§ [Relevant document: Fourth Report from the Social Security Committee of Session 1997–98, on Disability Living Allowance (HC 641).]
§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kevin Hughes.]9.34 am
§ Mr. Malcolm Wicks (Croydon, North)
I am speaking instead of the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood), the Chairman of the Select Committee on Social Security, who, unfortunately, has injured his back. Although members of our Committee do not have the power to send him a mobility allowance, we certainly send him our best wishes.
The background to the Select Committee report is increasing recognition of disability in our community and, as a consequence, a growing proportion of the social security budget going to disability benefits. The report, which is the fourth from the Select Committee, deals with disability living allowance. Our inquiry focused on two matters: DLA in general and the so-called benefit integrity project, from the Department of Social Security. We conducted our inquiry at a time of growing concern about intentions regarding disability benefits, which many hon. Members will have picked up on in their constituencies.
The history of DLA goes back quite a long way. Invalid tricycles were introduced for war pensioners in the early 1920s, and more recently, in the 1970s, mobility and attendance allowances were introduced. They gave way to DLA in 1992. DLA is a benefit that is based on care and the mobility needs of people with disabilities, for people who become disabled before the age of 65. Its structure is in some respects complex, because the care component has three rates—the highest is £51.30 a week and the lowest £13.60. There are also two rates for mobility.
To the surprise of Governments and of Parliament, the number of people claiming DLA has increased dramatically since 1992, from 1 million in those early days to almost 2 million by 1997–98. By any measure, that is a surprising increase which requires explanation. The puzzle about DLA is compounded by the fact that there is considerable evidence that some people are not claiming their entitlement; in the jargon, there is a take-up problem. Estimates vary, but perhaps as many as 50 per cent. of eligible people are not claiming DLA.
Those two factors—an increasing number of claimants and evidence of DLA not being taken up—suggest the need for review. The Government are conducting a review 280 of disability benefits, which we welcome. In our report, from which I shall quote carefully to reflect the view of members of the Committee, werecommended an urgent review of all aspects of DLA.We add:In its present form, DLA is an unstable benefit and its future … almost impossible to predict.That is partly because of court decisions, which have changed the basis for eligibility, and because of flawed administrative procedures, which failin terms of simplicity and workability.
Much of the DLA procedure is based on self-assessment, and rightly so in many respects. It is important that there is not just a medical model, and that a person can state details of disability and needs, but we are not convinced that the balance is properly struck between self-assessment on the one hand and objective functional criteria and medical evidence on the other. We recommend that the Government look at that again. We also recommend reconsideration of methods of reviewing claims and dealing with changed circumstances as a matter of urgency.
The number of claimants raises the issue of what DLA is intended for. Who are the target group? We recommend that the Government should decide whether greater targeting on more severely disabled people would represent a better approach. We also state that, whatever the criteria in the future, a greater effort must be made to ensure full take-up. Many of the people whom we are discussing have serious needs. We must frame policies that can be easily understood, so that those people can claim the allowance to which they are entitled. We also ask the Government to consider how certain groups who are currently excluded from DLA, such as those with mental health problems, can be helped in the future.
Other members of the Select Committee may want to say more about DLA. Indeed, hon. Members who are not on the Committee may want to talk about it—that, after all, is the purpose of the debate. Before I sit down, however, I want to say a little about the benefit integrity project, which, I think, has implications for the relationship between the House and the Executive.
The project was initiated during the dying days of the last Administration. It was based on a desire to attack fraud or, as it might be described, incorrectness in the programme. One estimate suggested that DLA fraud could amount to some £499 million a year. It is clear that the Department received money from the Treasury to pursue a benefit integrity project designed to cut costs. I should add that DSS officials now say that fraud is probably minimal, rather than amounting to the large figure which I have mentioned.
The Committee is seriously concerned about the genesis and implementation of the benefit integrity project. In the run-up to the launch of BIP, as it is known, no consultation whatever was undertaken with groups representing those affected, despite an undertaking by the then Minister of State responsible for disabled people. The Committee does not blame that former Minister, Alistair Burt, whose good intentions regarding consultation we respect; nor do we blame current Ministers. Our criticisms are levelled at officialdom in the DSS. We believe that the failure to undertake even the slightest consultation was a serious error which has had serious consequences. 281 BIP involved people being visited in their homes, or receiving postal inquiries about their entitlement to the higher rates of benefit. The timing is important. BIP was formally launched on 28 April 1997, just three days before the general election. The first questionnaires were issued on 6 May 1997; I suspect that the minds of hon. Members were on other matters then. It was on that day that ministerial responsibilities were announced. The Minister responsible, Lady Hollis of Heigham, was not even made aware of BIP's existence until 29 May 1997, when, we are told, she took a telephone call from departmental officials at Preston railway station. Despite that incident, it is possible that Preston railway station will never achieve the prominence of, say, the Finland station in European history, but we were puzzled by the fact that the Minister was only informed by officials at that time.
The Committee believes that launching BIP without proper ministerial authority was avery serious error of judgement.There are clear general election guidelines for officials which say that no new action should be launched during an election campaign if it is of a long-term character, and we think that those guidelines were ignored. We have recommended to the permanent secretary at the DSS that, in conjunction with her opposite numbers in other Departments, she should renew the rules of conduct and good practice in regard to general elections, to minimise the risk of such errors of judgment occurring in the future.
The Committee has put the benefit integrity project on what we describe as a six-month probation, and has asked Ministers to report to us on its progress by the end of July. We had considered calling for the suspension of the project, but, given the improvements that have been made, we thought that a probation period was more appropriate.
This matter has serious consequences for some of the people who are most at risk in our society. It has an important impact on people with major disabilities. We were struck by the witnesses with disabilities who gave evidence to the Committee, and we thank them for doing so. We particularly remember a woman with muscular dystrophy, who was clearly very ill and needed artificial breathing aids. She had been visited by officials, but it turned out later that her forms had been filled in incorrectly, and, although she needed virtually around-the-clock care, her higher rate of disability living allowance had been withdrawn. Apparently her general practitioner said that, if that had happened to her, no one could possibly be entitled to the allowance. The GP's disgust was shared by the Committee members who saw that brave witness.
