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I make no apology for mentioning that admirable organisation ThriveI know that the noble Lord, Lord Skelmersdale, knows it very wellwhich aims to help disabled people from local communities change their lives through gardening. Part of the work of the Battersea garden project, under the Thrive umbrella, aims to help those with learning difficulties to fulfil
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Lord Ramsbotham: I apologise to the Committee for being absent at the very start of the debate, but I am also involved in the debate on the Iraq invasion. My reason for putting my name to the amendment is very much linked with remarks I made at Second Reading of the Policing and Crime Bill. That may sound slightly strange, but there I drew attention to the fact that at present the House is faced with an enormous number of different Bills, each with an impact assessment attached. I wonder whether anyone has bothered to do an impact assessment of the impact of any one of these Bills on any of the other Bills. With this Bill, that issue comes very much to mind, for two entirely separate reasons.
I declare an interest as an adviser to the Sainsbury Centre for Mental Health, which is embarked on two separate studiesone on the problem of mental health in prisons and the second on the problems faced by those with mental health problems, including learning disabilities, in getting employment. At the same time, in the apprenticeships Bill, a number of us are tabling an amendment to ensure that before starting school, every child is given a proper assessment of its learning abilities and disabilities to enable it to engage in education. In prisons, an enormous number of people lack the learning ability to engage in the system when they reach the age of 15. We find that in Northern Ireland they have decided that every child should be assessed at the age of two to ensure that the sort of learning difficulty being discussed under this amendment is raised at an early enough stage for something to be done about it.
Therefore, I voice my concern and my strong support for the noble Lord, Lord Rix, and the noble Baroness, Lady Thomas, in every word that they said. There seems to be a disconnect; on the one hand, we have an enormous number of efforts being made to improve what is happening for the identification of learning skills problems and learning disabilities and to do something to harness them; on the other hand, we are proposing that something should be done, if, for reasons perfectly explicable in the context of the disability, the disabled person cannot meet the conditions proposed in the Bill.
Baroness Murphy: The amendment has been so ably moved that I do not need to add much more than my tuppenceworth. I support the amendments, particularly their thrust on training. We have got down to the nitty-gritty of what happens in practice to assist those who may not have worked for some time, have real potential but whose circumstances have been against them for all kinds of reasons, among them learning
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The strength of this Bill lies in its potential for therapeutic interaction and a proper action plan that is supportive, whether individualised or personalised. It is a little bit like doing a care plan for somebody subject to a community treatment order under the Mental Health Act. You have to sit down and negotiate what the blocks are to remaining well and how to get through the system of hurdles to get well again and back into recovery. This is an analogous situation. My real fearand we have brought this up beforeis that we need to create an attitude that comes with training and understanding peoples conditions, and a cultural change among those who provide the services so that they get into the right relationships with people. Therefore, the fundamentals of training for the private providersthose who are going to the actual jobare crucial in a whole series of amendments, of which this is the most important. We must somehow use this Bill to make a real difference to how people become engaged with the work-related activity process, which then has the potential to lead them on to work. I support the amendment.
The Countess of Mar: The noble Baroness, Lady Thomas, mentioned horticulture. Perhaps I may also mention the fact that a lot of people with learning difficulties have an extraordinary affinity with animals. Working with animals expands their view and they become more able to work with humans. We should not lose sight of that. In rural set-ups, some farms are very mechanised and difficult for young people, but others have animals, including horses, sheep, pigs and cows. A lot of kennels take on young people as well. You do not need an A-level or a university degree to work with animals. Animals love these people because they seem to understand them. It is a wonderful thing to see and I am fortunate to see it quite often. I support the noble Lord, Lord Rix.
Baroness Turner of Camden: I, too, support this amendment. Although it is not within my particular area of expertise, I have listened with a great deal of interest to what the noble Lord, Lord Rix, and others have said in support of it. It is very necessary for the text of this amendment to appear in the Bill, in particular in the section to which it is related: that is, the directions about work-related activity. In Committee, we have already had quite a lot of discussion about the necessity of ensuring that those responsible for administering this legislation have adequate training. That is doubly important for people with learning disabilities.
It is in the Governments interests to ensure that this Bill covers adequately people with learning disabilities in the manner proposed under this amendment. I hope that the Minister will agree. He may not accept this wording, but I hope that he will accept the principle and ensure that something like this appears in the Bill.
