Welfare Reform Bill

Public Bill Committee, 10 May 2011.

Written evidence to be reported to the House

James Gray (Conservative, North Wiltshire)

I am sorry that I missed the Committee’s extended sitting on Tuesday, but I was with you in spirit. Last night, the House agreed an instruction to the Committee that it has the power to make provision to establish the social mobility and child poverty commission. The proposed remit of the commission would have been beyond the scope of the Bill, but the House’s instruction enables the Committee to consider such a provision.

Stephen Timms (Labour, East Ham)

On a point of order, Mr Gray. I welcome you back; we missed you during our extended sitting. Towards the end of the sitting on Tuesday morning, when you were in the Chair, I asked the Minister of State:

“Can the Minister tell the Committee what proportion of those who go into the work-related activity group he expects to be back in work within one year?”

He replied:

“At the moment, we do not have a specific answer to that”.––[Official Report, Welfare Reform Public Bill Committee, 3 May 2011; c. 651-2.]

It turns out that that reply was incorrect. The Minister’s Department had an answer to my question. We know that now because on the same day the Minister sent me a written parliamentary answer. I had asked:

“what estimate has been made of the proportion of contributory employment and support allowance recipients in the work-related activity group who will be affected by a one-year time limit”?

The reply was:

“It is estimated that in steady state, without time-limiting, around 77% of contributory ESA claimants in the Work Related Activity Group or Assessment Phase would have duration of 12 months or more.”—[Official Report, 3 May 2011; Vol. 527, c. 722W.]

I received that answer the morning after our debate, but it was sent to me on the day of the debate—3 May. We know that the Department had that figure at the time I asked my question in Committee. We can also safely assume, unless the—

James Gray (Conservative, North Wiltshire)

Order. I think we have the general drift of the point of order.

Chris Grayling (Conservative, Epsom and Ewell)

Further to that point of order, Mr Gray. I am delighted that the Department was able to respond so quickly to the right hon. Gentleman’s questions. I assure him that I will do everything I can, as will my colleagues, to make sure that he has information in as timely a way as is possible for the rest of the debate.

Stephen Timms (Labour, East Ham)

Further to that point of order, Mr Gray. I am grateful to the Minister for that assurance. I suggested that fewer than a quarter of people would be out of ESA and—

James Gray (Conservative, North Wiltshire)

Order. That is not a point of order for the Committee. The right hon. Gentleman knows that perfectly well. He has put the point on the record and the Minister has responded to it.

Clause 75

Margaret Curran (Labour, Glasgow East)

May I reiterate the comments of my right hon. Friend the Member for East Ham? We missed you very much on Tuesday afternoon, Mr Gray, and I am sure that you are deeply disappointed to have missed our extended sitting.

I am keen, as others will be, to participate in the stand part debate on clause 75. It marks a critical stage in our proceedings, with the introduction of the personal independence payment, which is a substantial part of the Government’s programme. The payment will replace disability living allowance, and payment rates are outlined in subsection (2) under the headings of daily living and mobility components. I therefore thought that it was important for the Committee to have the opportunity to discuss the handling, key principles and concerns behind part 4.

There has been much focus on this part of the Bill. Disability living allowance reform has attracted much attention and provoked much controversy. It has perhaps not made the political headlines on the scale of the Health and Social Care Bill, but thousands of people will take to the streets around Westminster for the rally tomorrow. That may well trigger a wider debate on the reform. These changes are causing enormous concern among disabled people and their families, as well as among wider disability organisations.

There have been many debates, questions and representations, and it is incumbent on us to address them. I am sure that we have all read reports this week that Jobcentre Plus staff have been sent guidelines on how to deal with claimant suicide threats. It is quite extraordinary that they have to tackle that. We cannot underestimate the strength of feeling out there among some of the most vulnerable people on these big changes to the welfare system. Their feelings and concerns must shape our debate today. I hope we keep that in mind as we go through the various amendments in part 4, which is substantial and important. It is important that we place that discussion in the right and proper context.

Fundamental concerns need to be addressed in the framework of clause 75, including the objectives and outcomes of the personal independence payments—I will refer to the personal independence payments as PIP. How have the Government gone about that fundamental change? What is the Government’s approach to including important representations made by disabled people themselves and by their representatives?

A great many people will be affected by the reform, with the latest estimate from Disability Alliance projecting the figure to be some 800,000. Perhaps the Government will, at an appropriate point in our deliberations, address that figure so that we may understand it. Who will be affected by the daily living component, by the mobility component, and by a combination thereof? Who will gain, and who will lose? What is the Government’s objective in introducing the reform?

There is no doubt, and it has been plainly stated, that there is a case for reform. The Opposition and I are clear about that. How we go about making that change is important, and its underpinning principles need to be clarified. We need to understand the drive behind the reform. If we get that right, we could move towards more effective and long-lasting reform.

As I understand it, part of the Government’s argument is that there is a problem with the increasing uptake of DLA, but the Government have failed to look at the reasons for that increasing uptake. Undoubtedly the Government have an argument to make, and I will listen to it constructively. Disability living allowance was introduced in a different time, well before the Equality Act 2006 and the Disability Discrimination Act 1995. There have been various health and social care measures, education Acts, and other new legislation that have shaped our understanding, and shaped the principles underpinning our understanding, of disability.

Before we embark on fundamental change, potentially to the detriment, it is alleged, of so many disabled people, it is reasonable to argue that we should look at the evidence, the facts, the context and the grounds on which reform is based. What factors have led to an increase in the uptake of DLA, which has led to the argument for change? It could be changing demography. People are living longer with longer-term conditions. We have a better understanding of existing conditions and a greater appreciation of new illnesses and new disabilities. Mental health issues are emerging much more frequently now than they did 20 years ago. Our understanding of conditions such as autism is much improved.

Reflecting on the legislation, the definition of disability is changing and social care services are evolving. How do those changes interact and grapple with benefits? How do different benefits interact? It is reasonable and legitimate for the Government to say, “We now need to take stock. We need to look at how all these benefits interrelate and how we pay for social care services.” How does all that factor into a grand narrative? That would have been a much better and more effective basis for reform.

The Government have yet to make that argument—we certainly have not heard it. We believe that reform of DLA is necessary. Such reform is the next logical step in welfare reform after the reform of incapacity benefit, in which my right hon. Friend the Member for East Ham played a significant role.

It is imperative that we learn the lessons from incapacity benefit reform and ensure that they are built into our current deliberations on DLA reform. Again, we are not at that stage yet. Particular lessons need to be learned from the work capability assessment, to which I do not doubt we will return when we discuss the details of the new assessment for PIP.

What could the principles of reform be? How do we introduce a proper system of entitlement and review? How do we avoid unnecessary and duplicate assessment processes, about which disabled people tell us they are deeply concerned? How do we gather evidence to make decisions on awards? That is critical to how we take the reform forward. How do we learn the lessons of the Harrington review, extrapolate them and apply them in a different context? That could have been the basis of reform. I would argue that, if one engages constructively with the disability organisations, many of them also see the need for reform. They will argue that DLA reform is necessary, but they would argue strongly that one should look at the evidence and the facts. That should be the basis of reform.

I am sorry to say that the Government’s approach, as illustrated in clause 75, has fallen far short of that method, and has alienated wider elements of the disability movement. That has sadly undermined the case for reform of DLA, and now many people have rolled back from that argument, because they are so terrified of the prospects.

Clause 75 is essentially the accumulation of a large consultation process entitled disability allowance reforms. I shall say a few words about that consultation. The period for it was cut short; it fell short of the 12-week recommendation for Government consultations, and the consultation period included the Christmas holiday and the new year break. Rushing such a fundamental reform is unforgivable. It was completely unnecessary to cut off a couple of weeks. It was particularly provocative to disabled people; anybody with engagement in the disability field will understand that. Those people need longer to go through standard consultation procedures, because they often need extra assessment and aids to go through the documents. Assistance is needed to submit recommendations and so on. I was particularly concerned about that. I know that the Minister has had his ears pinned back about that several times.

More significantly, the Government published the core of their welfare reform legislation while the consultation process was still under way. The process was not even closed when the Government said what they were going to do and what their proposals were. Of course, when the Government produced their response to the consultation, there were few changes from the original proposal, despite the fact that the Department acknowledged that it was one of the biggest responses to a Government consultation in recent years. We also know that a strong case for change was made during the consultation process, because many of the organisations published their consultation submissions. We know that many substantial questions were raised during that process. The fact that the Government produced their response—largely unchanged from their original proposals—before the consultation closed, was again provocative to disabled people. The Minister has had his ears pinned back about that, too.

That undermines the Government’s claim that they want to listen and work with disabled people. The organisations will tell hon. Members that they do not feel that they were listened to. I argue that there are some principles in the Bill that we want to engage with and look at. There are some big arguments, but it is not complete and there are big gaps. There are still fundamental questions to be asked, implications to be spelled out and the need to understand the impact on some of the most vulnerable members of the community before we go ahead. I am sure we will do so as we look at the amendments in detail.

We need to consider the underpinning issues. Some guiding principles are beginning to emerge in the Government’s approach, which we need to explore and extrapolate, to see how the argument goes. The Government are now clear that PIP will be available only to those with the greatest need. It is vital that we address the implications of that proposal for the current case load. We need to work out who will be the losers. Will the Minister spell out the underlying principles? For example, who currently gets DLA but will not get PIP? What kind of group are we looking at? The shift in prioritising PIP for those with the greatest needs raises fundamental questions about the Government’s overall approach to disability. It is of course an attractive argument in a time of scarce resources, but we always live in a time of scarce resources; that will always be the argument about welfare spending. There is never enough money to spend on welfare, so we are always trying to manage limited resources.

People will always say that of course such benefits should go to those with the greatest needs, but we will have to be clear about the implications of that. Does that mean that the Government intend to concentrate resources on those with the most severe disabilities? That term is used time and again in documents and papers, and the Under-Secretary of State for Work and Pensions, the hon. Member for Basingstoke (Maria Miller) has used the term again and again in her contributions and announcements, but it has caused concerns. Does it mean that there will be a hierarchy of disability? Where should the line be drawn in that hierarchy? How will “severest needs”, “severest disability” or “those in the greatest need” be defined?

What are the implications for people with autism, for example? Some people would say that those with the severest disabilities are essentially those with a physical disability, but most members of the Committee know that that is not adequate and that we need to move beyond that. Where does one draw the line? For example, one of the big questions that has emerged and is causing great concern is whether people with mild learning difficulties will essentially no longer receive financial support in recognition of the extra cost of their disability. We need to be honest and have that debate.

We need to look at the full implications of subsection (2). For example, how do we interpret the daily living component? How do we interpret mobility? Significant representations have been made about the Government’s proposals concerning aids and adaptations, because they seem to imply that if a person has some aids and adaptations that facilitate their daily living and mobility, perhaps they no longer need PIP or financial support. If that is the Government’s argument—it is a reasonable argument—let us debate it and look through the implications thoroughly. People will ask, as they have asked me, whether they will no longer be eligible if they have a wheelchair that helps them to get about.

What if someone has a guide dog? I know that the Department has given us some briefing on that, which we will discuss later, but there is still some ambiguity. Like it or not, many people who have severe visual impairments are deeply worried that they will lose their benefits because of the Government’s proposals about aids and adaptations. If someone has a carer, will they still get PIP? We need some clarity about what circumstances will be included, what criteria will be used, and who will be affected by this.

We know that even if some aids and adaptations are assessed as necessary—when an assessment has clearly been undertaken and it has been recognised that a person needs and should get an aid or an adaptation—they will not necessarily be provided. Sometimes a local authority has agreed a person’s eligibility but does not have the resources to allocate to the necessary aid or adaptation. We know that that is happening more and more with cutbacks in local government. If people are cut out of benefit and they still do not get their aid or adaptation, they are in a particularly serious position. What happens if they get their aid or adaptation and they are cut out of PIP, but their aids and adaptations are affected by cutbacks in local government? They might not get the ramps or the necessary adjustments in their house, for example. Would PIP be reinstated in such circumstances?

In conclusion, there are fundamental issues about the principles behind clause 75. During our debate on the Bill, we will advance a number of detailed amendments that reflect the broad concerns that I have highlighted. We have concerns of substance about this reform, such as the six-month wait and the end to automatic entitlement. In this clause stand part debate, we have to highlight that there are fundamental concerns about the speed and scale of this reform. There has been no pilot and there will be no proper tiered approach to the assessment, so many people feel that they will have to go through this process reasonably quickly and are unsure of the outcome. Overall, the principle of reform is one for which support could and should have been garnered. It is an opportunity that the Government have lost.

There is a need to modernise benefits, and I would always support that. We need to address the current gateway, but I strongly argue that we could have mobilised and galvanised more support if we had taken an evidence-based approach, paced the reform properly, and worked alongside disabled people and disability organisations. The basis of the reforms should have been consulted on properly, and the gaps in the existing legislation could have been addressed. Sadly, I do not think that the legislation in front of us today is full and proper.

Sheila Gilmore (Labour, Edinburgh East)

One of our concerns about the introduction of PIP is that the background to it seems to be legislation by assertion, rather than by evidence. A number of assertions have been made, and I am interested to hear the Minister’s response about what the basis of the evidence for those assertions is and what further research would hopefully be ongoing to back them up.

For example, it is frequently stated that—it was said in the consultation paper and it was repeated in the response to the consultation—DLA is out of date, that it needs to be modernised, and that things have changed since 1992. However, 1992 is not 1892, or even 1952. It is not so very long ago, and it is not clear in what way things are so different from 1992 that we need a fundamental overhaul of the system—not just an updating of parts of it or a modification of it. There is the idea that it all has to be thrown up in the air already, and I did not see anything in the consultation paper that ever really supported that. It was an assertion without evidence.

Clearly, people are concerned about the increased numbers of claimants and, therefore, about increased expenditure, but are we probing the reasons for those developments properly? We need to understand why those changes are happening, because a number of things can happen. First, people may lose benefit who need it, because there is an underlying assumption that if the numbers have gone up, it is not justified, and that in some way, people are getting benefit who do not need it. That comes through several times, certainly in the wording of the consultation. Secondly, if we have not probed why claims and expenditure are increasing, we might find that the same thing happens again with the new benefit, because there is actually a real need out there.

A number of things have happened, even in recent years, and they are still happening. There has been the de-institutionalisation of many people with disabilities. In my city, and I am sure in many other areas, for some 20 years, a programme of closing down large institutions and enabling people to live in the community has been ongoing. That has many advantages for individuals, and I think that we all accept that. In the bad old days, people, whether they had mental health problems or physical health problems, would be sent to the equivalent of Gogarburn in Edinburgh and would spend the rest of their lives, more or less, in that hospital setting. That was not good for them, or for society.

Although the term was always used in a rather negative fashion, the “reprovisioning” of such places—moving people into the community and enabling them to live independent lives—has depended in part on such things as DLA. If that financial support had not been available, it would have been far more difficult to set that up. It is not the only thing that has helped; many people have a whole spectrum of practical support that comes from the local authority, although that has a cost, too. However, the financial support from such measures as DLA has been very important in enabling people to live independent lives and to help them pay for the costs of doing that. That is just one aspect of why there may be more claimants now than there were at a time when people lived very differently. That was a cost, of course, to a different budget—the health budget. When people were institutionalised in that way, it was an NHS provision, so we have shifted that cost, but we need to understand why that has happened.

I stood down from my council in 2007, but in the years before that, we were becoming increasingly concerned about the number of young people who were entering adult life with disabilities. That was because of huge advances in medicine, predominantly. Increasingly, children who would not have lived out of infancy were living. There are conditions that used to be seen as so life shortening that children would be unlikely to live into adulthood, but they are now able to do so. That means that there are individuals who need considerable support to lead independent lives. That is another, growing, group that did not really exist before. That concerned us as a council because it presented a cost which previously we did not face. It was seen as a major pressure on our council budgets and we expect that pressure to continue into the future.

Additionally, people are living longer in both adulthood and into older age. Some people with DLA will continue to receive it, even after they reach the end of their normal working lives. People are able to live longer, but longer life is not always healthier life and gives rise to issues about people’s health and disability needs. Those are the challenges we face. It would, therefore, be useful to be clear about the reasons for increases in expenditure and factor in such increases and new and increased real demands. That is not necessarily to allow a budget to overrun or to let people who do not deserve it make claims. Throughout this process, upon first reading the consultation paper, I have had concerns, which my hon. Friend the Member for Glasgow East has referred to, about the increase in concentration on—

James Gray (Conservative, North Wiltshire)

Order. I have allowed a fairly general Second Reading-type debate, this being the first debate in part 4. Nevertheless, we are discussing clause 75 stand part. I wonder if the hon. Lady might come back slightly to the particular points. After all, there will be plenty of other opportunities in the remaining clauses in the part to discuss other matters. Perhaps she could focus her attention entirely on the issues in clause 75.

Sheila Gilmore (Labour, Edinburgh East)

Thank you, Mr Gray. I would conclude by saying that, although the benefit will be called a new name and is put forward as a substantial change in clause 75, it is clear that in some respects there is not a great deal of difference. That poses the question of why the whole matter needs to thrown up in the air and reviewed. Daily living component and ability component are not very different from DLA. It remains to be seen, as we have discussed in the remainder of the clauses, how far they really are different and will make a substantial difference, and whether the entire reform, in the way it has happened, is justified.

Kate Green (Labour, Stretford and Urmston)

Nobody would suggest that the existing disability living allowance benefit is perfect, but it is absolutely vital for many disabled people in terms of their quality of life and their ability to participate fully. In seeking to make changes, we must not underestimate its importance and the need to protect its achievements for disabled people. Therefore, I support the concerns my hon. Friends have raised this morning about understanding the Government’s purpose in introducing the changes. I welcome the clarity in clause 75 that DLA continues to be replaced by a benefit in PIP that is to meet daily living and mobility needs, but we are entering into unknown territory.

Will the Under-Secretary of State for Work and Pensions, the hon. Member for Basingstoke, address specifically a few issues about the philosophy and purpose of PIP and offer reassurances, as I hope she can, to disabled people today? We need to be clear that this is a benefit that will continue to be provided to disabled people as a proxy for meeting the extra costs that they face in living with their disabilities and to enable them to fully participate in society as those of us who do not to experience disabilities are able to do. I would like absolute clarity from the Minister that it remains the philosophy of the Government, in introducing PIP, that this is a participation benefit and no other sort of benefit and that it is on that basis that the changes are being introduced.

I say that in the context of the recent introduction of the work capability assessment, which was introduced by the previous Labour Government and which had many teething problems, as we all accept. It is to the Government’s credit that they have commissioned a review of the introduction of that test, which was required under the Welfare Reform Act 2009, and that they have committed to making the changes recommended by Professor Malcolm Harrington. We also welcome the fact that he is conducting further reviews to improve that test.

There is significant confusion in disabled people’s minds, however, between the work capability assessment, including the many difficulties that they have experienced or heard about, and the forthcoming gateway test for disability living allowance. It is imperative that Ministers allay those fears and confusion and that they make it absolutely clear to disabled people that the personal independence gateway assessment is entirely different from the work capability assessment in purpose and, therefore, in design.