I was also struck by the fact that, when we questioned senior DSS officials—including those directly responsible for BIP—it became clear that, despite the controversy that the visits were running into, none had seen fit to accompany their junior officials to see what was actually happening. The gap between policy and administration in offices and what was happening in people's homes is lamentable. It may explain why the thread of common sense and human compassion failed to run through this part of social administration.
As well as asking for a review of the benefit, we urge Government to 282consider publishing a draft Bill, following the normal process of consultation, to allow a full public debate to take place before legislation to reform DLA is introduced into Parliament.I hope that our report will help the House in its deliberation on these important matters.
§ Mr. David Atkinson (Bournemouth, East)
I welcome the opportunity to refer to a constituent's experience of the benefit integrity project, which astonished me so much that I concluded that the project, in so far as it affected the severely disabled, should be scrapped immediately.
I have no problem with the original concept of BIP as envisaged by the last Government. It was a sensible response to the outcome of the 1996 benefit review, which suggested that 27 per cent. of claimants' awards were incorrect, and that the figure for fraud amounted to 16.7 per cent. No responsible Government could ignore an estimated annual loss of £500 million in overpayments due to fraud.
The Select Committee is right to question the Department's judgment in launching BIP during the week of a general election and without the benefit of consultation with outside bodies, which was originally promised by the Minister. That is the main source of the problems that have arisen, which, in my view, have caused the project to be fatally flawed in the context of the severely disabled.
I knew little about BIP at the time, although I welcomed it as further evidence of the last Government's determination to control public expenditure, and saw it as a response to previous Select Committees' demands for a better way of combating fraud.
In January, my constituent, Mrs. Lesley Burton, wrote to draw my attention to the problems that she and her disabled husband were experiencing with the Department of Social Security and the disability living allowance. This is the same Lesley Burton to whom the hon. Member for Croydon, North (Mr. Wicks) referred. With the greatest courage and determination, she came to the House on 25 March to give her testimony to the Select Committee.
Mrs. Burton told the Committee that she has had muscular dystrophy—a progressive muscle-wasting disease—for 35 years. She, will never get better. She had been receiving the higher-rate mobility component paid with the highest-rate care component. She gave evidence about her experience of the visiting officer from the Benefits Agency under the benefit integrity project. I shall not repeat it in detail, because it is reported on page 47 of the report.
The outcome of the visit was that the adjudication officer decided that Mrs. Burton satisfied only the criteria for an award of the middle-rate care component. The news that her benefits were to be reduced obviously came as a distressing surprise in view of the fact that she is physically completely dependent 24 hours a day on people, on life support machinery and on her two electronic wheelchairs. Unlike other equally severely disabled people, who understandably may not have had the will to challenge that outcome, my constituent did and, as a result, her entitlement to the highest rate of care component was restored, as was her husband's—but that is another story.
In preparing her testimony for the Select Committee, Mrs. Burton obtained a copy of the DLA form completed by the visiting officer, from which it became immediately 283 clear that the officer had had an entirely inadequate appreciation and understanding of my constituent's disabilities. As Mrs. Burton told the Select Committee:I wish I could express to you my disbelief on reading page 24"—of the form—which asks about the help I need at night. This was simply crossed through 'not applicable'. The questions were not asked. The last five pages she simply ignored. Nowhere on the form is there any mention of the suction equipment I could not live without. … That without the ventilator at night I would die.She also said that the form did not show thatI need someone with me all night. That I am dependent 24 hours a day.
The Minister, Baroness Hollis, referred my letter to the Secretary of State to the chief executive of the Benefits Agency, who replied to me, as did the screening officer of the ombudsman. When I had received a reply from Baroness Hollis, I visited my constituent at home to meet her and to discuss our next move. Suffice it to say that any hon. Member would have been as astonished as I was, having seen my constituent's situation at first hand, that any visiting officer from the Benefits Agency should have completed a questionnaire in a way that would lead to a reduction in her benefits.
In my view, Mrs. Burton's testimony to the Select Committee about her condition was entirely accurate. Therefore, I must conclude that the experience and training of at least one BIP visiting officer are inadequate. To how many more does that apply? I must also conclude that the DLA questionnaire is inadequate to establish a true appreciation of the complicated nature of disabilities, such as those of my constituent, although, to be fair, in her case key questions were not asked.
It is obvious that notification of a reduction in benefits to genuinely severely disabled people, such as my constituent, and especially to the more vulnerable and frail, must cause the most terrible distress. I regret that the chief executive of the Benefits Agency did not apologise in his letter to me, but tried to discredit my constituent's recollection of the visit. I have sought an apology from him. I have asked the ombudsman to accept the comparison of the questionnaire completed by the visiting officer with the one completed by my constituent as sufficient evidence to proceed with an investigation of her complaint of maladministration.
Far from establishing fraud in cases of severely disabled people in which there is little scope for fraud, the benefit integrity project is an expensive exercise that is causing great distress to the most disabled in our society. There is a risk of tragic misjudgments being made about the level of benefits on which people rely to sustain a minimum quality of life. I have written to the Secretary of State to urge that the most severely disabled be excluded from the benefit integrity project. I share the Select Committee's concerns and agree with the recommendations about the benefit integrity project, but I am sorry that it has not recommended the same in the report that we are debating today.
§ Ms Patricia Hewitt (Leicester, West)
I endorse everything that my hon. Friend the Member for Croydon, North (Mr. Wicks) said in opening the debate on behalf of the Chairman of the Select Committee. I am grateful to the House for giving me the opportunity to participate 284 in this inquiry as a member of the Select Committee. From the inquiry and from the experience that constituents have shared with me, I have learnt far more about the operation of disability living allowance and other disability benefits in the past six months or so than I had dreamed of before becoming a Member of Parliament.
I want to stress the appalling and intolerable complexity of the disability living allowance and, more generally, of the support system for people with disabilities. Although each part of the system has no doubt been developed with the best of intentions, it is virtually impossible for people with disabilities, their advisers or the civil servants who try to operate it to make sense of the system.
One of my constituents, a woman called Lisa, was a nurse for many years. Some 16 years ago, after a severe bout of flu, she contracted myalgic encephalomyelitis. Since then, she has suffered from not only ME, but degeneration of the spine and severe depression. In May 1996, she applied for disability living allowance. Despite the evidence of her condition, which is recognised by the World Health Organisation, and the fact that various medical specialists attested to the merits of her case, she was refused the allowance. She appealed, and in January this year she was awarded DLA care component at the middle rate, which is one of about 15 possible outcomes under the current structure.
