§ 'The Secretary of State shall, before 30th September 1996, lay before each House of Parliament a report on the operation of the test of incapacity for work under Part XIIA of the Social Security Contributions and Benefits Act 1992, which shall (among such other information as he may think fit) include—
- (a) an account of the number of people who attended a medical examination under that part of that Act and a description of the type of such examination;
- (b) an account of the number of people who, having attended such an examination were determined as incapable of work;
- (c) an account of the number of people who having attended such an examination were determined as capable of work;
- (d) an account of the reasons for determinations of capacity for work;
- (e) an assessment of the medical test by such persons whom the Secretary of State may choose'.—[Mr. Bradley.]
§ Brought up, and read the First time.
§ Mr. Deputy Speaker (Mr. Geoffrey Lofthouse)
With this, it will be convenient to consider the following: New clause 4—Annual Report by Secretary of State: appeals— 165'The Secretary of State shall, before 1st April each year after the commencement of this Act, lay before Parliament a report concerning appeals against determinations that a person is capable of work, which shall, among such other matters as he may think fit, for each area of the Benefits Agency Medical Service—
- (a) specify the number of occasions on which an appeal was heard more than ten days after it was made, and the average time between the making and the hearing of the appeal;
- (b) summarise the outcome of all appeals;
- (c) report on the extent to which medical or other evidence influencing the outcome of an appeal;
- (d) summarise the reasons for any failure by a claimant to attend a hearing; and
- (e) report on the use made by claimants of representations at an appeal.'.—
Amendment No. 22, in clause 5, page 11, line 28, at end insert—
'(c) defining the way in which relevant evidence or information submitted by that person or by any medical practitioner or professional health worker will be used during the assessment'.
Amendment No. 24, in clause 6, page 13, line 17, leave out lines 17 to 23 and insert—
'(4) When a social security tribunal is to determine an appeal concerning a determination that a claimant was capable of work the tribunal shall sit with the claimants' general practitioner,'.
Amendment No. 25, in page 13, leave out lines 18 to 26 and insert—
'for appeals against determinations that a person is capable of work to be heard by a tribunal constituted under section 42 of this Act.'.
Amendment No. 26, in page 13, line 26, at end insert—
'(5) When a claimant has made an appeal to a social security tribunal concerning a determination that he was capable of work—
§ Mr. Bradley
This substantial group of amendments goes right to the heart of the Labour party's opposition to the Bill, and it shows why we have consistently and rigorously opposed the Bill on Second Reading and throughout Committee, and why we will continue to do so.
The clear purpose of the legislation is that the Department of Social Security must make its contribution to the cuts in public expenditure because of the Government's economic mismanagement. The £50 billion public sector borrowing requirement overspend is being addressed by the Government, and the Department of Social Security has looked at the people in the greatest need to try to make its contribution. It is clear that the legislation is Treasury-led, and its purpose is to make substantial cuts in the amount of money available to disabled people.
By the Government's own admission, they expect to save £550 million in 1995–1996 and a staggering £1,450 million in the following year. There can be no greater testimony to the fact that this is about saving money, rather than about a rational and careful replanning of benefits to meet the real needs of disabled people. Those benefits must be made in conjunction with a co-ordinated and coherent policy by the Government to try to enable people with disabilities who are able to return to work to do so. Those who cannot return to work should receive an adequate and proper level of income to meet their needs and those of their family.
166 We have made much this afternoon of the fact that the Government are introducing this measure by regulation, rather than by primary legislation. The purpose of new clause 3 is to enable there to be proper parliamentary scrutiny of the medical test, which is a vital element of the new legislation. It is a disgrace that the medical test on which all of the decisions are to be made about whether a person is eligible for the new benefit is not before the House as we debate the legislation. The test does not form part of the Bill, and it will be brought forward at a later stage by regulation.
It is a great abuse of Parliament that the Opposition are not able to examine properly today the details of the medical test, and that we must wait several months before that test is available for scrutiny through regulation. When it is brought forward, there will be no opportunity for the Opposition to amend the test, and we must accept it or reject it on regulation. That is an unsatisfactory way of dealing with the crucial matter of determining whether a person with disabilities is able to work.
The purpose of new clause 3 is to force the Government to produce a report to Parliament about the way in which the medical test will operate in practice. That report is crucial to ensure proper parliamentary scrutiny and understanding of the way in which the medical test will operate.
The report is also crucial because of our general views, which we explored in detail in Committee, on how the Government are developing the medical test. The process is a consultation sham. It is outrageous that a Bill entitled the Social Security (Incapacity for Work) Bill does not contain a definition of incapacity for work.
The medical test is intended to exclude people rather than make them eligible for incapacity benefit. A test of incapacity based on functional limitations alone is inadequate, unfair and unworkable, and the way in which it will be used for new claimants, compared with people in receipt of invalidity benefit, will be inequitable.
If one wants to determine how the test will work in practice, the type of work that someone can reasonably be expected to do must be included in the Bill, but it contains no definition of the work that will apply to the test.
Our first major criticism, and the reason why a report to Parliament on medical tests is so vital, is that the way in which the test is being developed has no validity. We welcomed the explanation that medical officers from the Department of Social Security gave about how the test has been developed, but that explanation did not comfort us that the outcome of the final deliberations will be a test that has any relevance to determining whether people are able to work.
As we have stated before, it is to say the least very unsatisfactory that the so-called panel of experts who will draw up the medical test have to remain secret from the public, and that their deliberations will take place behind closed doors. It is also unsatisfactory that the Government are not prepared to release the names of the people who are devising the test on behalf of disabled people until after the process has been completed.
A crucial element of new clause 3 is that, when a report is prepared after the medical assessments have been scrutinised, it will be passed to the group of experts for their views. It is important that they should continue to have a role once they have gone public and that they should have some voice in the way in which the test operates.
167 We are concerned about the fact that it is not clear how the final test will be validated by the group of experts. In Committee, we sought clarification of whether the test will be based on a consensus model, the Government will take views on the test and impose their final solution on the group of experts—regardless of whether they agree—or there will be room for public dissent. We would welcome an explanation from the Government.
I am sure that all my hon. Friends, and Conservative Members, will have received briefing after briefing. I have here a sample of those that I have received from organisations throughout the country. Those organisations carefully analysed the consultation document that the Government published, and the briefings explain why they are so critical of the Government's attempt to introduce a purely functional test that can be applied to the world of work for people with disabilities.
Those bodies also assert very strongly that they have been asked to take part in consultations on a document that changed almost before the ink on the first draft was dry. The whole exercise is such a mutant creature, such a changing phenomenon, that it is not clear at what point the final word will be said.
We welcome the Government's undertaking in Committee that, following completion in August of the final deliberations on the medical test, the form of the new test will be published, and that further public consultation on the outcome of the deliberations will be allowed. I hope that, in the context of this new clause, the Government will be able to assure us that they do indeed intend to engage in that process. There must be new and full consultation when the new medical test has finally been devised.
We are greatly concerned at the fact that, in the absence of a definition in the Bill, it is difficult— almost impossible — to debate incapacity for work. On this ground also, the new clause is important. We are told that a full definition will be provided in regulations. Without knowing how the Government intend to use the medical test in practice, it is very difficult to look forward to a clear understanding of the relationship between the medical test and the work situation. The Bill itself should contain a proper definition so that we might have an opportunity for parliamentary scrutiny.
Given the consultation document's criticism that case law hasbroadened and blurred incapacity beyond its original meaning",and given that part of the thrust of the Government's argument seems to be that they need to tighten up the way in which invalidity benefit is currently administered, it is surprising that a precise definition has not been provided.
A clear definition in statute law might have gone some way towards resolving any supposed problems of misinterpretation of the original intention. If the Government had addressed their mind to that point, all the other proposed changes in the administration of invalidity benefit might have fallen away, and it might have been seen as inappropriate to introduce this new benefit. This can only give additional thrust to the theory that the main purpose of the Bill is to cut public expenditure rather than to focus benefit effectively on people with disabilities.
There is little evidence that the only way properly to target—that is the Government's terminology; they used the word "focus" in Committee; we believe that the proper word is "cut"—invalidity benefit is to set about this 168 elaborate new procedure. We believe very strongly—no one has suggested otherwise at any stage of debate on the Bill—that not every person in receipt of invalidity benefit is a genuine case.
It would be absurd to make such a suggestion. However, the dismantling of the whole system and the introduction of entirely new procedures—in particular, the new functional medical test—does not support the Government's contention that they are trying to help disabled people rather than to take essential benefits from them.
If the Government's purpose is genuinely to focus invalidity benefit, why will people who pass the medical test receive benefit at a lower rate? If the purpose is simply to tighten up the rules and ensure that the medical test is properly applied, why will there be a cut in the amount of money available to people with disabilities who pass the test?
This is a crucial question, which the Government must answer. They must tell the public why, if they are simply trying—in their terms—to wean people off invalidity benefit, those who pass will receive benefit at a lower rate.
So new clause 3 is intended to bring a report forward on the medical test, because we believe that the test of functional limitation is inadequate, unfair and unworkable. As a tool for assessing incapacity, the test is inadequate. The Government have based their research on the previous Office of Population Censuses and Surveys scales, which were defined very much for research purposes and not for the purpose to which they are now being applied. We believe strongly that other factors, and not just functional limitation, must be taken into account when using the medical test.
Not only must we look at the individual's medical condition and disability; we must also assess the effect of their condition on their ability to carry out a range of social and functional activities, including the ability to travel to work, and their capacity to sustain functional and social activities within the specific demands and constraints of the workplace. A study undertaken by the Policy Studies Institute suggests that four criteria are important in the assessment of work capacity—age, skills, the accessibility of the job and discrimination by employers—and that a much wider test than the purely functional one proposed by the Government must be applied.
The test, we believe, will produce unfair results. We were encouraged to a certain extent by the fact that now included in the medical test will be open-ended questions for applicants to answer, to explain some of the limitations imposed by their incapacity. But, by their very nature, open-ended questionnaires are difficult to analyse, and it will be hard to produce consistency of treatment as between claimants.
As anyone who has undertaken social research knows, the interpretation of open-ended questions and their answers is extremely difficult. So there will be great differences in treatment, not only within Department of Social Security offices dealing with these matters, but between offices throughout the country. That is the importance of the new clause—that a report will be presented to Parliament so that we can look at the analysis to ensure fairness and equality of treatment throughout the country.
We are also concerned that any functional medical test will fail to take into proper account what has been mentioned in many of the briefings that we have received 169 on this from organisations such as the Multiple Sclerosis Society, Arthritis Care and others: fluctuating conditions whereby people's ability to work varies from day to day, or even situations in which, as a result of undertaking some task at work on a particular day, they may be prevented from doing it the following day. We are also concerned that the functional test arrangement will not properly reflect the condition of people suffering from long-term debilitating illnesses such as myalgic encephalomyelitis.
We are concerned about people whose disabilities are invisible, particularly those with chronic pain, who often experience difficulty in convincing others that their pain is real. There is a great deal of research on this point, and the sensitivity with which the medical test is applied will be crucial in ensuring that people who genuinely can or cannot work are properly and uniformly assessed. We have no confidence, from the way the test is currently being organised, that it will lead to that conclusion.
Finally, we are concerned about people who have "managed" their disability through the use of medication and so on, but who have great difficulty in undertaking tasks to which the test may be applied. There are difficulties not only in the way in which the medical test will be applied to people's current occupation, but in the way in which it will be applied to all work.
We are very worried that the all-work test will not reflect the relationship between the ability of the individual, through the functional medical test, and the real work opportunities for disabled people. We are worried that that will not be applied in a way that will lead them into real employment because, by the Government's admission, they expect 200,000 people who would currently claim invalidity benefit not to receive the new incapacity benefit, but to end up as unemployed.
That is the reverse of the Government's previous policy, by which they sought to reduce unemployment by pushing people into any benefit they could find that was not unemployment benefit. Invalidity benefit was one such benefit that the Department of Social Security found, but it now wants to reverse that trend and to force people on to the dole queue rather than giving them a proper level of benefit.
The other part of the group of amendments which is crucial aims to link the medical test to the appeals procedure. In Committee, we had some debate about the appeal procedure, but by our proposed new clause 4 we are strengthening the deliberation and looking towards the Government to give further comment and consideration to the way in which the appeals procedure will work in practice.
The mechanism which we are employing is the presentation of an annual report to Parliament so that we can give proper scrutiny to the way in which the appeals procedure operates. Linked to that appeals procedure is the role of the general practitioner and of medical and other professional advisers in the appeals procedure.
There were some welcome comments in Committee about the way in which the appeals procedure would work. We welcome the points, for example, that appeals could be made to a social security appeal tribunal unless otherwise specified, that the GP will continue to have a role, and that a decision of "fit to work" reached by the Benefits Agency medical service will be accepted by the Employment Service, so that people will not fail tests by both agencies 170 and fail to qualify for any benefit. Those points were welcome, but we need much greater clarification of the way in which the appeal procedure will operate.
I know that the Minister said in Committee that further thought and discussion about the appeals procedure were continuing, but it is clear that we need to flag up some of our anxieties even more firmly.
One issue which was mentioned to us since we debated the Bill in Committee and which is important to many organisations representing disabled people, is the current delays in the hearing of appeals—the time that it is taking for decisions to be made. As a result of what we believe to be the more stringent nature of the new medical test—I emphasise that we cannot say for certain the way in which it will operate, because it is not before us to debate—and the arbitrary way in which we believe that it may be applied, not only to current work patterns but to all work employment, it is essential that the Government provide some certainty about the length of time that they would expect the appeals to take.
There will be a growing number of appeals. We must ensure that the Government will commit the resources to ensure that the appeals procedure is effective, and that the time scale in which claimants can expect a decision to be made is satisfactory. It must be especially satisfactory because of the structure of the new benefit. There is a change in rates at 28 weeks. Up to 28 weeks, a lower rate of benefit will be paid than after 28 weeks. Claimants will not qualify for the full rate of benefit until after 52 weeks. Therefore, we must be especially sure that the appeals procedure does not flow over that timespan, and that people do not lose on changing rates of benefit in that time.