As we discuss the personal independence payment clauses, I hope that we will understand exactly how the Government intend to implement the gateway assessment, because there is certainly considerable concern about the potential for confusion in disabled people’s minds. An example of that might be the way in which the two tests need to look at the same person and their circumstances in different ways. A blind person might be able to pass the work capability assessment, because, with the aid of suitable adaptations either to the equipment that they use or to their workplace, they can work in paid employment. We have many encouraging examples of blind and partially sighted people who are able and keen to be in paid work. That is different, however, from saying that that person does not necessarily need financial support for their wider social participation. We need to be absolutely clear that the PIP gateway test is about that wider social participation and that failing to pass, as it were, the work capability assessment does not get bound up with or predispose an outcome on the PIP gateway test.

Harriett Baldwin (Conservative, West Worcestershire)

Does the hon. Lady share my concern that the current 50-page assessment is extremely complicated and that many recipients of the DLA do not understand that it is not a means-tested award and that it is not an out-of-work benefit?

Kate Green (Labour, Stretford and Urmston)

The hon. Lady has highlighted some important concerns about the DLA, which have existed for several years and which the previous Government sought to address. A number of reforms and extensive consultation took place on exactly the issues that she has raised about take-up, particularly among people in paid employment, complexity of claiming and so on. Although many of the organisations that participated in the review three or four years ago were positive about the way in which the then Government engaged with them, I must say that, in terms of complexity of claiming, it actually led to a lengthening of the form. That was because the nature of the information that is needed to carry out a satisfactory, comprehensive and well-informed assessment requires that we gather all the relevant evidence. There is a real challenge, which I am sure that Ministers will be thinking about, about how to ensure that, on the one hand, information is appropriately collected from disabled people and, on the other hand, that it is not too burdensome or bureaucratic—insofar as that is at all possible.

How will the clarity that this assessment is different from and has a different purpose from any other assessment around work capability or otherwise be guaranteed and communicated to disabled people, to those who work with them and to their families? How, in due course, will the assessment process sit alongside other assessment processes, so that disabled people do not find themselves being constantly tested and retested for different benefits in a way that could cause them great stress if it is not handled well?

The second issue that I want to raise in this stand part debate concerns the introduction of the new benefit and the lessons that can be learned from the early months of the work capability assessment or employment and support allowance. I highlight the need for very clear communication to disabled people, their families and the organisations that work with them about when they are likely to be affected by the new assessment. The hon. Member for West Worcestershire and I were present in the Select Committee discussion the other day, in which we heard that a timetable of when assessments would affect different disabled people would be very much welcomed, particularly by those with mental health conditions, autism, learning difficulties and so on, who are likely to be anxious in a period of uncertainty.

I hope that the Minister will discuss communicating the process of transition and change. If she cannot do so in the stand part debate, I hope that she will discuss at a later stage of our consideration the nature of the assessment, the descriptors and characteristics that will be used to determine whether somebody is entitled to the new personal independence payment and the level of the payment. I hope that she will say something about the decision-making process, because there are some powerful and important lessons for us to learn from the experience of the work capability assessment.

I warmly welcome the changes that Ministers have introduced to the process of the work capability assessment as a result of the Harrington review. In particular, Ministers have put extra so-called touch points into the process, where a Jobcentre Plus official will be in direct personal contact with the claimant as their claim proceeds, and their entitlement taken, assessed and reviewed. Will the Minister tell us what sort of decision-making process, and design around that, has been carried out so far? What lessons are being learned about designing an appropriate decision-making process from the work capability assessment, though it is different in purpose? Will she assure us that excellent decision-making processes will be in place; that staff will have the necessary training; that it will not be the sort of tick-box exercise that, regrettably, the work capability assessment has been in its early months; and that there will be absolute clarity that there will be a Jobcentre Plus decision, as there is now?

Those issues may come up in other clauses as we debate the personal independence payment, but I think that they are broad, ground-setting issues, on which I hope that the Minister will reassure us this morning. I look forward to her response.

Maria Miller (Conservative, Basingstoke)

I join the hon. Member for Glasgow East in saying that this is an important stage of the debate on the Bill. It is also important that we have a measured debate, because, as the hon. Lady has said, this measure affects many, many thousands of people, and they will be looking at the tone of this debate to take a lead in how they respond to the issues put forward.

I want to set out from the start that the Government remain committed to providing unconditional support for disabled people who are unable to get into work and have problems with the costs that they incur in daily life. The DLA and its principles remain at the heart of what we are trying to do.

Many of the issues brought up today will possibly arise under more specific amendments further on, and I do not want to risk incurring—

James Gray (Conservative, North Wiltshire)

Order. It is perfectly in order to answer the general points that have been raised, bearing in mind that we should not get into detailed debates on the amendments that are coming up later this morning or on Thursday.

Maria Miller (Conservative, Basingstoke)

Thank you, Mr Gray, for you guidance. I will try to stick with it.

Stephen Timms (Labour, East Ham)

May I pick up the Minister on the “principle” point that she was just setting out about the purpose of the new benefit? The DLA was always about helping to meet the additional costs of disability, as my hon. Friends have said; is that still the purpose of PIP, or is it slightly different?

Maria Miller (Conservative, Basingstoke)

The right hon. Gentleman is right to pick up on that. There is a slightly different purpose; PIP is not simply about the additional costs of being a disabled person, but about trying to identify how we can help disabled people to participate in society. It is important to make that distinction, because that drives the assessment criteria that we are putting forward, and it goes to the heart of why PIP will provide stronger support for disabled people than the DLA, which is because it recognises that participation is what disabled people want support with. One of the key weaknesses of the DLA is that it does not pick up those participation issues, particularly around people with sensory impairments and learning difficulties. Rather than going into the detail of that now, however, perhaps I can draw back to some of the broader points.

All the main parties accept the need to reform the DLA. Indeed, the right hon. Member for Doncaster North (Edward Miliband), said in Prime Minister’s questions in October that the DLA is an important reform and that it needs to be done. Clearly, the debate we will have in Committee will be about the type of reform undertaken and the framework for that reform. I am sure that the hon. Member for Glasgow East and others will take the opportunity through amendments to set out their approach to reform.

Margaret Curran (Labour, Glasgow East)

Will the Minister answer the specific point that I have raised? If I were Minister with responsibility for disabled people, I would not have closed the consultation early; I would not have published the response to the consultation before I had received all the submissions; and I would have engaged with disabled people. Will she directly address those comments?

Maria Miller (Conservative, Basingstoke)

I intended to address the hon. Lady’s concerns in a moment. I will do so after I have set out the broad parameters. There must be a misunderstanding, because the consultation did not close early.

I hope that, where there is agreement between the Opposition and the Government, we can work together. Given the premise that there is a need for reform and that Opposition parties have had to grapple with the matter over the years, we will look to work together where we can.

Core to the Government’s principles and approach is that PIP remains the support that disabled people need to participate fully in society. It remains a non-means-tested, non-taxable benefit, not related to work. Hon. Members have said that there is confusion; there is confusion, particularly among some of the media when they conflate the role of DLA with some in-work benefits. I hope that today’s debate will provide clarity.

Kate Green (Labour, Stretford and Urmston)

I am grateful for the Minister’s assurances that the purpose of the benefit is to assist people with daily living. Will she explain how she expects an objective assessment properly to understand and appreciate the particular pressures that an individual may face, and the adaptations that they may need to make to their daily living circumstances?

Maria Miller (Conservative, Basingstoke)

The hon. Lady has drawn me into some of the details of the assessment criteria, which the Committee received last week. It is difficult to assess each individual’s needs on a case-by-case basis. Therefore, the assessment criteria are inevitably used as proxies for some of those barriers that people face. Rather than being drawn into a detailed debate on assessment criteria, I will refer to the broader principles outlined in clause 75.

Our philosophy is that PIP remains to support disabled people in their participation in daily life. It is equally important to treat disabled people as individuals, so that they are not labelled by their condition. Each person requires an individual approach. Disabled people are experts in their own conditions. We will continue to make that the core of our philosophy, and we will focus on giving disabled people the support they need to live more independently. Disability is one word with many meanings. I challenge the Committee to keep that complexity in mind as we try to agree the architecture of a benefit that will successfully meet a multitude of needs. That is complex and difficult, but it must be tackled.

The hon. Member for Stretford and Urmston set out an important challenge: communications. As with so much that we do in government, the way that we communicate with those affected is most important. I assure the hon. Lady that the task of communication is already under way. We are working in co-production with disabled people and their organisations on the design and architecture of the proposed benefit. For many months now, we have had a specialist group working with us on the design of the assessment, to make sure that we get that right from the start. We are doing some testing now, and there will be further testing during the summer. I am sure that we will talk more about that as we move forward.

The hon. Lady is right to emphasise that communication about what changes are being made, how they will affect people and when they can expect those changes to come into play, is most important. I hope that we can work with her and other Labour Members and disabled people’s organisations to make sure that those communications are strong and clear, because it is in the best interests of disabled people to know the facts, rather than some of the assertions that have been made in recent months.

The hon. Members for Glasgow East and for Edinburgh East questioned the evidence that is being used to shape reform and, indeed, whether there was evidence of the need for reform. There is clear evidence that the current structure of DLA is simply not working in the way that is in the best interests of disabled people. First and foremost, my key concern about DLA is that it fails to recognise many of the problems faced by people with sensory impairments and learning disabilities. It took some 10 years of debate and changes to primary legislation make a simple change to recognise that people who are blind have considerable mobility problems that were simply not picked up in the current architecture of the benefit. That shows how DLA is flawed at its heart and lacks the flexibility to adapt to the changing way that we want benefits to work to support disabled people.

Secondly, I cannot believe that the hon. Ladies think that a benefit that has no inbuilt method of reassessment is right for the 21st century. Why? Because we leave disabled people at risk of either being over-rewarded or under-rewarded. I certainly feel deeply uncomfortable about their condition not being regularly reassessed.

Kate Green (Labour, Stretford and Urmston)

On that specific point, what are the Minister’s intentions in relation to people who currently have a DLA award for life?

Maria Miller (Conservative, Basingstoke)

The hon. Lady makes an important point, which I believe was dealt with by one of my predecessors, but perhaps I will come back to her with the exact details. As the previous Government set out, there was some misinterpretation of the idea that an award was given for life; indeed, it was only ever the case that an individual would receive a benefit as long as their condition continued. I understand the point she makes, though, and perhaps it comes back to her earlier communication point: we have to be clear with people about exactly what we mean. Perhaps some looseness of words in the past led people to believe that they were given a benefit that would not be subject to review.

Perhaps the hon. Lady makes my point for me: if we have an inbuilt review, disabled people can be confident that they will still receive that benefit if they require it, and that if their condition has deteriorated, that will be acknowledged. The Committee might be interested to know that 130,000 people who were awarded DLA in 1992 have not had their benefit either reviewed or reassessed since then. It is difficult to believe that absolutely nothing has changed for those people in the intervening period.

Kate Green (Labour, Stretford and Urmston)

For absolute clarity, can the Minister confirm that every working-age adult currently in receipt of DLA will be subject to the new gateway assessment?

Maria Miller (Conservative, Basingstoke)

The Government’s intention is to move working-age adults from DLA to the personal independence payment. Obviously, we are not currently looking at children and individuals who are past retirement age.

To return to the questions about why we believe reform is needed, I have already touched on the problems DLA poses for people who are blind, but I also draw the Committee’s attention to the problems faced by people with learning disabilities in terms of obtaining recognition of the barriers they face and the necessary support from DLA. The failure to recognise the very real problems that people with learning difficulties have with mobility should be of deep concern to Committee members. I hope they feel reassured that PIP will start to address some of those issues through its new, much more robust assessment criteria.

Ian Swales (Liberal Democrat, Redcar)

I have a further question of clarification: how does the Minister believe that the assessment process will deal with intermittent conditions such as ME, where the degree of disability experienced one day might be quite different from that experienced on another day?

Maria Miller (Conservative, Basingstoke)

I thank my hon. Friend for his intervention, because I am sure many members of the Committee are concerned about people with fluctuating conditions. I assure him that ensuring that the assessment deals well with fluctuating conditions and picks up on them will be an important part of the development process. I am sure that we will discuss that further.

The purpose of clause 75 is the introduction of the new personal independence payment, a more transparent and sustainable benefit for the 21st century. The DLA system we inherited has become very confusing and complex, as members of the Committee have pointed out. Who qualifies can be unclear and the decisions about qualification can be deeply inconsistent and subjective. I am sure that none of us wants to leave those problems unresolved.

Margaret Curran (Labour, Glasgow East)

On the question of qualification and further to the point I made earlier, how will the Government’s commitment to giving the benefit to those with the greatest needs be demonstrated in the distribution of the benefit?

Maria Miller (Conservative, Basingstoke)

The hon. Lady is jumping ahead to the more detailed discussion. As we set out clearly in the papers given to Committee members, we are in the process of establishing the assessment criteria which we believe will give the best analysis of an individual’s need for support. The criteria have been developed not by the Government but by an independent group of experts to try to provide a proxy for the problems that disabled people face. As we test the assessment criteria, we will look at how they affect different people, and I assure the hon. Lady that a great deal of testing will be done before the arrangements are finalised.

Charlie Elphicke (Conservative, Dover)

Is it not an incredible example of neglect that, since 1992, 127,000 or so people simply have not been seen? We do not know whether they still need DLA or their conditions have improved. Is that not fundamentally wrong and a betrayal of taxpayers’ trust?

Maria Miller (Conservative, Basingstoke)

I thank my hon. Friend for his intervention. As well as taxpayers, that is a betrayal of disabled people. We are leaving some of the most vulnerable people in our society in a situation in which they may believe that they are still entitled to a benefit, but in fact they require more support than they are receiving, or indeed less, and there is no inbuilt means of reassessment. We believe that the PIP will be quite different from its predecessor because of its objective assessment and its transparency in how people’s needs will be assessed through the daily living or mobility criteria.

Stephen Timms (Labour, East Ham)

May I ask again about the difference between DLA and PIP? The DWP website points out that DLA is to help with the extra cost of personal care, supervision or getting around. Is it correct to say that PIP is there to help with the extra cost of participation? Is that the purpose the Minister has in mind?

Maria Miller (Conservative, Basingstoke)

Yes, although the two things are described in slightly different ways. In revising the assessment criteria, I am trying better to reflect the reality of disabled people’s lives. If the right hon. Gentleman looks at the current assessment of the need for mobility assistance, for example, he will see that it is focused on the physical needs or the physical problems that people face in terms of being able to walk a certain distance, whereas PIP is designed to pick up on the other mobility problems that disabled people frequently face, particularly in being able to plan a journey between A and B. Even if one can walk a certain distance, if one cannot plan that journey and undertake it independently one’s mobility is as severely undermined as that of an individual who cannot physically walk. That is a clear example of the deep flaw in DLA as it stands. In response to the hon. Members who challenged whether DLA needs to be reformed, I would assert that that is one of the many challenges that we face in reforming DLA to ensure that it is fit for the 21st century and how we understand disability now.

Stephen Timms (Labour, East Ham)

That is a helpful answer, but I want to confirm that PIP is about meeting extra costs. The Minister is defining the extra costs in a slightly different way—they are about participation rather than the things that the DLA was about—but it is about meeting extra costs that disabled people incur.

Maria Miller (Conservative, Basingstoke)

It would be difficult to analyse every single extra cost that a disabled person might incur. The administrative system required would be complicated and difficult to implement if we looked at every single extra cost. By definition, we have to look at proxies for some of those extra costs, which are set out in the assessment criteria.

I will make a little progress before I am waylaid again and asked for further detail. Entitlement to DLA depends on the extent to which somebody needs help with personal care, needs supervision or has difficulties walking. PIP will consider the impact of an individual’s impairment or health condition on their daily life, as I have outlined to the right hon. Gentleman. PIP will take account of changes in individual circumstances and the impact of disabilities, as well as reflect wider changes to society that have taken place since 1992—for example, our understanding of conditions such as autism and learning difficulties was not as well developed in 1992 as it is today.

Sheila Gilmore (Labour, Edinburgh East)

As I am sure the Minister knows, a large number of applications for DLA are unsuccessful, albeit some appeals against the decisions are successful. The Minister has given examples of people who may not currently be eligible for DLA but who may be eligible for PIP. Is she satisfied that that will not lead to an increased demand? If it does, what effect will that have on her Department’s financial planning? It appears to me that we are talking about people who are not currently eligible.

Maria Miller (Conservative, Basingstoke)

I am sure that the hon. Lady expects me to take a principled approach in the reform of any benefit, which is what we are doing. We will be led by what is right in terms of the support that needs to be put in place but, as with every other benefit, we will be mindful of our other budgetary requirements. Every Minister in every Government has to contend with that balancing act.

To return to PIP, I assure the Committee we will prioritise support for those individuals who face the greatest day-to-day challenges and are therefore likely to experience the highest costs. It will be non-contributory and non-means-tested, and the aim is to help people to live more independent lives in their community. PIP will not be linked to an individual’s impairment, but will focus on an individual’s ability to carry out a range of activities that are necessary for day-to-day life and the extra costs that arise as a result. It will be payable to people who are in work as well as those who are out of work.

Measures to deal with many of the issues that will arise are set out in the Bill. For Members who are interested in the challenges that we have to deal with, tests of residence and presence will be similar to those used for DLA and they will be set out in regulations. We intend to introduce an habitual residence test to bring PIP into line with other non-contributory benefits, instead of the ordinary residence test, which applies for DLA. Entitlement to PIP will be determined by a new objective assessment, which will enable us more accurately and consistently to assess individuals to determine who will benefit most from additional support.

The hon. Member for Stretford and Urmston asked how what we propose will differ from the work capability assessment. The new test is a completely different way of assessing people. The two tests assess things differently. It is important to be clear that the personal independence payment will focus on the ability to carry out key everyday activities, whereas the work capability assessment looks at the capability to work, so any direct comparison between the two assessments is not strictly possible.

As the hon. Lady would expect, however, we are seeking to learn from our experience of delivering the work capability assessment. As part of that, we are looking at the findings of the first review carried out by Professor Harrington to see whether we can ensure that the design of the PIP claim and assessment process is as good as it needs to be. We recognise the need to ensure that the processes are transparent and empathetic, which is an important finding of Professor Harrington’s work. We are considering the scope for using mental, intellectual and cognitive champions to support the assessments for PIP, as Professor Harrington recommended for the WCA.

The hon. Member for Glasgow East asked about aids and adaptations. I am sure we will return to that later in our deliberations, but I want to make it clear—the hon. Lady mentioned guide dogs—that we do not intend that guide dogs be considered an aid or an appliance, nor do we intend to take them into account in the assessment process. Guide dogs do not help people to complete the activities considered in the assessment.

On the hon. Lady’s more general comments on aids and appliances, our approach is that support should be targeted at people who are least able to take part in everyday life. We believe that the assessment should take account of the successful use of aids and appliances, which can lessen the impact of health conditions. We recognise, however, that some aids and appliances, such as electric wheelchairs, that help individuals also attract significant costs. We have attempted to reflect that in the detail of the descriptors, and we will also seek to do that in the associated point scores. I assure the hon. Lady that we will get that right before finalising the assessment criteria and full testing will be carried out. If she has had an opportunity to look at some of the notes we have issued in support of our approach, she will be reassured that the aids and adaptations we are talking about are things with which she would feel comfortable.

