls into the relevant category. As my noble friends have rightly said, mentally ill people who currently want to receive benefit have to engage with the claim process for incapacity benefit or disability living allowance. They have access to the support of their carer, their family or their advocate if they need it. We are not requiring anything different in their interface with the social security system. Through the single gateway we are developing support, based on an interview with heavily trained staff. They will have undertaken seven weeks of training, including input from mental health groups. That opportunity will allow us to discuss with the claimants their opportunities for returning to work if they are well, fit and able. Only 11 per cent of those with mental health problems are in the labour market, but when I met representatives of the National Schizophrenia Fellowship I discovered that such people were desperate to return to work and that their chief obstacle was not their own inability to enter the labour market, but overcoming the stereotype in employers' minds.

Disabled people who have a mental health problem already have to interact with the social security system. We are giving them the advantage of the support offered by the single gateway. Even if it does not necessarily take them into work--although many of them desperately want to work--it will give them information about benefits and contact groups.

If a claimant is in poor health at the time proposed for interview, it can be deferred or waived altogether if appropriate. Some of the situations that we have heard about could well come into that category. It would not be appropriate for the small number of people who are acutely ill to come in for an interview, but that does not mean that the opportunities of the single gateway should be denied to the much larger span of people who may be suffering phobias, stress or depression. With the help of drug therapy, support, mentoring, buddying and the backing of the disability rights procedures, many of those people would like to re-enter work. If we accepted the amendments, those people would never get the opportunity to explore what they can do and what support mechanisms might be available for them.

The amendments would exclude from the initial work-focused interview people who have been diagnosed as mentally ill or who in the previous three months have been in-patients at a mental illness hospital. It is wrong to approach the issue stereotypically and to exclude large numbers of people from the interview. The noble Baroness, Lady Buscombe, said that one in four of the adult population had suffered from a mental health problem at some time. I have checked the statistics. In 1978, 9 per cent of people on incapacity benefit claimed it because of a mental health or behavioural problem. Ten years later that had nearly doubled to about 16 per cent. The figure

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is now nearly 30 per cent. Should those people, who have had a job in the past, be denied the opportunity that we are offering?

The noble Lord, Lord Rowallan, said that the system could be voluntary, but that would put us in the same loop that we found with the New Deal. If people do not know what they are going to get from the interview, they do not come. One of the difficulties is to ensure that people have the full knowledge and information that they need. The interview can be deferred if it is inappropriate at that point, or it can be waived. Advocates or carers can also be present, or the interview can be held at home if that is helpful. We do not want to exclude 30 per cent of IB claimants from the reach of the single gateway, because it is in their best interests at least to have the opportunity to come within the system. The amendments are not appropriate because the range of people affected is very broad.

Staff will receive appropriate training and skills, with the help of groups such as MIND, Mencap and the National Schizophrenia Fellowship. It is right to approach the issue flexibly, supportively and decently by bringing those who already claim from the system to a sensitive and well handled interview. After that we can ensure that they have the necessary support, opportunities and information. They and their carers cannot know until they have been through the interview.

I have given assurances about what the interviews are intended to do. People with a mental health problem already have to engage with the social security system, but without the benefit of face-to-face support. The interviews can be deferred, or even waived, and they can be conducted in the presence of an advocate or in the person's home. The staff will be trained and skilled. Their approach will be sensitive and they will work with voluntary groups. We shall learn from the pilots whether we need to make our procedures more helpful and supportive. With those assurances, I hope that the noble Lord, Lord Addington, will not press his amendment.

5.45 p.m.

The Earl of Listowel: Before my noble friend sits down, may I check something with her? Is she talking about in-patients alone or out-patients as well?

Baroness Hollis of Heigham: I was trying to suggest that many people who have been mental health in-patients may have gone to the hospital voluntarily with a relatively mild illness because they do not have support from their families or because their condition has made it impossible for their families to support them. Others with more severe mental health illnesses are able to lead rich lives in the community in half-way houses supported by other carers. The test of whether someone is an in-patient or under the support of some other mental health organisation is not an appropriate benchmark by which to judge whether someone should come within the single gateway.

Lord Addington: I have listened to the debate with considerable interest. I am surprised by the amount of agreement in principle. The Minister agreed that there was a problem but said that the amendments were far

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too broad-brush. A reference to severe or acute mental illness in the amendments might have been more appropriate. When it comes to drafting, if I ever get anything right it is more by luck than by judgment. I accept that there is a problem.