Lord Skelmersdale: The noble Lord, Lord Rix, will be glad to hear that this is an occasion when I will not be a bit of grit in the ointment. I support the theory of these amendments. Whether it is necessary to have them in the Bill, the Minister will no doubt explain in
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As an employer, I have to accept that an employer would normally be extremely cautious in considering the employment of someone with learning disabilities. Noble Lords should not get me wrong because my wife and I have for some time employed an individualin horticulture, as it happenswith learning disabilities. Both he and we cope with the situation very well. But I can imagine other employers and other people with learning disabilities who would not gel anything like as well. In this day and age, I am not sure what interests one should declare. Some time ago I was asked to be a trustee of Thrive, which the noble Baroness, Lady Thomas, has mentioned. I also have a sister who is a trained psychological therapist and is studying animal therapy, with particular reference to horses, which, as the noble Countess, Lady Mar, said, often has very desirable effects on those with learning disabilities.
I am sure that the Minister will not disagree with the view expressed by all noble Lords who have spoken that particular attention will have to be paid to people with learning difficulties if these schemes are to be successful in getting them back to work or into work for the first time. I expectalthough I am, as usual, prepared to be proved wrongthat the Minister will agree with all of this and assuage noble Lords by saying that this will all be taken care of under the individually tailored action plans. Of course, we are not allowed to call them that; they are just action plans. This is why the key amendment in the groupas with a similar set of amendments tabled by the noble Countess, Lady Mar, which are shortly to be debatedis the one that refers to precisely what training will be provided to jobcentre staff to enable them to draw up action plans addressing the needs of participants with learning difficulties.
We have not yet explored the activities of the contractor in all this. My guess, and hope, is that, to a great extent, the prime moverthe contractors personal adviser, if you likewill draw these things up. They will be approved by the jobcentre personal adviser. Of course, directions, sanctions and so on have to work in that way; they will be suggested by the contractor, and the more normal agents of the Secretary of State then actually impose them.
I would also be obliged if the Minister gave us the most up-to-date statisticsor perhaps the noble Lord, Lord Rix, has themindicating what percentage of those out of work have been diagnosed with learning difficulties so that we have a clear grasp of the scale of the problem.
At the beginning of my speech, I indicated sympathy but expressed doubt that it is necessary to have these amendments in the Bill. I expressed doubt because I note that at the top of page 7gosh, we are moving fast todayit says:
Of course, a persons circumstances would include any disability, including a learning disability. The noble Baroness, Lady Afshar, has spoken of the paucity of English among certain of the individuals we are talking about. As usual, I will listen carefully to what the Minister says, but that is not to say that I disapprove of the actions taken by the noble Lord, Lord Rix, this afternoon.
Lord McKenzie of Luton: I thank the noble Lord, Lord Rix, for moving his amendment. It brings us to an important topic that we have touched on a little before in Committee. I entirely empathise with the sentiments behind the amendments in this group, as the noble Lord, Lord Skelmersdale anticipated.
I assure noble Lords that we take supporting customers with learning disabilities seriously. As I noted in one of our previous Committee sittings, however, the noble Lord, Lord Rix, identified the big gap between the employment rate of people with learning disabilities and that of pretty much every other group that we monitor. As I said then, we cannot allow this to continue. I hope that the provisions in the Bill, effectively resourced and applied, will be the route to help.
To successfully help those with learning difficulties, we will have to ensure that our advisers are adequately trained to deal with customers who have a learning disability; this is a strong theme that I will come back to in a moment. We will also have to ensure that any directions to a specific work-related activity take account of a persons individual personalised circumstances, including any learning disability that they may have.
Amendments 54 and 92 seek to ensure that advisers must take into account a customers learning disability when issuing a direction to a specific work-related activity. I reassure noble Lords that the power to direct customers to a specific activity will be used only in a small minority of cases. Advisers will always encourage, persuade and support people into activity they genuinely feel is necessary before considering issuing someone with a direction to undertake a specific activity.
As stated in Clauses 2 and 8, any direction to an activity must be reasonable and, as the noble Lord, Lord Skelmersdale, cited, have regard to the persons circumstances. Hence, any direction to undertake an activity by the adviser must be appropriate to the customers abilities and circumstances, which would include taking into account any learning disability that the customer may have.