The hon. Lady also touched on the consultation on the provisions before the Committee today. The consultation, which is the second largest that the Department has run, ran from 6 December to 18 February and some 5,500 responses were received. Importantly, in parallel to that we held a number of meetings with disabled people and their representatives and organisations before, during and after the formal consultation. We ensured that people had the opportunity to comment not only in the consultation, but in more detail in those discussions. I strongly refute the allegation that we somehow rushed the consultation and pre-empted its outcome. A response to the consultation was published in April and provided an explanation of our approach, which takes into account the views from the consultation.

Margaret Curran (Labour, Glasgow East)

For the record, will the Minister confirm my clear recollection that the Bill was published before the consultation on that particular element was finalised?

Maria Miller (Conservative, Basingstoke)

The hon. Lady well knows that the Bill provides a very broad framework for the reform of DLA, and in no way goes into the detail on which the consultation sought responses. I absolutely assure her that our response to the consultation was developed and published subsequent to the consultation’s closing, and will strongly inform our approach, as she knows that it already has. To imply in any way that we were not running that consultation properly was probably not her intention, but I hope that that sets the record straight.

Charlie Elphicke (Conservative, Dover)

My understanding of the consultation is that it was to inform secondary legislation on the detailed design of the benefit, including requirements for the new assessment. It was not about the primary legislation—the bookcase—but the detail that is to follow. Is that not the case?

Maria Miller (Conservative, Basingstoke)

I thank my hon. Friend for his intervention, and of course he is absolutely right; we will set out this sort of detail in secondary legislation. I am sure that Opposition Members who have been involved in the reform of benefits will know that we are well down the track in developing draft regulations and policy advice notes, and that a great deal of detail is available to hon. Members. Of course, there is still much more work to do, but I am sure that hon. Members are grateful for the amount of detail that has been set out and very much informed by the consultation that we ran.

Kate Green (Labour, Stretford and Urmston)

We expect a very extensive set of regulatory measures to implement the Government’s intentions. Will the Minister assure us that there will be every opportunity to scrutinise them appropriately? Has she given any consideration to seeking the advice of the Social Security Advisory Commission?

Maria Miller (Conservative, Basingstoke)

I can assure the hon. Lady that we would expect all regulations to be available for scrutiny in the usual way. Perhaps we can cover that in more detail when we reach the relevant parts of the Bill.

Ian Paisley Jnr (DUP, North Antrim)

Does the Minister accept that any consultation launched in the jaws of Christmas always raises suspicion that there is a deliberate attempt to make sure that three or four weeks of consultation are not actually usable, because most people’s minds are elsewhere, and that suspicion means that this consultation has not actually been long enough?

Maria Miller (Conservative, Basingstoke)

I might understand the hon. Gentleman’s point if we had not received 5,500 responses to the consultation, of which only 500 were from organisations, and 5,000 were from individuals. It is clear that perhaps people who are interested in issues around disability do not find Christmas such a distraction.

Ian Paisley Jnr (DUP, North Antrim)

I am surprised that there were only 5,000 consultation responses. I would have expected the figure to be tens of thousands of responses, given the tens of thousands of people that this affects.

Maria Miller (Conservative, Basingstoke)

I understand the hon. Gentleman’s point, but I did say that this was the second largest response to a consultation ever, and perhaps if he were to look at other consultations he might see that the responses are often in the hundreds rather than the thousands.

Margaret Curran (Labour, Glasgow East)

Will the Minister outline three issues raised in the consultation process that went on to change the substance of the Government’s proposals?

Maria Miller (Conservative, Basingstoke)

I think that the hon. Lady would expect me to deal with that sort of detail in the context of amendments, rather than the clause stand part debate. To ensure that we get to those very amendments so that we can discuss things more fully, I encourage the Committee to support the clause.

Clause 76

Margaret Curran (Labour, Glasgow East)

I beg to move amendment 208, in clause 76, page 54, line 33, after ‘condition’, insert ‘or communication needs’.

James Gray (Conservative, North Wiltshire)

With this it will be convenient to discuss the following: amendment 209, in clause 76, page 54, line 37, after ‘condition’, insert ‘or communication needs’.

Amendment 210, in clause 77, page 55, line 17, after ‘condition’, insert ‘or communication needs’.

Amendment 211, in clause 77, page 55, line 23, after ‘condition’, insert ‘or communication needs’.

Amendment 213, in clause 78, page 56, line 5, after ‘condition’, insert ‘or communication needs’.

Amendment 214, in clause 78, page 56, line 7, after ‘condition’, insert ‘or communication needs’.

Amendment 215, in clause 78, page 56, line 9, after ‘condition’, insert ‘or communication needs’.

Amendment 216, in clause 78, page 56, line 11, after ‘condition’, insert ‘or communication needs’.

Margaret Curran (Labour, Glasgow East)

The amendments focus on communication needs, which we have already emphasised this morning, and the whole Committee has recognised their importance. This group of amendments would ensure that the communication needs of claimants are taken into consideration as part of the assessment for the daily living and mobility components of PIP at both the standard and enhanced rates.

The amendments seek to put an individual’s communication needs on an equal footing with the barriers that disabled people face in relation to their physical or mental condition. The amendments, which number 208 to 216, span clauses 76 to 78 and ensure that, with regard to both the daily living and mobility components, the communication needs of the individual are taken into consideration when assessing the barriers that they face in living a fully independent life. The amendments would ensure that any Government commitment to take the communication needs of a disabled person into consideration in the application of PIP, as has been suggested in the Government’s narrative, is turned into a clear commitment in the Bill. That is the substance of the issue that I am bringing to the Committee this morning.

I have the support of the Disability Benefits Consortium in promoting this group of amendments, and it stated the following in its briefing:

“For some disabled people, it is communication barriers rather than personal care needs that lead to additional costs.”

The Minister has indicated that, to use the vernacular, she gets that. The briefing continues:

“Without adequate recognition of this, individuals can become isolated and cut off from their local communities. Communication needs affect individuals’ ability to carry out the activities that are expected to be included in the assessment for both components of PIP. For example, communication needs affect an individual’s ability to take part in ‘planning and buying food’, where someone faces difficulties in communicating with others and understanding what is available. Additional costs could therefore be faced by needing human support or an accessible home delivery service.”

Some supermarkets do not provide that, and there is need for communication with customers to support that purchase. As the Minister has used in examples:

“Equally communication is essential to mobility. For example, communication will be crucial for the activity of ‘planning and following a journey’. Individuals will face significant communication barriers in asking other people who do not know them for advice when following a journey. Strangers may not be able to communicate effectively”.

The amendments are especially important given the clear shift that the Government have decided to make in targeting PIP on those with the greatest needs only. Those with a physical or mental disability may appear in great need of support, but it is imperative that, if we introduce a new modern benefit to meet the demands of the 21st century, our understanding of disability develops according to the times that we live in. Disabilities are not just those that can be seen or those that have no obvious physical dimension, and there can, of course, be an overlap between physical and mental communication difficulties. By putting this commitment in the Bill to ensure that individuals’ communication needs are taken into consideration during their assessment for PIP, the Government have the opportunity to do just that.

As the hon. Member for Redcar said, communication needs also fluctuate, and we need to grapple with that in the assessment, as well as how that will be taken into account in a controlled environment such as the assessment itself. Physical disability—for example, with a double amputee—is not only clear from the outset of any assessment of that individual’s needs, but is a permanent, static impairment that will not come and go. That does not necessarily apply to those with communication needs.

Ian Swales (Liberal Democrat, Redcar)

Does the hon. Lady recognise that communication is a two-way process? As MPs, we often experience people who, either through a lack of understanding of the process, or fear about where an admission of incapability may lead in terms of being taken into care or whatever, have been assessed as more capable. Two-way communication is, therefore, extremely important.

Margaret Curran (Labour, Glasgow East)

I thank the hon. Gentleman for that powerful point. In fact, I was just about to make it. I am sure that the Minister has had this experience, too: we have had powerful testimony, particularly from the parents of adults with autism who participate in the assessment process. They are determined to answer the questions as they are interpreted and to reveal the entirety of the disability or its impact. I appreciate that we are all trying to grapple with that to ensure that we bring it into account as we develop the new assessment.

My drive today is to ensure that we include such communication in the Bill, because it is such a significant development in how we carry out the assessment. I do not want to go back to bookcases and those issues, but we need to be emphatic about this and make it centre stage. The best way to do that is to put it into the Bill. As I have said, it is in the Government’s narrative, but we have to go one step further. It would give a vital signal to all the organisations that are on the other side of the process and ensure that it is a two-way process. That is vital.

I have spoken about the importance of communication needs in assessing impairment, but in emphasising the other dimensions of communications in no way do I underestimate the significance of the physical and mental dimensions of disability. The key point is to put them all on an equal footing. We are almost there in terms of an agreement to do so. I urge the Government to go that one step further to show the significance of doing so. I understand the argument that some things need not be included in the Bill, but perhaps in this case it might be worth doing so, given the step change that we are all engaged in here.

Maria Miller (Conservative, Basingstoke)

I am pleased to respond to this group of amendments, and I should like to say from the outset that communication is more than in the Government’s narrative; it is in our proposed assessment criteria. The hon. Lady may not have seen the assessment criteria when the amendment was tabled, so I will take her through the thinking behind them. She seeks to ensure that communication needs are taken into account, alongside physical and mental impairments. I absolutely recognise the importance of communication and taking into account impairments that affect communication. That is a perfect example of why we need to reform DLA, which takes only very limited account of communication needs. Indeed, the National Autistic Society’s recent report, “Who benefits?”, highlights that any new assessment should reflect the needs of people with autistic spectrum disorders.

Many individuals with disabilities affecting speech, language, comprehension, sight and hearing may not have received as much priority in the benefit as their needs deserved. That failure in DLA led to the introduction of the measure recognising severe visual impairment. It was a necessary workaround to ensure that blind people were fairly treated. In PIP, we want to treat people fairly and assess their needs properly as a matter of course, avoiding the need to bolt on special rules for groups of people affected by particular impairments. That lies at the heart of our philosophy. It might be helpful to say a little about the assessment and the work that has been done to develop it to this point, perhaps to reassure the hon. Lady that we are very much on the same page.

The assessment will consider the impact of a full range of impairment types: physical, mental, intellectual, development, cognitive and sensory. It is also designed to look beyond the care and mobility needs considered in DLA. Although care and mobility remain essential to the new assessment, we recognise that they alone do not fully reflect the impact of disability. In particular, DLA takes only very limited account of communication needs. Last week, I circulated to Committee members a copy of draft regulations on the assessment, with a supporting technical note, to show how the assessment is likely to work. We have since published them on our website, and I urge any member of the general public who is following today’s debate to look at them and send us their comments, because that is, again, part of our ongoing consultation process.

As hon. Members will have seen, we have set out 11 key activities that we propose to consider in the assessment. They relate to an individual’s ability to access food and drink; to manage their personal care and health needs; to get around; and importantly, to communicate with others. The activities that have been selected are not intended to cover all the activities that might be affected by health conditions or disabilities, nor all the areas that might create extra cost for disabled people, as I have outlined before. That would not be possible without creating yet another extremely complicated, time-consuming and expensive assessment. Instead, they are meant to represent the key activities that are essential to everyday life and cumulatively to act as a reasonable proxy for the impact of disability.

The inclusion of communication in the assessment is a key development, and it was one of the things that our assessment development group felt most strongly about. As hon. Members will know from the draft regulations, the assessment will consider ability to communicate as a spectrum. We propose taking into account people who can only communicate with support, such as someone who is trained to communicate with limited communication ability—for example, lip speakers—and where people are unable to engage socially without causing overwhelming stress to themselves or others. Individuals unable to communicate with people familiar to them will receive higher priority than those who cannot communicate with unfamiliar people. As the hon. Lady will understand, we need to recognise varying degrees: the greatest priority will go to those unable to understand and communicate even simple instructions and basic needs.

Although we have published the initial draft criteria of the assessment to support discussions in Committee, our work on that assessment is far from complete. We intend to spend the summer engaging disabled people and their organisations on the criteria, as the Committee would expect, and to seek their views on how the criteria will work and what their likely impact will be. In particular, we are keen for views on communication activity—the most radical departure from DLA. We will also be testing that in our assessment process.

Our aim is to provide a further draft of the assessment criteria after the summer to support discussions on the Bill in the other place. In particular, the regulations do not, at this stage, include details of how much priority will be awarded for an ability to carry out activities. We intend to include those detailed weightings and the thresholds that will be used for entitlement to the benefit rates in the autumn draft regulations, once we have been able to test the initial criteria and discuss them with disabled people and disabled people’s organisations, which is important.

I hope that my explanation helps hon. Members to understand our approach. The hon. Lady also picked up on fluctuating conditions, and I hope that she heard my response to my hon. Friend the Member for Redcar, when he intervened earlier. I reassure the hon. Lady that the assessment will not be a snapshot of one day, but that it will consider an individual’s ability to carry out activities over a period—we are suggesting a year—and impacts that apply for the majority of time.

The assessment will also take into account whether activities can be carried out reliably, repeatedly, safely and in a timely manner. We will explore that area further in discussions with disabled people and their organisations. With individuals who have autistic spectrum disorders, it is vital to ensure that decision makers and assessors have appropriate training and guidance, and, as I have said, we are very much learning from the Harrington review.

I hope that we have been able to reassure hon. Members. I should like to point out to the hon. Lady that her amendment would perhaps work in a way that she did not mean. It could involve taking into account communication needs that are unrelated to health conditions or disabilities; for example, where an individual does not speak English or does not understand it, so they cannot communicate on a daily basis. I am sure that that was not her intention, but it serves to underline why I cannot accept her amendment. I hope that I have reassured her, however, and I urge her to withdraw the amendment.

Margaret Curran (Labour, Glasgow East)

I thank the Minister for that substantial answer, and I want briefly to make a number of points in response. I have seen the papers from the Department for Work and Pensions; they arrived on Friday and there were quite a lot of them, so perhaps I have not quite grasped them all, but I think that I have. I and other hon. Members will return to this point during our debates: although I appreciate the pressures on the Government and staff, it would help the Committee and allow us to conduct our business more effectively if we had such information rather earlier. That is beginning to be an issue, and it reinforces the point made by my hon. Friend the Member for Stretford and Urmston that we need further scrutiny by the Social Security Advisory Committee.

I understand from those papers that work has been done on the descriptors, but some people still have concerns about them. The Disability Benefits Consortium has said that we do not sufficiently recognise the cross-cutting nature of the communication needs that will have an impact across all the activities that are being considered. Those points must be addressed.

The Minister has indicated that she has a plan to take this work forward, and I am sure that she will work with the relevant organisations to address their remaining concerns about those descriptors. I think that that is fairly reasonable. The range of work that she has said will be carried out over the summer, before the Bill goes to the other House, indicates that in this whole policy area so much work still remains to be done, and I return to my earlier point that the Bill is rushed. It is important that Members such as myself who have such an interest in the subject should have the opportunity—

Maria Miller (Conservative, Basingstoke)

May I remind the hon. Lady that we are discussing the broad principles of the Bill, and it is entirely in accordance with the way in which the business of the House is conducted to look at more detailed issues as we progress to regulations? I suggest that in being able to give draft regulations and detailed policy notes to the Committee we are well ahead of other legislation at a similar stage. I take her point, however, about ensuring that the Committee receives such documents in a timely manner.

Margaret Curran (Labour, Glasgow East)

As a general point, I accept that, but some of the things that we are dealing with impinge on the principles of the Bill. We cannot test properly whether those principles are being correctly applied, because we do not have the supporting evidence. I am not saying that every bit of secondary legislation or every regulation should be in front of the Committee—I understand how legislation works—but I think that there are significant gaps. It strikes me that this is different from my normal experience of legislation. The Minister should not dismiss that quite as lightly as she does, because I am not the only one saying so; it is quite a widespread view. None the less, although I am not sure that I agree with the Minister about how the amendment would work and some of the unintended consequences, I will not argue with her about that. I beg to ask leave to withdraw the amendment.

Margaret Curran (Labour, Glasgow East)

I beg to move amendment 207, in clause 76, page 55, line 11, at end insert—

‘(7) In section 70, Social Security Contributions and Benefits Act 1992, for subsection (2) there is substituted—

(2) In this section, ‘severely disabled person’ means a person in respect of whom there is payable either an attendance allowance or a personal independence payment by virtue of entitlement to the daily living component at a rate prescribed in regulations, or such other payment out of public funds on account of his need for attendance as may be prescribed.”.’.

We come to another substantial area of discussion. I will refer to the information that the Government have provided, and I am sure that we will discuss some of the detail as well as the text of the amendment, which would make a small but vital change to the Social Security Contributions and Benefits Act 1992, to ensure that a clear link remains between carer’s allowance and the main disability benefit in the United Kingdom. I will address some of the further information we have had from the Government but, as it stands, part 4 of the Bill contains no explicit reference to linking the new personal independence payment to carer’s allowance. The amendment would change that to ensure that the personal independence payment was a new passported benefit to carer’s allowance.

Under current legislation, an individual who cares for a disabled person who receives either the middle or higher rate component of disability living allowance is entitled to claim carer’s allowance. Carer’s allowance is respected and understood by carers throughout the country, and it is important that the main disability benefit—the personal independence payment that may replace DLA—continues to be a key passport to receiving carer’s allowance. According to Carers UK, there are 6 million carers in the United Kingdom and, as of April 2010, 530,000 of them were in receipt of carer’s allowance. A further 44,000-plus have an underlying entitlement to the benefit, implying that they may be entitled to other means-tested benefits. Even those families choosing not to receive carer’s allowance for whatever reason have an interest in the wider reform of disability living allowance. Indeed, families who care for a disabled person but do not receive carer’s allowance greatly rely on DLA payments to help them meet the extra costs associated with caring for a person living with a disability.

When we discuss DLA reform and the impact it will have on parents, it is important to consider not only parents who receive carer’s allowance but those who do not receive the benefit, despite being eligible under the current rules, and those who are not eligible but have substantial caring responsibilities for others in receipt of disability living allowance. All those groups are entitled to clear and succinct information on how the eligibility criteria for carer’s allowance and the Government’s plans to support carers more generally may change in the light of such big changes to the welfare system, especially with the introduction of PIP, which is a very significant and substantial change to people living with a disability.

The Government have decided to keep carer’s allowance outwith universal credit—a decision that we have welcomed, as has, I am sure the Minister knows, Carers UK. As it has said, drawing carer’s allowance into the new system would result in hundreds of thousands of carers facing a means test on their household income and savings, and the risk of losing the right to £233 a month in carer’s allowance and a key recognition of their contribution to society. However, we welcome the clarity of the Government’s position regarding carers and universal credit. The position of carers in the wider reform of DLA has not been subject to the same clarity, and particular elements remain uncertain.

The briefing note that we received last Friday said:

“It is our intention that PIP will provide part of the gateway for receipt of carer’s allowance in the way that DLA currently does.”

It also said that

“we are not at this stage able to confirm which rate(s) of the daily living component will be used”.

That is very significant and will be of great interest to carers throughout the UK. The amendment seeks to include in the Bill a clear commitment to ensure that PIP is part of the passport to carer’s allowance. It also provides us with the opportunity to raise the needs of carers and make sure that we are really grappling with the impact that the change in PIP will have for them. If the Government are dealing with that, let us put it in the Bill.