Therefore, we very much welcome some consideration and further comment by the Government about the way in which the procedure will work, what resources will be provided and what the cost of those resources will be to the Government, to ensure that a satisfactory procedure is put into place.
What is crucial, as a result of the much more limited nature of the medical test, is the way in which the reports of medical officers, general practitioners and other medical professionals will be dealt with at the appeals stage. The Government are setting about a system which limits the role of the GP at the initial point of assessment. GPs will be allowed to produce their medical evidence on the condition of the claimant, but will not be allowed to give an assessment about the way in which that condition relates to the claimant's ability to work—or, if the GP chooses to do so, I suspect that that information will be ignored.
§ Mrs. Gwyneth Dunwoody (Crewe and Nantwich)
I have a constituent who received support from his general practitioner, who was told by the Department's doctor that he was perfectly fit to work and then had three subsequent different examinations by different doctors, all of whom said that he was incapable of working.
This morning, I received a letter—not from Monsieur Bichard, but from the personnel director of the agency, which I thought was a new development—which said cheerfully, "Yes; it is perfectly true that it did take 18 months. He has now got all the money back, and how inconvenient." There was not even a word of apology. Does my hon. Friend think that there will be a great deal more of that in future?
§ Mr. Bradley
I am grateful to my hon. Friend for mentioning the way in which the appeals procedure currently operates. Interestingly, evidence from agencies such as citizens advice bureaux up and down the country shows that, when a case has gone to appeal, ultimately the evidence that was given by the GP is upheld at appeal. I therefore suspect that we shall get into more and far more elaborate appeals, which will take an enormous amount of time, effort and cost, and which will fall back very much on the original assessment that may have been undertaken by the GP.
No one suggests that the current situation is perfect; no one suggests that all GPs are happy with the current arrangements; but there is a strong feeling that, if GPs were given far greater guidance, better training and help in preparing the reports for the Department of Social Security, far fewer people might have had to go to appeal and then fall back on the GPs having to draw up new reports—
§ Mr. Bradley
I am grateful to my hon. Friend.
We seek greater clarification of the role that GPs and other medical officers and assessments will play, and of the stage at which they will participate. It is feared that this will give rise to a massive number of discontented claimants who feel that they have been harshly treated by the medical test or its harsh interpretation.
The test has limitations because of its functional elements in relating the multitude of different conditions, illnesses and disabilities that people have. It is difficult to fix those into a set of procedures and to make a one-off determination about whether people are capable or incapable of work. I believe that it will cause great distress and anxiety.
I feel that the Government have not understood the threshold that they are trying to determine between capacity and incapacity for work. We are worried—because we have evidence of it throughout the changes that have been made to the social security system—that the guiding force in all the decisions will be the Treasury. Under the social fund, for example, people with exactly the same needs and circumstances are treated totally differently, depending on what time of the year they walk through the door.
Although the Government will deny it, there is a fear that, if the medical test, however it is devised, does not limit the number of claimants to the amount of money which the Government expect the benefit to cost—even if the amount is not set in concrete—they will immediately change the threshold and the weighting of factors within the test to limit even further the opportunity for disabled people to be eligible for the new incapacity benefit.
As all Government policy at the current time seems to be governed by that overriding Treasury figure, which is designed to force down public sector borrowing, but which causes those with greatest need to suffer as a result, that must cloud our judgment on all the Government's decisions.
It is important that the new clause should enable proper scrutiny by Parliament of matters that are not contained in the Bill. It is crucial that Parliament be given an 172 opportunity to look in detail at how the medical test will operate in practice, and at those who have been granted or denied the new incapacity benefit.
We need a report that gives a proper analysis, nationwide and region by region, of how the benefit operates in practice. We also need a proper analysis of how the appeals procedure will work in practice. We need evidence and research on how medical reports, GP assessments and the reports of other medical officers and professionals in the medical field are dealt with, to ensure consistency of treatment by claimants throughout the country.
We also need to ensure that, throughout the whole process, money is not the guiding principle in determining the Government's response to people's genuine claims for incapacity benefit. People must feel confident that Parliament can come to a considered, reasoned and certain decision because the evidence is before us. The evidence is certainly not before us this afternoon.
§ Mr. Alan Howarth (Stratford-on-Avon)
I hope that the Government will look carefully at the proposals in new clause 3 and the group of amendments. There is a case for having a report to Parliament on the effectiveness of the medical test and I am sure that my right hon. Friends will be willing to reflect on it and consider it positively. I know that they are looking to develop a system that will work humanely and practically.
The Government have offered us the concept of an objective medical test that contains considerable difficulties. At this stage of legislating, we do not know what the series of objective medical tests will be. We are grateful for the consultative document offered to us, but that itself has been changing, even during the consultation process. It is excellent that no less than 80 experts have been called in from outside the Department to offer their opinions and advice. But I suspect that, even if there were 800 experts, they would still face insurmountable difficulty in developing a satisfactory objective medical test.
Having said that, I welcome the developments which it is reported are taking place, even at this stage, although, as the hon. Member for Manchester, Withington (Mr. Bradley) suggested, the introduction of additional flexibility may take the test a little further away from objectivity.
We are contemplating a test not of incapacity for work but of functional incapacity. The purpose of the exercise is to establish objective and universal measures in a series of scores in tests. Will my right hon. Friend persuade me that that is not an impossibility? In assessing capacity or incapacity to work, one must consider the interaction in individual cases of a range of factors. One must consider the impairment or illness, which may be a fluctuating condition, in relation to the work experience and skills of the individual in question; his or her education and training; his or her personal household circumstances; and the work opportunities that may be available to that person.
The distinction must not be forgotten between "own work" and "all work"—the distinction between the work which the person in question has previously undertaken —and whether the person would be fit for that work or similar work and any other work of which that person may or may not be capable. If we ignore that distinction we shall inevitably get ourselves into considerable difficulties.
The Department's research makes us well aware of the difficulties that face people over the age of 50 in trying to 173 find jobs, and we are all too aware of the reality of discrimination against disabled people in relation to employment, an issue which we shall have a fuller opportunity to debate on Friday.
I remind the House that the Department of Employment's sponsored research in 1990 found that 6 per cent. of employers candidly and brutally said that they would discriminate against disabled people. Another 25 per cent. of employers admitted that they might discriminate. A Spastics Society study found that 34 out of 94 employers, willing to interview, were not willing to interview a registered disabled applicant with qualifications and experience equal to other applicants. It also found that 53 per cent. of employers use pre-employment health screening. That study by the Spastics Society, entitled "Wasted Opportunities", on the activities of training and enterprise councils in relation to training disabled people, also offers a gloomy account.
The disabled are three times more likely to be out of work and they are unemployed for longer than non-disabled people. At the beginning of this month, the citizens advice bureaux produced a gloomy dossier detailing instances of discrimination against disabled people.
Against that background, it is difficult—indeed, impossible—to talk in terms of an objective medical test that would define a person's incapacity for work, because incapacity for work in the real world depends on the circumstances in which someone finds himself or herself and those circumstances may be adverse. So incapacity is not an absolute; it is a relative matter.
Furthermore, we should think positively in terms of ability rather than disability and of capacity rather than incapacity. The title of the Bill, "Social Security (Incapacity for Work)", is somewhat chilling. Although I realise that it is not intended, I fear that the concept expressed by that title may encourage too negative a spirit when it comes to employing disabled people.
There is a good case for having a report on the lines proposed in the new clause. If we are to have a report, it should look at a range of relevant measures within the overall policy. I hope that, by the time the Bill has completed its passage, the report will cover a partial incapacity benefit. It seems appropriate that we should have not just a single absolute incapacity benefit but a partial incapacity benefit which would be proportionate to the degree of disability of the person being supported.
I hope that an amendment of that kind will be instated in the Bill. I know that new clause 5 was not selected for debate today, but there is no reason why it should not be considered in another place, where I am sure those involved in the debate would want to emphasise the value of gradualism and the rehabilitative experience of moving to part-time work, perhaps en route to full-time work. A partial incapacity benefit would be a useful complement to disability working allowance, under which benefit is cut off at a fairly low level of earnings.
Similarly, I hope that a report would cover more generous linking rules, which we do not have an opportunity to debate today, but which I hope will be introduced into the legislation. The trap created by an eight-week rule is a deterrent to employment. I hope that 174 we might move to a two-year linking rule under incapacity benefit parallel to the rule under disability working allowance.
The Government's strategy surely must be to get people into work. That is good for them and, of course, for the Government's finances, about which the Government are legitimately concerned. Rigid rules and rigid cut-offs are not conducive to that end and will, unquestionably, be insensitive to the variety of circumstances and needs. The formula used by the Benefits Agency medical service must, at the very least, be made flexible.
I welcome the announcement by my right hon. and hon. Friends that the terminally ill, those on the higher rate care component of disability living allowance, and those on the prescribed list will not be required to undertake the test. I also think that people who are made exempt in that way should be fast tracked on to benefit, but that is a debate for another occasion. We are unable to debate amendments Nos. 17 and 18 because they were not selected. They too may be the subject of a debate in another place.
As has already been argued, the report should cover the involvement of general practitioners. I cannot bring myself to believe that it is right to suggest that doctors consider that it is beyond the range of their normal responsibilities to play a part in the first assessment. I know that they are to offer an opinion on a rather curtailed basis in the first assessment, but because of some of the factors that I mentioned earlier, and because the personal history and circumstances of each individual should be considered, we should find ways to involve general practitioners as much as possible in the process. I know that many general practitioners would welcome such involvement and recognise it as a normal and proper part of their professional responsibilities.
We need to know what role general practitioners will play in appeals. My right hon. and hon. Friends have said that GPs will have a role in the appeal process, but it has not yet been made clear what that role should be. A report should cover that aspect of the procedures.
The report should tell us a good deal about what is happening in appeals. In recent years, the success rate of appeals involving invalidity benefit has risen. I believe that the figure was 21 per cent. in 1979, and 53 per cent. in 1992. A consistent weight of anecdotal evidence on appeals shows that the success rate of appeals has risen yet further since then. I suspect that the search for economies and the administrative guidance prompting benefits officers to be more stringent has perversely led to higher administration costs. In their unsuccessful attempts to weed out a considerable number of "unjustified" claims, they have incurred administrative costs. That has caused difficulties for everyone, both officials and claimants.
The appeal process has lengthened from 21 weeks in 1986 to 30 weeks in 1992. We should also be concerned that it is possible for a claimant not to receive income during those lengthening periods while they wait for the outcome of an appeal. It would be helpful and proper if the report dealt with that matter as well.
The purpose of the legislation is, very properly, to ensure that there is no waste in, or abuse of, this part of the benefit system. It also aims to ensure that appropriate support is provided to claimants who are entitled to it, and that such support is provided reliably and quickly. The objective of the legislation should be humanity, not 175 parsimony. It is a part of the benefit system through which we acquit ourselves, in part, of our responsibilities to those who are vulnerable and poor.
There is a good case for having a report laid before Parliament, as the new clause proposes. We are, after all, embarking on an experimental approach that has not yet been fully formulated. For the reasons that I have explained, we cannot yet be confident that it will work. The Benefits Agency medical service will face a massive task. It is estimated that perhaps 600,000 people who currently receive invalidity benefit may have to undergo the test. We will need assurance, therefore, that the procedures and the quality of decision-making are of the necessary standard.
To have a report would be fair to everyone who is sick and disabled, especially those who are rejected at the medical test. They are entitled, as we all are, to see that the system is performing as it should and that proper standards are defined and are being met.
Finally, the Government should consider positively the suggestion to provide such a report as it would be a mark of their respect for Parliament and the public.
§ Mr. Malcolm Wicks (Croydon, North-West)
This is an important Bill and therefore an important debate. The number of people currently receiving invalidity benefit is substantial. The Government estimate that 1.5 million people will receive benefit either now or in about a year, so we are discussing substantial amounts of public resources. More importantly, we are discussing the way in which our society, through the will of Parliament, will treat people with disabilities. For reasons that I think are clear, not least sheer demography, there are likely to be more people with disabilities in our community as we approach the end of this century and a new millennium. The debate is of great importance to social policy.
As hon. Members have said, much depends on the medical test and how we define incapacity for work. I greatly enjoyed the speech of the hon. Member for Stratford-on-Avon (Mr. Howarth). I agreed with him when he said that incapacity was not an absolute concept but was, inevitably, a relative concept. I want to develop that argument to say that incapacity is relative to the employment position.
The Government's legislation is based on an assumption which, in the current employment climate, many of us would regard as heroic. It assumes that those who fail the strict medical test will, by definition, be capable of work. I assume that the assumption is that with a bit of willingness those people will not only seek, but find, jobs.
Will Ministers say more today than they have done so far, and more than they said in Committee, about how they view the association between medical capacity for work and the true prospects for gaining work? I hope that Ministers will respond and consider policy in those broad terms. Parliament today could not agree to the measure with any great confidence if it felt that the result would be that many people with disabilities which were not serious enough to pass the test would be consigned to poverty because they would be unable to find their way into the employment market. I hope that the Minister will say something about that. A strict medical test, regardless of the employment situation, must make for poor social policy.
I will put forward two employment scenarios relating to the medical test. One would be where the medical test was 176 being applied in full and buoyant employment, where not only were the official unemployment levels very low, but there was a shortage in the labour market and employers were crying out for decent labour. In those circumstances, employers would be bending over backwards to accommodate people with disabilities. They would be heavily into training, they would be adapting their premises and they would in a variety of ways be sensitive to the needs of those with disabilities.
We all know that to assume that people with disabilities—even serious disabilities—are not capable of work represents great prejudice and potential discrimination against such people. There are remarkable people around—we have all had them as colleagues in different walks of life—who, despite many disabilities, are making a major contribution to their workplace and therefore to the economy.