The award was backdated to 1996 when Lisa applied for DLA. At that time, it was the rule that people awarded the care component at the middle rate were automatically deemed to be 80 per cent. disabled. Once people were judged to be 80 per cent. disabled, if they had been unable to work for several months they qualified for severe disability allowance, which is a non-contributory benefit to compensate for the fact that a person cannot work. However, between her application and the appeal that awarded her the backdated DLA, the rules were changed. From April 1997—halfway through the history of her case—only people on the higher rate of DLA care component were judged to be 80 per cent. disabled.
Although Lisa's claim for DLA has been awarded and has been backdated to 1996—at which time she would have also been entitled to severe disability allowance—as she had to go through the appeal procedure she has been refused SDA as a result of the change of rules in 1997. That is just one example of the extraordinary complexities that are inherent in the system and have forced my constituent and many others to become expert not only in managing their own disability but in understanding this abstruse part of welfare rights law. With the help of a solicitor and welfare rights officers, my constituent is now pursuing an appeal on the other aspect of her case—the claim for severe disability allowance. I intend to write to the Minister about her case but, in general, I want to reinforce the Select Committee's recommendations for a dramatic simplification of the system.
Costs are inherent in any such simplification and some cases will not be precisely covered by such new rules. However, it is clear to all those who have examined the matter and have learnt from our constituents that simplification will bring immense benefits not only to those who are trying to administer the system but, above all, to people with disabilities who are the system's intended beneficiaries. I shall illustrate the need for simplification in the context of people with disabilities who are able to undertake employment. Our report recommends a much closer and more comprehensive 285 review not simply of DLA but of other cash benefits, services and equipment, all of which can assist disabled people to live independently and, in many cases, to work.
Last week, I was privileged to visit the centre for integrated living in my constituency where I heard from people, many of whom with severe disability, who were in work. They included a social worker who is completely wheelchair-bound and a welfare rights advocate, an organiser at the centre, who is completely blind. Those people are assisted not simply by DLA but by access to work grants. That is a fairly new benefit, but those people are struggling because the system is complex and it is often administered by staff who know much less about the adaptations that are available than the disabled people.
I have given the example of the blind man, whose name is Aslam. He knew when he applied for employment that he needed a laptop computer with a Braille keyboard and a voice synthesiser. That is expensive equipment, but it is one of the wonders of modern technology which enables him to do a full-time job. He applied for it in early June last year and a decision was finally made by the regional office of the Department for Education and Employment towards the end of October, and I think that the equipment was provided in December. His employer was willing and able to wait but many would not have been willing to wait for the access to work grant to come through that made it possible for Aslam to be employed.
The plea by those constituents of mine is for the Select Committee's recommendation to be acted on rapidly, and they ask that staff who implement the access to work grant be given the training and support that they need to ensure that the benefit's potential is fulfilled, as it must be if the new deal for people with disabilities, which every hon. Member warmly welcomes, is to succeed.
I plead not simply for all our recommendations to be implemented but for a simplification of the system so that disabled people know the purpose of disability living allowance and of the overall system of benefits, services and adaptations in equipment. I also ask for a simplification of the gateway to those various forms of support that will provide disabled people with opportunities for independent living when possible and with security of income and of services on which, above all, they depend.
§ 10.4 am
§ Mr. Mark Oaten (Winchester)
I attended the Select Committee meeting at which evidence on the introduction of the benefit integrity project was heard and, as it unfolded, I could hardly believe what I was hearing. The clear message was that none of the misery that has been caused by the project was necessary in the first place. Disabled people should never have been subjected to it. It is utterly frustrating for those of us who have constantly argued against the system to discover from the Select Committee report that BIP was an illegitimate creation with no political warrant.
In introducing the Select Committee report, the hon. Member for Croydon, North (Mr. Wicks) said that no consultation took place with disability groups about BIP. However, worse was to follow. It is bad enough not to consult such groups, but, from the evidence, it transpired that incoming Ministers did not get a look-in either. It is 286 outrageous that a controversial scheme that has had an impact on so many of our constituents should have been launched in that way in the middle of a general election campaign and without the incoming Government's approval. The Select Committee report rightly sets out recommendations to ensure that that scenario never occurs again.
Four questions need to be answered. First, I have always assumed that, in advance of a general election, shadow Ministers had some sort of contact with civil servants to discuss plans and the timing of legislation that remained on the books. The evidence to the Select Committee makes it quite clear that, immediately after the election, no new Government figures were informed on such matters. Perhaps the Minister will confirm in his winding-up speech that there had been no discussion on the timing and details of BIP with the shadow Cabinet before the election.
Secondly, when a Labour Minister finally became aware of BIP during the now infamous telephone call to Preston railway station, why did the Government not act? Why did they not halt the project immediately they became aware of its timing and undertake an investigation into the reasons for BIP and, in particular, carry out a detailed examination of the way in which it would be executed? That would have enabled them to make a clear judgment on whether it was a project that they were prepared to inherit and for which they would take responsibility.
Thirdly, did the Secretary of State for Social Security consider cancelling the project when the matter was ultimately drawn to her attention? As the project has not been cancelled, the fourth question is: why did the Government decide to proceed with BIP? I hope that the Minister will answer those questions. It is clear that the Department's civil servants made a serious error in introducing the project when they did. Is it not also true that the Government were at fault for failing to call off the project at the earliest available opportunity? Since the crucial period for that opportunity, towards the end of May, there have been many opportunities to abandon BIP.
The Government have had plenty of evidence to suggest that BIP is not working. We have heard stories of poorly trained staff carrying out bad assessments and of incorrect targeting leading to groups of people who should have been excluded from the project being placed under BIP. There has been a threat about Motability vehicles to those who chose to appeal against decisions and, of course, the long and arduous appeals process is full of inconsistencies. There is plenty of evidence to suggest that the project should have been abandoned.