I have a number of questions about carers and the introduction of PIP. The Government will be aware that there are a series of questions about their plans for the fall in carer’s allowance, reform of DLA, and the introduction of PIP. Before the publication of the note last Friday, I had not received a response to clarify the relationship with carers’ benefits. For example, on 24 March, I asked the Minister what impact assessment had been done into the impact of DLA reform on carers, and she replied that

“at this point the new assessment has not been finalised and the impact on carers will only be determined when this is completed.”—[Official Report, 24 March 2011; Vol. 525, c. 242W.]

On 28 March, when I pressed the Secretary of State for further information as to whether any carers would lose out as a result of DLA reform, he replied that

“we are reviewing all of this.”—[Official Report, 28 March 2011; Vol. 526, c. 15.]

Last week I received a response from the Minister to a written parliamentary question asking for information on the demographic of carers in relation to DLA, and she could only say:

“Some early analysis has been undertaken to use additional information to link the two datasets”.—[Official Report, 28 April 2011; Vol. 527, c. 533W.]

That is deeply concerning, given the critical relationship between carer’s allowance and DLA as it currently stands, and the wholesale reform of DLA that the Government are undertaking.

Kate Green (Labour, Stretford and Urmston)

Does my hon. Friend agree that it is worrying that we are not able to assess the cost impact? The loss of both DLA—or PIP in future—and access to carer’s allowance could make family care untenable for some disabled people, which would create additional costs to social services.

Margaret Curran (Labour, Glasgow East)

I strongly agree with the point that my hon. Friend has made, which highlights the importance of the debate. Families with disabled members feature disproportionately in poverty statistics. We know the struggles that they face; an extra couple of pounds can make all the difference in the world. If someone is planning for their future and does not know what it holds—whether they will have that resource—it is enormously important. That is why clarity and pace are so important in the debate. I am not saying that reform is not important, but how it is done is critical. It must be managed and paced appropriately, with the information available.

We need to explore the relationship between carers and DLA. It would have been preferable if that had been done properly before the introduction of the Bill. There are serious questions and implications as to whether sufficient parliamentary scrutiny has been allowed on the Bill. The lack of answers from the Government to my questions on carers is reflected in a wider lack of information from the DWP following publication of the Bill. For example, there was no mention of carers in the initial impact assessment of DLA reforms published alongside the Bill, nor did one appear in the quality impact assessments published during the Committee stage. According to Carers UK, 73% of carers in the country are women, so it raises significant concerns that carer’s allowance was not mentioned at all in the quality impact assessments released by the DWP, especially given the scale of reform that we are discussing today.

That is why, as I am sure the Minister is aware, many carers have made strong representations that they have not been properly part of the process. There is growing concern that the Bill therefore lacks joined-up thinking and that there is a need for a more coherent approach. Rather than look at each component on a one-to-one basis, there must be an understanding that a disabled person and their carer are not completely individual entities, and we cannot pretend that they have no impact on each other. That is the point my hon. Friend the Member for Stretford and Urmston was making, and that is why certain information in the briefing note for carer’s allowance is concerning. It says:

“It is only when we have fully developed and tested the new objective assessment later this year that a decision can be made on the appropriate rate(s) to be used.”

That is incomplete, I think, at this stage. Changes to carer’s allowance should be developed alongside the reform of DLA. They should evolve together; it should not be the case that the impact on carers is only realised after the settlement of a new gateway has been agreed and after we have established the principles. Our attention to carers should be embedded in the principles of the Bill.

I would like to highlight a case study that illustrates the point that I am trying to make. It was provided by Carers UK and serves to highlight how interdependent DLA and carer’s allowance are, and why we need a more joined-up approach to this reform. Tony gave up work to care for his wife Laura who is partially blind and has memory problems following a car accident. They have two young children. Laura needs Tony to be there to help her wash, dress and use the toilet and she struggles to prepare food on her own. Tony would love to go back to work but does not want to leave Laura on her own during the day. Tony claims carer’s allowance and Laura receives the middle rate care component of disability living allowance. The support that the family receives from care and support services is being reduced, because the local authority has just raised their eligibility criteria to critical needs, and Laura has been assessed as having substantial needs. If, following assessment for the new PIP, Laura receives a reduced amount of disability benefit—equivalent to the lower rate care component of DLA, for example—that might not allow Tony to qualify for carer’s allowance; we do not know. The family could lose almost £60 a week, over £230 a month, as a result of the reduction in disability benefits, the removal of carer’s allowance and carer premium. Tony would be forced to claim jobseeker’s allowance, even though he knows that he cannot work because of the care and support his family needs, and the fact that their social care support is also being cut. That is why we need to see these issues in their totality.

From that, we take away two points. First, our amendment seeks to retain the independent relationship between carer’s allowance and the new PIP; secondly, we note the importance of the rates that trigger qualification for the carer’s allowance. The Government have said repeatedly that they do not believe that the growing case load and expenditure on DLA are sustainable—my hon. Friend the Member for Stretford and Urmston referred to that. Do they think that the case load and expenditure on carer’s allowance will be sustainable, and how does that feature in their financial planning?

If the personal independence payment is to be a key gateway to carer’s allowance, will the Government clarify that by supporting the amendment? If the Minister believes that PIP will be a passport to carer’s allowance, will she provide more information about whether that will apply to the enhanced or standard rates—or both—of the daily living component? Do the Government plan to allow the mobility component of PIP to be linked to carer’s allowance, or will it remain accessible only via the daily living component? Will there be an updated equality impact assessment to look at how people in receipt of carer’s allowance will be affected, given the proposed reduction in the DLA case load? Has the carer’s role been taken into consideration in the assessment process outlined in clause 78?

The amendment would carry the rules of eligibility for carer’s allowance, which currently apply to the disability living allowance, over to the PIP. It is not a massive change and would not require a huge step, but it would maintain our current position and provide much needed clarity and assurance to millions of carers throughout the country.

Sheila Gilmore (Labour, Edinburgh East)

There is a tendency when dealing with carers to be supportive, but not necessarily to create the structures needed to ensure that their role is rewarded and understood. When looking at public expenditure as a whole, it is important to join up several things, but because we are looking at one Bill and particular expenditures, it is easy to concentrate only on those to the exclusion of other matters. If we take a step back during our consideration of various forms of public spending, it sometimes becomes clear where there are links and why some things save money for the public purse. Carers are one group who probably save the public purse a considerable amount of money. In their absence, many people would require various different forms of care. Some people, for example, would not be able to live independent lives without their carer, who is often a family member and saves the state a considerable amount of money by providing that care.

It is important that carers have the security of knowing that an income source is available. They have to give up much of their time, and they may not be able to enter into or carry out paid employment because of their caring responsibilities. If the situation is not clarified, anxiety could be created for carers and those for whom they care. If the intention is for PIP to be a passport to the carer’s allowance, that should be made explicit at the outset and written into the Bill. In that case, much of the anxiety and the concerns expressed by those who have written to Members of Parliament and others about the issue would be removed, and it would be easier to enter into more detailed discussions about the reforms suggested in the legislation.

Anxiety remains that some carers will no longer find it easy to qualify for carer’s allowance. If the PIP is not the passport to that allowance, it is not clear what the criteria will be for those who receive carer’s allowance. That could lead to the establishment of another set of tests that would be expensive to administer and unnecessary.

As usual, when we deal with carers—it was Carers Week recently—we want to sign up to the issues and have our picture taken with whoever is present at the time. Warm words are frequently spoken, but those of us who have had the good fortune not to have to undertake such caring responsibilities have no concept of the extent of the commitment that people make and the lives that they lead. Added to the pressures on their lives, such people do not need uncertainty about whether the payments will still be available, the basis on which the payments will be available and how easy it will be to claim them. I hope that the Minister considers that in such circumstances it is reasonable for the Government’s views not only to be made explicit but to be made explicit in the Bill.

Maria Miller (Conservative, Basingstoke)

I hope that I can provide clarity and reassurance to the two hon. Ladies. I am pleased to be able to confirm that I intend the key conditions for eligibility for carer’s allowance to remain as they are now. It is important to provide such clarity, and I thank the hon. Member for Glasgow East for giving me the opportunity to do so. We intend the daily living component of the personal independence payment to be part of a gateway for receipt of carer’s allowance, as DLA is now.

As the hon. Member for Edinburgh East pointed out, we need to ensure that the extent of our commitment to carers is more than benefits alone. I reassure her that the Government are committed to that in the way in which we treat carer’s allowance within the universal credit. We have an ongoing commitment to supporting carers within Jobcentre Plus. We will ensure that where carers want to stay close to the labour market, which is often an issue for many carers, they have the support to be able to do so. Our support for carers goes beyond simply ensuring that carer’s allowance is in place; it goes much deeper than that.

The hon. Member for Glasgow East raised a case study of an individual who is concerned about whether they will receive carer’s allowance in future. Obviously, it is difficult to respond to a particular case study such as that, because the assessment criteria for PIP are yet to be finally determined, but if an individual has a disability that requires intensive support such as that outlined in the case study, clearly the individual would be eligible for PIP. With PIP being used as a gateway to carer’s allowance, I am sure that the appropriate level of support will be forthcoming.

Margaret Curran (Labour, Glasgow East)

I thank the Minister for generously giving way again. I may pre-empt some of the comments she is about to make, so forgive me if I do.

The Minister used the word “intensive”, which, as I understand it, is the word used in the briefing notes that were produced last Friday. Some concerns have been expressed about that, so I am again looking for clarity. Will the Minister explain what is meant by “intensive”? She knows that my point is not only on the principle of whether there is a link between carer’s allowance and PIP, but on the level at which that allowance is paid. That is the point of the case study.

Do the Government envisage that PIP will mean a decrease in the carer’s allowance claimant count? Do the Government have any modelling that projects such a decrease? What does “intensive caring responsibilities” mean? Answers to those questions would enhance our debate.

Maria Miller (Conservative, Basingstoke)

I am not sure whether I can satisfy the hon. Lady on the assessment, because, as I said earlier and as she knows from the briefing notes, we will be working through the summer with disabled people and their organisations on the detail that she is looking for.

On carer’s allowance, I intend to ensure that people who require such support receive it. It is not part of my work at the moment to look at restricting the support that we give to carers; as I said earlier, it is quite the opposite. We are ensuring that both universal credit and the support we give through Jobcentre Plus provide the support that carers need.

The hon. Member for Glasgow East asked about the things we are taking forward from the consultation. I can reassure her that we have carefully considered the thoughts on carers that arose from the consultation. Indeed, that is why we have said we will take PIP forward as a gateway into carer’s allowance; that was one of the issues that was brought up within the consultation. Another thing from the consultation that we will be taking forward is recognition of the importance to disabled people and their carers of not having multiple assessments.

I hope that my response will provide the sort of assurance that the hon. Member for Glasgow East wanted. While I do not feel that it is appropriate to specify this in the Bill, she can be assured that, in looking at the way we are setting out other aspects of the support information that we have provided to the Committee, we have a common cause, ensuring that carers have the support that they need. Indeed, there is a provision under clause 89 to make an amendment such as she suggests, and I intend to use that power to make necessary changes to PIP, if required. I hope that the hon. Lady is reassured and will withdraw her amendment.

Margaret Curran (Labour, Glasgow East)

I thank the Minister for her reply. She will be very busy over the summer; she has quite a lot of work to do.

Maria Miller (Conservative, Basingstoke)

I am always busy.

Margaret Curran (Labour, Glasgow East)

I am sure that she is. There are still a number of issues outstanding, but I assume that the Minister will continue to engage in these matters, and on that basis I beg to ask leave to withdraw the amendment.

Clause 77

Margaret Curran (Labour, Glasgow East)

I beg to move amendment 212, in clause 77, page 55, line 39, leave out from ‘where’ to end of the clause and insert ‘the person is in a coma or vegetative state’.

The amendment would ensure that the power to remove PIP mobility from people who are “unlikely to benefit” would explicitly and only apply to people in a coma or vegetative state. As the Bill currently stands, subsection (7) would allow the removal of the mobility component of PIP from people who are “unlikely to benefit”. Opposition Members are very concerned about who this group could be, and I hope that this morning’s debate will address the ambiguity. I am grateful to the Disability Benefits Consortium for their assistance in the production of this amendment. This is a source of further worry among disabled people who fear that they may have their mobility component removed.

According to subsection (7):

“Regulations may provide that a person is not entitled to the mobility component for a period (even though the requirements in subsection (1) or (2) are met) in prescribed circumstances where the person’s condition is such that during all or most of the period the person is unlikely to benefit from enhanced mobility.”

Subsections (1) and (2) provide that a person is entitled to the standard or enhanced rate of the mobility component if they are over the prescribed age; if their ability to carry out mobility activities is limited by their physical, mental, or—I presume we would add—communication needs; and if they meet the required condition. In other words, we are talking about removing the mobility component from people who may be eligible for PIP but will not necessarily receive this. We need clarity on that.

This is not about removing the mobility component from people who do not need help with fulfilling mobility activities; I understand that. It is about removing mobility from those who are “unlikely to benefit”. I think it is important to keep that in the front of our minds as we debate this amendment. In some ways, it refers back to some of the significant principle points that the Minister and I were probably disagreeing about earlier, and I am sure that that will emerge later.

At the crux of this debate is the phrase “unlikely to benefit” and its definition. The Minister has given some reassurance about this, but I would be grateful if she could give further assurance. She will know that disabled people who have wheelchairs, guide dogs, or a walking stick are worrying about whether this will affect their application. I think the Minister has said that if people have a wheelchair or a guide dog, that will not affect their claim. However, she said earlier that it was the intention to take account of other aids and adaptations. Will she clarify which people are unlikely to benefit, and whether this is a reference to this section of Bill? We need to get to the heart of what is meant by “should take account of aids and adaptations”.

Is this what clause 77(7) is getting at? If it is not, I would be more than happy, but if it is, we need to be clear that this is on the table and we need to have a full and proper debate.

It would be a substantial shift in disability benefits if we were to take into consideration aids and adaptations when calculating the level of PIP award or eligibility for a PIP award. I understand that the details of the assessment process and criteria are ongoing and have yet to be finalised. We will no doubt come back to that. I hope that in her response the Minister can shed some light on those whom she believes are unlikely to benefit. It looks as though she can do that, and I would be grateful. Could she also clarify whether this will merely affect the later debate we will have about mobility in care homes? I would like reassurance that this is not connected in any way to this part of the Bill.

Maria Miller (Conservative, Basingstoke)

It will help the Committee if I explain that this clause carries into the new benefits similar rules to those that currently apply to DLA. We are thinking along the same lines as the hon. Lady in envisaging that this would largely apply to people who were in a coma or a vegetative state and therefore immobile and unable to benefit from the mobility component.

However, placing these specific conditions in the Bill is contrary to the approach to PIP that I have already set out, that we do not want to be prescriptive about the conditions within the primary legislation. These conditions would fail to take into account individuals who may not be able to benefit from mobility assistance, who are not in a coma or vegetative state but in some similar state. I hope that that clarity will provide some reassurance to the hon. Lady that this is not connected with discussions that may be had on other parts of the Bill. This provision is linked to a provision in the existing legislation on DLA. I hope that, with that assurance, the hon. Lady will be able to withdraw her amendment.

Margaret Curran (Labour, Glasgow East)

I thank the Minister for that. She will be aware that a number of disability organisations have made similar interpretations and wanted this clarification, and I am grateful that she has given it. It is significant that concerns are so heightened; it is for this sort of clarity that we are having this debate. As long as the Minister is telling me that it is a comparable state to coma—where people are completely immobile, they are ruled out of that—I will ask the leave of the Committee to withdraw the amendment. The Minister is indicating assent to that, so I beg leave to withdraw.

Clause 78

Guto Bebb (Conservative, Aberconwy)

I beg to move amendment 193, in clause 78, page 56, line 21, at end insert—

‘(d) must provide for the assessment to be carried out in accordance with the Welsh Language scheme adopted by the Department and endorsed by the Welsh Language Board.’

It gives me great pleasure to bring this issue to the attention of the Committee today. Obviously, it is an issue which is specific to Wales. However, it is important to give some context, so that Committee Members can understand why I have raised the issue.

The Welsh Language Act was passed in 1993 by the Conservative Government of John Major. The Act tries to ensure that public services in Wales are available in the medium of Welsh and English on an equal basis. When the services in question are being supplied by a Government Department such as DWP, the demands of the Welsh Language Act can only be implemented if the Department in question decides to take on board the need for a Welsh language scheme to be adopted. I am glad to say that the Department for Work and Pensions has adopted the Welsh language scheme and in 2010 that scheme was revised and it has been approved by the Welsh Language Board.

The scheme is a very good scheme. It would ensure that the provisions of the Welsh Language Act applied to the work of the DWP in Wales, and that people in Wales could access services through the medium of English or Welsh, according to their choice. That choice is something that we all support. However, when it comes to services provided by a third-party agency for Departments like the DWP there is an issue as to whether they comply with the Welsh language scheme that has been adopted by the Department.

The requirement for a third-party agency to work within the demands of the DWP’s Welsh language scheme is clear. It says:

“Any agreements or arrangements which we make with third parties based in or outside Wales will be consistent with the relevant parts of this scheme, when those agreements or arrangements relate to the provision of services to the public in Wales. This will ensure that third parties provide those services in accordance with this scheme.”

Indeed, I have asked numerous questions of the Department on this issue and I have had the same response, which I welcome. However the proof of the issue is in the way in which the third-party organisation implements policy in Wales. Unfortunately, since I was elected last May I have had a number of complaints from constituents that the organisation providing services and assessment in Wales—Atos—has failed to offer a comprehensive service through the medium of English and Welsh.

Many members of the Committee may not be aware that 600,000 people in Wales speak Welsh as their first language and communicate in Welsh, and nothing else, until the age of six when they go to school. A constituent who suffered a stroke at an early age now finds it difficult to communicate in English. She had to relearn English as a result of the stroke, but can communicate quite fluently in Welsh. Her disability was assessed by an assessor who was unable to communicate in Welsh. There is clearly a problem when someone with a communication issue is assessed on her ability to communicate in a language that she is relearning as a result of a stroke.

The other issue about the assessment process for the personal independence payment is that we are also looking at the assessment of children. In the same way it has to be noted that there are numerous monoglot Welsh speakers in Wales, but they all tend to be under five or over 85. Again, when we look at the ability to deal with children, it is important that the provision, which is pretty clear in the DWP’s scheme, ensures that third-party organisations delivering those services can do so through the language of choice of the individual in question.

As a result of the complaints to my constituency office and complaints that other Members in Wales have received, the Welsh Language Board instigated an investigation into DWP procedures. It is a fair summary of that investigation to say that the scheme adopted by the Department was more than acceptable, but failures were found.

I have tabled the amendment to get some clarity and assurances. The Department has adopted a strong Welsh language policy, and there is a commitment to ensure that third-party organisations work within the scheme’s remit, but I should like an assurance that the written confirmation provided to me is what is happening on the ground now. My understanding is that as a result of the Welsh Language Board’s review, an effort has been made by Atos to recruit more Welsh speakers. I am looking for some assurances—[Interruption]—but I will obviously take an intervention from a fellow Welsh Member.

Jennifer Willott (Liberal Democrat, Cardiff Central)

Does my hon. Friend share my concern that it is incumbent on the Department to monitor what is being done by Atos? Having looked at the Welsh Language Board’s report, I understand that one of the concerns was that the Department was not properly monitoring Atos. Does he not agree that the Minister must take on board the fact that the Department must ensure that Atos lives up to the commitments that it made through the Welsh language scheme?