Professor Stephen Hawking labours under the most considerable disabilities imaginable, yet he is one of the most brilliant scientists in the west and has made a major contribution not only to his university, but to the enlightenment of us all. To assume that someone with even such grave disabilities was incapable of work would be a great slur on that man and many others less famous. In the right employment conditions, many people with the most grave disabilities are capable of work and, equally important, should be able to obtain work. In the right circumstances, we might have more confidence about even a strict medical test.
Sadly, the employment scenario that I have outlined is very far from the reality in the United Kingdom. Instead, for many the reality is not employment, but unemployment; there are 3 million or 4 million people out of work, the trends in the labour market are towards less security and permanence and people have to chop and change their jobs.
Increasingly, Ministers and other pundits make a virtue out of that. They say that those are the circumstances that workers will have to face in future; they will have to retrain constantly and no job is for life—even for those with safe seats in the House—and that people should not expect such security. In those changed employment circumstances, it will become more difficult for people with disabilities to find employment. I wonder how the Government would present their Bill to us in that context, which they will need to address.
The evidence so far, without taking account of developments in the most recent years, is worrying for the employment prospects of those with disabilities. In 1989, Social and Community Planning Research estimated that 22 per cent. of people with disabilities who regarded themselves available for work—the so-called economically active as the statisticians would have it—were out of work. If the Government have data for a more recent period, they would be useful, because I suspect that things have changed for the worse, even since 1989.
Another report in 1992, from Stephen Smith of the Spastics Society, found that employers were six times more likely to turn down people with disabilities for interviews even where their qualifications, experience and CVs were just as good as those who were not disabled. We face a problem of discrimination from employers; it is well known to the House and well documented. Other Government studies have estimated that it is 2.5 times more likely for people with disabilities to be out of work than those who are able-bodied.
177 A survey organised by the voluntary organisation, PACT in Brighton, also relates to the debate. It found that 40 per cent. of employers in Brighton regarded people with disabilities as unsuitable for employment. That is another example of the prejudice and discrimination that we face in Britain.
Perhaps the most telling to the House is that many years ago, shortly after the second world war, the House in its wisdom passed a Bill saying that larger employers—those with 20 or more workers—should have a disability quota of 3 per cent. of their labour force. We understand that, despite having had many years to implement that measure, three quarters of employers do not meet the quota. Since 1975 there has been no prosecution to enforce it. That suggests that, although we may willingly pass legislation in the House, we are rather lax in its implementation.
Still on the theme of the association between the medical test and the reality of finding work, I was struck by a briefing that many of us received from the Policy Studies Institute written by one of their senior social scientists, Richard Berthoud, about the reality behind the medical test. He talked in particular about discrimination by employers. I quoted from it in Committee and I shall quote a paragraph today, as it makes an important point. It states:At a meeting of the 'panel of experts' convened by the DSS to discuss the medical assessment, a disease was described which caused people to tremble permanently and uncontrollably. People with this disease are not impaired in any way: they could stand, walk, sit, grip, reach and do all the other things required by the medical test. But other people, it was said, could not bear to watch them—they became upset and could not concentrate on their own tasks. As a result of the effect on other employees, no employer was prepared to hire someone with this condition.The reaction of the panel would be the reaction of many of us in the House—we would be appalled. Many suggested that it was outrageous and that employers should be made to hire those people. But in reality, sadly, many employers will not hire such people because of their effect on other employees.
The document went on to say that most people would agree that employers and employees should not discriminate in that way and that perhaps they should be banned from doing so. However, as long as discrimination persists, removal of trembling and other socially embarrassing conditions such as disfigurement from the assessment criteria would mean that those affected would be denied incapacity benefits and face the punitive treatment offered to the unemployed. Here we have the real and complex association between the danger of failing a medical test, because, objectively, the person can work, and the reality whereby the prejudices of many ordinary people and employees and the prejudices and discriminations of employers mean the person cannot find work.
Again I put it to Ministers: what are the employment prospects of those who may fail the medical test? Do the Government think, even at this stage, that it is wise to bring to the Chamber legislation which, however scientifically well constructed—and we do not know that, because we do not have the details—nevertheless does not seem to take account of current reality?
I have received correspondence from people who say that in practice, in the labour market today, if they have a disability, particularly if they are no longer very young, 178 they find it difficult to get work. Someone wrote to me from Kent saying that his local disability employment adviser had written to him and said that he was unlikely to get a job. Why? He was told:Because of the changes in companies employment policy as a result of the recession, your age, your disabilities, which would preclude you holding down a full or part-time job, and the fact that you have not worked since 1987.The DEE went on to say:I am sorry, but you are now unemployable.I do not know the full details of that case, but that may well be someone who passes the test prescribed by the DSS but fails the most important test of all—the jobs test—and ends up not in employment but in unemployment.
I would like to add to what has been said by hon. Members in Committee and in the House today about those who have conditions that fluctuate from day to day, week to week or month to month and put this important point to Ministers. How will the medical test allow for those who perhaps on the day of the test seem to be relatively able-bodied and therefore capable of work according to the legislation but who perhaps the next day, week or month have a relapse and find that they cannot work? That is of real concern.
I am told by those with ME—myalgic encephalomyelitis—including those who come to see me in any constituency office in Croydon, that on some days, despite suffering for many months, they may feel relatively fit and confident about life and the prospects of work, while on another day they may wake up in the morning and find it almost impossible even to get out of bed, such are the debilitating effects of ME and similar conditions.
The point was mentioned in Committee, but I will put it again to Ministers. How can a test, however sophisticated, allow for such a condition on the day? It appears to be true for those with physical conditions. I suspect, although I am no expert, that it is even more true for those with mental illness, certainly certain forms of mental illness. Again, someone from Croydon came to see me, speaking on behalf of those in the Manic Depressive Fellowship—those who suffer from the terrible condition of manic depression. He told me a similar story—that on one day he may truly be one of the most depressed people in the community and be almost unable to function, certainly not in the labour market and hold down a job.
He used to be a lecturer at a college. After many years —indeed, decades—of battling against his manic depression, he finally had to succumb and leave his place of work and is now dependent on invalidity benefit. He said that on some days he is really down, but because his condition fluctuates from week to week and month to month, at other times he may be almost up in the clouds and almost too active—indeed, hyperactive. It makes him do foolish things. He gives away too much money to his charitable causes. That is a fluctuating condition. How would a strict medical test allow for that?
This is a serious debate. I am not making a polemical point. I am interested in how the Government can devise a test to allow for the reality of people's conditions, because we all know that the prospects of any of us at some stage becoming mentally ill are quite high. We are not talking about small numbers of people, but about a large percentage of men and women. How they will be treated is important.
It would be helpful if the Government could tell us more today about the conditions that will be on the exempt list.
179 I welcome the assurance given in Committee that, although they are not shown on the face of the Bill—I understand that—people suffering from many other conditions, including those suffering from AIDS and symptomatic HIV, are likely to receive extremely sympathetic treatment from Government when the exempt list is drawn up. If Ministers have a moment today to confirm that assurance, I know that many people would be most grateful.
In my experience, social security, while often presented in terms of policy, grand principle and key objectives, depends crucially on its detail. It is therefore up to the House to take its role as scrutineers of legislation extremely seriously. Again, I offer this not as a polemical point but as a serious contribution to the debate. Having served on the Committee that considered the Incapacity for Work Bill, I have been appalled by the manner in which Conservative Back Benchers treated the Committee in such a cavalier way. I have been on Committees for smaller Bills, but that was my first major experience. I offer, therefore, an innocent essay on what I found. But I was genuinely surprised and appalled by the way in which Conservative Back Benchers approached the Committee.
It is partly a function of the fact that, sadly, the more independent-minded Conservative Back Benchers were on the exempt list and not allowed to serve on the Committee. It was packed, I suppose, with trusties. At one stage—it was a rare moment—a Back Bencher rose to make a contribution and said that he would be very brief. Indeed, he had promised his Whip that he would speak for only four minutes.
Those of us who—at our teacher's feet—studied the British constitution, read textbooks which, I now realise, came from the section called "Fiction". They told us the story that, having been considered in broad terms in the Chamber of the House of Commons, a Bill is then subjected to scrutiny line by line in Committee. That includes this most important matter that we are discussing now about the medical test.
The Bill was subjected to scrutiny in great detail by Opposition Members, but not by Conservatives. I was genuinely surprised that certain Conservative Back Benchers spent more time in conversation with their secretaries on constituency matters in the Committee Corridor than they did in Committee. When challenged on that, because we tried to encourage genuine debate and scrutiny, one Conservative Back Bencher—I forget which one—said, "Don't tell me this. I approve of the Bill. I do not need to be here."
Surely that is not the point. Either we take the scrutiny of such proposed legislation seriously—not least social security legislation, where the detail is so vital; hence the debate today about the medical test and our urging of a report—or we do not. I think that the Bill, in a sense, has become a case study of poor Government and poor parliamentary scrutiny.
§ Mr. Adam Ingram (East Kilbride)
I am sure that the Conservative Back Bencher to whom my hon. Friend referred was the hon. Member for Teignbridge (Mr. Nicholls). My hon. Friend will notice that he has not even attended this evening's debate. I am sure that it has not escaped my hon. Friend's notice that few Conservative Members have turned up for the debate on this important aspect of the new clause. Perhaps that is something that he would want to write into his revision.
§ Mr. Ingram
My hon. Friend informs me from a sedentary position that the hon. Member for Teignbridge was not on the Committee, but I am sure that when my hon. Friend amends the textbook on the British constitution, this will prove a major part of the new edition.
§ Mr. Wicks
I am flattered that my hon. Friend was scrutinising my speech with such care and made that timely intervention.
We are dealing with a serious matter. Although I do not want to strain your patience, Mr. Deputy Speaker, many of us returned time and again in Committee to one of the recent pieces of social security legislation—the Child Support Act 1991. Why? We now find that that piece of legislation, which went through Parliament and Committee, is causing an almighty row because what we may regard as "the detail" is blood and thunder detail for families in this country. I understand that today there has been a huge lobby of Parliament because people are upset by the detail.
At this stage, the medical test and the Bill are not causing a furore; the Press Gallery is not packed. Whatever parliamentary correspondents do, we find that they do not correspond with Parliament. No journalist ever attended the Committee stage of the Bill. It will be different, however, when the effects of the detail come home to roost. Constituents will turn up in our surgeries, saying, "Once upon a time I would have received such and such a benefit. I have just taken the medical test, but I did not pass: I was told that I was capable of work." My constituents will then say to me, "Mr. Wicks, I tried my best to find work: here are my applications. I have been told that, because I have a disability and am over 50"—or 55—" I shall not be able to find work."
I know what will happen. Conservative Members will say, "How can this have happened? We do not understand it. Who was looking after the detail?" Indeed, I have heard Conservative Members say of the Child Support Act, "I support the principle"—that ritual cry—"but I did not know that it would be like this." I suggest that even those hon. Members who spent hours in the Corridor when they should have been in the Committee Room will say to Ministers, "What has happened to the detail? A man cannot find work; he has a disability; yet he has failed the medical test. Think again."
This is important. We should draw lessons from our recent experience of scrutiny, or rather lack of scrutiny: Bills, not least social security Bills, should include social impact statements spelling out the implications for people in the real world, and there should be pre-legislation hearings. I remember the Minister of State's saying that he thought that that was a good idea. We need Back Benchers on both sides who, while playing a party role, also take very seriously—
§ Mr. Deputy Speaker
Order. I have allowed the hon. Gentleman quite a bit of licence, but I should be grateful if he would now return to the new clause.
§ Mr. Wicks
You have been very kind, Mr. Deputy Speaker. Unlike my hon. Friend the Member for Newport, West (Mr. Flynn), I did not speak Welsh, which would 181 have given you an opportunity to intervene earlier; I have done my best with my north London accent. I am glad that you have allowed me to express some of my thoughts, because the way in which we scrutinise the legislation is clearly important.
We should consider very carefully the motivation behind the Bill and the medical test. Have we been presented with a measure that is principally a piece of social policy—including the provision for the medical test, which we think warrants an annual report—or with a piece of financial policy?
In Committee, we were assured that the medical test provision was truly a piece of medicine—a piece of science —which had little to do with finance or the Treasury. I know you will consider what I am about to say very relevant, Mr. Deputy Speaker. The Bill contains no impact statement about people, but it contains such a statement about money: we are told that, by 1996–97, gross savings of £1.45 billion will have been achieved.
How can we be confident that the medical test will be objective if we already know the bottom line? The Treasury has set the targets. Whatever the details of the medical test, and whatever the committee of experts may come up with, the threshold for receipt or non-receipt of benefit will have to be set according to financial targets. I have thought hard about this, and I consider it wise of my hon. Friend the Member for Manchester. Withington (Mr. Bradley) to suggest an annual report on the test if the Bill is enacted—which I hope it will not be; I hope that the House will think again. We should be able to see for ourselves how the test is working in practice—whether it is working according to a financial criterion, or just according to a medical one.
If we allow the Bill and the medical test to proceed, the inevitable consequence will be the impoverishment of many people with disabilities, and their further marginalisation in the community. That is the great worry. In future, more people who do not receive this benefit will find themselves on unemployment benefit or income support: that is clear from the financial statement in the Bill. The Government admit that although there will be gross savings, there will also be marginal costs as a result of the increase in income support and unemployment benefits. Perhaps Ministers will now come clean, and tell us how many more people with disabilities—people whom we should be looking after—will become dependent on means-tested income support if the Bill is passed.
I think that there is an alternative to the medical test. It should be understood that people with disabilities are full citizens who should be part of an active society. The best policy that we could introduce is not about incapacity, but about capacity and full employment. Unless we return to full employment, we shall never be able to integrate those affected by the Bill into the community. If the Government are assuming mass unemployment in the future, it seems that more and more people with disabilities will become marginalised and unable to seek work; more and more will depend on income support. I believe that there is an alternative way forward, in terms of a public policy with decent social implications for people with disabilities which would also make economic sense.