Safeguards are in place which will apply if the claimant has misunderstood a direction to a specific activity. The claimant could ask for the direction to be reconsidered as part of the action plan reconsideration process. If the claimant does not comply with the requirement to undertake an activity because they did not understand it, they will be able to raise it as good cause for failure to comply.
In addition, every customer has the right to be accompanied by a carer or advocate when attending an interview. This person can help them to interpret and understand the advice and requirements being set
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Amendment 89 aims to ensure that personal advisers are adequately trained to deal effectively with ESA customers who have learning disabilities. We recognise the central importance of the adviser role if we want customers to be able to progress positively and confidently towards a return to work. We shall focus strongly in the progression-to-work pathfinders on developing the staff who deliver this role and invest in the necessary training. We have already started talking to stakeholders about adviser skills and knowledge and will continue to do sothat is vital.
However, pathways personal advisers already have considerable training in dealing with customers with a range of health conditions. It is important to point out that pathways advisers are not working in isolation. In Jobcentre Plus pathways areas, they can seek advice from, or refer customers on to, specialist disability employment advisers or work psychologists.
In provider-led pathways areas, all our providers have delivered specific training to their staff to assist them in dealing with customers with health conditions. They also have links to specialist subcontractors to whom clients with specific medical conditions can be referred for additional assistance. They can also refer customers to the disability employment adviser via the jobcentre. For example, WorkDirections provides advisers with training in learning disabilities, facilitated by vocational rehabilitation specialists from the organisation Disability Matters. The training covers effective communication and providing support to clients, as well as information about agencies that can provide additional support to clients with specific conditions when in work. It specifically addresses working with clients who have Downs syndrome, autism, Asperger's, cerebral palsy, dyspraxia or acquired brain injury. Working Linkshas used theNational Autistic Society, which delivered a one-week training course to personal advisers on Aspergers.
All advisers working with ESA claimants also receive advice from approved healthcare professionals about the impact of the customers health condition from the work-focused health-related assessment, which is completed in the early stage of a customers claim. The report will flag up whether the customer has a learning disability and its likely impact on them.
Lord McKenzie of Luton: The Sainsbury Centre for Mental Health was involved in the development of the Jobcentre Plus adviser training. We shall also consult a range of other mental health charities, including Mencap, on training for advisers in the progression-to-work pathfinders. It is important that we do so.
Baroness Afshar: What provisions are there for recognising certain disabilities, particularly mental disability, among minorities that are ashamed of mental disability and where having such disability is unlikely to be stated? What training is provided to enable anyone to recognise that?
Lord McKenzie of Luton: I readily recognise the challenge involved in that. If we are dealing with ESA customers, there is a process of work-focused interviews and a work-focused health-related assessment, currently undertaken by Atos Healthcare on our behalf, whose professionals get training. However, it is important that people from the minority ethnic communities who have language or cultural difficulties in expressing themselves on these issues are accompanied by people who can support them through these processes. We need to be ever vigilant to make sure that the training recognises that some people who come in as customers may not be forthcoming because of cultural issues around their health condition. It is important that people have the skill to probe that.
I am conscious that I can assert from the Dispatch Box that we have lots of provisions and training and that we are going to engage with stakeholders to improve that but, as we all know, what actually matters is what happens in practice and not only getting the training in place but having proper monitoring of our staff and contract monitoring of our providers.
The noble Lord, Lord Rix, asked about the social care Green Paper. I regret that I am not in a position to say more than my colleague Phil Hope. The Department for Work and Pensions has been closely involved in its preparation, and I hope that it will see the light of day before we get to Report so that we can revisit it then.
The noble Lord also asked about specialist subcontractors. We encourage specialist subcontractors within a framework of strategic partnerships with prime contractors and later in our deliberations we will be discussing how that works. We are not seeking to squeeze out smaller providers, very much the contrary. The draft ESA regulations include a provision for failure to understand the requirements to be a good cause. However, I am happy to revisit the wording. I believe the provision is there; it is certainly intended to be there.
The noble Lord, Lord Ramsbotham, urged us to be joined up on this as a Government. As ever, he raises an important point. The impact assessment for the Bill has encompassed equality and child poverty as part of its approach, but there is always more that government can do to be joined up. We are dealing with work-related activity. There is no question of mandating anybody to a specific job. That is not the group that we are dealing with.