Guto Bebb (Conservative, Aberconwy)

That is a fair point, but the Department’s revised scheme should ensure that that failure to monitor is addressed in the future. With that, I ask the Minister to give me the assurances that I seek.

Maria Miller (Conservative, Basingstoke)

It is a pleasure to respond to my hon. Friend’s amendment. He is an assiduous advocate for the 600,000 Welsh speakers in Wales. He not only represents a beautiful part of our country, but is an assiduous local Member of Parliament. Let me reassure him that I share his ambitions for the Department in ensuring that assessments are always available in Welsh. Indeed, the people who have helped me to prepare for this debate have given me the words in Welsh—if only my Welsh was that good. Moreover, I do not want to test Hansard ’s ability by making it decipher what I am saying. Suffice it to say that my hon. Friend and I have a shared objective. Of course, we will meet our commitments to comply with provisions in the Welsh Language Act 1993 as part of the implementation of PIP. We will ensure that when required, assessments will be carried out in accordance with the Welsh language scheme, which is endorsed by the Welsh Language Board.

As my hon. Friend has mentioned, the scheme is already in place with regard to the work capability assessment, but there have been hiccups along the way, and my hon. Friend has made it a priority to raise them with me. I reiterate that I will happily take up any case in which the provider of services—whether Atos or any other service provider—does not provide a bilingual service to a Welsh speaker in Wales.

My hon. Friend the Member for Cardiff Central said the pivotal point was that we should be monitoring the situation. I can reassure her that that is exactly what we do. DWP monitors compliance with the Welsh language scheme through a mystery-shopping programme that also monitors customer complaints. A quarterly return is produced as evidence of compliance, and it is forwarded to the Welsh language liaison point within the DWP. Any evidence of non-compliance is taken extremely seriously and immediately taken up with Atos.

As my hon. Friend the Member for Aberconwy implied, this is something that he and I have been in correspondence about. I hope that he is reassured that we take the matter seriously and that we are already taking action. Atos is already taking action with regard to the work capability assessment to ensure that it has sufficient bilingual staff to provide just the sort of services that his constituents and other Welsh speakers need. Whether they are old, young or of working age, they should have access to such a service. With those reassurances, I hope that my hon. Friend will withdraw his amendment.

Guto Bebb (Conservative, Aberconwy)

I am grateful to the Minister for her comments. The Department has been consistent in its support of the Welsh language scheme—I did not make that point in my opening remarks—but the implementation has not always been perfect. Given that a new Welsh language scheme was adopted in 2010 and the fact that the Minister’s comments were extremely positive, I beg to ask leave to withdraw my amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 200, in clause 78, page 56, line 25, at end insert—

‘(ba) about which people, including healthcare and other relevant professionals, may provide information or evidence for consideration in determining the questions mentioned in subsections (1) and (2).’.

It is a shame that the Minister did not try out her Welsh in her last response, because we will not need her to do it any more today.

The amendment is about who is able to provide evidence as part of the assessment for PIP. Given that the assessment is not designed to be medical, there are many conditions where a GP or a consultant—the people generally approached to give evidence—are not the most appropriate ones to highlight an individual’s day-to-day needs. GPs can explain a claimant’s disability, but they are not best placed to explain the effect of that disability on daily life.

I was recently visited by a constituent whose 29-year-old son has Down’s syndrome and severe learning disabilities. He has carers looking after him day to day, who are in a much stronger position to explain not only his more obvious needs—such as feeding, changing and assistance at home—but the less obvious things, such as how he copes with roads and traffic. Those things have a serious impact on his ability to co-ordinate with other people, to attend activities, to get out and about and so on. The doctor could not provide that information as part of the assessment because he or she would not know. The carers are much better placed to identify his needs, particularly since PIP is concerned with how a person can be independent and interact in daily life, rather than with the prognosis of a condition.

The amendment would restrict those who could provide evidence to carers, social workers and others in a formal role. It could be extended to take evidence from people, such as informal carers, parents, partners and so on, who see someone every day and know how their disability or condition affects their everyday life. Will the Minister let us know what type of assessment the Government envisage? What sort of evidence will be taken as part of that assessment process? Would the Government consider broadening the group of people giving evidence, to make the assessment more personal and specific to the impact of a disability or condition on daily life, rather than just a traditional medical assessment?

Sheila Gilmore (Labour, Edinburgh East)

We have heard a lot about how important it is to regard the benefit as being not primarily about medical conditions, but about the social model of disability developed recently. The amendment is important in that context, as it draws out the importance of looking beyond the obvious people to whom one looks for information.

The hon. Member for Cardiff Central showed clearly the role of carers in the social model, but other professionals are not always involved at this level: occupational therapists, for example. They are often the people called in to make recommendations if people need aids and adaptations, and they often have a good grasp of the more practical aspects of daily living with a disability. Occupational therapy has gone far beyond its original image of teaching people to make baskets. It is about how to manage daily life.

There have been criticisms of how the work capability assessment has operated. It has been stated clearly that it is to be seen as a different form of assessment, and I hope that remains the case. However, one criticism that I have heard from constituents is that somewhere in the process the original intentions were not carried out. There are issues around what information is given and what is available for the decision maker, beyond the relatively brief snapshot tests by independent assessors, that can give a rounded picture and enable a good decision to be made. Many people who have had difficulties with the work capability assessment have brought that up in particular.

Regrettably, I have had a recent experience—I hope that it was a one-off—of a constituent who assured me that she had tried to provide information for a work capability assessment, but it was not taken. Admittedly, that experience came at the end of last year—I hope that things have changed now—but it shows why it is perhaps important to bring this matter out right from the start, so that, as we go down through the process, some of the same mistakes are not made again. When a decision maker is making a decision, they should have in front of them the best sorts of information from the people who are best able to provide it.

Yvonne Fovargue (Labour, Makerfield)

Does my hon. Friend agree that some GPs provide excellent information to the assessors for a reasonable charge? However, I have seen reports of other GPs charging in excess of £150 for two lines that simply say, “This person has a disability,” or, “This person has a condition.” The range of GP reports is variable, and they do not always give the correct information.

Sheila Gilmore (Labour, Edinburgh East)

I thank my hon. Friend for her intervention. From her experience, she will obviously have had cases where that has happened. For many GPs, their contact with an individual may be relatively limited. Going to a GP, even with an ongoing condition, is about being ill. It is not necessarily about having the kind of regular contact that shows what someone’s life is really like and what difficulties they are actually encountering. That is not in any way a criticism of the GP, but that is the kind of contact that they are likely to have. They will not necessarily see someone in their own home or see how they get to work or how they undertake employment, volunteering or whatever it is that the individual wants to do. There is no doubt that a GP will have had little contact with that.

It would be useful to hear what the Minister has to say about the amendment, but this is an enhancement to what might otherwise be a narrow test. I understand that the Minister feels that people are getting unnecessarily concerned, but many of the fears that people have are because of a recent experience of a test that they feel has failed to take wider circumstances into account. They want to ensure that that does not happen in this case.

Maria Miller (Conservative, Basingstoke)

I hope that I can provide some clear reassurances to the hon. Ladies who have contributed to this part of the debate and say up front that we do not want to be prescriptive about from whom supporting information will be sought. When it comes to the PIP assessment process, we recognise the importance of getting evidence from the individual disabled person themselves. As I said from the outset, disabled people are those who know the most about their own conditions. We will also, however, be working with them to identify the most appropriate additional sources of information, including professionals and those who support them on a regular basis, which may mean a GP or another individual. It is important that we are able to tailor that to the individual to ensure that we get the best possible information.

I can reassure hon. Members that we recognise the fundamental role of evidence gathering, and we want to gather the best and most appropriate evidence and do it early in the claim to ensure that assessments are as informed as possible. The evidence-gathering process will build upon our experience of DLA, where we have found that relevant evidence and information can be gained from a wide range of sources, including GPs, consultants, social workers, community psychiatric nurses, occupational therapists—the list goes on.

We are also seeking to learn from the experience of the work capability assessment, including Professor Harrington’s review, which highlights the importance of seeking advice from the claimant’s chosen health care adviser and from an appropriate health care professional who best knows the claimant’s impairment. We are still considering which people are best placed to provide such information, but we are designing an assessment that will treat people as individuals, so we do not want to be prescriptive about from whom, as I said up front, supporting evidence is sought. We believe that that could hinder the flexibility of the assessment process in responding to an individual’s circumstances. As we develop the detail of the operational processes, we will want to work with disabled people and their organisations to ensure that our approach to evidence gathering is appropriate.

I hope that by setting out our approach today, I have reassured hon. Members about the way in which we are tackling this very important problem, and that with those reassurances, my hon. Friend feels that it is appropriate to withdraw the amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I am glad that the Government are taking the concerns into account and are using a personalised approach, and I look forward to seeing some practicalities about how the assessments will work further down the line. I am reassured in particular by the broad range of professionals who might be taken into account, as the Minister just highlighted. That would hopefully mean that when the decisions are made, they are right first time, rather than having to go to appeal over and over. Therefore, following the Minister’s reassuring response, I beg to ask leave to withdraw the amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 201, in clause 78, page 56, line 29, at end insert—

‘(d) allowing a suitable person, as defined under regulations, to participate with or on behalf of the claimant in a consultation to determine the questions mentioned in subsections (1) and (2).’.

The amendment would establish the right for somebody to take an advocate into the assessment with them. Many people with disabilities rely heavily on support, not only from parents, partners, or carers in an informal way, but from formal advocates, such as welfare rights advisers, and so on. That is particularly important during the assessment process, and especially for people with communications needs or disabilities, as we discussed earlier.

At the moment, whether somebody can take an advocate into the assessment depends on the adviser’s discretion, and practice varies hugely across the UK. In some places, advocates are allowed to participate in the assessment itself. In certain areas, advocates are allowed to come into the room to sit and support in silence, but they are not allowed to say anything, while in others, nobody is allowed into the room at all. We clearly do not want to assess the advocate rather than the claimant. However, if we are trying to get the most accurate picture of somebody’s needs, and want to make a very clear assessment, putting that person at ease and having someone to interpret as necessary will mean that a better decision is made at the end of the process. Given the existing differentials across the country, leaving it to the discretion of the assessor does not work, so the amendment would clarify that everybody is entitled to have an advocate with them, if they so wish.

A number of cases have been raised about the lack of awareness by Atos doctors about some conditions, and advocates being present in assessments could help in those instances. For example, people with some forms of autism can often be very eager to please, so they say what they think the doctor wants to hear, rather than the bare truth about their condition. If a doctor or assessor is not aware of that, has not had the appropriate training, or does not know how to interpret what they are being told, the outcome of that assessment could be very unfair. Others with mental health conditions, and particularly those with anxiety disorders, might need support to be able to cope with the assessment itself. Some people with learning disabilities may need somebody to be able to explain the questions—in effect, the questions are translated into a way that the individual can understand, so that they can respond and give the information that is being asked for. That is particularly necessary, again, if the doctor does not have the appropriate training to deal with somebody who has that condition.

The amendment would make it clear that everybody can have an advocate in the assessment, and that the advocate can participate if it is appropriate, or if the claimant wants them to be able to do so. That would hopefully lead to better decisions, and it might reduce the number of appeals, thereby saving resources, too. The proposal would, all in all, make the process run more smoothly, and it would help people with a wide range of different disabilities feel that their assessment was fair, and that they had the best opportunity to put their case forward.

Margaret Curran rose—

Kate Green (Labour, Stretford and Urmston)

I shall say little on this amendment. The hon. Lady makes an important case. We have seen from the work capability assessment exactly the patchiness of understanding that she describes about when and in what form advocacy or accompaniment by a friend of other supporter will be permitted if appropriate. I simply add to the hon. Lady’s excellent list that it is not simply a matter of conferring such an entitlement; as she said, it must be made absolutely clear to claimants how that entitlement can be exercised. I should be grateful if the Minister were to confirm that, when notifying people of the requirement to attend for an assessment, there will be absolute clarity about their entitlement to take somebody with them to that assessment and what that permission will encompass.

Margaret Curran (Labour, Glasgow East)

I apologise, Mr Gray, for impersonating a jack-in-the-box; I am aware that I should sit when you stand, and I apologise for getting it wrong.

I join my hon. Friend in congratulating the hon. Member for Cardiff Central on making such significant points. She has a clear grasp of the assessment process. Highlighting the role of the advocate is important in principle, and it means much to those who make use of it. Inconsistency of practice throughout the country should be addressed centrally, and the amendment is strong on that aspect. It goes some way to addressing concerns that I have tried to articulate about the process as it is currently experienced. One of the most striking aspects, as I have mentioned before, is to do with families that have experience of autism, either directly or through caring for someone else with autism; it is their experience of officialdom that people have an enormous struggle with, and the amendment would have a significant effect in that respect. It would be a great enhancement to the process, and I support it.

Maria Miller (Conservative, Basingstoke)

May I tell my hon. Friend the Member for Cardiff Central at the outset that we believe that face-to-face consultation with the trained independent assessor will be an essential part of the assessment process for most individuals? Such consultation will not only provide for an in-depth look at the individual’s circumstances but, most important, it will allow the individual to put across his or her views of the impact of their health condition. That two-way engagement will ensure that the advice provided by the trained independent assessor to the Department reflects a full understanding of the individual’s circumstances. If an individual wishes a suitable person to attend the face-to-face assessment—a relation, a friend or possibly a professional who supports them—we will of course allow it. Such people may help them not only to articulate the impact of their health condition or impairment but to remove any personal anxiety that they may feel by taking part in the process.

The hon. Ladies who spoke to the amendment set out very well some of the concerns that we all have about an individual’s ability to put across an accurate reflection of their circumstances. Certainly there will be many instances when additional support from someone who knows the individual well and who knows the impact of their condition will be important. The person offering that support will have an important role in ensuring that the assessment process is both accurate and fair.

Individual circumstances vary, however, so we shall resist the urge to be too prescriptive in identifying who might attend the face-to-face consultation alongside the individual. We want to be flexible enough to respond to the varied lives of our customers and disabled people, and allow individuals to be able to choose who they believe would be more appropriate to accompany them to a face-to-face consultation. However, although we are absolutely supportive of the idea of another person attending an assessment, the hon. Member for Cardiff Central and I will have to agree to disagree about whether someone can attend in place of the disabled person.

Maria Miller (Conservative, Basingstoke)

I will continue with my comments on the amendment. As I was saying before we adjourned, I was not sure whether it was the intention of my hon. Friend the Member for Cardiff Central to table an amendment that would allow an individual to have another individual attend an assessment in their place, but that is what the amendment would do.

The face-to-face consultation will play a pivotal role in the assessment as a whole, allowing the nuance of how a health condition or impairment affects the individual specifically to be explored in a two-way discussion. It also provides an opportunity to observe an individual, consider their mental state and directly assess any physical impairment, if relevant. As such, it is critical that the individual themselves be part of the process wherever possible.

We recognise the importance of ensuring that the assessment process is appropriate to an individual’s circumstances and appreciate that face-to-face consultations may not be appropriate in absolutely every case—for example, when there is sufficient evidence on which to make an assessment for those individuals with the most severe impairments or those who are terminally ill.

My hon. Friend raised concerns about the work capability assessment and the role of advocates within the system. I assure her that individuals are encouraged to bring someone along for support if they feel that it would be useful. Atos Healthcare, the organisation that provides the work capability assessment, ensures that training includes guidance on how to work effectively with advocates.

Jennifer Willott (Liberal Democrat, Cardiff Central)

From my experience and that of other hon. Members, I understand that there are instances in which people have not been allowed to take the advocate into the assessment with them, and other times when an advocate has been allowed to go in but not to say anything, participate in any way or even assist in the assessment. What will the Department do to ensure that that does not happen? If the Department encourages advocates to go along, it would be helpful if that were to happen everywhere and they could participate as and when necessary.

Maria Miller (Conservative, Basingstoke)

Although I do not want to stray too far into the work capability assessment, I assure my hon. Friend that we very much believe that advocate supporters have an important role, and we certainly see them playing an important role within the personal independence payment scheme and the work capability assessment. There could be circumstances in which advocates might not have a positive role within an assessment process, but I am sure that such cases will be few and far between.

It is important to us that advocates have a role, whether in the PIP scheme or the work capability assessment. If there were instances in which that was not happening and my hon. Friend brought it to my attention or the attention of my right hon. Friend the Member for Epsom and Ewell, the Minister, I am sure that we would be interested in looking into the matter further.

It is, of course, essential to get the PIP processes right. No conclusions have been reached yet on the delivery model for the new assessment, and we are therefore keen to work with disabled people and disability organisations to develop appropriate processes that reflect and cater for individuals. I hope that with those reassurances, my hon. Friend feels that it is appropriate to withdraw her amendment and feels encouraged that we are very much in the same place on this issue.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I am reassured that the Minister sees the role of an advocate as important in the process and that the Department is “encouraging” their involvement. “Encouraging” is a good word; it is positive and proactive, and I am reassured that it reflects the Department’s attitude. There are problems with how the work capability assessment will be rolled out across the country. Given that the Minister has highlighted her belief that advocates will play an important role in PIP assessments, I hope that the Department will take on board some of the issues with work capability assessment advocates when PIP assessments are rolled out.

I am reassured by the Minister’s words, however, and I appreciate that the wording of the amendment has some unintended consequences. I clearly did not mean that someone should be able to attend an assessment in place of someone else. Given that the wording is dubious, I beg to ask leave to withdraw the amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 202, in clause 78, page 56, line 29, at end insert—

‘(d) exempting certain groups from a requirement to participate in a consultation to determine the questions mentioned in subsection, (1) and (2).’.

James Gray (Conservative, North Wiltshire)

With this it will be convenient to discuss amendment 218, in clause 78, page 56, line 40, at end insert—

‘(9) Regulations shall exempt people with prescribed medical conditions from the requirement in subsection (4)(c), including in prescribed circumstances where the individual is—

(i) severely mentally impaired;

(ii) a double amputee;

(iii) deaf/blind;

(iv) undergoing haemodialysis;

(v) severely visually impaired; and/or

(vi) meets the requirements of special rules set out in Clause 80.’.

Jennifer Willott (Liberal Democrat, Cardiff Central)

The amendment is about exempting some people from the initial assessment. The Minister mentioned in her comments on the previous amendment that the Government see that some people should be exempt—those with terminal conditions, in particular. She mentioned some other exemptions as well, so I will be brief, and grateful for more detail.

As the principle has already been accepted, the amendment is for teasing out a little more what the Government are thinking. I appreciate that the proposal does not need to be in the Bill, but it is a good opportunity to raise some of the issues. Until now, some cases have been exempt from regular assessments; a selection is set out in amendment 218. I was trying to be less prescriptive about some cases, but others are laid out clearly. Some disabilities are so serious—people are born with certain conditions—that they will never change. Assessing those in the most severe categories seems a waste of time and money.

For some groups, in particular those with various mental health conditions, assessment worsens their condition. I have examples from casework, as I am sure other Members have. In a work capability assessment, a GP may in effect sign people off, by stating that it would not be appropriate for them to go to regular reassessments for the purposes of continuing their employment and support allowance, on the basis of the detrimental effect on mental health. How that works involves a number of issues, and it applies to a very small number of people, but through the amendment I hope to explore whether there can be a similar mechanism for PIP assessments.