In Committee, Conservative Members—occasionally, when they were present—would throw the following 182 thought at us: "Are you saying that you would spend more money?" I think that we are saying that the right package of economic and social policies for those with disabilities—
§ Mr. Deputy Speaker
Order. The hon. Gentleman is displaying great skill, but we are returning to a Second Reading debate. I ask him to relate his remarks to new clause 3.
§ Mr. Wicks
I am coming to my final paragraph, Mr. Deputy Speaker.
I firmly resist the charge that financial costs are attached to our suggestions in Committee. I believe that there is a way in which the House—and even the present Government—can think about people with disabilities and the range of policies that they need which would not only be desirable in social terms but would make economic sense to our community.
§ Mr. James Wallace (Orkney and Shetland)
My hon. Friend the Member for Roxburgh and Berwickshire (Mr. Kirkwood) usually speaks for the Liberal Democrats on social security matters. Unfortunately, he has been placed in an unenviable position: amendments have been tabled in his name both here and in the Standing Committee of which he is currently a member. As he has no party colleague in the Committee, it fell to me to deputise here —which I do with some trepidation, given the thoughtful speeches that we have heard so far. It is clear that hon. Members on both sides of the House have given the matter considerable attention and thought.
It is apparent to me that the application, or the detail, of the all-work test is so vague, unpredictable and unknown that—having briefly looked through some papers—I may know as much about it as almost any other hon. Member who is present. As I listened to the debate and tried to take in what was happening, I had some horrible ideas about what might be in prospect.
The hon. Member for Croydon, North-West (Mr. Wicks) referred to someone in the position of Professor Stephen Hawking. Let us suppose that someone who had not even acquired O-levels found himself in exactly the same medical condition. It sounds to me as though such a person would be deemed fit for work, and able to take on the job of professor of science at one of our leading universities.
The Minister may say that that could not possibly happen—
§ Mr. Wallace
But I am not entirely persuaded by what I have heard so far. I accept that I have given an extreme example, but I feel that in any event there is considerable scope for injustice and unfairness to be visited on people with disabilities, or what could be described in common parlance—as opposed to the legal terminology that we are about the pass into law—as incapacity for work.
One can perhaps think of a number of such factors, and the hon. Member for Croydon, North-West referred to a report by Richard Berthoud of the Policy Studies Institute which outlined some of the circumstances that could arise.
The report draws attention to the case of a person who is academically well qualified and lives in a town where there is a considerable amount of service industry, especially clerical jobs. That person sustains a serious 183 injury to his leg but, after it has healed, is able to return to employment and take up the clerical duties in which he was involved before.
Another person in the same town who suffers exactly the same accident might have a different employment history. Perhaps he left school without any qualifications and laboured on a building site. He might have the same physical injuries, but suitable employment opportunities might not be available for him.
We are being asked to accept a test that relates purely to the narrow range of medical functions. It is merely a check list that will be ticked off, or otherwise, but which will take no account of how a particular medical condition can affect someone. It is not simply a matter of whether someone is capable of walking 100 m; there might be psychological effects. A person's previous training and the current job opportunities must be taken into account. What are a person's living circumstances?
In my constituency, many people live miles from the nearest town. An injury that renders them incapable of driving a car might cut off a range of employment opportunities, but, if they lived in the middle of a town, a good number of employment opportunities might be open to them.
Another mental picture of the system being set up is that it resembles the competitions or quizzes that sometimes appear in magazines. One is asked questions A, B and C, and one receives five points for A, two points for B and zero for C, and the points are added up at the end. It seems that we are devising a rigid system under which points will be added together: if one scores more than a certain number, one is disqualified from benefit, whereas if one falls beneath that number, one qualifies.
I accept the point made by the hon. Member for Manchester, Withington (Mr. Bradley). He said that the application of such a system places a great deal of power in the hands of those setting the rules. One of the briefings that I have seen believes that the Government estimate that 400,000 current recipients of invalidity benefit will have to undergo a new test as their cases come up for review, and that as many as 250,000 will no longer qualify.
I have no doubt that an estimate has been made—it was probably in the original Bill before Second Reading, when the financial consequences had to be spelt out—of how much saving will accrue to the Treasury. One has the feeling that, as long as there is a strict objective test with a score card, it will be possible to make adjustments to ensure that the anticipated savings materialise, and that is quite apart from the effect that the system could have on individuals.
The hon. Member for Croydon, North-West made another important point. It is not only a question of incapacity for work or otherwise, but of a person's ability to get work even if he or she is deemed to be capable of work. This raises the question of the prejudice and discrimination that is often suffered by people with disabilities. I remember that, in the days when I was my party's employment spokesman, the issue of the 3 per cent. quota arose. It was clear that it was honoured far more in the breach than in its enforcement. I fear that we are ensuring that many people will lose on invalidity benefit, without any obvious road back to employment.
It might not be possible to get them but, in addition to all the figures that the Government would be asked to put before Parliament under new clause 3, it might have been 184 useful to add another one—what percentage of those who have been deemed capable of work got jobs within two months of that determination being made?
Some element of judgment must come into play, and it is important that general practitioners should have a role. Many doctors are not keen on having thrust on them the duty of being, as it were, enforcement officers on behalf of the Benefits Agency. It is perfectly understandable that they do not want to be the last arbiters, but I am sure that all hon. Members will agree that GPs nevertheless have an important role to play.
In Committee, the Under-Secretary of State, the hon. Member for Bury, North (Mr. Burt), said:GPs retain an important role.He said that a GP's input would bea vital part of the consideration … We are not writing GPs out of the picture.My colleagues and I tabled amendment No.22 because we seek some way to ensure that the role, advice and information of GPs can be properly channelled into those considerations. The Minister also said:The GP's opinion on whether a person is incapable for work is not specifically sought."—[Official Report, Standing Committee E, February 1994; c. 351–2.]He said that after having said that consideration of the GP's opinion was part and parcel of the process. The purpose of amendment No.22 is to ensure that, in regulations, a way is definedin which relevant evidence or information submitted by that person or by any medical practitioner or professional health worker will be used during the assessment".It is our concern that such a method is introduced as early as possible.
The briefings which I think all hon. Members will have received from citizens advice bureaux give examples of cases in which the absence of a general practitioner's involvement at the critical tribunal stage led to benefit being withdrawn and having to be granted again after an appeal, or even in the intervening period.
For example, a CAB in the west midlands reports that a woman in her mid-fifties was examined by a medical officer after four months on invalidity benefit. She was found fit for work, but, at the tribunal, on presentation of a letter from her GP, the Benefits Agency presenting officer conceded that the withdrawal of invalidity benefit had been inappropriate. Similar cases of invalidity benefit being withdrawn but restored after a report from a GP have been reported in Staffordshire and the north-east.
We want GPs to be involved in the provision of essential information. Not only should that be recognised and accepted as part of the process, but the way in which the information is to be channelled into the process should be formally set out. It should not be left to chance or good fortune, or to whether someone has got around to getting their GP's view.
It is not necessarily true that GPs are usually lenient. Indeed, one survey showed that 80 per cent. of respondents believed that their GPs sometimes refused sick notes to people whom advisers considered to be unfit for work. We should trust the medical profession to give its view—a view very often based on long experience of the person involved.
On the day that a person is assessed, he may be capable of carrying out particular tasks and functions, but a medical person who has had the opportunity to see the progress of 185 a condition, or who has seen the person a number of times, might know that, under stress, in certain circumstances or more often than not, that person will not be capable of performing those functions.
We are trying to secure justice. If the new clause stands as it is, I, like the hon. Member for Croydon, North-West, fear that, in the months and years to come, many more constituents will come to our surgeries asking how in the world it was ever accepted. We shall have to say that some of us warned of the problem at the time. We hope, having issued the warnings, that the Minister is prepared to listen and to do something about it.
§ Mrs. Dunwoody
One of the hazards facing any legislation is either that it slips through the House of Commons late at night or that it is fairly lightly examined. I am afraid that the Bill and its implications are in grave danger of not being properly examined.
I do not find it surprising that there are no former members of the Committee present on the Government Benches. I remember being stunned in Committee by a Conservative Whip when, in a voice which carried round the room, he said to one of his own Members who was making what I thought was a coherent speech "Sit down you little 'blank' and shut up." I remember being even more astonished when the Member did as he was told. It illustrated simply the difference between Her Majesty's loyal Opposition and Her Majesty's Government, because had I, as a Whip, endeavoured to say such a thing to a Labour Member, I suspect that I might have been in a highly dangerous position.
We are discussing a Bill which will affect some of the most vulnerable people. I find it a horrifying suggestion. It is a cynical move, which is made clear in the Bill by the suggestion that large sums of money are to be saved by the change in the legislation. If it were a straightforward matter of changing a medical examination and of ensuring that general practitioners were not put under unnecessary pressure to support their patients when they did not believe that it was justified, the Government should be able to spell out in exact detail the sort of tests which are to be applied, the kind of hazards that the applicant will have to face and exactly how the applicants will be expected to respond. That has not happened.
Regulations are increasingly used as a trick to hide from Members of Parliament the implications of changes in legislation. It is not the first time that that has happened; it is an increasing habit. The Government consistently introduce regulations, not on the basis of a full discussion of the Bill in Committee, but in subsequent moves after the Bill has reached the statute book. That is not only unhelpful but positively misleading.
The Child Support Agency is an interesting example of that process. We were told of its principle and the House of Commons took on trust the ideas that Ministers presented as a clear impression of what was to happen. We are told that the legislation before us will not damage the interests of the disabled, but that it is simply a matter of ensuring that the medical tests are set out clearly, that people have to comply with certain conditions and that if they are in receipt of the wrong benefit, all that will happen is that they will find alternative forms of benefit or will receive alternative forms of support. Frankly, I do not believe that.
When two of the nicer members of the Government are sitting on the Front Bench, it is difficult to be as vicious as 186 one would want to be in the debate, but I do not believe that the Government are bringing forward the medical tests because they think that they will improve the lot of people who are receiving the wrong benefit: they are looking to save money. If they were not, they would have no objection to the new clause, which sets out a number of sensible, straightforward ideas. What is the objection to telling Parliament how many people attended a medical examination, or what number of people, having attended an examination, were determined to be incapable for work? What is the difficulty?
The Government intend to do something much more straightforward—to try to save money from those who are already among some of the poorest people in our society. We do not have to consider the proposed changes to know what will happen. In case after case in our constituencies people are referred to tribunals. The length of time before their cases are heard is becoming longer. When they eventually get to court, a number of them receive verdicts that they do not accept and they undergo the whole procedure again.
A number of general practitioners support the claimants because they know that the claimants are telling the truth and finally, as happened today, one receives a letter from the agency—not even the Department—saying that it is correct that that man or woman, who has gone through an enormous amount of highly complex bureaucratic machinery, is to be given back their benefit, but only after a long time.
Ministers seem to think that, if people are deprived of their benefit for a number of weeks or, in some cases, for months, giving them a sum of money is all that is necessary. That does not begin to deal with the difficulty.
§ Mr. Burt
The hon. Lady mentioned that case a little while ago. I had not heard of it previously. What she says disturbs me and I am more than happy to consider the circumstances. I should not like her to think that I consider that what she has described to be normal or just. I shall certainly look at the circumstances.
§ Mrs. Dunwoody
I must give the Minister his due. I do not believe that he would consider it normal or just, but the reality is that his Government have introduced legislation which has precisely the effect of that case. The fact that the Minister does not accept it cheers me up only marginally.
Increasing numbers of people who are in receipt of benefit are being destabilised because they are being told that they will have their right to benefit questioned in such a manner that they will have to go through a great deal of re-examination, that they may have to present the case over again, that they may lose their benefit, that they may have to reapply and that it may take some months before the case is cleared up.
In a civilised society, I do not regard that as an acceptable way to conduct matters. It means that, if people are already on benefit, they will tend to try to borrow and beg from everybody they know to keep themselves going while their benefit is stopped, and when they finally receive the money they will be in such difficulty that they will—
§ Mr. Deputy Speaker
Order. The hon. Lady is an experienced campaigner in the House and she knows full well that there is a new clause before us to which I wish that she would address her remarks.
§ Mrs. Dunwoody
No; I would not dream of it.
The new clause addresses the important question about the medical test. The House of Commons ought to be informed at every level of what is happening to those who are in receipt of benefit. When the Bill was introduced, I was horrified by the suggestion that general practitioners were not altogether to be trusted and that, if they had people on their list who were to be in receipt of benefit, we could not wholly take their word on a person's medical condition, because they might be influenced by their relationship with the patient.
In 22 years of general practice, I have met all sorts of general practitioners—some pompous, some intelligent, some less intelligent, some hard-working and some who were not overwhelmed with a desire to kill themselves with hard work. However, one thing that they all had in common was their ability to talk to their patients to a greater or a lesser degree. The idea that they will not be able to tell their patients honestly about their medical condition and about their right to receive benefit is a crazy and ill-founded idea.
I would rather that the House did not pass the Bill because I have grave doubts about it. If we accept the new clauses, we may go some way towards giving ourselves a fall-back position because I suspect that, in a year, the House of Commons will have to re-examine the entire legislation to see whether it is working and what effect it is having on recipients of benefit.
I take the Minister's word for it that he is happy to investigate specific cases. That is helpful, and I shall take him up on it. However, I tell him firmly that I think that the change in the law is not about entitlement to the correct benefit—I wish that I thought it were—but about saving the Treasury money. The Treasury has lost a lot of money and it has to get it back. People in receipt of benefit are a jolly good target.
I must also tell the Minister that I do not think that the Bill will have that effect. I do not believe that it has been thought through. We may find that at the end of its first year of operation the medical tests are not producing the saving of money, and that all that has happened is a change in the circumstances of the people at present in receipt of invalidity benefit.