The Select Committee report is excellent, but the catalogue of incompetence in the process is likely to bring despair to disabled people. However, the positive recommendations in the report at least provide a constructive way forward on DLA. The acid test is whether the Government will now choose to follow up the recommendations of the report quickly. I hope that the Minister will tell the House that the Government endorse many of the Select Committee's ideas, but they need to go further than that. Having had a chance to read the report, I believe that disabled people deserve an apology from the Government for the fact that the whole mess was allowed to happen in the first place. Again, I hope that the Minister will make that clear today. 287 There is one key area in which I disagree with the Select Committee's recommendations. The hon. Member for Croydon, North said that the Committee was prepared to place BIP on probation for six months, but surely we have had enough black-and-white evidence by now. We have talked about probation periods and reviews, but none of that will work. The project should be scrapped and we should move on to a different system for reviewing DLA. How can we resurrect a system that was implemented without proper political scrutiny? How can something as discredited as BIP begin to regain the confidence of those being assessed? How can something that failed to tackle the problems in the first place be worth propping up for a further six months?
We should look to the future and not start from the perspective that benefit is paid to too many people, as both the previous Conservative Government and the Labour Government appear to believe. The critical question should be framed in terms of how those who are not claiming DLA to which they may be entitled can be brought into the system. All the evidence suggests that take-up is low among those who are in most severe need of the benefit. We can put in place parallel measures to help people to move away from benefits wherever possible, but the fact that a large number of disabled people need DLA should not be disputed.
We should introduce a new system of reviewing benefits and set up a disability home visit programme. That should be established with the aim of carrying out a proper assessment of people's needs, rather than of reducing Government benefit spending. Such a programme should be targeted at those who are not currently claiming and those who should be claiming at the higher level of the severity scale. It should involve careful and well-thought-out visits from staff who have been properly trained to assess uptake of benefits, to identify where equipment could help, to talk through disability rights issues and to help individuals with a whole package of appropriate benefits.
Disabled people want that sort of exciting development, which exemplifies the standards that we expect to govern the new Government's policy and to be upheld in the civil service. The Conservatives cannot afford to be sanctimonious—after all, B1P was their idea—but, equally, the Labour Government can take no comfort. What started out as a lack of information and an error by civil servants has now become a lack of constructive Government action to remedy or to replace the project. Today provides the Government with another opportunity to take decisive action and I hope that the Minister will not disappoint when he winds up the debate.
§ Mr. Deputy Speaker (Sir Alan Haselhurst)
Order. To enable everyone who is desirous of catching my eye to do so, short speeches would be helpful.
§ Mrs. Joan Humble (Blackpool, North and Fleetwood)
I am not a member of the Select Committee on Social Security, so I read the report with great interest. It is an excellent and detailed report, which reflects many of my constituents' concerns. As other hon. Members have said, we all get complaints from people who have been made 288 desperately anxious that their DLA may be taken away or reduced. After Christmas, my advice surgeries were full of people who had received their complicated forms just before Christmas—what sort of present was that? They did not understand why their benefit was reviewed, especially those who had originally been told that their benefit was for life. Apparently, a benefit is not for life if BIP comes along and a decision is made to review that benefit. There was great concern, some of which was unnecessary.
I was pleased by the measures taken by the Government earlier this year to address some of the worst aspects of the benefit integrity project, but, as the report makes clear, there are still aspects that cause serious concern. Underpinning the whole report is a lack of understanding of why DLA is paid: many of those who come to my surgeries see DLA not as a benefit to help meet their care needs, but as compensation for their disability. They do not understand that, although their disability or illness has not changed, their care needs might have changed and the benefit might need to be reviewed. We need to clear up that basic confusion.
Part of the confusion surrounds the lack of medical evidence used when assessing DLA, which is currently based on self-assessment. The report, rightly, asks whether DLA should be based entirely on self-assessment, or on a medical model, or on a mixture of both. My constituents' main complaint is that, as adjudication officers are not medically trained and do not understand the nature of my constituents' disabilities, how dare they say that my constituents no longer need the higher-rate component or the middle-rate component?
The DLA headquarters are located in my constituency, so thought that I had better go along and talk to the staff who administer the system, instead of continuing to send them letters as I have done since being elected. I have visited Warbreck house three times; my third visit was fascinating, because I discussed in detail with adjudication officers how and why they arrived at their decisions. I assure hon. Members that adjudication officers are not monsters, but people who operate the system that we set up. We have a responsibility to them to make sure that the system is one that they can efficiently and effectively administer, which is what they want to be able to do. Those who work in delivering DLA care about the people to whom they speak on the phone and about whom they read; they get to know those individuals and want to support and help them. Our responsibility is to look carefully at the report, to ensure that the Government pay attention to the serious failings it identifies and to translate that into a more efficient management system for benefits for people with disabilities.
The issue of self-assessment and the role of medical evidence are important, because those hard-working adjudication officers who are my constituents have to make extremely difficult decisions. On the one hand, they read an individual's own description of his or her condition, but, on the other, that description might not illustrate the level of care needed to support the individual's life style. Adjudication officers base 289 decisions on the paper evidence before them, but that evidence is not always sufficient. Therefore, I welcome the report's recommendation that there needs to beA better balance between corroborative evidence, objective functional criteria and the claimant's self-perception".Like many disability organisations, I would not be entirely happy with a change to a fully medical model, but we need to redress the balance.
The report also recommends that we should set up across-departmental working group … to examine … assessments and service provision for disabled people across health, community care, Independent Living Fund and local authority direct payments".Many people with disability are bewildered by the wide array of Departments and services and by the number of doors on which they have to knock to get the support that they need to be active members of our community. Some local authorities that have introduced charging policies for social services take into account the whole of DLA; some take into account only part of DLA; some do not take it into account at all; and some local authorities do not charge for social services. Some local authorities have introduced direct payment systems and others have not. Disabled people are expected to make their way through this minefield, of which DLA is just one part. One of the important issues highlighted by the report is that, as my hon. Friend the Member for Leicester, West (Ms Hewitt) said, disabled people need a simple system that they understand, and a system that can be properly administered.
We need a disability benefit system that reflects the proper status of people with disabilities. I hope that the Government will consider in detail the report's many recommendations and will respond positively.