Some of the disability organisations have suggested a tiered approach to assessment, so that we start with the paper evidence in the self-assessment and from medical professionals. If the evidence justifying a PIP is already there, so be it; if more evidence is needed, that person can go to a face-to-face assessment. That would mean that not everyone needs to go on to that second stage and some cases could be decided earlier, on the paperwork.

The Government are looking flexibly at the issue. Lord Freud recently said in the other place that the Government would not insist that people were seen face to face if that was

“not realistic, helpful or appropriate”—[Official Report, House of Lords, 10 March 2011; Vol. 725, c. 1749.]

A similar point was made in the Government response to the PIP consultation, so I know that they are minded to be flexible.

The amendment need not be included in the Bill, but it provides an opportunity for the Minister to clarify the circumstances and possibly to expand a little on the types of cases in which people will be exempt from the initial assessment. I hope that the Government will be generous about whom they consider to be in that category.

Margaret Curran (Labour, Glasgow East)

I will speak to amendment 218. I thank the hon. Member for Cardiff Central for some interesting points. My points are similar, but my emphasis in this amendment and some of the issues that I wish to flag up are probably slightly different, although they sit happily with the points that she made.

Amendment 218 would secure automatic entitlement to the personal independence payment for the severely disabled. The emphasis that is different is that those conditions would be the same as for those who already automatically receive DLA because of the consistency argument and the message around that. I hope that my argument will become clear as I progress through my points.

I remind the Committee that the categories are: severely mentally impaired; double amputee; deaf-blind; undergoing haemodialysis; severely visually impaired; and terminally ill, which is already covered by clause 80. I understand the argument that I am sure the Minister will make—she has already done so this morning: some people believe that there should not be automatic entitlement because the issue goes to the heart of the principle of what is trying to be achieved. It is not about defining people by their disability, and it is not about an impairment-linked disability benefit. I understand those arguments, but my limited proposal would not undermine the principle. I have had some interesting discussions with groups and individuals about the matter.

My amendment would improve part 4 of the Bill in two major ways. First, it would greatly reduce anxiety among severely disabled people who fear having a test to prove their disability, and would have to have one again and again. It would provide a cost and administration saving on the needless assessment. It is important to appreciate that the amendment would give automatic entitlement for only six conditions. At the moment, around 41,500 severely disabled people of working age automatically receive DLA. In the grand scheme of reform, which will affect 1.8 million people of working age on DLA, the change would be small, but would make a massive difference to those who are incredibly anxious about going through a face-to-face assessment.

To put the matter into context, I had asked the Minister how many new claimants of working age for PIP payment could be identified year on year, so that we had some sense of the scale. She could not say; I got that answer on Monday. However, if the number is 1.8 million overall, around 600,000 will have to be reassessed per annum, which is around 11,500 every week or around 2,300 every day. That is a monumental exercise, so my amendment to exempt 41,000 is a small matter. Given the circumstances in which the people involved live, it is also reasonable.

The Minister will know that there is widespread support within the disability movement for an amendment to retain automatic entitlement for those with severe disabilities that will clearly not change during their lifetimes. Many organisations understand the social mobility model and the arguments about people not being defined by their impairment, and they argue their case strongly. The Disability Benefits Consortium says:

“PIP will not have any ‘automatic entitlements’. However, if it is clear that certain impairments will always meet the criteria for PIP then PIP should include automatic entitlements in these cases, as they provide an easy way of awarding benefit to people who are certain to qualify and mean money is not wasted on assessments that could be spent on supporting disabled people. PIP should include automatic entitlements for those cases where an individual’s impairment means they will always meet the criteria for the benefit”

and everyone will know that. The Royal National Institute of Blind People has described the move to end automatic entitlement for certain conditions as

“a retrograde step which would not only introduce uncertainty for claimants, but would remove an administratively straightforward process from a small number of well-defined groups. This runs counter to wider efforts to streamline benefit administration.”

Another quote is:

“The case for the deaf blind and severe visual impairment higher mobility provision is very strong. The numbers of visually impaired people getting DLA (where visual impairment is the ‘main disabling condition’) are broadly the same as the numbers registered, so automatic entitlement based on registration and certification evidence would be accurate, objective, administratively simple, cost-effective and easy for claimants to understand. Existing experience of DLA, where an assessment is carried out by a non-specialist, is that the assessment is often inaccurate or clear medical evidence is misinterpreted”.

We must address the stress and anxiety of face-to-face assessments for those who clearly need help. Wholesale reform of DLA will have massive implications for millions of disabled people, as I have already said. We cannot underestimate or brush aside the level of anxiety that many people feel about that. The prospect of going through a face-to-face assessment and having ultimately to prove their disability to receive help is incredibly stressful and worrying for many, many disabled people.

Let me quote one example of what someone has said:

“My other general concern - as someone with no sight at all and who is registered deaf blind - is the withdrawal of automatic entitlement. I can’t really see the point. Certification as vision impaired is done by an eye consultant with whom one usually has a long-term relationship and who knows your case history and the impact of your sight loss intimately. I cannot see how a so called ‘objective’ assessment can replace this.”

Wherever possible, we should do anything to try to ensure that the transition to PIP is as smooth and calm as possible. Surely protecting the severely disabled from facing an assessment is one way in which we can do that. We know that the Government plan on spending £675 million on the establishment and administration of PIP. That is a huge amount of public money and I am sure that we will continue to talk about it. However, just a small amount could surely go some way towards dealing with my concerns.

I shall refer to some of the points made in the briefing paper that the Minister issued last week, which picks up some of the matters raised by the hon. Member for Cardiff Central. The briefing note published by the DWP last Friday suggests that some people may not be subject to face-to-face assessments. It states that assessments will be carried out with a trained assessor but, in some cases, a paper-based assessment may be more suitable. Just to repeat the comments made by the hon. Lady, I would be grateful if the Minister said what that will actually mean. Although a paper-based assessment is better than a face-to-face assessment, it is still an assessment and it means that we are taking away that automatic entitlement and guarantee. The use of such an assessment does not fundamentally address my points.

The briefing note has also produced some draft indicators that are beginning to shape our understanding of the Government’s direction in relation to the assessment process—although, again, we are told that that process and consultation on the assessment is ongoing and is by no means complete. We have had that discussion and I will not repeat those points but, none the less, many people face anxiety about the matter.

One set of draft indicators that are causing concern are those that affect the severely visually impaired. Of course, that is relevant to the discussion on clause 78, as the severely visually impaired are one of the groups that the amendment seeks to cover with regard to automatic entitlement. I presume that Committee members know that the previous Labour Government worked very hard and successfully with disabled people and their organisations to campaign for those with severe visual impairments to be automatically entitled to receive the higher rate of DLA mobility. Under the current proposals, some 25,000 severely visually impaired people stand possibly to lose out as a result of the decision to discard a hard-fought-for and much-agreed-upon policy development.

What is more, according to the draft indicators before us today, it is becoming increasingly apparent that the Government plan not only to stop thousands of severely visually impaired people from automatically receiving PIP, but to go a step further and separate claimants into two specific groups: those who have adapted to their visual impairment and those who have not. That raises ambiguity and questions about what aids and adaptations will be taken into account. I ask the Minister for clarity on that because a lack of clarity raises alarms and concerns.

I am obliged to note that the Minister supported automatic entitlement for severely visually impaired people no later than June 2010, when she indicated that she was: “committed to making sure that help gets to the people who need it.”

She went on to say:

“We’ve taken steps today to extend the higher rate mobility component of Disability Living Allowance to severely visually impaired people”.

The Minister was pleased that 22,000 people benefited from that. I cannot understand how in June she was pleased, but she is now trying to take away that automatic entitlement.

The core point that I am trying to make is about the guarantee of the entitlement, so that people know they will receive it, rather than their needlessly having to go through an assessment that everyone knows they will probably pass, with the administration costs that go with it. It is important that we look at those issues and see whether we can amend the Bill appropriately.

This is an important amendment. It seeks to avoid needless assessment that will both cost the taxpayer money and put unnecessary stress on the disabled person who must now prove that they have a severe disability before they are given support. Does the Minister think that people with the conditions listed in the amendment, such as severe mental impairment and those I have already described, should always have to undergo an assessment? Currently the Bill automatically gives PIP to only one group of people—those who are terminally ill. While we agree with that decision and welcome it, we urge the Government to go one step further. The issue matters fundamentally to the people in this category and their families. They are waiting for us to give ground on this matter, so I hope that the Minister will look at those arguments.

Maria Miller (Conservative, Basingstoke)

We have reached an important point in the debate. We have found an important point of difference between the Government’s approach to the reform of DLA and the Opposition’s approach. One of the firm, underlying principles of what we are doing is to recognise each and every disabled person as an individual. That is important. For too long, disabled people have been labelled by their disability rather than considered as individuals. Blanket assumptions have been made about what people can and cannot do simply because of their conditions. We do not feel that that is an appropriate way forward and the responses to our consultation would tend to suggest that many others would agree with that stance.

We recognise that people live varied and complicated lives and do not fit neatly into boxes. Many people will have multiple conditions. The hon. Member for Glasgow East referred to individuals who are deaf-blind. That is a condition that deteriorates over time. There is a risk in simply saying that an individual does not require some sort of touch point with the Department to make sure that their needs are being met. Individuals who are looking for support from various benefits should be able to make sure that they are in receipt of the right level of support for their conditions.

Sheila Gilmore (Labour, Edinburgh East)

If the person is already receiving the highest rate of benefit, what is the purpose of further assessment at that stage? Is the Department putting itself in the role of a key worker for that individual to access other forms of support and is that something the Minister envisages the Department doing?

Maria Miller (Conservative, Basingstoke)

The hon. Lady mentions individuals who are in receipt of the highest support. I am not sure which conditions she is thinking of. Those conditions might change over time. It is impossible to say that one would just exempt people from having a reassessment simply because they were in receipt of the highest support. I should like to assure the Committee that, in some situations, individuals might not need to come forward for face-to-face assessments. We could assess them through a paper application process, with supporting evidence that they did not need a face-to-face assessment.

I have been in discussions about various other opportunities as well, particularly for people with serious mental or cognitive impairments where it would be difficult for them to go to an unfamiliar place. We are already exploring opportunities for the potential of home visits or assessments in more familiar places. The previous Government created this principle so that lone parents could go to interviews while they were in receipt of income support. They would go to Sure Start centres for assessments—an extremely good way to ensure that individuals regularly attended the interviews, being mindful of the restrictions that might affect them.

Lilian Greenwood (Labour, Nottingham South)

I want to pick up two points. First, my hon. Friend the Member for Edinburgh East said that, under the current rules, those who are deaf, blind or severely visually impaired have an automatic entitlement to the higher rate of mobility component. I think that she was seeking to make the point that, if someone is reassessed, there is no further support if they are already on the higher rate.

Secondly, the Minister seemed to imply that the Opposition did not seek to treat disabled people as individuals. The point about automatic entitlement is made in a joint submission for the visual impairment sector, which speaks on behalf of a number of people dealing with visual impairment and deaf-blindness. I do not feel that we are out of kilter with the views of the disabled people whom we seek to represent.

Maria Miller (Conservative, Basingstoke)

I apologise if I misunderstood the hon. Member for Edinburgh East. I did not realise that she was particularly focusing on those groups. When an individual is in ongoing receipt of the highest benefit, there may always be ways in which we can assist people to look for new ways to try to support them with their impairment. PIP might have a role not in removing the support that is there, but in ensuring that they get access to the right level of support.

The hon. Member for Nottingham South mentioned briefings that she received from various groups. She may be aware that there is a difference of opinion between groups on whether it is appropriate to look at an individual’s impairment and passport them through as a result of a specific impairment. That is a debate for another day. It is an important principle that we look at the people first and foremost and at the effect that the condition has on their ability to participate in daily life.

Kate Green (Labour, Stretford and Urmston)

I want specifically to ask the Minister about the point she made a moment ago about the possibility of assessment in people’s own homes. Of course that would be welcome and appropriate in a number of cases. However, many people cope better in their own homes than when they are out and about. Will the Minister assure us that the individualised approach that she talks about will properly reflect whether people can function, not just in their homes, but in the wider community?

Maria Miller (Conservative, Basingstoke)

The hon. Lady makes an extremely important point. We are in no way suggesting that the proposal is an attempt to reduce or identify inaccurately the support that an individual needs. As we move forward, it is right to explore different ways to assess individuals. The hon. Lady might be aware that we already undertake some home visits where appropriate—this is not a completely new idea—but she is right to caution and to want to ensure that the assessment is accurate.

A number of hon. Members referred to the DLA blind measure recently put in place. It is important that the Committee knows why the Government decided to proceed with that. The previous Administration worked on that important measure for a number of years, because of DLA’s failure to tackle or accurately assess the needs of individuals who are blind. Our decision to proceed with the measure underlines the DLA’s shortcomings. Its assessment criteria simply do not accurately pick up the needs of individuals who are blind. We talked earlier about mobility and the fact that because someone could not walk, they will be deemed as in need of further mobility support. The current DLA assessment simply does not take enough account of individuals who have sensory impairments. Presumably, the Opposition agree, which is why they introduced the measure in the first place.

Margaret Curran (Labour, Glasgow East)

May I ask the Minister to clarify what she has just said? She seemed to be arguing that the Government extended a benefit that they did not agree with because it was not structured or organised properly and it had fundamental flaws. Why did the Government agree to extend a benefit that they fundamentally disagreed with?

Maria Miller (Conservative, Basingstoke)

We agreed to implement the DLA blind measure because we want to ensure that support is there for people who need it. As the previous Administration had identified, DLA was not supporting people who were blind. They proposed a measure that took an extremely long time to introduce. The legislative structure of DLA meant that the allowance was not easy to amend. Such provisions are mainly defined not in regulations but in primary legislation. In a nutshell, the reason why we have introduced this measure is that we want blind people to get the support that they need and, at the moment, DLA fails to give them that.

Lilian Greenwood (Labour, Nottingham South)

Will the Minister clarify how many blind people are missing out on the opportunity to get extra help with the costs of their disability? How many extra people will be able to claim PIP and how much will it all cost?

Maria Miller (Conservative, Basingstoke)

If the hon. Lady had been following the earlier part of the debate more closely, she would know that we cannot define that yet because we are in the process of finalising the assessment. We will produce more detailed figures in the future.

At the risk of us all incurring the wrath of Mr Gray, we should perhaps go back to the issue at hand in amendments 202 and 218. For most people, a face-to-face consultation with a trained independent assessor will play a key role in creating a much fairer, more objective and more transparent assessment process. Such a consultation will also provide individuals with the opportunity to put across their own views on how their health conditions or impairments impact on their everyday lives. We recognise the importance of having a system that is flexible to meet each individual’s needs. As I have outlined, we will have those flexibilities inbuilt in our system.

In proposing these amendments, my hon. Friend the Member for Cardiff Central mentioned individuals who are born with disabilities and conditions that do not change. She said that they could benefit from an assessment exemption. At this stage, we do not propose that the new PIP would apply immediately to children. We want to take time to learn from the initial implementation of PIP and then look at how we can simplify the assessment process for children as we move forward, working in consultation with our colleagues in the Department for Education and the Department of Health.

I take issue with my hon. Friend’s key point. It is important that we help people as their conditions change and evolve over time and that we have a real understanding of the multiple conditions that they face. The way in which conditions change can be variable. Blanket treatment of individuals opposes one of the key and underlying principles of PIP, which is that of treating each person as an individual.

The broad condition types are listed in amendment 218, which was tabled by the hon. Member for Glasgow East. They do not necessarily say much about need and the impact that the impairment has on the individual. We may not need to see some people with such conditions on a face-to-face basis, but that may be the only way in which we can truly understand the support that other people need.

Exempting individuals with prescribed conditions would fail to reflect any co-existing condition that an individual may have. Such conditions could have a far greater impact on the individual, but that may not be identified simply because they are defined by the principal condition. It is precisely for those reasons that, although we accept and appreciate that face-to-face consultations are important for the majority of people, we will have exemptions, but we will not state them in the Bill.

Margaret Curran (Labour, Glasgow East)

Did I hear the Minister correctly when she said that there will be exemptions? Will she clarify what those exemptions will be?

Maria Miller (Conservative, Basingstoke)

As I said earlier, there will be situations where a face-to-face consultation may not be required because of paper-based evidence. There may well also be cases where such a consultation may not be required in a prescribed place because of a serious mental or cognitive impairment, and we could then provide home visits. As my hon. Friend the Member for Cardiff Central said, the important thing is that we ensure that the way that we assess individuals is as flexible as it can be. We have also made it clear that we will continue the special rules for terminally ill people, and we do not plan to ask them to attend face-to-face consultations. I hope that those comments reassure my hon. Friend and the hon. Member for Glasgow East and that my hon. Friend will feel able to withdraw the amendment.

James Gray (Conservative, North Wiltshire)

Order. I am conscious that it is rather warm in the Committee Room, and therefore hon. Gentlemen may, if they wish, take their jackets off. That is contrary to my normal practice; I will not be doing so, but hon. Members may.

Jennifer Willott (Liberal Democrat, Cardiff Central)

We have had an interesting debate about exactly how the proposal will work. I am aware that we have strayed into the territory of the next group of amendments, so I am sure that the debate on them will be quick. I am glad that the Government will consider paper assessment to be appropriate for some people.

Stephen Timms (Labour, East Ham)

I think that I understand where the hon. Lady is heading with her remarks, but I urge her to stick to her guns with the amendment. From the Opposition’s point of view, she made a telling case in introducing her amendment, which was expanded further by my hon. Friend the Member for Glasgow East, and we have had a vague and unsatisfactory answer from the Minister. I hope that she will press the amendment to a vote, and if she does, she will find a good deal of support from the Opposition.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I thank the right hon. Gentleman. He has not yet heard my remarks, but I will disappoint him, because I do not plan to press the amendment to a vote, and I will now explain why.

I am glad that the Government accept that it is not appropriate for everyone to have a face-to-face assessment. That principle is quite important. I am also glad that they are exploring alternative ways of doing an assessment, because those of us who have been Members for a while are always coming up against cases where people have not been treated appropriately for their disability. Taking that into account and doing assessments in different places might make the system simpler for people to participate in. Our recent debate on advocates is a crucial example of why we need them to be encouraged to be part of the system and for them to be accepted as part of it. If we assess a broad range of people, it will be hard for many of them to get a fair hearing without support and advocates working with them during the assessment.

Kate Green (Labour, Stretford and Urmston)

Does the hon. Lady share my puzzlement at what the Government are assessing in respect of the people whom she encompasses within her amendment? Their conditions are severe and unchanging, and it is clear that even paper evidence will simply reinforce evidence that was received two, four, six and eight years ago.

Jennifer Willott (Liberal Democrat, Cardiff Central)

Amendment 202 actually relates to the initial assessment only, and the next amendment that I tabled is about the ongoing reassessment of people. I agree with the hon. Lady that an assessment is not necessary for some people who should be entitled to PIP. I understand where the Minister is coming from when she says that she wants everyone to be assessed at the beginning of the system, but I have some issues. Some people should be exempt, but the Minister has made it clear that there will be some exemptions, and we have to see, in time, who the Government include in those exemptions.