I regard the Bill as a most unacceptable move. It is doubtful in intent, and I believe that it will be unworkable. The people who will pay for it, as always, will not be all those Tory Members of Parliament who are not here tonight, but the people who are most in need—the people now in receipt of benefit.
§ 6 pm
§ Mr. George Mudie (Leeds, East)
It is quite a challenge to follow that impressive address by my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody).
I rise to speak with some regret at the fact that the Secretary of State has left the Chamber. He is the villain of 188 the piece and the architect of the legislation, and he should be forced to sit through the debate and hear the truth about it being aired—he should even forced to defend it.
As I said in Committee, the Under-Secretary of State for Social Security and the Minister for Social Security and Disabled People are the acceptable face of the Department of Social Security, and it is unfair on them that they should have to sit through 25 or 30 hours of Committee proceedings, and then come to the Chamber, to defend the indefensible.
In Committee, I drew an analogy with the present Government ban on Sinn Fein, under which we see Gerry Adams speaking but cannot hear his voice, so his words are spoken by an actor. In fairness to the two Ministers present, it would have been better if, during proceedings on the Bill, the voice of the Secretary of State had been piped in. It is clearly not those two humane and compassionate junior Ministers who are forcing through the legislation. No, what we see is the hard heart of the Secretary of State in action.
I regret that the Secretary of State has left the Chamber, partly because on Second Reading he said, as my hon. Friend the Member for Crewe and Nantwich has also said —it is worth repeating—that the legislation affects the most vulnerable people in our society. The Secretary of State finds it difficult to recognise vulnerability or compassion, so when he recognises who are the most vulnerable, we must be well aware what we are dealing with.
The amendments concern the most vulnerable people in our community, so they require great concern and great thought. If the Minister is really so compassionate and so worried about individuals having such a long wait for their appeal hearings, and the consequent effects on their benefits and their families—I shall touch on those later —the best way in which to show that his concern is genuine would be to accept amendment No. 26, which would ensure that appeals would be heard within 10 working days. That would show a real acceptance of the vulnerability of the people concerned.
I know that you, Mr. Deputy Speaker, become understandably worried that we are straying from the chosen path when we refer to the Child Support Agency, but there is a valid analogy with the Bill.
One of the reasons behind the amendments is the fact that the Bill will adversely affect individuals; it will not affect whole communities, so there will be no great uproar as there was with the poll tax. Like the Child Support Agency, the Bill will adversely affect individuals who may be isolated in the community. The argument is exactly the same as the argument about the Child Support Agency. We can discuss the principle and largely agree on that, but it is the operation of the detail, and its effect on individuals, that will cause the problems.
Because of your knowledge of your area and the industries in it, Mr. Deputy Speaker, you will know that any cut in invalidity benefit, such as the cut that will result from the introduction of incapacity benefit, will have dramatic effects on the standard of living of families whose head is someone who, through working in one of the industries with which you are familiar, has suffered accidents or strains on the body, and who is unable to get the money.
I know that you worry when we keep referring to the Child Support Agency. It is because the same principles—
§ Mr. Deputy Speaker
Order. I shall not worry at all if the hon. Gentleman will base his remarks on new clause 3 and the amendments associated with it.
§ Mr. Mudie
Thank you, Mr. Deputy Speaker.
New clause 4 calls for an annual report, which would reveal the facts and figures to enable the House to see the individual distress that will be caused throughout the country.
The Bill is a disgrace, not only because of the content that I have already mentioned, but on constitutional grounds too. Even according to the Government's figures, it is estimated that 250,000 people out of the 600,000 on the existing benefit who will be referred for medical tests will lose their benefit. On constitutional grounds, I worry about the House of Commons passing a law the heart of which is unknown to its Members.
I shall give a brief illustration of how bad the constitutional effects are. Clause 5 introduces a new section of the Social Security Contributions and Benefits Act 1992 that has seven subsections, most of which begin with phrases such as "Regulations may provide". Subsection (2) begins:Regulations may make provision as to".Subsection (3) begins, "Regulations may provide", and so does subsection (4). Subsection (5) begins, "Regulations may prescribe". I could go on.
Those subsections deal with a crucial part of the Bill —theTest of incapacity for workwhich is related to the medical test, yet six out of the seven do not contain provisions that we can argue about with objectivity and detailed knowledge, because everything will be subject to regulation. The detail is not here. It is difficult to deal with the details of the medical tests, because we do not have them.
It is interesting that the hon. Member for Orkney and Shetland (Mr. Wallace) referred to Stephen Hawking. Stephen Hawking makes a mockery of this Bill, because, with his disabilities, he would clearly be eligible for one of the fast-track cases under the legislation. He would go through—he would not be subjected to a medical test, and he would get the benefit.
The Minister may say that he would get the benefit because the Government are not taking age, experience, education and previous work into consideration. I ask the Government what would happen if an ex-coal miner got the same disease as Stephen Hawking.
§ Mr. Mudie
Exactly, but he would not get the benefit because of age, experience and so on—he would get it on purely medical grounds. One of the factors that is wrong with the Bill is that the medical test will be the be-all and end-all, and no other factors will be taken into consideration. Incredibly, here we are in March after a long session in Committee—I think that it was 25 to 30 hours.
§ Mr. Mudie
We spent 34 hours in Committee. Here we are on Report, and we do not have the details of the medical test, which is at the heart of the Bill.
Can I tell the House anything about the medical test? I cannot do so, because it is not spelled out in the Bill. Can anyone tell the House about the medical test? No. The details of the medical test will come before the House after 190 the Bill has gone through, when we are on holiday in August. The Bill will go to another place, although there are no details of the medical test—and they are not expected until August.
I think that Madam Speaker was in the Chair when my hon. Friend the Member for Manchester, Withington (Mr. Bradley) was explaining who will draw up the test. There are 80 faceless people drawing up the test. The Minister is so confident about the legislation and its principles that the medical test is being drawn up in secret, and he will not allow the names of the people who are drawing it up to be made public.
In Committee, when we discovered that two of the 80 experts did not wish to have the Minister's protection and were prepared to make their names public, we were told that they were forbidden to do so. Therefore, the disabled organisations which wished to have a dialogue with the experts to ensure that the medical tests were the best that could be worked out among everyone involved could not do so, because the identities of the people who are drawing up the tests are secret.
This secret medical test will be coming in August, and we are discussing the Bill in March. If that is not defensible in the country on a matter that will take benefit away from 250,000 people, I do not know what is indefensible. [Interruption.] If the Under-Secretary wants me to give way, I shall sit down.
I shall refer to amendment No. 26 briefly, because I do not wish to take up the time of the House. My hon. Friend the Member for Crewe and Nantwich spoke in telling terms about the amount of time it takes to hear appeals. If the amendment is accepted, it will mean that appeals must be heard within 10 days. I am pleased to know that I have the right amendment for once. This is an historic moment in my speaking history in the Chamber, and I hope that it will allow the Chair to relax. I even know the contents of the amendment, which makes a welcome change.
Amendment No. 26 says that any appeals would be heard within 10 working days, and individuals would be allowed to be represented. Both parts of the amendment are important, but I wish to talk about the first part, because it is especially important. As a result of the Minister's intervention on my hon. Friend the Member for Crewe and Nantwich, I hope that he will tell the House that he accepts the amendment.
If the information provided by the National Association of Citizens Advice Bureaux is genuine, the Government's statistics show a distressing situation. According to the information provided to hon. Members, the length of time for hearing appeals increased from 21 weeks in 1986 to 30 weeks in 1992.
I shall go a bit further in terms of the repercussions for an individual. If an individual has been turned down for benefit and has lodged an appeal, he cannot get unemployment benefit or income support, and is therefore incomeless. I was grateful for the sign of humanity—I do not say this lightly; it is accepted—that brought the Under-Secretary to the Dispatch Box to ask my hon. Friend for details, because the present situation is not acceptable.
At present, it takes 30 weeks for an appeal to be heard, which can mean 30 weeks without income. If the Government's figures are accepted—I intend to catch your eye, Mr. Deputy Speaker, in the debate on a later 191 amendment—they show that the average benefit paid is £79. If a person who is sick long-term appeals against a decision and is turned down, how does he run his home?
I understand that you, Mr. Deputy Speaker, get very excited when we refer to the Child Support Agency. However, the same Department takes a decision which lands on people who lead very ordinary lives with very ordinary budgets. It takes a decision that has a frightening financial effect on people, and the Government wonder why there is an outcry.
I challenge the Minister to come to the Dispatch Box and accept that 30 weeks translates into seven months. Would the Minister, without warning—even though, after his considerable time in the House, he may have built up considerable savings—like to have to go without income for the next seven months? That can be the effect of a decision. If that happened to me, without the considerable savings that I am sure the Minister has, the effect on my domestic expenditure would be devastating. However, that is what is happening.
This is no game; this is not semantics. When hard-working people in communities all over the country —according to Government statistics, we are talking about people over 50 on average earnings, manual workers and people who are often in occupations without sick schemes —are off work because of illness, they face up to seven months before a decision is taken and they can get some money flowing into the family. What effect does that have on rent, hire purchase and mortgages? What family's income could withstand seven months with a block on one income?
I am grateful that the Under-Secretary leaped to the Dispatch Box, and I would not for a second challenge his compassion, but I want now to see the proof of it. That proof would be his acceptance of amendment No. 26, which would impose on the bureaucrats who run the system that two weeks is a sufficient time for anybody to be without income, and that an appeal should be heard within two weeks.
Although I said that it was less important than my previous point, the question of representation is important. I recently appealed to a Child Support Agency tribunal, and I made the point that both the child support officer and the chairman of the tribunal seemed to have a thick handbook. I made the point informally after the hearing that it would have been better if they had warned me, as a representative, that they would be using that handbook. It might have saved hours in the hearing.
Incredibly, I was told that representatives are not told, because it is difficult for them to understand those books. Those involved with the tribunal have trouble in understanding them, so the representatives would not be able to understand. They may have got that right in my case, but, as a general principle, it is rather patronising. It seems to be symptomatic of the objection to representation and of a culture in which representation is a nuisance.
In 1990, the Public Accounts Committee looked at invalidity benefit. The Committee's report showed that people with representation had greater success than those who were not represented. The technicality of the proceedings and the regulations makes that straightforward. That point should make amendment No. 26 even more alluring to the Minister, and I look forward to him joining me in the Lobby.
§ Mr. Flynn
It is a pleasure to follow my hon. Friends, and the prophecies of my hon. Friend the Member for Crewe and Nantwich (Mrs. Dunwoody) will come back to haunt the Government.
This is a deeply flawed Bill, which has no central heart. We are passing the bare bones of the legislation. We know that the Government are saying—as they said often in Committee—"We are the Government, trust us." Some of us take a rather cynical view of that promise. They have said again and again that they are nice chaps. There was wonderful praise in Committee for the two Ministers who are on the Government Front Bench today. They are saintlike and give all of their salaries to the poor.
We pointed out that there are other people on that Front Bench who are absent now. Those people help to make up the Government's soft man/hard man technique, which is well-known for interrogating prisoners. The prisoner gets pummelled into one state by the crude savage, and then the nice man comes in and offers him a cup of tea and a bag of sweets. That is the kind of psychological treatment that the House and the country are getting from the Ministers.
The Secretary of State—who is absent—is a terrifying sight when we see him in full colour on television. At the Nuremberg rally—the Conservative party conference—he threatened everything under the sun. That was the last time that he descended to bad German and barbed French—"Ich bin ein Führer", or "Après moi, la déluge." It was a terrifying sight. The right hon. Gentleman did not have the list that he had before of all the scapegoats that he was to pursue in the coming year.
The great problem for the Government is translating the party rhetoric into legislation and, in their attempt to do so, they produce atrocious legislation. The new clause gets to the heart of the Bill—the test for incapacity for work. I have sat through many hours of the Committee—as have many of my hon. Friends—and I still do not know the answer to the central conundrum.
It is good to know that Government Back Benchers are unanimous in their support of the new clause—they speak with one voice, it may be said. They are saying that they will approve the new clause, and that is splendid. We must test whether we believe the Government when they say, "We are the Government, trust us." They have enunciated a new heresy today. An entirely new part of the Government's policy has been announced, and can be described as the right to lie.
I have heard of the right to buy, in housing—my hon. Friend the Member for Workington (Mr. Campbell-Savours) is pursuing an interesting case where the right to buy has become the right to steal—but the right to lie is something quite new. I understand that the Minister with responsibility for open government told a Committee that, in exceptional cases, it is necessary to say something untrue in the House of Commons. The little trust that we had in the Government will be shattered.
§ Mr. Flynn
That is what a Minister said this morning to a Committee. One of the national newspapers has quite rightly headlined that as a shocking statement.
Are the Government telling the truth now about the Bill? Our cynicism suggests that the new clause is needed. It asks for very little. It provides that there should be a report to both Houses of Parliament that would reveal the 193 effectiveness or otherwise of the test for incapacity. The Government still want to proceed with the all-work test, which is based on a fundamental misconception—perhaps the Minister can try to explain it to us again. The misconception is that the capacity for work can be defined as an objective test that applies to everybody, regardless of his education, training, work history, personality, age and ability to cope with the consequences of ill-health and disability.
An anonymous army of experts is meeting, perhaps in a secret cave at midnight, to decide on the score sheet on which people will be classified as capable or incapable of work. That is a fundamental absurdity. The case of Stephen Hawking was quoted at length during the Committee. Another case quoted was that of someone who was blind and might not be able do his work, but who might be able to become a Front-Bench spokesman for the Labour party. It is nonsense to suggest that there can be any test for incapacity for work.