§ Mrs. Theresa May (Maidenhead)
I am grateful for the opportunity to contribute briefly to this important debate. I welcome the fact that the Select Committee on Social Security undertook its review and produced a thoughtful report on the disability living allowance. I am a former joint chairman of the all-party disablement group, and I think that the group can take some credit for having at least triggered the idea that it was important that DLA be examined. I think that it was the representations made by Lord Ashley that led the Committee to do so.
As the hon. Member for Croydon, North (Mr. Wicks) said, the investigation was carried out against a background of considerable concern among people with disabilities and disability organisations about the threats that appeared to be hanging over disability benefits under this Government at the turn of the year and in the early months of this year, and against a background of growing concern about the way in which the benefit integrity project was operating.
We have heard some telling comments this morning, especially from my hon. Friend the Member for Bournemouth, East (Mr. Atkinson). He spoke of his constituent who gave evidence to the Select Committee about the hardship caused by the way in which BIP has been operating. The project has caused real distress because people are concerned about the threat of cuts to disability benefits under this Government. Concerns remain. Although some were dealt with by the 290 Government in their welfare reform Green Paper, they failed to address certain aspects of the problem, and people are still worried about the threat that hangs over DLA.
I shall focus on certain details in the report. I am worried that BIP continues to operate regardless of the evidence of the very real hardship that it is causing. I was disappointed that the Select Committee chose to give six months' probation to BIP and did not call for its suspension pending a full review, something for which disability organisations have been calling for some months.
I hope that the Minister will be prepared to reconsider. He has always set his face against a suspension of the project, but I hope that he will today say that he is prepared to suspend its operation pending a full review. The project has operated under this Government and they have had several opportunities to suspend it. They have considerable evidence of the damage, anxiety and distress that it is causing to people whose benefits have been cut or taken away quite erroneously, as in the example cited by my hon. Friend the Member for Bournemouth, East. I hope that the Minister will go further than the Select Committee report and say that the Government are prepared to suspend and review BIP.
The Select Committee considered how assessments were carried out for DLA. I will not say that the Select Committee appeared to dismiss self-assessment, because it agreed that such assessment should continue, but there is some concern about its references to the possibility of adapting an all-work test to some sort of all-living test. There is great anxiety about the way in which the all-work test operates, and questions remain about it in the case of incapacity benefit. Scope has already said that it is worried that such a test could be adapted as an assessment for DLA. I would caution against moving too quickly down that path. Self-assessment is important because it is the people with disabilities who know best what their needs are. It is important that self-assessment continues to be a key aspect of any assessment for DLA.
Taxation is another source of anxiety hanging over DLA. In her evidence to the Select Committee, Baroness Hollis said:Means testing has been ruled out … Taxation has not been ruled out".That worries many people with disabilities because of what DLA was intended to be. It was intended to cover the costs that people incurred because of their disabilities. It is about empowering people with disabilities. The Government should not lose sight of the concept of empowerment when considering any changes to DLA.
I shall read out two quotations which clearly show what DLA is really about. One comes from evidence to the Select Committee given by Richard Wood on behalf of the British Council of Disabled People. He said:It is paid to give disabled people dignity, to allow us to live independently in the community, to allow us to be independent of other people, to make our own choices about how we choose to buy our care in, whom we would wish to pay to do that. which goods and services we need to be able to purchase to support that independence.
The second is from Scope, which said:The current system is consistent with the Government's commitment, as expressed in the Welfare Reform Green Paper, that disabled people should be enabled to live fulfilling lives, 291 with dignity. This commitment can only he achieved if disabled people own and control how their needs are met, rather than having them judged by other people who cannot have the same insight into the effects of their impairment on their daily life.DLA is about empowering the individual. It is a recognition of the fact that it is people with disabilities who best know their own needs and how they should be met. Those two key principles underpin DLA. I should have liked a little more recognition of that in the Select Committee report and its recommendations. However, it is an important report which raises several key issues about the operation of DLA and BIP. I look forward to what I hope will he a constructive and positive response from the Minister. This is the second Adjournment debate to refer to the problems of BIP, and I hope that the Minister's reaction will he more positive this time.
§ Mr. Paul Goggins (Wythenshawe and Sale, East)
I am a member of the Select Committee on Social Security, and I found the inquiry extremely important and timely in that it provided a focus for the widespread concern that is felt about the benefit integrity project.
Clearly, the inquiry was too short to be able to make detailed recommendations about the disability living allowance as a whole, but the Committee heard enough evidence to suggest that the Government should undertake an urgent review of all its aspects. That review should take account of several points made in the Committee's report and in this morning's debate. My hon. Friend the Member for Leicester, West (Ms Hewitt) spoke about the need for simplification of the benefits for disabled people. Consideration should be given to the role of self-assessment, which is desirable in itself, but no doubt leads to the benefit becoming unstable. There is also considerable evidence, which Ministers should consider, that many severely disabled people are not getting the level of help that they require.
I shall refer to three aspects of BIP which still concern me greatly. The first is the relationship between costs and savings. It was estimated that in years one and two of BIP, the costs would be £23 million and the savings, now revised down, would be £45 million. Therefore, for every LI spent, £2 would be saved. However, the estimated figures for the first year are that £11.5 million will be spent, and that a mere million will be saved. So, for every £2 spent, less than £1 would be saved. Such a financial result may strike hon. Members as hardly worth the effort of attaining it. When the result is set against the fear and upset that the benefit integrity project has undoubtedly caused, it becomes extremely difficult to justify. I think that all Committee members were struck by the evidence given by disabled people who had been disallowed their benefits.
Secondly, I am concerned about the issue of incorrectness and allegations of fraud in claims for disability living allowance. The hon. Member for Bournemouth, East (Mr. Atkinson) mentioned the Department of Social Security benefit review—on which the benefit integrity project was based—which alleged that there was 27 per cent. incorrectness, nearly half of which was attributable to fraud. It alleged that, every year, there was almost half a billion pounds of fraud in disability living allowance claims.
The implication or undercurrent of the DSS benefit review is that many disabled people are fraudsters, which I reject. Moreover, the evidence being produced by the 292 benefit integrity project shows that such a conclusion is wrong, and that, although there is about 21 per cent. incorrectness, there is almost no fraud in DLA—which is a salutary reminder to Ministers and all other hon. Members that we have to be extremely cautious when making claims about levels of benefit fraud.