I hope that the Government will keep an open mind and see how the system works in practice, because there is a whole world of difference between the theory—the way that legislation and guidance are put together—and how it is implemented. An awful lot of the cases that we have seen as Members of Parliament, where people have had difficulty with the structures currently in place, were never foreseen, or the difficulty was caused by the way that something was implemented, rather than the bare bones of the structure. It will be important to see how the system is actually implemented on the ground. A lot of that will involve working with Atos and how it implements the system. The Department can have various policies in place, but if they are not implemented by Atos, we have a whole load of problems.

Maria Miller (Conservative, Basingstoke)

I absolutely endorse what the hon. Lady says. This is an iterative process and we will always learn along the way, but may I gently remind her that Atos has not been chosen to implement this programme? Any assignment of that contract will be done through the usual procurement processes.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I am glad to hear that, and I hope that the Government keep an open mind about who they might consider for running the assessments as well. I hope that, in keeping that open mind and learning from how the system works in practice, the Minister will consider, over time, adding categories and conditions to the list that would be exempt from initial face-to-face assessments. She referred to flexibility. I hope that the Government will consider extending that flexibility as we learn and possibly include other people in the exempt category, so that we learn from the experience as PIP is rolled out. Given that there are already exemptions and that the Government intend to make them, it seems clear that the amendment is not needed; it is already possible to make exemptions.

Stephen Timms (Labour, East Ham)

Does not the hon. Lady accept that the Minister has plainly refused to give her the reassurances that she is seeking? I accept that there is another mechanism by which such things might be done, but the Minister has given absolutely no assurance that that will happen.

Jennifer Willott (Liberal Democrat, Cardiff Central)

It is clear that the amendment is not necessary. We do not need to amend the Bill for such things to happen. I might not completely agree with the Minister on how many people are exempt, who is exempt and how that operates, but it seems clear to me that the amendment is not needed for that to happen.

Maria Miller (Conservative, Basingstoke)

Perhaps the right hon. Member for East Ham is not clear about what I said, so perhaps I should make it absolutely plain that, where we have sufficient evidence to make an assessment for someone with the most severe impairments, we would not expect to undertake a face-to-face consultation.

Stephen Timms (Labour, East Ham)

Will the Minister give way?

Maria Miller (Conservative, Basingstoke)

The right hon. Gentleman cannot intervene on an intervention.

We could therefore provide individuals with an alternative to face-to-face assessment as part of that process. I do not think that there is a huge gap between us.

Jennifer Willott (Liberal Democrat, Cardiff Central)

We are discussing how many people are considered exempt—the categories and conditions for which the Government would consider an exemption from the initial assessment. Clearly, the legislation does not need to change for that to happen. There is now a debate about who is considered in that category and what process there is for considering more people.

Kate Green (Labour, Stretford and Urmston)

The hon. Lady talks about categories being deemed exempt from face-to-face assessment, but my understanding is that the Minister is saying that individuals will not be required to go for face-to-face assessment. Does the hon. Lady accept that that is rather different from the assurance that she seems to think that she has heard?

Jennifer Willott (Liberal Democrat, Cardiff Central)

I do not understand exactly what the hon. Lady is saying. I apologise if my language is not precise enough but, from what the Minister has said today, it is clear that the Government will put in place a process in which not everybody is expected to go for a face-to-face assessment. My concern was that the legislation was going to make it compulsory for everybody to have a face-to-face assessment whether or not that was appropriate. It is clear from what the Minister has said that there is a process for identifying people—whether categories of people or individuals—who do not need a face-to-face assessment. I wanted to hear the acceptance that such assessment is not appropriate for everybody. I am sure that there is going to be an ongoing debate on Third Reading, and in the other place when Bill goes to the House of Lords, about the individuals or categories to which assessment should apply .

Stephen Timms (Labour, East Ham)

Several Committee members find themselves in a slightly difficult position. We agree with the case that the hon. Lady has put to the Committee and disagree with the response that the Minister has given. We would like the opportunity to vote in favour of the amendment that the hon. Lady has moved and support the argument she has put to us. I hope that she will give us that opportunity.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I am sorry to disappoint the right hon. Gentleman, but I do not intend to push the amendment to a vote. It is quite clear that we do not need such a measure in the Bill. There is going to be a lot debate in future about which categories and individuals should be exempt, but we do not need the amendment in the Bill for that to happen and for people to be exempt. I beg to ask leave to withdraw the amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 203, in clause 78, page 56, line 29, at end insert—

‘(d) exempting certain categories of people from any requirement to participate in an assessment (or repeated assessments) where their diagnosis, or available medical and other expert evidence, is deemed sufficient to determine the questions measured in subsections (1) and (2).’.

This should be a brief debate, because we strayed into this territory in the debate on the previous amendment. The amendment is designed to make it possible for some people not to have to go for reassessment, so that, after the initial assessment, they do not have to be reassessed regularly. In some cases, it is a waste of resources to do that when people have a condition that we know will not change, or will certainly not get any better. Reassessments were raised with me by a constituent whom I mentioned earlier and whose 29-year-old son has Down’s syndrome and a mental age of less than six. That condition is never going to change—it probably will not get much worse, but it certainly will not get better. His condition will be constant throughout his life. Reassessments seem to me to be a waste of time and money, and it causes stress for him and his family to go through them regularly.

That point applies to a range of different conditions; there are degenerative conditions such as Parkinson’s, motor neurone disease and multiple sclerosis, where there will not be an improvement, and someone will only get worse over time. I appreciate that the Government in effect want to keep tabs on how somebody’s condition is progressing, and I hope that the Minister can confirm today that they will consider paper assessments in circumstances where people’s conditions will not improve and they will not be taken out of eligibility for PIPs.

We have already discussed necessary exemptions for the initial assessment, but slightly different criteria apply to regular reassessments. There is probably a fairly limited group of conditions and a limited number of people involved, and it should be possible to do an assessment using a medical assessment, prognosis, GPs, consultants and so on, rather than requiring people to come regularly for reassessment. Given that we have had a lengthy debate about this issue, that is all I will add, but I hope that the Minister can reassure us on those matters.

Margaret Curran (Labour, Glasgow East)

I want to make a few points. Although similar arguments were made about an earlier amendment, there are a few points of principle wrapped up in this amendment too, and I wish to draw attention to them. I take the point that this is about reassessment, and perhaps we cannot cover the principle of assessment itself. However, enshrined in the amendment is the notion of categories of people, not individuals, and that is not in step with what the Minister has said, so I think that we need to resolve that issue. I support what the hon. Member for Cardiff Central said, as it is reasonable to look at categories. We are talking about a very limited number of people, which will not undermine in any way the general thrust of the Bill.

The hon. Lady also discussed the Government’s intentions. The implicit purpose of looking at individuals, rather than categories, is to keep tabs on people with such conditions. I have not yet heard a satisfactory argument about why it is necessary to keep tabs on certain people, or what the purpose is of doing so. If it is to ensure that people receive a range of support to assist them with their conditions, I would accept that argument, but I do not regard that as a function of the Department for Work and Pensions. It is more likely to be the function of the health service, or social care support. If it is to be the function of the DWP, that is a very significant development, which should be clarified this afternoon. It is very important to try to understand exactly what is in the Government’s mind. If there are other benefits to which they think people are perhaps not entitled, perhaps the Minister will explain that. We have not received proper clarification about those matters at all, but the principle that the hon. Lady is promoting in the amendment is worthy of consideration and support.

Maria Miller (Conservative, Basingstoke)

I do not want to repeat the points that I made on the previous amendment, but I will summarise our view for my hon. Friend the Member for Cardiff Central and reiterate some points that I have made. Although we think that face-to-face consultations are an important part of the process for most people, we accept that it will not be appropriate in every case. In particular, where we have strong enough evidence to make a decision on entitlement, a face-to-face consultation may not add very much value, and in such cases, a paper-based assessment of an individual may well be more appropriate. All individuals should be assessed, but we want the process to be tailored to individual circumstances and, most importantly, to be carried out sensitively, as emphasised in Professor Harrington’s review.

Lilian Greenwood (Labour, Nottingham South)

I am trying to understand the Minister. She seems to be saying that there will be a reassessment, albeit a paper one. If people are in receipt of the higher rate of PIP and they have a lifelong or degenerative condition, the purpose of the reassessment process is not clear. For example, if they are deafblind or have multiple amputations and are in receipt of the higher level, why do they need to be reassessed at all?

Maria Miller (Conservative, Basingstoke)

I hope to address that very issue, if the hon. Lady will allow me.

As the Committee knows, we are indeed considering the detail and the likely operational processes of the new personal independence payment. We recognise the importance of getting it right, which is why we are working with disabled people and their organisations as we develop such matters, ensuring that we can cater for individuals and individual circumstances.

If we should decide—for example, as a result of testing the assessment or in the light of operational experience—that we need to deem certain individuals exempt, we already have the powers to do so in clause 78(3)(a). For that reason, I cannot accept the amendment of my hon. Friend the Member for Cardiff Central, because it would duplicate an existing power in the Bill. However, perhaps the hon. Members who participated in the debate can, in summary, accept that it is our overwhelming desire to treat every person who applies for or is in receipt of a PIP as an individual. That is the main premise of this benefit.

We fully understand the issues raised in the consultation and in today’s debate. For some individuals, the standard approach is not an appropriate way forward. We have already made provision in the Bill to consider the matter further. In all cases, it is right to have a tailored and flexible approach so that we can, wherever possible, accommodate the needs of disabled people, in the way in which we would accommodate the needs of every other person in this country, not simply labelling them by their condition.

As I have said, the Bill includes clear provisions on terminally ill people. Those separate provisions, in clause 80, allow people to be dealt with quickly. It is remarkable that, at the moment, the Department is able to deal with such requests in less than six days, which is to be commended. I hope that my comments and the existing provisions in the Bill to accommodate such circumstances, if the need arises, will allay some of the concerns expressed in the heated debate on the amendment. It is important that such concerns are expressed and that we talk about general principles, but it is also important that we touch on some of the practical realities as we progress. With that, I hope that my hon. Friend will feel it appropriate to withdraw her amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I appreciate the fact that the Government are considering different and less intrusive ways of reassessment. I hope that they make progress, because the process of reassessment can be extremely stressful, generating significant anxiety for many people, in particular those with mental health problems. For those with lifelong, unchanging conditions, facing yet another reassessment seems more of a drag. I am glad the Government are considering less intrusive reassessment.

Margaret Curran (Labour, Glasgow East)

I urge the hon. Lady to press the amendment to a vote. I take the point that the Government are addressing some of the concerns that have been expressed, but we need to take the opportunity to make provision in the Bill and to resolve some of what we are beginning to hear as contradictions, otherwise the people whom she is describing and whose cause she has advocate will not get the anticipated outcome. The best way to achieve that is to stick with it and to press the amendment to a Division.

Jennifer Willott (Liberal Democrat, Cardiff Central)

First, the Minister has clarified the fact that the issue is dealt with in the Bill. Secondly, if Opposition Members wanted to press the matter to a vote, they should have tabled their own amendment. They did not table any amendments on the matter, although it was entirely in their hands to do so.

I am sure that it will become clear as the process continues that there are people whom it is simply not worth reassessing—it is not worth if from their perspective and it is not worth it from the Government’s perspective. I am reassured that the Minister clarified the fact that the Government will look at that in future and that the power is already in the Bill to take that into account. As the power is there already, the process will need to adapt with time. Strong views are clearly held across the House and by members of the public that there are people whom it is not worth reassessing and who should be exempt from the initial assessment. Given that the Government have accepted both those principles and the power is in the Bill, I beg to ask leave to withdraw the amendment.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 204, in clause 78, page 56, line 40, at end insert—

‘(7) The Secretary of State must consult with appropriate organisations prior to drafting regulations made under sections 78(3), 78(4) and 78(5).’.

This is a less controversial issue. The amendment is linked to the previous amendments that I have tabled. It is about the importance of consulting disability organisations and individuals with disabilities. I am sure that the Minister agrees that it is important to consult at an early stage to avoid the mistakes made by the previous Government in designing the work capability assessment. If we can make the system better right from the start—particularly for things such as fluctuating conditions, which are a perennial problem in the assessment process—we can make life much easier for the people who are undergoing assessment.

I appreciate that the process is different from the WCA and that the system is entirely new. The fact that it is an entirely new type of assessment and a totally different benefit means that it makes sense to involve disability organisations and individuals from the start to try to get it right. I know that the Government consult constantly. In discussing an earlier amendment, the Minister mentioned the consultation that has already taken place with organisations representing disabled people. I would be grateful if she were to reassure us that the Government will consult both organisations and individuals, because they have an important voice that needs to be heard. We should ensure that we do not make the mistakes of the past, and that we design a system that needs fewer changes once it has been put in place.

Kate Green (Labour, Stretford and Urmston)

I am pleased that the amendment has been tabled, for the reason highlighted by the hon. Member for Cardiff Central. It is clearly important that we improve the process from the outset, rather than having to catch up later by putting right badly designed provisions.

Will the Minister outline how the consultation process will be carried out? Will there be written consultation, with an invitation for people to put in written submissions? Will there be an opportunity for proper detailed work to be carried out with disability organisations and disabled people to design the detail of what the assessment will look like, and not just a high-level and generalist consultation in which those organisations and people express concerns? The lessons that I learned from the early stages of attempting to design the WCA were that that there were initial attempts to do that round table detailed design work with disability partners. After a time, that process became more difficult, and ultimately perhaps some of the organisations lost faith in it. Will the Minister assure us that that will not happen? What processes and steps does she intend to take to ensure that is the case?

Maria Miller (Conservative, Basingstoke)

I assure my hon. Friend the Member for Cardiff Central and the hon. Member for Stretford and Urmston that consultation is at the heart of this programme of work, right from the start. The latter asked for an assurance that this is not only about high-level consultation. It is easy to reassure her on that, because we have been working with a group of specialist advisers of disabled people, representatives of organisations and health care professionals on the development of the assessment criteria, and we will continue to work with them on testing the criteria to ensure that the criteria are working in the way in which we want. As we move forward this summer, we will be doing grass-roots consultation and testing, and we will be talking to disabled people about our assessment and asking people to take part in testing the criteria. That will provide the rich feedback that hon. Members have discussed today to ensure that we get the new PIP assessment right from the start.

We will continue to work with disabled people and their organisations. We are planning to involve them in a number of ways as we design the operational processes—the way in which the assessment will be carried out. We have set up a dedicated PIP implementation consultation group specifically for that purpose. Membership has been drawn from a wide range of national and grass-roots user-led organisations. My officials and I have met many of them already, and we look forward to the work they are going to be doing with us on this most important part of the process. Many of them are people who have expressed an interest in working with us on the operational processes, and I look forward to progress as we move forward.

We will ask the group to look at the practical way in which operational issues will be developed. The initial list of issues will be discussed at the group’s first meeting on 16 May. I hope that that reassures the Committee that consultation and co-production are at the heart of the development of PIP. I stress that our approach is not only about meeting legislative requirements. The development of PIP will be, as the WCA has been, an iterative process in which we actively seek out opportunities to learn from our experience to ensure that we make the changes necessary to make it the success that we all want it to be. That is why we have already published initial draft assessment criteria, which are available on our website. Members of the public can access them now and e-mail or write in with their comments on the assessment criteria. We are being open and transparent about how the new support is being developed. We intend to publish a second draft of the assessment criteria in the autumn, building on the comments that have been made. I assure Committee members that we view this as an ongoing process and we will continue to work with disabled people and their organisations on the criteria after that point, as we work towards finalising draft regulations to submit for parliamentary scrutiny.

We are absolutely committed to transparency and engagement with disabled people. I hope that what I have outlined today will show that consultation is not at a very high level—to use the phrase of the hon. Member for Glasgow East—but is at grass-roots level. We see that as integral to the way we work. I hope that given the reassurances about the key role of consultation and engagement, my hon. Friend will feel it appropriate to withdraw the amendments and continue to work with us with her thoughts on how the assessment and the operational processes work in practice.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I am reassured by what the Minister has said; clearly, a lot of work is already going on and will be ongoing. I appreciate that the work capability assessment is very different from the PIP assessment, but I hope that we can learn lessons from it when designing the PIP assessment—how it was implemented and what changes have been needed since then—and in particular incorporate the recommendations made by Professor Harrington. I am glad that so much consultation is going on. Piloting is a really important way of ensuring that the problems are ironed out before the regime is implemented, rather than testing it on people and finding out that it does not work when it has already been brought in.

Maria Miller (Conservative, Basingstoke)

Just for clarification, we are not piloting the study; we are testing it with real individuals to ensure that we know it will work well.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I apologise for the wrong use of “pilot”; I meant “testing”. It is crucial to the credibility of the new assessment, as well as to having a system that works, that it is well tested and worked through with individuals with disabilities and the organisations representing them. If it does not have credibility and is not seen to be fair, it will not work. It is important to ensure that people are involved at an early stage and throughout the process, so that they feel that their voices are listened to and so where it does not work, the problems are identified and changes are made. Clearly, those things are already happening.

I beg to ask leave to withdraw the amendment.

Stephen Timms (Labour, East Ham)

I beg to move amendment 217, in clause 78, page 56, line 40, at end insert—

‘(7) The Secretary of State shall ensure that any assessment carried out under this section is performed by an individual who has access to sufficient skills and expertise appropriate to the impairment type of the claimant, as defined in regulations.

(8) The Secretary of State shall issue clear guidance outlining the needs of different impairment groups for the use of professionals assessing people under this section.’.

The amendment has two main purposes, both of which relate to the individuals who will carry out assessments. The amendment’s first aim is to require assessors to have access to sufficient skills and expertise about the impairment type of the claimant whose application is being assessed. The second half of the amendment fulfils our second aim by requiring the Secretary of State to issue clear guidance about the needs of different impairment groups, which will be used by those who carry out the assessment process.

As my hon. Friend the Member for Glasgow East has explained, we recognise that it is right to reform the DLA and accept that it is perfectly sensible to use a medical test as the basis for assessment, but we need to be confident that assessments will result in the right decision. One reason why an incorrect decision might be made is that the person carrying out the assessment does not have enough expertise about the impairment.

Before our debate today, we all received a briefing from the Disability Benefits Consortium, from which I shall quote a couple of sentences:

“It is essential both for the applicants, and for the integrity of the benefit, that the assessments are carried out fairly and effectively. Studies have shown that various groups have been disadvantaged in the past due to assessors not understanding certain conditions. This causes distress to the applicant and their family; and can lead to a tribunal process which is costly to the state and often ends in the initial decision being overturned.”

That is the point that the Disability Benefits Consortium made to the Committee.

The amendment applies to all types of impairment, but we are particularly concerned about two particular types, with which we are becoming familiar in Committee. The first is fluctuating conditions and how they will be assessed—the hon. Member for Redcar raised the point earlier today—because they may appear less severe than they typically are on the day of the assessment, and there are plenty of examples of erroneous assessments. If the person conducting the assessment has access to expertise and guidance for dealing with the impairment, there is a much better chance of being able to make a correct assessment when it is carried out.

The second group, which we discussed during earlier debates, is people with mental health impairment. We have been reminded that in his independent review of the WCA, Professor Harrington found evidence that some mental health conditions may be being inappropriately assessed at present. The briefing notes circulated by the Government on PIP, which we all received on Friday, strike me as muddled on what we can learn from the WCA about the assessment for PIP. The Minister has touched on that a couple of times today. The notes state:

“Employment and Support Allowance and Personal Independence Payment are different benefits paid for very different reasons. Any direct comparison between the Work Capability Assessment…and the new assessment for Personal Independence Payment is not therefore possible or helpful.”