Traditionally, Mr. Deputy Speaker, in the industries where you and I worked before we entered this place, young men who were healthy, fit and in the prime of their lives did the hard manual labour. Towards the final years of their working lives, they would have lighter jobs, such as sweeping up or possibly clerical work, which would be made available to them if their health was failing. That can happen to many of us. We can all go through periods of incapacity from the moment we come into this world, and we can have failing capacity throughout our lifetimes.
In these hard, Thatcherite days, if someone can no longer do his full work, he is thrown out. There is nothing left, and there is no alternative. However, we are entering an age when many alternatives are available. I wish that the Government would take seriously the opportunities provided by the new supercomputers, which will provide thousands of jobs on the information highway. It looks as if we will lose out on that, as we have lost out in many other industrial developments.
Those opportunities will, however, produce work that requires little physical effort. A keyboard must be operated, but little is required in the way of physical strength. That does not mean that anyone can do it. Someone in the unfortunate state that Stephen Hawking is in could not; his brain functions very well, but he can hardly even use his voice.
Some people can work in such jobs and can contribute richly to our society. However, many people could not do so because of their background and often because of an objection—based on their generation—to using high-tech machines, which now affect all available work. People who used to do manual jobs in a heavy industry find that there is nothing else that they can do and that they cannot move to the sunrise industries that are taking its place.
The Bill will have a catastrophic effect on certain areas of the country where many people receive invalidity benefit. That is not because doctors in those regions operate a different regime but because there is a tradition of heavy industry, which crippled and maimed the people who worked in the mines, quarries and steelworks. When workers in those industries finished their careers they were generally very run down and greatly damaged by their work.
The Bill will not only damage people in those areas; it will hit their communities. We shall be taking a vast sum of money—millions of pounds—from small communities. We shall be taking away money that went straight into the local economy. It was not invested in Lloyd's, or on the stock exchange, or spent in Penang; it was spent in local shops and went straight into the local economy. We shall be taking that money out of the economy.
The effect of social security legislation on the great British press has been mentioned. Tonight, one newspaper is carrying a headline about a Minister's right to lie to the House of Commons, but no newspapers will report the debate tomorrow. I once heard hon. Members who take an interest in social security described as social security buffs, as though they collected stamps, were interested in steam engines or must be a special breed to be interested in such an obscure subject. However, that subject involves the livelihood of tens of millions of people and the small disposable income on which they depend on. Few parts of our work can be more important or have a more profound effect on the lives of millions of people. The Bill will not affect the lives of members of the press, however, as few of them receive invalidity benefit.
§ Madam Deputy Speaker(Dame Janet Fookes)
Order. I am sorry to interrupt the hon. Gentleman, but I have looked closely at the new clauses and amendments and he seems to be very wide of them. Will he return to the subject under discussion?
§ Mr. Flynn
Of course, Madam Deputy Speaker.
In Committee, we discussed the medical test that lies at the heart of the legislation. The consultation document was the only written sign of Government thinking and certain organisations were invited to respond to it. However, even that document was modified between its publication date and the closing date for responses. We are therefore being asked to approve legislation that is merely a sign of what the Government will do and that does not contain any of the details.
We could argue that the test is not so much a medical test, as has been claimed, as a mechanical test. It is a test of a person's ability to perform certain activities. It does not make sense to have that type of test unless there is some way to relate it to the type of work available in the area, to the job that the person concerned can do and to his or her training and ability. That is our fundamental objection.
We are asking for very little in the new clause. We wantan account of the number of people who attended a medical examination under that part of that Act and a description of … such an examination".The House has been down this road many times before. Hon. Members have referred to the deficient Child Support Agency legislation—the Child Support Act 1991. I cannot find a Back-Bench Member of Parliament who admits to being a member of the Standing Committee that considered the Child Support Bill. There must have been a Committee stage, but no one confesses to having been a part of it, apart from Front-Bench Members, who are the guilty men—
§ Madam Deputy Speaker
Order, whether that is true or not, it is not relevant to the subject under discussion.
§ Mr. Flynn
By asking for the accounts, Madam Deputy Speaker, we shall improve the legislation.
195 Will it be difficult to provide such an account? The information must be available. The Department must have some way to keep a record of how this disastrous legislation unfolds in the years to come. Millions of people will be affected by the Bill. We need to know how many people have medical examinations.
When questions were tabled about the progress of other new legislation and about disability working allowance, we found that the results were quite different from what the House had expected. When the Bill is enacted we know that there will be confusion and that people will be upset by the unfairnesses of it. It is essential for Parliament to have information about how it is working at regular intervals.
In new clause 3, we are asking foran account of the number of people who having attended such an examination were determined as incapable for work".That is crucial because we believe that the legislation will be a disaster. The Bill is a means to cut expenditure and it will take people off one benefit and put them on another.
§ Madam Deputy Speaker
Order. We are discussing not the Bill but two new clauses and several amendments. I remind the hon. Gentleman of that fact.
§ Mr. Flynn
I was quoting from new clause 3(c), which asks foran account of the number of people who having attended such an examination were determined as capable of work".How will the test work? What will take place? I am sure that the Minister will be happy to tell me.
The new clause also requiresan account of the reasons for determinations of capacity for work".In the absence of any details from the Government, we can conclude only that the decisions will be subjective and will be made on the spot and that the same injustices, unfairness and different treatments that exist with the social fund will result from this legislation. Benefit will depend on whether one turns up on a Monday, or in March, or on whether one comes from one side of the street or the other. We already have an example of imperfect legislation causing great unhappiness.
In new clause 3(e) we are asking foran assessment of the medical test by such persons whom the Secretary of State may choose".The test is new and we are going into uncharted waters without a rudder. Therefore, it is crucial that the Government accept the new clause.
§ Mr. Burt
I am grateful for the opportunity to respond to a variety of remarks on the amendments. I shall be as brief as I can, but I will try to cover them all. The hon. Member for Manchester, Withington (Mr. Bradley) made many of the remarks straightforwardly, and they were amplified by some of his hon. Friends.
New clauses 3 and 4 would require my right hon. Friend the Secretary of State to report to Parliament on aspects of the operation of the new incapacity benefit. New clause 3 wants such a report no later than 30 September 1996 on the operation of the newtest of incapacity for work".The new clause also requests details of people who attend medical examinations under the Act between April 1995, when the test will be introduced, and September 1996.
There is a case to be made for the provision of information about the workings of the legislation, but I am not certain that there is a case to be made for the publication of a report as such. We shall collect 196 information of this type, and we believe that we shall do so in better quality and greater quantity than the new clause suggests. It would not be wise to restrict ourselves to the time scales and other parameters of the new clause.
§ Mr. Burt
Not at this stage; I should like to make some progress.
In the case of any social security benefit—new or existing—we routinely collect a wide range of statistical information. This is published both in the annual reports of social security statistics and in specialist studies, which include evaluation reports on specific benefits. It is all the more important that new benefits be monitored in order that their effectiveness and performance may be evaluated.
The new incapacity benefit is a good example of one that will be subject to very careful monitoring. The introduction of incapacity benefit brings a considerable change to the current provision of benefits for the sick and incapable by refocusing the benefit on those who, for medical reasons, are incapable of work.
By September 1996, incapacity benefit will have been in place for 18 months, and we shall have collected much information about its operation. I see no advantage in making reports to Parliament along the lines suggested, but the information will be available to hon. Members from a variety of sources, including the statistics that I have mentioned already, and parliamentary questions.
§ Mrs. Dunwoody
The hon. Gentleman will know that, increasingly, hon. Members who put questions to his Department are referred to the relevant agency. They are told that the agency must take responsibility for day-to-day operations. The hon. Gentleman has not made a case for not publishing statistics, and he certainly has not made a case for Ministers' refusal to answer questions on the Floor of the House. Why cannot we have a report that is capable of being discussed by Members of Parliament? By his own evidence, he will by then have information.
§ Mr. Burt
The hon. Lady will be aware that answers to parliamentary questions that come through executive agencies are published, and that Ministers are responsible for answering on the Floor of the House any oral questions that relate to their work. In addition, there are plenty of opportunities for debate in the House about such matters.
§ Mr. Wallace
If questions such as those envisaged in the new clause are asked, will the Minister answer them, or will he refer them to the executive agency?
§ Mr. Burt
It will depend on the nature of the question. Hon. Members know that the next steps agencies are being developed in an attempt to separate the operational arm of Government from the policy arm. Policy questions are always answered by Ministers, but questions about operations can be answered more speedily by the executive agencies. Ultimately, however, Ministers are responsible for operations.
§ Mr. Dafydd Wigley (Caernarfon)
I should like to refer to a matter that I raised during a recent meeting with the Minister. Can the hon. Gentleman assure us that, under the new regime, the range of questions answered will be no narrower than in the past? Can he give an assurance that, when an hon. Member presses for an answer from a Minister rather than from the agency, the Minister will not refuse to reply?
§ Mr. Burt
The rules governing parliamentary questions may be a little more strict than those governing letters. Suppose, for example, that an hon. Member presses for an answer from me about a particular operational matter relating to the Child Support Agency. I take the view that the chief executive should first deal with the query. That is the purpose of the agency. However, if ultimately pressed, I shall answer by letter. Slightly different rules may apply to parliamentary questions. However, such questions are always published, so the information is made available.
I should like now to deal with a number of specific issues in relation to new clause 3. The debate was started with the usual comments about the Government's mean-mindedness. I should like to put in hon. Members' pipes three facts for them to smoke later—if such a metaphor is not politically incorrect these days.
The Government's record on benefits for disabled people is extraordinarily good. Spending has increased by 225 per cent. since 1978–79, and it is currently some £16.5 billion. The disability living allowance, which the Conservative Government introduced, has already brought 500,000 successful claims. Expenditure on invalid care allowance was £4 million in 1978, and it is now £366 million. I could give many more statistics, but I shall not do so. Any suggestion that the Government have been mean-minded in relation to the disabled is absolute fantasy, so I do not expect to hear that argument again tonight.
The test of medical incapacity for work has constituted the meat of this discussion. What do we mean by "medical incapacity for work"? [Interruption.] I tried in Committee to give an explanation, and I am happy to repeat that explanation for the benefit of those who were not members of the Committee and for those who want further clarification.
We mean a restriction or lack of ability to perform the activities involved in working. We do not mean a restriction or lack of ability per se. Nor do we have in mind the fact that the likelihood of getting a particular job is reduced by factors other than medical ones. We are interested in the point at which the ability to do any form of work is substantially reduced—not the point at which all work becomes impossible.
We are trying to establish a threshold above which it would be unreasonable to expect people to work. Many disabled people will choose to work, but benefit will be available to those who do not. This is the Professor Stephen Hawking argument. There will clearly be no question of anyone in a position like that of Professor Hawking being required to work. That that remarkable man is able to work bears testimony to the fact that there are others, similarly disabled, who work—
§ Mr. Burt
I have too much to get through. Several hon. Members who were on the Committee and who have been present throughout this debate need answers.
The threshold is not one above which it would be reasonable to expect anybody to be able to work. [Interruption.] Exactly: if Stephen Hawking can work, anyone can work. Clearly, that cannot be the test.
We are trying, through a process of consultation and consensus, to get a wide range of people—panel members and those they consult—to provide their definition of 198 incapacity for work: a definition that relates functional limitation to a substantial reduction in the ability to do work of some kind. That is what is being discussed at the moment.
A number of points were made by my hon. Friend the Member for Stratford-on-Avon (Mr. Howarth), whose contribution I greatly appreciated. My hon. Friend referred in particular to disabled people's disadvantage in the jobs market.
All employment services and training—enterprise and education programmes and services for unemployed people—are open to people with disabilities, often with the entry criteria relaxed. There is a wide range of services and schemes for those who need special help. In 1992–93, 62,978 people with disabilities were placed in jobs. That is an indication of what can happen, and it is a point of great importance.
A number of questions about the snapshot element were raised. Is the medical test a snapshot? No, it is not. It involves the completion of a questionnaire by the claimant, a statement of diagnosis by the claimant's general practitioner, a list of principal disabling conditions and, where required, referral to a departmental doctor for a report or examination.
The departmental doctor who examines a claimant will take account of the variability of the condition over given periods. Thus, the assessment will create an overall picture of the effect of the medical condition on the person's ability to carry out a range of work-related activities, and hence his capacity for work.
This is an appropriate point at which to mention the role of the general practitioner. As I said in Committee, the GP plays his vital role at the beginning of the period of incapacity, when it is still the GP's medical certificate that counts. Of course, it is very important that the GP should feel that he has a continuing role to play and may submit information on behalf of the patient at any stage.
Several hon. Members made a point about whether the GP's role was appropriate. It was alleged that we had suggested that, in some way, general practitioners had not been doing their job. That is not the point. General practitioners themselves have been concerned about their role.
I want to quote from a report to indicate that I am not the only person who is saying this. The medical journal Monitor Weekly of 2 June 1993 said:More than two-thirds of the 100 GPs questioned by Monitor admitted they had signed a sickness benefit form for patients whom they knew not to be sick, or for an illness that would not prevent the patient from working.That is borne out by other studies, which have shown that it is a question not of GPs' deliberately avoiding the test but of their taking part in a way that they find inappropriate as the gamekeepers in the area of this benefit.
§ Mr. Ingram
Can the Minister tell us how many general practitioners there are, what percentage the sample represents, and whether he considers it a scientific sample?
§ Mr. Burt
No one claims that the point made by GPs and what they have said over a period is invalid. Again, I am making the point that GPs retain a role in this benefit right the way through, but do not have the definitive and distinctive role that they had in the past. I see nothing wrong in that.
Turning to other issues, some hon. Members asked about particular illnesses and whether, on their own, they 199 would be a matter for a decision. The effect of any medical condition or disorder on the capacity to work is of cardinal importance, but such an effect can vary in intensity, over time, from mild to severe. We are taking steps to ensure that the needs of people with such conditions are addressed in developing the new tests. As part of the development of the medical assessment, in-house studies have researched the extent to which certain complicating factors, such as pain, stiffness and fatigue, may affect capacity to work. [Interruption.]