I am concerned, thirdly, about the issue of reviews and appeals. If people dispute decisions made under the benefit integrity project, they can ask for a review. Subsequently, if necessary, they can seek an appeal. The Committee's report contains the review figures for January 1998, which show that one quarter of all reviews resulted in an increased award. However, the latest figures, for April 1998—which are in the Library—show that a third of all reviewed cases received a benefit increase. Moreover, two thirds of the 61 appeals that were completed in April resulted in the restoration of or an increase in benefit. The results are a very worrying indication that the quality of the original BIP decision was extremely poor. The report makes it clear that the Committee expects there to be major improvements in the project.
Many hon. Members have asked in this debate whether BIP should have been suspended. Like my Committee colleagues, I gave serious consideration to the question, but two factors prevented me from going along with a suspension. First, the Secretary of State took action in tightening the BIP guidelines. The most severely disabled people were exempted from the project, and objective corroboration is now necessary before benefits are withdrawn. Secondly, there is no denying that Ministers have made sterling efforts in gaining the confidence of disabled people and their organisations, and in making progress on these issues.
I therefore concluded that BIP should have six months' probation, and I certainly hope, and expect, that further progress will be made in the project. Nevertheless, I have no doubt that, in the long run, the Government must consider a major overhaul of disability living allowance.
§ Miss Julie Kirkbride (Bromsgrove)
I shall speak only briefly, as I know that the Minister and the shadow Minister wish to speak. I should like to pay tribute to my colleague on the Select Committee on Social Security, the hon. Member for Croydon, North (Mr. Wicks), for his excellent precis of our recommendations. I should like equally to pay tribute to my hon. Friend the Member for Bournemouth, East (Mr. Atkinson), whose constituent I well remember appearing before the Select Committee. It was quite inconceivable that her benefit should have been removed in such a fashion. I felt that she was very dignified, but certainly in need of state support, of which she was being deprived. I hope that those matters will be resolved very shortly.
I thought that the Select Committee's report was useful, as it highlighted the reasons for the need for reform of disability living allowance, albeit it did not give many suggestions on what that reform should include. I think that the resolution of two matters—one of which has been mentioned in this debate—would be helpful in reforming DLA. I should like to pay tribute to the hon. Member for Leicester, West (Ms Hewitt), who kept mentioning in Committee the first of the matters—which is that DLA forms are not helpful to people with blindness or other sensory disabilities. It would be very helpful if such people were considered when the forms are produced.
293 The second matter, which hon. Members have mentioned in this debate, is medical assessment and the current self-assessment system. I think that, at the very least, we shall have to require the use of much more medical corroboration in deciding the cases of people seeking disability living allowance. If we were to do so, provision of DLA would gain much more public support.
The Select Committee has clearly identified the fact that the system operates very much in an ad hoc manner in determining who receives DLA and at what rate they receive it, which cannot encourage public support for the benefit, or give confidence to those who need the benefit that they will receive the amount to which they are entitled. The hon. Member for Croydon, North explained how such a situation has arisen, and also said that introduction of DLA was a great achievement of the previous Government.
The DLA programme has grown over time and been subject to changes by the courts. It is now very unclear who should be eligible to receive the benefit and how much they should receive. I very much hope that the Government properly review the benefit and make changes that will reassure everyone that it operates in a manner that hon. Members can justify, and perhaps even explain, to our constituents.
I should like to mention one other matter dealt with in our report, and mentioned in this debate by my hon. Friend the Member for Maidenhead (Mrs. May), on which I should be grateful for the Minister's comments—the spectre of taxation of disability allowance. Conservative Members would very much object to choosing such an option which, although it was mentioned in the context of a review, is in the report.
The Select Committee was told by many disability organisations that they would consider such taxation to be extremely unfair, and that the purpose of disability living allowance is not to redistribute income, but to enable people to live full lives, despite their disabilities, and to pay for the things that they require to tackle their disabilities, so that they can live their lives as best they can. Conservative Members would vehemently oppose any proposal by the Government to tax DLA.
I should be very grateful if the Minister would put the taxation issue to rest once and for all, as it—like the benefit integrity project, and other issues raised by the Government on the future of DLA—is mentioned very frequently in my postbag. I should be very grateful if, in future, I could write that the Minister has firmly ruled out taxation of disability living allowance, either now or in the future.
§ Mr. Chris Pond (Gravesham)
I shall speak very briefly, because I know that we have to leave time for Front Benchers to speak. I know also that my fellow Labour members of the Select Committee would like to add to the tribute paid by the hon. Member for Maidenhead (Mrs. May) to Lord Ashley, who has worked in both Houses on disability issues and on stimulating our inquiry.
Our inquiry has shown that there are considerable difficulties with the current operation of disability living allowance, and particularly with how the benefit integrity 294 project sought to address some of those difficulties. It is very clear that there were difficulties in some of the DLA assessments, many of which appeared to be arbitrary. Lack of take-up of the benefit also demonstrates that it is not working well. I think that all hon. Members involved in the debate have been clear about the fact that the BIP project—as initially conceived, or misconceived—made matters considerably worse.
At its conception, I described BIP as something of a Whitehall farce—which would have been comic had the project not caused such severe anxiety and hardship to so many people. I know, after talking to people with disabilities in my constituency, that the project itself was such a cause of anxiety that it could well have made their condition worse. That is why the Select Committee seriously considered calling for the suspension of BIP. However, we decided to call for BIP to be put on probation rather than suspended to see how the changes implemented by the Government were working.
A review of DLA, which is much to be welcomed, should focus on claims made in the early years of the introduction of the benefit, when there was real chaos in the way in which it was being administered and officials were clearly uncertain as to its implementation. The review should also look at the issue of life claims, which is something of a misnomer because many claims issued supposedly on a lifetime basis have to be reviewed as a result of changing circumstances.
I welcome an overall review of DLA. We need to consider seriously whether or not BIP should be suspended, and I know that the Minister will be examining that, subject to the probation that we have suggested. It is also important that we make a clear distinction between what has happened under BIP and DLA and the Government's overall approach to welfare reform, which is not about cuts in benefit to severely disabled people, but about seeking to ensure that people who have to depend on benefit have a level of income that provides them with dignity and independence, while encouraging as many as possible to work.
