Work & Pensions CommitteeWritten evidence submitted by the Scottish Campaign on Welfare Reform

Introduction

1. The Scottish Campaign on Welfare Reform (SCoWR) is a coalition of leading civil society organisations.1 Members work with people experiencing exclusion and poverty across Scotland. This response outlines the consensus of opinion which exists among SCoWR members over key concerns with the UK Government’s proposal to replace Disability Living Allowance (DLA) with personal independence payment (PIP). Many of our members are also providing their own, detailed responses. This response is intended to complement those provided by individual members.

Our Response

2. The SCoWR manifesto sets out the five reforms that our members believe are necessary for an adequate welfare state:

Increase benefit rates to a level where no one is left in poverty and all have sufficient income to lead a dignified life.

Make respect for human rights and dignity the cornerstone of a new approach to welfare.

Radically simplify the welfare system.

Invest in the support needed to enable everyone to participate fully in society.

Make welfare benefits in Scotland, suitable for Scotland.

Increase benefit rates to a level where no one is left in poverty and all have sufficient income to lead a dignified life

3. The Government hopes to save £1.45 billion of annual DLA/PIP expenditure by 2014–15. To put this figure in context; annual expenditure on all those currently in receipt of lowest rate care is approximately £900 million. It is clear that this saving won’t be achieved without a significant reduction in the number of claimants. We oppose this objective, because whatever the fiscal situation, the number of disabled people in society already exceeds the number of DLA claimants. It is not justifiable to penalise some of the most vulnerable people by removing this vital support—particularly when plans to bring in the new benefit and re-assess all current claimants are estimated to cost £675 million.

4. We question the Government’s claim that the objective of the reforms is to facilitate independent living. In reality, many disabled people will find their ability to live independently seriously limited by these reforms. We would also challenge the implication that these reforms are necessary to combat a rise in fraudulent claims. The DWP’s own statistics estimate DLA fraud at 0.5%, and that the rate of overpayments caused by departmental error is significantly higher. The increase in the number of DLA claimants can largely be explained by the overall increase in population since 1992 and the fact that the UK has an ageing population. Furthermore, an individual must be under 65 to claim DLA for the first time, but once s/he has started receiving it s/he can continue to do so regardless of age. In 1992, all claimants were under 65—but there are now claimants up to the age of 84.

5. The Government has not specified the rates at which the new benefit will be paid. We believe that the Government should increase the rates at which the components are paid to reflect the reality of the extra costs that disabled people face. The Government’s own figures show that the rates of benefit are not adequate to meet the costs that many disabled people face. Research estimates that the additional costs attached to having a disability vary between £7.24 to £1,513 per month.

6. We are also concerned that the descriptors proposed to assess eligibility for PIP are not accurate proxies for the added costs of disability. For instance, in relation to activity two of the assessment “Preparing food and drink”, the distinction between different descriptors (and therefore different points allocations) do not relate to a change in daily living related costs. Someone who needs “continual prompting” to prepare a simple meal will have the same care costs as someone who needs “continual assistance” to prepare that meal. Other descriptors require further clarification. For instance, a person will be less likely to qualify for the mobility component of PIP under Activity 10 if they “can follow a simple journey”. A simple journey is defined a “travel to a familiar destination that requires walking and/or a single mode of transport such as a bus”. We are concerned that this might be interpreted to include the ability to arrange a door to door taxi journey—which will clearly be very costly. There is a need for the government to provide further information and to reassess the extent to which these criteria act as a proxy for a need for financial support.

Make respect for human rights and dignity the cornerstone of a new approach to welfare

7. These reforms will undermine the dignity and violate the human rights of thousands of disabled people. The proposed assessments are similar to the work capability assessments for ESA, which has been widely criticised, including by the independent Harrington review. The review is a damning indictment of the way in which the assessment system functions. Despite this the Government is pressing ahead with similar proposals for PIP.

8. Where sufficient supporting evidence is available, claimants should not be forced to go through a medical assessment. Furthermore, it is vital that the PIP assessment is planned, designed and administered with the dignity and respect of disabled people as the starting point. Assessments should be carried out by independent specialists relevant to a person’s condition, and whose focus is on the information provided by claimants and people who know them well. Training should be provided to those carrying out the assessment to ensure they have an adequate knowledge of the social model of disability, human rights and independent living. There is also a great need for independent advocacy to ensure that those being assessed understand the process and can engage with and challenge it. This should be government funded and widely available.

9. The Government’s argument for reviewing all PIP awards is the apparently large number of indefinite DLA awards that have never been checked. This has created the impression that a high proportion of indefinite DLA awards are inaccurate, without providing any evidence that this is the case. Reassessments will cost money, and will involve needless distress to disabled people with lifelong conditions. In a time of austerity any proposal to spend public money on an increased number of assessments should be subject to the greatest scrutiny.