This research has been incorporated in the development of the medical test so far. The consultation exercise has informed the debate, and a consensus will be reached, to give sufficient and appropriate weighting to such factors in the medical test.
I turn now to information about the panel and the allegations there. Once again, the hon. Member for Leeds, East (Mr. Mudie), in particular, and the hon. Member for Newport, West (Mr. Flynn), suggested that these people were being kept well away from the public, working in secret, working in caves.
All I can say is that members of the panel will certainly have had full access to the reports of the Committee and of these proceedings in the House, and I imagine that they would want to keep well away from hon. Gentlemen like the hon. Members for Leeds, East and for Newport, West if they believe all they read about them.
§ Mr. Burt
It is as rough as I get: the hon. Gentleman knows that.
In relation to anonymity, we decided at the outset that the participants in the expert panel exercise should be anonymous, to ensure that they could give their professional input without the possibility of any external influence. [Interruption.] We have, however, readily agreed to give details of their areas of expertise. [Interruption.]
§ Madam Deputy Speaker
Order. If the hon. Member for Crewe and Nantwich (Mrs. Dunwoody) wishes to intervene, perhaps she will do so in the normal way, rather than from a seated position.
§ Mrs. Dunwoody
I am deeply grateful to the hon. Gentleman. Is he aware how many doctors, male and female, sit on how many assessment panels, how many research papers they publish, and how much effort they put into researching a vast number of medical conditions and their implications? Why does the Minister have this poor, weak, pathetic, little group who must be protected, not only, according to him, from hon. Members but also from the general public, because they are somehow terrified that their views would be influenced? How many are there? How often are they protected? Is this the only way in which the Minister protects them, or does he protect them in other spheres as well?
§ Mr. Burt
Perhaps the hon. Lady will let me complete my remarks about this section, and then she will hear some of the answers.
200 The group has access to anybody it wishes, and should its members wish to beat a path to the hon. Lady's door, they will no doubt do so. We have readily agreed to give details of their areas of expertise, and the answers to a number of parliamentary questions confirm that that is the case.
Once the expert panel have completed their work, we will give full details of all those who were approached. The idea is that we should issue a report round about August, which will summarise the results of the consultation exercise, the work of the panel and the evaluation exercise and which will also give details of who they are. There will then be an opportunity to consult in relation to the work they do, with a view to trying to get down to a test.
So there is no way in which this work can be said to be done in secret or anything like that. It is very important that the results of the panel's work are published in a formal report, so that they can form part of the debate on the regulations which will establish in law the medical test of incapacity for work.
§ Mr. Howarth
Before my hon. Friend moves away from the matter of confidentiality, may I press him on confidentiality in another but relevant context? He will be aware that one reason for the increasing number of appeals is that applicants are not made aware of the contents of the reports produced by the Benefits Agency medical service. Will my hon. Friend ensure that in future those reports are made available to claimants? It will show a properly respectful attitude to claimants, and it may mean rather less time, energy and resources wasted in appeals.
§ Mr. Burt
My hon. Friend is right, and I am happy to give the assurance, which I gave in Committee, that the information will be available.
New clause 4 seeks details of those appeals heard more than 10 days after they were made, a summary of the outcome of all appeals, a report on the extent to which medical evidence influenced the appeal outcome, a summary of the reasons for any failure by claimants to attend the hearing, and a report on the use made of claimants' representatives at an appeal.
The Benefits Agency and the independent tribunal service are committed to looking at ways to improve the clearance times for appeals across the whole social security benefit system. There has been considerable activity to identify and eradicate causes of delay, and there are some indications that this is already successful.
Every party, including claimants, representatives and adjudication officers, is entitled under Social Security (Adjudication) Regulation 4(2) to at least 10 days' notice of a hearing. Times run from the date of posting of the appeal papers to the day before the hearing of the case. However, both the claimant and the adjudication officer will wish to prepare submissions before a hearing is confirmed.
Furthermore, the claimant's representative will require time to prepare, and often he or she is unavailable for the designated hearing date, necessitating a postponement. I hope that hon. Members will acknowledge the sheer impracticability of the suggestion that appeals should be heard within 10 days of their being made.
I am not certain what purpose the final two parts of the new clause would serve. Where the claimant is absent, the tribunal will satisfy itself that papers were duly notified and whether the claimant has indicated an intention to be 201 present, before considering whether to continue with the hearing. The Department has no obvious interest in the reasons for a claimant's absence or a yearly summary of those reasons. Similarly, it has no interest in the use made by claimants of representations at an appeal.
We are rather confused by amendment No. 22. It appears to seek to ensure that the Secretary of State shall set out in regulations the manner in which evidence and information are to be used in the assessment of incapacity.
If the House is looking for reassurance that all evidence, whether provided by the claimant, his GP or another person, will be properly considered in the assessment of incapacity, I can provide that reassurance. All relevant evidence will be taken into account at all stages, both in the Benefits Agency medical services doctor's assessment of the claimant and in the adjudication officer's determination of incapacity. Nothing will be excluded.
I question the need for amendment No. 24, the purpose of which is to require the claimant's GP to sit with the tribunal where the appeal concerns determination of the capacity to work. I am sure that the medical profession would not wish to spend time and resources in that manner. GPs, and the British Medical Association, have said for some time that acting as policemen for the social security system can undermine the doctor-patient relationship. They have complained for many years of an ever-increasing amount of paperwork.
The new method of assessing medical incapacity will mean that GPs need to complete many fewer statements of incapacity, and that the Department will be writing to them for further reports rather less often. I fail to see, therefore, what purpose amendment No. 24 serves.
In relation to amendment No. 25, our intention is that appeals against decisions made by an adjudication officer on incapacity benefit shall go to social security appeal tribunals. The tribunals comprise a legally qualified chairman, who guides the proceedings and advises on the law, and two lay members. The arrangement reflects the existing provision in invalidity and sickness benefits.
The most sensitive appeals on incapacity benefit will be those which concern a dispute about the level of the claimant's functional limitations. In these cases, we think that the tribunal should have access to independent medical expertise. The members of the tribunal, who are trained and expert in this, will weigh the evidence and they will make the decision.
I believe that the new clauses and amendments will not provide any additional benefits for claimants, and I invite hon. Members to reject them.
§ Mr. Bradley
The Minister's explanation has done no more than reinforce our view that an annual report is required. He started by claiming how good the Government's record was on benefits for disabled people, but forgot to mention that the purpose of the legislation is to cut £1.45 billion from that budget in the next two years. If that is a mark of success, I despair of the Government's intentions in relation to other aspects of social security.
We have had an interesting and wide-ranging debate, well supported by all my hon. Friends, and especially by the contribution of the hon. Member for Stratford-on-Avon (Mr. Howarth) which, as the Under-Secretary of State said, was greatly appreciated by the Government. It was 202 certainly greatly appreciated by Opposition Members because he fully supported our new clauses and amendments.
We would have had an even more interesting debate in Committee if the Government had not censored the membership of the Committee but had allowed a proper debate among people genuinely interested in the topic, with the knowledge and expertise that would have been greatly welcomed in our deliberations during our 35 hours in Committee. It is a sad reflection on that censorship that not one Conservative member of the Committee has deigned to turn up to speak on Report.
By our proposals we simply seek information in terms of an annual report and a report on the appeals procedure to be presented to the House of Commons for proper parliamentary scrutiny. I find it incredible that a Government who claim to be the champions of open government should say that all that information will be gathered by the Government but that they will not present it in any coherent form to Parliament. One can only suspect that their real intention is to gather that information, recognise the realities of the way in which the medical test is operating and suppress the information, because they will not want a genuine debate in Parliament about the operation of the medical test.
The debate could not have made clearer why the medical test should be considered by us today—so that we could have a proper debate about the way in which it would operate in practice. The Minister has reaffirmed that the Government seek a clear threshold on which to base the decision whether someone is capable or incapable of work. It is clear from all the information—all the representations from organisations that represent disabled people throughout the country—that it is inappropriate to set a fixed threshold.
Incapacity is a continuum. One needs to judge the nature of the illness or the nature of the disability against the real world of work. It is incredible to suggest that the Government could apply that medical test—which is not before us—to that concept of own work and all work without explaining the way in which all work will operate in the current employment market.
We must demand that information be presented to Parliament at the earliest opportunity. Reports on the way in which the incapacity benefit will work are crucial. We place clearly on record our total opposition to the Bill because, as all my hon. Friends have said, the reality of the Bill will not bite for at least 12 months. Then Conservative Members will come whining back to the House, as a result of their casework, and say, "We did not vote for this. We did not understand what would happen. We did not understand that the medical test would be applied in this way. We did not understand that there would be a reduction in the amount of benefit available under the new incapacity benefit compared with the previous invalidity benefit."
We must say clearly, through the amendment, that we are voting to oppose the cuts in benefit to disabled people, and to oppose the tightening of the regime on the medical test and applying the reality of people with disabilities to a situation in which at least 3 million people are unemployed. That is what we are voting for. Let no Conservative Members return to the House in future and pretend that they did not understand what they were voting for. This is the opportunity to make their intentions clear.