§ Mr. Simon Burns (West Chelmsford)
First, I congratulate the Select Committee on its report on DLA and BIP as both issues have been of great concern and of a sensitive nature to the country for the past year or so. The problem arose because the Government caused people with disabilities a great deal of anxiety and fear over the future of DLA. The sole reason for that was their shoddy and piecemeal approach to reforming social security. The lack of a clear policy direction is far more damaging than having no policy at all. The rumours, the leaks, the counter-rumours and the counter-leaks with which we have all become so familiar might be the ideal way for the Government to carry out their market research and gauge public opinion, but they have to realise that such actions affect real people, and in this case they have had a serious effect.
As Margaret Pedlar of the mental health charity MIND said:I cannot stress too strongly the anxiety that was caused earlier in the year by rumours over means-testing or taxation of Disability Living Allowance or its replacement by services. Nor should the importance of this benefit to people's lives be underestimated.295 The Government have singularly failed to recognise the sensitivity of the subject and even now, after more than a year, there remains uncertainty as to whether or not DLA should be taxed.
The problem began last November when there was a press report that the Government were considering the taxation of DLA. The leak was neither confirmed nor denied by the Government, leaving thousands of people with disabilities unsure as to the future of their benefits. Yet rather than making their position absolutely clear, which would have prevented a great deal of the heartache, confusion and sheer panic, the Government greatly added to the uncertainty by letting it be known that they were considering cuts not only to DLA, but to the whole range of disability benefits. It was made quite clear in the report by Channel 4 in mid-December that the Government were planning wide-ranging cuts in disability benefits. Again, the Government did nothing to dispel the fears of people with disabilities for the future of their benefits. Even when the Opposition pressed them on many occasions on whether DLA would be means-tested or taxed, Ministers did nothing to clarify the position.
People with disabilities had to wait until late March this year, with the publication of the long-awaited Green Paper on welfare reform, finally to receive the assurance from the Government that DLA would not be means-tested. The question must, therefore, be asked about why the Government waited four months from the initial rumours about means-testing before ruling it out. If it was never their intention to means-test DLA, they could have ruled it out at the time and saved many people much anxiety, but the uncertainty that pervades Government policy in these matters continues.
The Government still have not made up their mind about whether DLA ought to be taxed. Only a few weeks ago, we heard from the Minister for Welfare Reform on the Dimbleby programme that the taxation of DLA was one of the options being considered. He said:I can't give you the answers yet—because we are having a general consultation about it.It seems that the uncertainty will continue until the Government finally make up their mind, but it is still causing concern to many people.
The Select Committee report makes the strong recommendation that taxation of DLA should be considered only in the context of a full review of the purposes and the level of the benefit. It is worth raising here the important argument that disability benefits, of which DLA is one of the most important, serve the purpose of levelling the playing field to some extent. It is essential that any proposals to tax DLA do not erode that fundamental principle which underlies disability benefit. However, it seems that so far, the Government have done all they can to ensure that the concern and worry continue, and that is nothing compared with the damage caused by their operation of the benefit integrity project, which has quite rightly featured so significantly in our debate today and in the Select Committee report.
The detailed Select Committee report offers a full and dramatic account of how the lack of communication between incoming Ministers and the Department of Social Security resulted in the shambles that has marked the project so far. We have the extraordinary circumstance, unearthed by the Select Committee, of the Minister concerned only discovering the existence of the project 296 on 29 May during a telephone conversation from Preston railway station. It seems extraordinary that, for 23 days after taking office, Ministers were completely oblivious to a fundamental policy that was being implemented by their Department, which already had a significant impact on the lives of so many people.
§ Mr. Burns
No. I am very short of time.
I should like the Minister to explain something to the House, as I cannot see it anywhere in the report and I am puzzled. Certainly under the previous Government, whenever there was a Government reshuffle—and I suspect that it was also the case on 4 May 1979 when new Ministers were first appointed—Ministers were issued by their civil servants with significant briefing material on every policy for which they had direct responsibility and on the overall policies being pursued by the Department. Were Ministers at the Department of Social Security—on or shortly after 6 May—issued with detailed briefings of their ministerial responsibilities and the policies that the civil service anticipated that the incoming new Government would pursue? If they were, did the benefit integrity project in any shape or form feature in that briefing? If the answer to either of those questions is yes, how did it escape the notice of Ministers—particularly the Minister directly concerned with the policy—until 29 May? If the answer to the question is that there was no reference to the project in any briefing to new Ministers, what action have Ministers taken to reprimand civil servants who made such a significant failing, and what confidence do they have that other policies being hatched in the Department will not be enacted in a similar way, oblivious of ministerial knowledge or control? I would appreciate an answer from the Minister.
Like several hon. Members who spoke in the debate, I am perplexed and disappointed that the report has simply put BIP on probation until the end of July. In an earlier debate two or three months ago, we called on the Government to suspend the project—notwithstanding the actions taken by the Secretary of State in February to seek to improve its immediate impact—so that it could be overhauled and reviewed thoroughly without causing harm to those individuals most directly affected. We urged the Government to get it right once and for all, rather than continuing to try to sort it out piecemeal. The Select Committee has put BIP on probation until the end of July. As we shall presumably go into recess in July, when will the Select Committee study and reconsider what has occurred during that probationary period? Will nothing be done for another three or four months? If so, we shall face an on-going problem.
Time is short and I do not wish to eat into the Minister's time. We are concerned about the way in which DLA has been handled, and the report has picked up on those concerns. We are also gravely concerned about BIP and its introduction, which the report has picked up on starkly. I hope that the Minister will respond to the genuine concerns expressed by all hon. Members who have raised the issue, particularly the question of the briefing of new Ministers when Labour came to power in early May last year.
§ The Parliamentary Under-Secretary of State for Social Security (Mr. John Denham)
I thank the Social Security Select Committee and my hon. Friend the Member for Croydon, North (Mr. Wicks), who introduced the debate in the absence of the Committee Chairman, the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood). We hope that he will be better soon.