10. Furthermore, assessors should not be set targets in relation to outcomes, processing time or scores. Any payment to a contractor defined by numbers of assessments performed automatically drives down the quality and means costs are shifted to tribunals and advice organisations. Instead, as described above, assessors should be required to carry out their functions within an ethical framework which makes treating disabled people with dignity and respect their performance bench mark. They should also be encouraged to perform well by way of fines when they make too many wrong decisions (ie decisions that are later overturned at appeal).

11. According to the Government, the purpose of PIP is to “contribute to the extra costs of overcoming the barriers faced by disabled people to live full and active lives.” However, the descriptors do not assess the individuals’ capabilities in relation to certain everyday activities – often in violation of their human rights. Examples include the fact that there is nothing in the assessment to measure a person’s ability to access information, despite this being a right under Article 21 of the United Nations Convention on the Rights of People with Disabilities (UNCRPD). Nor is there any measure of the individual’s ability to participate in cultural life, leisure recreation and sport. This is particularly surprising given that, according to the Government, “participation” is the objective of these reforms. The right to the highest attainable standard of health could also be undermined because—although there is reference to the ability to prepare a meal - there is no mention of that meal being balanced or nutritious. Eating toast and cereal for every meal is not acceptable. Furthermore, there is nothing in the assessment about a person’s ability to handle their finances or budget. Finally, there is no equivalent to the “day supervision” test employed under DLA. This will impact people whose main impairment arises from unpredictable, episodic conditions such as epilepsy.

12. We are strongly against the Government having the power to remove mobility related PIP from people living in care homes. There is no rational justification for this measure, which has the potential to undermine independent living and violate the human rights of around 80,000 people across the UK. This view is shared by the Social Security Advisory Committee, which has recommended that these measures undermine the objective of supporting disabled people to live independent and active lives. For more information see Capability Scotland’s research on the issue.

13. There is also a more general concern that the dignity of disabled people is being undermined by the continual introduction of laws and policies aimed at reducing costs. There are too often portrayed as minimising fraudulent claims and making sure disabled people don’t take more than they deserve. This is contributing to the construction of disabled people as liars and cheats.

Radically simplify the welfare system

14. We appreciate that the DLA application form is too long and complicated, and that many claimants need significant assistance and time to complete it. The proposed PIP assessment, however, risks adding further complexity to the decision-making process. The single reform which would most simplify the process and vastly reduce administrative costs would be to extend the number of conditions that give rise to automatic entitlement. This would allow claims to be decided efficiently and awards to be more consistent. There should still be the option of a claim based on personal circumstances where costs may be greater than normal for claimants with a particular condition.

15. Furthermore, the removal of one rate of one component is not a “simplification” so much as a measure to save money by removing entitlement from large numbers of existing claimants. Reviewing that claims process to make it more claimant-friendly and increasing automatic entitlements are better ways of achieving this end.

Invest in the support needed to enable everyone to participate fully in society

16. DLA is a vital lifeline to many and to withdraw it from claimants is to exclude them further from society. The proposals suggest that only those in the greatest need will be eligible. This is entirely unacceptable. Eligibility should not be based on a person’s ability to complete “everyday essential tasks”; but on whether and to what extent that person requires extra income to live independently. Understanding need only in terms of “essential activity” is to completely disregard the principles of independent living, participation and basic human rights. The suggestion that it is somehow progressive to redistribute in favour of those most in need of support to function is flawed.

17. Furthermore, the same group who will lose eligibility for PIP because their need is not judged to be great enough will be the same people who are disadvantaged as a result of changes to ESA and cuts to local authority care packages. This is not only wrong, it will result in the deterioration of health and in people’s ability to live independently. As the Dilnot Commission on adult social care recently acknowledged, meeting lower level needs is essential to ensure prevention of higher or crisis level needs.

18. Other areas of the assessment which will undermine participation include:

The medical nature of the assessment

Eligibility under the plans will be based on a medical assessment and on evidence submitted by medical professionals such as GPs and occupational therapists. If the assessment is to be relevant and meaningful the individuals themselves must also be given the opportunity to submit evidence, particularly in relation to environmental and societal factors which prevent them from living independently and participating in society.

Poorly considered assessment criteria

There is a failure to appreciate the interaction of the assessment criteria and descriptors. For instance, a person’s ability to take medication is given a low weighting in relation to other aspects of the assessment. This approach disregards the fact that if a person cannot reliably take medication, they may not be able to participate in the other activities.

The Government also proposes that a person’s ability to use aids and adaptations to get around should be considered in assessing their mobility. However, the social and physical barriers to mobility are not removed by the possession of a wheelchair or a stair lift. While some wheelchair users may have an electronic chair and a ramp to their front door, they may also live at the top of a steep hill which they cannot negotiate or in an area with no accessible buses. This provision is also likely to result in higher rate mobility component being withdrawn from wheelchair users. This will be particularly problematic in remote rural areas and as such it will have a disproportionate effect on disabled people in Scotland.