The group whom we are talking about is different because the idea of the interview may be the primary problem. I have already said that it is not the idea of the interview that most of us are worrying about.

How many of us have heard examples of regulations being made; for example, in education, and the staff being inappropriately trained because it would take such a long time to get round to dealing with those who were already in place? That approach raises a frightening number of questions.

Baroness Hollis of Heigham: Perhaps I can help the noble Lord on that point. There are 200 advisers in the field who have gone through an average of 200 hours of training--and in some cases 300 or 400 hours--working towards established qualifications such as NVQ3. No one will be working as a personal adviser without being fully and properly trained. We are making a huge investment of staff.

Lord Addington: I thank the Minister for that, but the problem will be getting the right member of staff with the right training to the right person at the right time. Anyone who deals with specialist support services knows that. Demographic trends may cause problems. We have all had experience of that.

As I said, I appreciate that these amendments are rather widely drawn. I do not feel that the subject has been exhausted and we must look at it again, particularly in the light of what the Minister said. Much of that was helpful as regards the principle. Therefore, I shall now withdraw the amendment and return to the issue, having considered what has been said in this debate. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 94 not moved.]

Lord Rix moved Amendment No. 95:


Page 59, line 16, after ("benefit") insert (", save where a person is severely disabled")

The noble Lord said: In moving this amendment, I shall speak also to Amendment No. 114. Amendment No. 95 deals with the effect of removing the requirement for a work-focused interview from severely disabled claimants who need to access social security benefits. Amendment No. 114 deals with the need for advocacy support.

Many of the arguments written down in front of me have already been rehearsed during our discussions on the previous amendment. However, once more, I should like to amend, as it were, thoughts about different incapacities. Mental illness and learning disability are not the same conditions. It was unfortunate that the expression "educationally sub-normal" was used in your Lordships' House. Regrettably, that categorises people with learning disabilities back to the bad old days.

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There must be a way in which to remove the requirement for interview from the benefit claiming process for the most profoundly and multiply disabled people. Incapacity and disability benefits often provide those claimants with their sole source of income. We cannot run the risk of that income being jeopardised if the claimant cannot legitimately attend an interview on grounds of severe unchanging disability.

The Secretary of State and the noble Baroness have both told me of their reluctance to exempt categories of people. I acknowledge that there are people with higher rates of disability living allowance who are indeed working. But case-by-case discretion exercised by a junior officer seems to be an unsatisfactory and unreliable way in which to address the reality that people so severely disabled should not face a compulsory work-focused interview in order to obtain benefits.

I am aware that it is not in the interest of anybody--neither the claimant nor the Government--to place unrealistic requirements upon severely disabled people or personal advisers, who are predominantly there to signpost work-ready clients into the labour market. But I shall be sufficiently reassured, as I am sure will other Members of the Committee, if the Minister will give a commitment to issue guidance on advancing the claims of those permanently unfit to attend an interview. That guidance should be developed in consultation with relevant specialists. If I am given such a commitment, I suspect that I shall not press the amendment.

I turn now to Amendment No. 114 which refers to advocacy support. To interview or not to interview will rarely be a straightforward choice, particularly when determining the value of conducting "one" interviews with clients with moderate learning disabilities. For although an interview may be theoretically possible for some, it is likely to be counterproductive unless appropriate support is provided.

Many people require support in order to express their own views, and that will undoubtedly be the case within the context of "one" interviews. Without such support, clients with a learning disability may not fully comprehend the process, what is being required of them and what choices they are entitled to make. Some people with learning disabilities may have difficulty taking in new information, handling complex material such as benefit claim forms and communicating effectively. They may need support to help them with what they want to say. They may need encouragement to answer a question. They may also derive considerable emotional support from the presence of an advocate who is in an independent position.

A skilled advocate can support all those functions and, through facilitation, ensure that an interview is constructive for the claimant and for the personal adviser. If the "one" scheme is really about providing a service to claimants, there is no reason why claimants should be denied the right to advocacy support and provision made, where necessary, for appropriate support. I presume that that advocacy would stretch long beyond the realms of learning disability.

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Perhaps the Minister will take this opportunity to assure the Committee that all claimants will have a statutory entitlement to advocacy support, which will be made available without cost to the claimant if the absence of such support makes a work-focused interview untenable.

A simple way to achieve that would be by advising claimants of their rights to advocacy support on their letter inviting them to a work-focused interview, setting out a structure for the reimbursement of costs. I beg to move.


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