§ Question put,That the clause be read a Second time:—
§ The House divided: Ayes 268, Noes 299.206
|Division No. 155]||[7.04 pm|
|Abbott, Ms Diane||Denham, John|
|Adams, Mrs Irene||Dewar, Donald|
|Ainger, Nick||Dixon, Don|
|Ainsworth, Robert (Cov'try NE)||Dobson, Frank|
|Allen, Graham||Donohoe, Brian H.|
|Alton, David||Dowd, Jim|
|Anderson, Donald (Swansea E)||Dunnachie, Jimmy|
|Anderson, Ms Janet (Ros'dale)||Dunwoody, Mrs Gwyneth|
|Armstrong, Hilary||Eagle, Ms Angela|
|Ashdown, Rt Hon Paddy||Eastham, Ken|
|Ashton, Joe||Enright, Derek|
|Austin-Walker, John||Etherington, Bill|
|Banks, Tony (Newham NW)||Evans, John (St Helens N)|
|Bames, Harry||Ewing, Mrs Margaret|
|Barron, Kevin||Fatchett, Derek|
|Battle, John||Faulds, Andrew|
|Bayley, Hugh||Field, Frank (Birkenhead)|
|Beckett, Rt Hon Margaret||Fisher, Mark|
|Beggs, Roy||Flynn, Paul|
|Beith, Rt Hon A. J.||Forsythe, Clifford (Antrim S)|
|Bell, Stuart||Foster, Rt Hon Derek|
|Benn, Rt Hon Tony||Foster, Don (Bath)|
|Bennett, Andrew F.||Foulkes, George|
|Benton, Joe||Fraser, John|
|Bermingham, Gerald||Fyfe, Maria|
|Berry, Dr. Roger||Galbraith, Sam|
|Betts, Clive||Galloway, George|
|Blair, Tony||Gapes, Mike|
|Blunkett, David||Garrett, John|
|Boateng, Paul||Gerrard, Neil|
|Boyes, Roland||Gilbert, Rt Hon Dr John|
|Bradley, Keith||Godman, Dr Norman A.|
|Bray, Dr Jeremy||Godsiff, Roger|
|Brown, Gordon (Dunfermline E)||Golding, Mrs Llin|
|Brown, N. (N'c'tle upon Tyne E)||Gordon, Mildred|
|Bruce, Malcolm (Gordon)||Gould, Bryan|
|Burden, Richard||Grant, Bernie (Tottenham)|
|Byers, Stephen||Griffiths, Nigel (Edinburgh S)|
|Caborn, Richard||Griffiths, Win (Bridgend)|
|Callaghan, Jim||Grocott, Bruce|
|Campbell, Mrs Anne (C'bridge)||Gunnell, John|
|Campbell, Ronnie (Blyth V)||Hain, Peter|
|Campbell-Savours, D. N.||Hall, Mike|
|Canavan, Dennis||Hanson, David|
|Cann, Jamie||Hardy, Peter|
|Carlile, Alexander (Montgomry)||Harman, Ms Harriet|
|Chisholm, Malcolm||Harvey, Nick|
|Clapham, Michael||Hattersley, Rt Hon Roy|
|Clark, Dr David (South Shields)||Henderson, Doug|
|Clarke, Eric (Midlothian)||Heppell, John|
|Clelland, David||Hill, Keith (Streatham)|
|Clwyd, Mrs Ann||Hinchliffe, David|
|Coffey, Ann||Hoey, Kate|
|Connarty, Michael||Hogg, Norman (Cumbernauld)|
|Cook, Frank (Stockton N)||Home Robertson, John|
|Cook, Robin (Livingston)||Hood, Jimmy|
|Corbett, Robin||Hoon, Geoffrey|
|Corbyn, Jeremy||Howarth, George (Knowsley N)|
|Corston, Ms Jean||Howells, Dr. Kim (Pontypridd)|
|Cousins, Jim||Hoyle, Doug|
|Cox, Tom||Hughes, Kevin (Doncaster N)|
|Cryer, Bob||Hughes, Roy (Newport E)|
|Cummings, John||Hutton, John|
|Cunliffe, Lawrence||Illsley, Eric|
|Cunningham, Jim (Covy SE)||Ingram, Adam|
|Cunningham, Rt Hon Dr John||Jackson, Glenda (H'stead)|
|Dafis, Cynog||Jackson, Helen (Shef'ld, H)|
|Dalyell, Tam||Jamieson, David|
|Darling, Alistair||Janner, Greville|
|Davidson, Ian||Jones, leuan Wyn (Ynys Môn)|
|Davies, Bryan (Oldham C'tral)||Jones, Jon Owen (Cardiff C)|
|Davies, Rt Hon Denzil (Llanelli)||Jones, Lynne (B'ham S O)|
|Davies, Ron (Caerphilly)||Jones, Martyn (Clwyd, SW)|
|Davis, Terry (B'ham, H'dge H'l)||Kaufman, Rt Hon Gerald|
|Keen, Alan||Powell, Ray (Ogmore)|
|Kennedy, Charles (Ross,C&S)||Prentice, Ms Bridget (Lew'm E)|
|Kennedy, Jane (Lpool Brdgn)||Prentice, Gordon (Pendle)|
|Khabra, Piara S.||Prescott, John|
|Kirkwood, Archy||Primarolo, Dawn|
|Lestor, Joan (Eccles)||Purchase, Ken|
|Lewis, Terry||Radice, Giles|
|Litherland, Robert||Randall, Stuart|
|Livingstone, Ken||Raynsford, Nick|
|Lloyd, Tony (Stretford)||Redmond, Martin|
|Llwyd, Elfyn||Reid, Dr John|
|Loyden, Eddie||Robertson, George (Hamilton)|
|Lynne, Ms Liz||Robinson, Geoffrey (Co'try NW)|
|McAllion, John||Roche, Mrs. Barbara|
|McAvoy, Thomas||Rogers, Allan|
|McCartney, Ian||Rooker, Jeff|
|Macdonald, Calum||Rooney, Terry|
|McFall, John||Ross, Ernie (Dundee W)|
|McKelvey, William||Rowlands, Ted|
|Mackinlay, Andrew||Ruddock, Joan|
|McLeish, Henry||Sedgemore, Brian|
|McMaster, Gordon||Sheerman, Barry|
|McNamara, Kevin||Sheldon, Rt Hon Robert|
|McWilliam, John||Shore, Rt Hon Peter|
|Madden, Max||Short, Clare|
|Mahon, Alice||Simpson, Alan|
|Mandelson, Peter||Skinner, Dennis|
|Marek, Dr John||Smith, Andrew (Oxford E)|
|Marshall, David (Shettleston)||Smith, C. (Isl'ton S & F'sbury)|
|Marshall, Jim (Leicester, S)||Smith, Rt Hon John (M'kl'ds E)|
|Martin, Michael J. (Springburn)||Smith, Llew (Blaenau Gwent)|
|Martlew, Eric||Snape, Peter|
|Maxton, John||Soley, Clive|
|Meale, Alan||Spearing, Nigel|
|Michael, Alun||Spellar, John|
|Michie, Bill (Sheffield Heeley)||Squire, Rachel (Dunfermline W)|
|Michie, Mrs Ray (Argyll Bute)||Steinberg, Gerry|
|Milburn, Alan||Stevenson, George|
|Miller, Andrew||Stott, Roger|
|Mitchell, Austin (Gt Grimsby)||Taylor, Mrs Ann (Dewsbury)|
|Moonie, Dr Lewis||Taylor, Matthew (Truro)|
|Morgan, Rhodri||Thompson, Jack (Wansbeck)|
|Morley, Elliot||Walker, Rt Hon Sir Harold|
|Morris, Rt Hon A. (Wy'nshawe)||Wallace, James|
|Morris, Estelle (B'ham Yardley)||Walley, Joan|
|Morris, Rt Hon J. (Aberavon)||Wardell, Gareth (Gower)|
|Mowlam, Marjorie||Wareing, Robert N|
|Mudie, George||Watson, Mike|
|Mullin, Chris||Welsh, Andrew|
|Murphy, Paul||Wigley, Dafydd|
|Oakes, Rt Hon Gordon||Williams, Rt Hon Alan (Sw'n W)|
|O'Brien, Michael (N W'kshire)||Williams, Alan W (Carmarthen)|
|O'Brien, William (Normanton)||Wilson, Brian|
|Olner, William||Winnick, David|
|O'Neill, Martin||Wise, Audrey|
|Orme, Rt Hon Stanley||Worthington, Tony|
|Parry, Robert||Wright, Dr Tony|
|Patchett, Terry||Young, David (Bolton SE)|
|Pickthall, Colin||Tellers for the Ayes:|
|Pike, Peter L.||Mr. Peter Kilfoyle and Mr. Dennis Turner.|
|Ainsworth, Peter (East Surrey)||Banks, Robert (Harrogate)|
|Aitken, Jonathan||Bates, Michael|
|Alexander, Richard||Batiste, Spencer|
|Alison, Rt Hon Michael (Selby)||Bellingham, Henry|
|Amess, David||Bendall, Vivian|
|Ancram, Michael||Beresford, Sir Paul|
|Arbuthnot, James||Biffen, Rt Hon John|
|Arnold, Jacques (Gravesham)||Blackburn, Dr John G.|
|Arnold, Sir Thomas (Hazel Grv)||Body, Sir Richard|
|Aspinwall, Jack||Booth, Hartley|
|Atkins, Robert||Boswell, Tim|
|Atkinson, David (Bour'mouth E)||Bottomley, Peter (Eltham)|
|Atkinson, Peter (Hexham)||Bottomley, Rt Hon Virginia|
|Baker, Nicholas (Dorset North)||Bowden, Andrew|
|Baldry, Tony||Bowis, John|
|Banks, Matthew (Southport)||Boyson, Rt Hon Sir Rhodes|
|Brandreth, Gyles||Griffiths, Peter (Portsmouth, N)|
|Brazier, Julian||Gummer, Rt Hon John Selwyn|
|Bright, Graham||Hague, William|
|Browning, Mrs. Angela||Hamilton, Rt Hon Sir Archie|
|Bruce, Ian (S Dorset)||Hamilton, Neil (Tatton)|
|Budgen, Nicholas||Hampson, Dr Keith|
|Burns, Simon||Hanley, Jeremy|
|Burt, Alistair||Hannam, Sir John|
|Butcher, John||Hargreaves, Andrew|
|Butler, Peter||Harris, David|
|Butterfill, John||Haselhurst, Alan|
|Carlisle, John (Luton North)||Hawkins, Nick|
|Carlisle, Kenneth (Lincoln)||Hawksley, Warren|
|Carrington, Matthew||Hayes, Jerry|
|Carttiss, Michael||Heald, Oliver|
|Churchill, Mr||Hendry, Charles|
|Clappison, James||Heseltine, Rt Hon Michael|
|Clark, Dr Michael (Rochford)||Hicks, Robert|
|Clarke, Rt Hon Kenneth (Ruclif)||Higgins, Rt Hon Sir Terence L.|
|Clifton-Brown, Geoffrey||Hill, James (Southampton Test)|
|Coe, Sebastian||Horam, John|
|Colvin, Michael||Hordern, Rt Hon Sir Peter|
|Congdon, David||Howard, Rt Hon Michael|
|Conway, Derek||Howell, Rt Hon David (G'dford)|
|Coombs, Anthony (Wyre For'st)||Howell, Sir Ralph (N Norfolk)|
|Coombs, Simon (Swindon)||Hughes Robert G. (Harrow W)|
|Cope, Rt Hon Sir John||Hunt, Rt Hon David (Wirral W)|
|Cormack, Patrick||Hunter, Andrew|
|Couchman, James||Jackson, Robert (Wantage)|
|Currie, Mrs Edwina (S D'by' ire)||Jenkin, Bernard|
|Curry, David (Skipton & Ripon)||Jessel, Toby|
|Davies, Quentin (Stamford)||Johnson Smith, Sir Geoffrey|
|Davis, David (Boothferry)||Jones, Gwilym (Cardiff N)|
|Day, Stephen||Jones, Robert B. (W Hertfdshr)|
|Deva, Nirj Joseph||Jopling, Rt Hon Michael|
|Devlin, Tim||Kellett-Bowman, Dame Elaine|
|Dorrell, Stephen||Key, Robert|
|Douglas-Hamilton, Lord James||Kilfedder, Sir James|
|Dover, Den||King, Rt Hon Tom|
|Duncan, Alan||Kirkhope, Timothy|
|Duncan-Smith, Iain||Knapman, Roger|
|Dunn, Bob||Knight, Mrs Angela (Erewash)|
|Durant, Sir Anthony||Knight, Greg (Derby N)|
|Dykes, Hugh||Knight, Dame Jill (Bir'm E'st' n)|
|Eggar, Tim||Knox, Sir David|
|Elletson, Harold||Kynoch, George (Kincardine)|
|Emery, Rt Hon Sir Peter||Lait, Mrs Jacqui|
|Evans, David (Welwyn Hatfield)||Lang, Rt Hon Ian|
|Evans, Jonathan (Brecon)||Lawrence, Sir Ivan|
|Evans, Nigel (Ribble Valley)||Legg, Barry|
|Evans, Roger (Monmouth)||Leigh, Edward|
|Evennett, David||Lester, Jim (Broxtowe)|
|Faber, David||Lidington, David|
|Fabricant, Michael||Lightbown, David|
|Fenner, Dame Peggy||Lilley, Rt Hon Peter|
|Field, Barry (Isle of Wight)||Lloyd, Rt Hon Peter (Fareham)|
|Fishburn, Dudley||Lord, Michael|
|Forman, Nigel||Luff, Peter|
|Forsyth, Michael (Stirling)||Lyell, Rt Hon Sir Nicholas|
|Forth, Eric||MacGregor, Rt Hon John|
|Fowler, Rt Hon Sir Norman||MacKay, Andrew|
|Fox, Dr Liam (Woodspring)||Maclean, David|
|Fox, Sir Marcus (Shipley)||McLoughlin, Patrick|
|Freeman, Rt Hon Roger||McNair-Wilson, Sir Patrick|
|French, Douglas||Madel, Sir David|
|Fry, Sir Peter||Maitland, Lady Olga|
|Gale, Roger||Malone, Gerald|
|Gallie, Phil||Mans, Keith|
|Gardiner, Sir George||Marland, Paul|
|Garel-Jones, Rt Hon Tristan||Marlow, Tony|
|Garnier, Edward||Marshall, John (Hendon S)|
|Gill, Christopher||Marshall, Sir Michael (Arundel)|
|Gillan, Cheryl||Martin, David (Portsmouth S)|
|Goodlad, Rt Hon Alastair||Mates, Michael|
|Goodson-Wickes, Dr Charles||Mawhinney, Rt Hon Dr Brian|
|Gorman, Mrs Teresa||Mayhew, Rt Hon Sir Patrick|
|Gorst, John||Mellor, Rt Hon David|
|Grant, Sir A. (Cambs SW)||Merchant, Piers|
|Greenway, Harry (Ealing N)||Mills, Iain|
|Greenway, John (Ryedale)||Mitchell, Andrew (Gedling)|
|Mitchell, Sir David (Hants NW)||Spink, Dr Robert|
|Moate, Sir Roger||Spring, Richard|
|Monro, Sir Hector||Stanley, Rt Hon Sir John|
|Montgomery, Sir Fergus||Steen, Anthony|
|Moss, Malcolm||Stephen, Michael|
|Needham, Richard||Stern, Michael|
|Nelson, Anthony||Stewart, Allan|
|Neubert, Sir Michael||Streeter, Gary|
|Newton, Rt Hon Tony||Sumberg, David|
|Nicholls, Patrick||Sweeney, Walter|
|Nicholson, David (Taunton)||Sykes, John|
|Nicholson, Emma (Devon West)||Tapsell, Sir Peter|
|Norris, Steve||Taylor, Ian (Esher)|
|Onslow, Rt Hon Sir Cranley||Taylor, John M. (Solihull)|
|Oppenheim, Phillip||Taylor, Sir Teddy (Southend, E)|
|Ottaway, Richard||Temple-Morris, Peter|
|Page, Richard||Thomason, Roy|
|Paice, James||Thompson, Sir Donald (C'er V)|
|Patnick, Irvine||Thompson, Patrick (Norwich N)|
|Pattie, Rt Hon Sir Geoffrey||Thornton, Sir Malcolm|
|Pawsey, James||Thurnham, Peter|
|Peacock, Mrs Elizabeth||Townend, John (Bridlington)|
|Pickles, Eric||Townsend, Cyril D. (Bexl'yh'th)|
|Porter, David (Waveney)||Tracey, Richard|
|Rathbone, Tim||Tredinnick, David|
|Redwood, Rt Hon John||Trend, Michael|
|Renton, Rt Hon Tim||Trotter, Neville|
|Richards, Rod||Twinn, Dr Ian|
|Riddick, Graham||Vaughan, Sir Gerard|
|Rifkind, Rt Hon. Malcolm||Walden, George|
|Robathan, Andrew||Walker, Bill (N Tayside)|
|Roberts, Rt Hon Sir Wyn||Waller, Gary|
|Robertson, Raymond (Ab'd'n S)||Ward, John|
|Robinson, Mark (Somerton)||Wardle, Charles (Bexhill)|
|Roe, Mrs Marion (Broxbourne)||Waterson, Nigel|
|Rowe, Andrew (Mid Kent)||Watts, John|
|Rumbold, Rt Hon Dame Angela||Wells, Bowen|
|Ryder, Rt Hon Richard||Wheeler, Rt Hon Sir John|
|Sackville, Tom||Whitney, Ray|
|Sainsbury, Rt Hon Tim||Whittingdale, John|
|Scott, Rt Hon Nicholas||Widdecombe, Ann|
|Shaw, David (Dover)||Wiggin, Sir Jerry|
|Shaw, Sir Giles (Pudsey)||Wilkinson, John|
|Shephard, Rt Hon Gillian||Willetts, David|
|Shepherd, Colin (Hereford)||Wilshire, David|
|Shepherd, Richard (Aldridge)||Winterton, Mrs Ann (Congleton)|
|Shersby, Michael||Winterton, Nicholas (Macc'f'ld)|
|Sims, Roger||Wolfson, Mark|
|Skeet, Sir Trevor||Wood, Timothy|
|Smith, Sir Dudley (Warwick)||Yeo, Tim|
|Smith, Tim (Beaconsfield)||Young, Rt Hon Sir George|
|Speed, Sir Keith||Tellers for the Noes:|
|Spencer, Sir Derek||Mr. Sydney Chapman and Mr. Michael Brown|
|Spicer, Sir James (W Dorset)|
|Spicer, Michael (S Warcs)|