Lack of clarity

The Government has stated that in order to be assessed as capable of doing something, they must be able to do it “repeatedly, safely and in a timely manner”. This is not contained in the draft regulations themselves. Furthermore, the government has not explained how these terms should be interpreted. How often should a person be able to repeat things to be classed as able to do them “repeatedly”?

There is currently very little detail in relation to if/how PIP will apply to children and individuals over pensionable age. We urge the Government to delay any changes to the entitlement of these groups until the effect of the reforms has been thoroughly assessed and any problems resolved. For children these reforms represent an opportunity to improve on the DLA assessment and, in particular, the “significantly greater needs” test, which is hard to satisfy even with significant extra costs. The evidence on early intervention suggests that more generous entitlement criteria will reduce overall costs in the long run and repay the investment in them.

Assessment of fluctuating conditions

We welcome the consultation’s acknowledgement of the need to take account of needs which vary over time, however, there is no explicit acknowledgement of the existence of varying conditions in the regulations. If people with fluctuating conditions are to be fairly assessed then less weight must be given to their medical assessments and more on any supporting documents submitted by practitioners who know the claimant. Again, we believe, the most effective way of providing consistent decision making and clarity to claimants would be to use an automatic entitlement for people with particular fluctuating conditions.

People with mental health conditions often have fluctuating conditions, meaning that they may be assessed on a “good day” but this would not be an accurate assessment of them when their condition is affecting them. There is great need for independent advocacy in this area. Also, there is no appreciation of how fluctuation in environment will affect conditions.

New conditions

The extension of the qualification period will act to exclude disabled people at the very time when adequate financial support can make the most positive difference. While other areas of policy are rightly focussing on the importance of early intervention, this proposal is regressive in the extreme. Using Government figures as a basis, the additional cost of six months of disability could range from £43.44 to £9,078. Lack of any support with these costs is unjustifiable and limits the ability of thousands of people to live independently at what may be one of the most stressful times of their lives.

Make welfare benefits in Scotland, suitable for Scotland

19. Whilst neither PIP nor UC will be matters devolved to the Scottish parliament, this legislation will impact on claimants in Scotland in different ways due to its interaction with devolved matters, principally health and social care. Any legislation should explicitly acknowledge the importance of devolved legislation in the areas of health and social care, and build into the regulations the flexibility to account for regional variations.

20. In many cases the removal of financial support will lead to increased reliance on social care and other local authority services. This extra burden on local authorities will be felt disproportionately in Scotland where many local authorities take disability benefits—such as the care component of DLA—into account when they are calculating care charges. As DLA is reduced, so will the available income of service users and, in turn, the amount that local authorities are able to charge for care packages. This will not be the case to the same extent in England, where the Department of Health has issued guidance on fair charging of disabled people.

21. Furthermore, the mobility component of DLA is often used to informally subsidise, upgrade or repair publically provided wheelchairs, aids and adaptations. If DLA (or its equivalent) is removed from 20% of claimants, then this burden will fall on local authorities and the NHS.

22. The Government has justified its intention of removing the mobility component of PIP from those in residential care on the basis that all care support and mobility requirements should be met from social care funding. This is not only an unrealistic prospect, but also undesirable and impractical. Research has found that, contrary to UK Government claims, local authorities do not tend to fund mobility costs for disabled people in care homes as part of contractual fees—meaning there is no duplication of funding. Half of disabled people who live in residential care give either the majority or their entire DLA mobility component to their care home. Of these, 40% said that it pays for a Motability car, and 21% said the money goes towards petrol for staff to take them out. This suggests that much of the burden will fall on local authorities.

Reference

1 SCoWR members include: Action for Children Scotland, Archibald Foundation, Capability Scotland, Carr-Gomm Scotland, Choices—One Parent Families West of Scotland, Citizens Advice Scotland, CPAG in Scotland, ECAS, Energy Action Scotland, Faith in Community Scotland, Glasgow Disability Alliance, Headway UK, Inclusion Scotland, Margaret Blackwood Housing Association, Momentum, One Parent Families Scotland, Oxfam in Scotland, Public & Commercial Services Union Scotland, Quarriers, RNID Scotland, Scotland’s Commissioner for Children and Young People, Save the Children in Scotland, Scottish Association for Mental Health, Scottish Council for Voluntary Organisations, Scottish Drugs Forum, Scottish Federation of Housing Associations, Scottish Trade Union Congress, Scottish Women’s Convention, Sense Scotland, The Action Group, The Church and Society Council of the Church of Scotland, The Iona Community, The Poverty Alliance, The Salvation Army in Scotland, Turning Point Scotland and the Welfare Rights Officers’ Forum.

2 September 2011

Prepared 15th February 2012