The Committee's fourth report on disability living allowance is both interesting and useful. It is a substantial report which makes many detailed, and in some cases far-reaching, recommendations—all of which are being studied carefully. Many of the issues are being addressed, and I understand why the House has sought an early opportunity to discuss the report. However, it is important that the Government consider all the issues carefully, so I shall not respond fully to the report today. We shall make a formal written response within the usual time scales that apply to replies to Select Committee reports. We intend to respond by the end of July, as requested by the Committee and my hon. Friend the Member for Croydon, North,
The Select Committee report will undoubtedly feed into the debate about disability living allowance. My hon. Friend outlined—as did several other hon. Members—the Select Committee's call for a review of disability living allowance. We set the ground rules for this debate in the welfare reform Green Paper. In that paper, we set out our firm commitment to the principle of providing special allowances to help with the extra costs of disability and maintaining DLA as a non-means-tested and national benefit for those who meet the entitlement conditions. I make it clear that taxation is a matter for my right hon. Friend the Chancellor of the Exchequer, but we have no current plans to tax DLA and there was no reference to that in the Green Paper.
§ Mr. Denham
I hope that the hon. Gentleman will forgive me, but I have only a limited time in which to respond to many hon. Members.
It is worth remembering the central role that DLA plays in the lives of disabled people. It has many positive aspects. It is paid to disabled people whether they are in or out of work. This year, we expect that about £5.5 billion of disability living allowance will go to help about 2 million disabled people. The Select Committee confirmed the importance of that help and those values. In considering DLA, we want to ensure that the many advantages of DLA as it stands at present are not lost in an effort to put right some of the faults.
However, as the Select Committee recognises, there is a question about whether some of those who receive DLA are entitled to it and whether others who are entitled to it are not getting the help that they need. In order to receive DLA, disabled people make a statement of their care and mobility needs, which is usually backed up by evidence from a general practitioner. Several hon. Members referred to medical evidence. In more than 40 per cent. of cases, there is either an independent medical examination or evidence from a GP.
The recent joint investigation of DLA by the DLA advisory board and the Department of Social Security suggested that there was insufficient evidence to support 298 the benefit claim in two thirds of cases. It also found that one third of the awards made for life—which constitutes two thirds of all awards—were made to people whose conditions might have been expected to improve. My hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) referred to life awards. That is the current term used in the legislation, but we accept that a life award does not mean an award for life. If people's conditions or needs change, their entitlement can be affected.
Many speakers, including my hon. Friends the Members for Croydon, North, for Leicester, West (Ms Hewitt) and for Blackpool, North and Fleetwood, expressed concern about the lack of clarity and robustness and the difficulty involved in understanding the criteria for current entitlement. That is why we gave an undertaking in the Green Paper to review the gateway to DLA and to set up a forum of representatives of groups of and for disabled people to help take it forward. We have now established the forum under the chairmanship of my noble Friend Baroness Hollis, and it is having its first meeting today. The forum's terms of reference are:To consider possible options for changes in the gateways to benefits for long-term sick and disabled people and carers, and how to ensure that help is directed to those who need it.A wide range of organisations are represented on the forum, and we take consultation seriously. I am sure that the Select Committee's report will feed usefully into the forum's discussions in the coming weeks.
I turn now to the benefit integrity project. There have clearly been problems with BIP, many of which the Select Committee has highlighted. However, the Select Committee also accepted the need for a mechanism to ensure that current DLA recipients receive their correct entitlement. After careful consideration, the Select Committee decided not to endorse the sorts of calls that we have heard today from some hon. Members to suspend the project. For our part, we believe that BIP is necessary, but we want to ensure that the project is conducted as sensitively as possible and that the right decisions are taken.
The hon. Member for Winchester (Mr. Oaten) asked why the decision was taken to proceed with the project when Ministers became aware of it. The Department of Social Security, backed by the National Audit Office, presented to Ministers evidence of fraud amounting to nearly £500 million and we acted immediately to improve the training available for staff. Due to the nature of the benefit, it has become clear that that estimate of fraud cannot be sustained, although the project has maintained that estimate of incorrectness.
I am not convinced—I do not think that the Select Committee was either—that it would have been right to be aware of a substantial level of incorrectness in a benefit and simply to choose to do nothing about it. It is clear that we must conduct the project sensitively and make every effort to ensure that we take the correct decisions. The fact that the benefit integrity project is necessary illustrates some of the problems surrounding DLA.
BIP is backed by standard assessment and adjudication rules—they have not been changed—and the responsibility for decision making rests with the same people who have always exercised that responsibility. The usual full rights of review and appeal apply to cases reviewed under the benefit integrity project, in the same way as to any other disability living allowance claim or review. Those rules ensure that decisions relating to benefit entitlement are objective and based on evidence. 299 We are already working on some of the issues raised by the Select Committee. We have kept the project under review since inheriting it, and we have made changes whenever they were considered necessary. One of the most welcome changes was announced by my right hon. Friend the Secretary of State on 9 February. From that date, no benefit has been reduced or taken away solely on the basis of evidence from the claimant—we shall always ensure that there is additional evidence. Disability organisations, the Select Committee and other hon. Members have called for that change to be extended to cases decided before 9 February. We are keen to explore that proposal.
I have already informed the House that we have been trying for some time to overcome the various legal and operational difficulties that such a change would present. The number of cases affected is not the major problem: the number of cases decided before 9 February without any additional evidence and where the claimant had not already asked for a review or appeal is estimated to be fewer than 2,000. However, the process must be handled very carefully.
For instance, re-examining very many cases will not necessarily lead to benefits being increased or restored. Indeed, there is always the possibility that benefit could be reduced further. Claimants need to be fully informed about the possible outcomes of any further review, but in a way that would not dissuade them from exercising the right to have their case re-examined.
Having described some of the issues that we have had to consider, I am pleased to be able to confirm that we shall be looking again at those pre-9 February cases which were decided without additional evidence and resulted in a reduction or removal of DLA, where the claimant did not seek a review of the decision. Exact details are still being worked out, but we shall move forward as quickly as possible, in keeping with a careful and sensitive approach. I am sure that the House will welcome the announcement.
We have made a series of further changes to the benefit integrity project. We have introduced regular meetings with representatives from organisations of and for disabled people. We have agreed that certain groups of DLA recipients will not be contacted directly as part of the project. There will be further consideration of other excluded groups at a meeting towards the end of the month, as the hon. Member for Bournemouth, East (Mr. Atkinson) suggested—