In moving his amendment, the noble Lord, Lord Rix, touched on the point that employers have a key role to play. We can do whatever we can to support people, but we need to make sure that we engage with employers so they have the benefit of people who have real talent and expertise that can brought to bear, which will help not only those individuals but the businesses the employers run.
The noble Lord, Lord Skelmersdale, asked about the numbers. We estimate that around 50,000 people claiming incapacity benefit or employment support allowance have a learning disability. This figure could be higher given that the estimate does not include those people whose learning disability is not listed as their main health condition. In addition, there are likely to be claimants who would still broadly be
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The noble Countess, Lady Mar, made an interesting point about engagement with animals, farms and so on. That would be an entirely reasonable work-related activity that could appear in somebodys action plan. I do not know if it ever has, but it is just the sort of thing that work-related activity should be about: helping people to engage and building their confidence.
The noble Baroness, Lady Murphy, made the analogy that action plans are about care plans. They should be jointly owned, trying to ensure that people can progress. As all other noble Lords have said, training is absolutely key. My noble friend Lady Turner supported the amendment in similar terms. Where we might part is on the need for it to be in the Bill. However, we are, I hope, agreed upon the need to ensure that these issues are addressed and inculcated into the processes that we set in train, and that we are resourced to ensure that we can deliver on them.
That is probably not the full loaf that the noble Lord, Lord Rix, was seeking with his amendment, but he will acknowledge what we are trying to achieve. As ever, I am happy, together with colleagues, to continue to work with him on these matters.
Lord Rix: I am grateful to all noble Lords who have spoken in support of the amendment, and to my noble friend Lord Ramsbotham, who, I am glad to say, escaped from the Iraq war long enough to add his support verbally. I am also extremely grateful to the Minister for a long and detailed response which, frankly, I will have to take away and read most carefullyprobably with a magnifying glass because there are so many words in it. There was some comfort for me there.
The noble Lord, Lord Skelmersdale, and the noble Baroness, Lady Thomas, plugged Thrive. Mencap has for many years had Lufton College in Somerset, which trains people in animal welfare, horticulture, agriculture and so on. It hopes that, at the end of the training, which can be anything from two to four or five years, they will be able to take up work in that activity when they finally return home.
The training of the advisers in learning disability, and all the other problems, is a case of How long is a piece of string?. Truthfully, how good are the trainers going to be? How good are the trainees going to be at receiving what they are trained in? It is a difficult problem, and I hope that, in four or five yearsif the Bill is eventually enacted and applieswe will not hear those dread words lessons have been learnt once again because things have gone horribly wrong.
During the passage of the Police and Criminal Evidence Act, all those years ago, the Kent police, who had a good film studio, made a DVD in co-operation with Mencap to show to all police officers who were likely to be involved with learning-disabled people. It was a great success and circulated to all police forces. I am not sure that one might not care to consider that device. I would be more than happy to step in front of a camera with some learning-disabled people and try to explain the problems and difficulties. It might be a practical help to the training of these people.
Nobody has yet mentioned the easy-read pamphlets that should be available for people with learning disabilities. Again, they should automatically be available. Easy-read versions of the actions of Bills, the Acts when they eventually come out, the regulations and so on are vital. It is not that they will exactly be the most popular reading, but they should be available.
Lord Rix: Yes, that is true. I have said enough. The Minister has said a great deal and I do not want to add to the time we spend here this afternoon. I will study the Minsters words tomorrow and the day after. I have a potential meeting with him on other matters concerning the Bill, so I will obviously bring up matters concerning the amendments as a result of what I read tomorrow. I beg leave to withdraw the amendment.
( ) must be reasonable, having regard to whether the person has a condition with fluctuating signs and symptoms, and the nature of that condition;
The Countess of Mar: I shall also speak to Amendments 90 and 93. In doing so, I declare a non-pecuniary interest as chairman of Forward-ME and patron of a number of ME charities. The amendment moved by the noble Lord, Lord Rix, was about people who want to go to work and are sometimes not thought fit to do so. I want to discuss people who are deemed fit to go to work but who are not fit to do so. The Minister will understand from long experience why I am concerned about this particular group of people. I explained in some detail at Second Reading the problems that they have when encountering the benefits system.
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