It is an odd turn of phrase to say that it is not possible, and then to say that it is not helpful. Those couple of sentences from paragraph 8 on page 8 of the briefing note at least make the position clear. The Government believe that lessons cannot be learned and that a direct comparison cannot be drawn between the two.

I do not agree with the statement, but it is at least clear about the position. Although the benefits are different, there is no doubt that the WCA and the new assessment for PIP, given what we received from the Government at the end of last week, have striking similarities, at least in how they look. But the Government’s briefing is clear, and having told us that the direct comparison is not possible or helpful, it states:

“'We are, however, seeking to learn from the experience of the WCA. As part of this we are looking closely at the findings of the first independent review of the WCA carried out by Professor Malcolm Harrington in order to inform the design of the Personal Independence Payment claiming and assessment processes.”

Having said that such a comparison is not possible or helpful, the Government go on to say that, after all, they are making a comparison. That seems to be a bit of a muddle.

Let me declare my position. I agree with the second part of that paragraph, which says that there are lessons that we can learn, and disagree with the first part, which says that it is neither possible nor helpful. It is important that the design of the PIP assessment process responds to the recommendations that the Harrington review identified and set out for the WCA.

I will quote Mind on the lessons that it thinks that we should learn from the work capability assessment:

“Mind supports the call for clear guidance for DWP staff carrying out the new PIP assessment We know from our experience of the Work Capability Assessment that DWP staff do not always have adequate knowledge and understanding of the ways in which mental health problems impact upon people’s lives, and their ability to participate in society. Nor do they always carry out the assessments in a supportive or suitable way, as the following quotes from Mind’s website demonstrate.”

It draws attention to comments that were made by three people who have been through these processes. The first person said:

“The assessors can hugely influence the answers by how they word the questions or how much they bother to probe to get the full truth. People with mental health problems feel ashamed of how bad things are and are unlikely to easily tell a stranger about their intimate difficulties unless that person bothers to ask in a way that is not judgmental and not many assessors are bothered.”

The second person said:

“When the documents came through and I saw the report from the medical assessment I couldn’t believe it - in fact I thought they had sent someone else’s by mistake, it was so full of inaccuracies.”

The third person said:

“When I saw the report I thought they’d muddled me up with someone else - it was so far from what happened in that room.”

It is clear that for people with mental health impairments, there is a great deal of scope for getting things wrong. This amendment is intended to minimise the likelihood of mistakes by ensuring that the assessor has access to appropriate expertise and guidance.

Proposed new subsection (7) stipulates that the assessment must be

“performed by an individual who has access to sufficient skills and expertise appropriate to the impairment type of the claimant.”

I am not proposing that the person conducting the assessment must necessarily themselves have that expertise. Given the very large number of people who will be assessed—my hon. Friend the Member for Glasgow East has talked about the number of people going through this process—it may not be possible or practical for everyone carrying out the assessment to have that expertise. None the less, those conducting assessments should have ready access to somebody who can guide and advise them on how to make an accurate assessment of the various types of impairment that they will need to deal with. The precise details of what would constitute access to or sufficient expertise would be set out in regulations under this proposed new subsection.

Proposed new subsection (8) specifies that the Secretary of State must issue clear guidance outlining the needs of different impairment groups for the use of professionals assessing people under this section, which is important for several reasons. First, it ensures that every person conducting assessments has access to a basic standard of expert advice to which they can turn. Secondly, the fact that the guidance would be written down means that there would be a degree of accountability on the assessor to ensure that this expertise is applied in practice. Thirdly, having a universal set of guidance would help to eliminate inconsistencies that might otherwise exist in practice between different individuals or between different parts of the country. It is possible that that guidance might also touch on the issue that the hon. Member for Cardiff Central raised in her contribution about different practices in different parts of the country on whether or not an advocate or a friend can attend the assessment process along with the person being assessed. The Minister helpfully clarified that that should always be permitted except in exceptional circumstances.

The most recent report by the House of Lords Merits of Statutory Instruments Committee states:

“In its 23rd report the Committee noted evidence that 40% of appeals against a decision that an individual is capable of work are currently upheld, so the quality of the guidance material provided to staff and the consistency of their decision making will be crucial to the scheme operating as intended.”

That seems to be an example of a case where the lessons learned from the WCA should also be learned for the assessment process for PIP. I hope that the Minister can welcome the intention of our amendment.

Kate Green (Labour, Stretford and Urmston)

I share with my right hon. Friend a wish to draw on at least some of the lessons that we have learned from the experience of the introduction of the work capability assessment. As the Minister has comfortingly acknowledged, we are discussing a test with a very different purpose this afternoon. None the less, there are some interesting points that we can draw on when we look at where some of the discrediting of the WCA in the eyes of disabled people and those who work with them has occurred. They perceive that the independent assessors, the Atos assessors in the case of the work capability assessment, are not suitably qualified or do not have a suitable appreciation of or suitable expertise to assess the condition of the person in front of them.

We have heard repeated reports from disabled people who have been through the work capability assessment that it felt like a tick-box exercise, that it was routine and that it was not focused on their particular circumstances and condition. It is really important that for the gateway assessment for the PIP we have professional, expert people who can temper what will presumably be the structured approach to making the assessment with their own expertise and experience in making judgments and interpretations in relation to the answers and information that they receive.

This is not just a matter of technical expertise. It is not just a matter of having, for example, someone who assesses someone with MS being a specialist in MS, or someone who assesses someone with a visual impairment having a long-term specialism in blindness. Although that might be useful, it is unlikely to be sufficient if the person making the assessment lacks what in the business context are often called soft skills. Those are the skills around empathy and the ability to interpret and to communicate. Two-way communication was mentioned earlier today, and it means that the way in which the disabled person offers a response to a question or an investigation is placed in an intelligent context. That is something that disabled people feel has not always happened in their experience of the assessment for the ESA.

It is important that the assessor recognises that the setting in which they meet the disabled people for the assessment is not necessarily the only setting in which that disabled person will want to operate. We talked earlier about assessing people in their homes. That could be useful and appropriate, but it will only give the assessor a picture of the way the disabled person works in that setting. The person carrying out the assessment will need to be sufficiently expert and experienced to translate what they can see in front of them in the home setting to the wider social setting in which the disabled person may need to operate.

When I met Atos, the provider of the work capability assessment a few weeks ago, I was interested to learn that it uses a whole range of professionals to carry out the assessments. Those professionals could be GPs or medical professionals with full medical degrees. They could be nurses with a particular specialism, generalist nurses or occupational therapists in some cases. The explanation that was offered to us was that these people had had additional training by the company providing the test, which in a sense rendered their initial professional qualifications, as Atos saw it, as a matter of secondary importance.

That is all very well if the training that the people carrying out the assessments receive is good enough for them properly to carry out the tests and to deal with a whole range of conditions that they may come across. If it is not clear that the people carrying out the assessments are trusted to understand and appreciate the conditions that they meet and seek to assess, there will a real credibility problem—Ministers might want to think about that at an early stage. Will the Minister say something about the sort of standards that will be put into contracts for the assessment process to ensure that credibility in terms of the expertise, qualifications and skills provided by the assessors is both perceived and real?

On who might be given the contract to carry out such assessments, what discussions has the Minister had so far about the specific levels of staff training and qualification required, and the areas and issues that such training should cover? What monitoring and quality assurance processes does she expect the DWP to put in place to ensure that assessments are carried out by appropriately qualified experts and skilled professionals? Will those processes be kept under regular review, and can she assure us that feedback from disabled people who have been through the assessments will form part of that procedure?

Maria Miller (Conservative, Basingstoke)

I thank the right hon. Member for East Ham and the hon. Member for Stretford and Urmston for their contributions. I fully agree with the right hon. Gentleman that the skills of assessors and the training and support available will be critical to the success of the reforms. The hon. Lady put her finger on the issue when she said that if we are to engender trust, we must have a group of people who are appropriate and have the right skill sets. We are giving a great deal of thought to that matter; work on developing the assessment is ongoing, as it is on the individual skill sets that will be needed to carry out the assessments.

In his opening remarks, the right hon. Gentleman described PIP as a medical assessment. It is not a medical assessment; it is more of an objective assessment, and that is important. The hon. Member for Stretford and Urmston said something similar on Second Reading, and it is an important point because that is one of the things that marks out PIP from other assessments. Now that we have a first draft of the assessment criteria, we will look at the matter in more detail and link it to our work on testing the criteria.

Early thoughts suggest that PIP will not necessarily be administered by doctors, and that a broader range of individuals may have more appropriate skill sets and be better able to carry out the assessments. Those include, for example, allied health professionals such as occupational therapists or physiotherapists. We are exploring that suggestion in our testing, and talking about it to disabled people. It is an important part of building the trust referred to by the hon. Lady.

Regardless of who is chosen, I assure the Committee that the assessments, including face-to-face consultations, will be carried out by fully trained independent and approved assessors. Assessments for ESA and the DLA are currently carried out only by health care professionals who have been approved by the Department’s chief medical adviser on behalf of the Secretary of State. Those doctors, nurses and physiotherapists have passed strict training and experience criteria and have received additional tailored training approved by the Department. Similar arrangements will apply for PIP and will include broad training in disability analysis as well as training on specific impairments. As I said at the start of today’s debate, disability is one word but it has many thousands of different meanings. It is important to get the training of health professionals in that area right, and we have learned from the work capability assessment, which I will come to in a moment.

Stephen Timms (Labour, East Ham)

I can well see how the use of physiotherapists adds choice of a kind. What sorts of skills would the Minister expect an assessor to have in the case of people with mental health impairments? Can she envisage a counterpart to a physiotherapist, for example, who could carry out the assessment when the impairment is a problem of mental health?

Maria Miller (Conservative, Basingstoke)

I thank the right hon. Gentleman for his question. The very fact that we are assessing such a wide range of different disabilities means that we need a range of people available to assess. Many people who have a more physical disability might have allied mental-health problems, so I am not sure that one would necessarily want to say that one set of individuals has one type of assessor and that another set has another type of assessor.

If the right hon. Gentleman will forgive me, he is still falling into the trap of simply pigeonholing people based on their assessment. Many disabled people will have a physical impairment, a sensory impairment and perhaps even a mental-health impairment. I do not think that we can go down the route that he is suggesting.

Stephen Timms (Labour, East Ham)

I presume that the Minister would not argue that a physiotherapist would be an appropriate person to make an assessment of an individual when a mental-health problem was being assessed. What kind of people would be appropriate in that case?

Maria Miller (Conservative, Basingstoke)

People who have access to trained individuals who have specialisations in mental health could well be how that problem would be dealt with. This is one of the many lessons that we are learning. Perhaps I can use the Harrington review as an example; the right hon. Gentleman highlighted that he felt somewhat confused about some of the information put out by the Department on Friday about the policy documents that we have issued around the assessment criteria. To clarify that for him, I should say that we are learning and will always learn from what we are doing with the WCA. The policy document that he was referring to discussed the assessment criteria. It would not be helpful to try to learn from the assessment criteria of the WCA in particular, because those criteria are to do with work, not everyday living, which is what PIP will be looking at in future. We can learn from the development process of the WCA and from its implementation.

We can particularly learn from the issue that the right hon. Gentleman raises about the professional skill set of the people undertaking the assessment. That is probably one of the biggest things that we have learned from the whole Harrington process. Harrington clearly said in his report that there is a need to ensure that those undertaking assessments have good qualifications and access to the sort of expert advice that the right hon. Gentleman mentioned. We are considering, therefore, the use of mental, intellectual and cognitive champions to support the assessment process for PIP in much the way that Professor Harrington discussed developments in how we ensure that we have the right assessment skills in place for the WCA.

Kate Green (Labour, Stretford and Urmston)

Will the Minister say whether she has any plans to make use of the expertise of specialist disability organisations in offering training, particularly awareness training, to potential assessors? For example, I know that the National Autistic Society has offered to provide such training to the DWP and its contractors in the past, but it feels that, from time to time, its offer has fallen on deaf ears.

Maria Miller (Conservative, Basingstoke)

There are two responses to that. One is “absolutely.” Drawing on the experience of the WCA and the role of some of the mental-health charities in supporting development in that area, we will be looking to work closely with specialist organisations in the training that is put forward. I would, however, take that one step further and say that we also need to look at the important role that user-led organisations can have in helping disabled people in this whole process.

The hon. Lady may be aware of an announcement that I have already made about a £3 million pot of money to help develop the role of such organisations throughout the country. In some areas, such as Norfolk and Essex, we have strong user-led organisations, but we do not in other areas. It is that sort of user-led organisation that can provide a great deal of support for disabled people through this process, and that will be extremely important as well.

There is a great deal to be learned from Harrington, and I hope that the right hon. Gentleman can understand where the mix-up has come in terms of his interpretation of the policy document. Ensuring that an individual who has been assessed has the opportunity to feed in properly and that their voice is heard; that evidence is gathered from the right people; that assessments are conducted by people with the necessary skills and training; and that those assessors have access to expert support where it is needed—we have learnt all those things very clearly from the Harrington process, and we will take them forward to the assessment and PIP.

On the other aspects raised by the right hon. Gentleman, I should say that fluctuating conditions have come up consistently. All hon. Members would expect that; it is very much to the fore of all our minds. It clearly exemplifies why we need individuals who have the right sort of training, but also have access to experts in other areas of disability to ensure that they are able to identify accurately when somebody is dealing with the realities of a fluctuation condition. We have designed the draft criteria to take account of physical, sensory, mental, intellectual and cognitive impairments, and it is essential that this assessment also deals effectively with variable and fluctuating conditions.

The assessment will not—I repeat, not—be a snapshot of one day, but will consider an individual’s ability to carry out activities over a period of time; we are suggesting a year. We will consider impacts where they apply for the majority of the time. The expertise of the assessor in looking at that on an individual case basis will be an important part of getting the implementation of this new assessment right. That is why we will continue to look at the skill sets of assessors, with disabled people and their organisations, to ensure that we get the balance right and that we have in place the sort of expert training that the hon. Member for Stretford and Urmston talked about.

Finally, I would like to turn my attention to the requirement to issue clear guidance. As expected, we will shortly begin the commercial process to identify who will be responsible for undertaking the personal independence payment assessment on a national basis. I assure the Committee that, whoever is successful in this process, clear guidance on how specific health conditions or impairments should be assessed will be available to staff undertaking the assessment. That guidance will also be made available to the public.

We will also ensure that there are clear monitoring and quality assessment and assurance processes in place, in much the same way as we spoke about earlier today in the debate about the provision of Welsh language access. It is that sort of quality assurance process that can help to ensure that we give every person who applies for the personal independence payment the sort of quality assessment and experience that we expect.

Given those assurances, I hope that the right hon. Gentleman will feel that we have a shared agenda. Given my clarification on what was included within the policy papers that were issued on Friday, I hope that he is assured that we will be learning very much from our experiences of the WCA, some of which were as a result of the work that he did when he was a Minister in this Department. I hope, therefore, that he will withdraw his amendment.

Stephen Timms (Labour, East Ham)

I am grateful to the Minister for her clarification that the briefing note did not mean what it said. I will draw her attention, again, to how it actually reads:

“Any direct comparison between the Work Capability Assessment (WCA) and the new assessment for Personal Independence Payment is not therefore possible or helpful.”

I am glad that she is making such comparisons and that she is willing to learn the lessons from that.

The Minister’s suggestion that physiotherapists might be used in future to assess people with mental health impairments could cause some concern. A lot of work would be required to assure people that those individuals can make accurate assessments. I am not ruling out the possibility of such people being used, but a lot of work will need to be done. I am grateful to her for recognising that much hangs on this measure and that a lot of work will have to be done to ensure that it is an effective process. As I do not intend to push my amendment to a vote, I beg to ask leave to withdraw it.

Stephen Timms (Labour, East Ham)

I beg to move amendment 219, in clause 78, page 56, line 40, at end insert—

‘(10) The assessment process specified in Regulations under subsection (3) shall, prior to its national implementation, be the subject of a pilot, which—

(a) shall operate in one or more specified areas; and

(b) shall assess the impact on specific groups of people, including those with fluctuating conditions and mental health conditions; and

(c) shall receive a formal response from the Secretary of State.’.

The amendment intends to insert in the Bill a requirement that the medical assessment to ascertain eligibility for PIPs should be the subject of a pilot before its national implementation. It specifies three characteristics of the pilot. First, it should operate in one or more specified areas. Secondly, it should assess the impact on specific groups of people. Thirdly, it should be the subject of a formal response from the Secretary of State. Although it is a relatively modest amendment in its scope, establishing a proper pilot is important for ensuring that the transition to PIP is not fraught with problems. We debated some of the reasons for that when we considered the previous amendment.

My hon. Friend the Member for Glasgow East has already made it clear that we do not oppose the establishment of an objective test to assess eligibility for PIP, and we firmly supported the reform of the gateway. None the less, the Government need to tread very carefully. We have already heard some sensible suggestions, including those from the Liberal Democrat members of the Committee. The hon. Member for Cardiff Central, who is not in her place at the moment, was rebuked by the Minister earlier for talking about a pilot when she should have referred to testing. I am much more persuaded by the suggestion of the hon. Member for Cardiff Central here. I am not quite sure what the distinction is between piloting and testing. Perhaps the Minister can clarify that in her answer. Perhaps the difference is in the scale and the seriousness of the exercise that is envisaged, with piloting being a step higher than testing. If that is the case, I feel that piloting is the appropriate action.

It is worth reminding the Committee again of the huge scale of the operation that will be required to assess people for PIP. My hon. Friend has already referred to this. Some 1.8 million working-age people who currently receive DLA will have to go through the new assessment by the end of 2015 and beginning of 2016. On top of that, there will be a steady stream of new applicants and a fair number of appeals. We are considering a very large number of people having to be assessed for PIP over a rather short time. If the Government get this wrong, or the process starts to go wrong, the implications could be very far-reaching and there would not be much time to put things right.

Harriett Baldwin (Conservative, West Worcestershire)

I wonder whether the right hon. Gentleman has read section 7 on page 12 of the briefing notes. It goes into the timetable in great detail. It outlines how the process might be tested and refined and then tested again. I just want to understand his distinction between testing and piloting.

Stephen Timms (Labour, East Ham)

The pilot for which I am arguing has the characteristics set out in the amendment. However, as I said, it should be in one or more specified areas, not just in one place or a particular centre. The pilot should assess the impact on specific, identified groups of people, including those with fluctuating conditions and mental health conditions. After the pilot has taken place, the Secretary of State should produce a written response—an assessment—of the experience of it. If one could have a test with all those characteristics, I would be perfectly happy to say, “That’s fine and will do.” At the moment, I do not know whether it does. Perhaps the Minister will set out for us in a moment whether the test that she envisages will meet those three criteria.

There are several specific reasons for needing to be cautious about the matter. First, and probably most importantly, we need to ensure that the process assesses people’s circumstances properly. As we have already discussed, we need to learn that lesson from the establishment of the WCA. The Minister made the point that the process is likely to be iterative. I hope that most of the iteration will take place in the piloting before we start applying the assessment to people who currently receive DLA. If we are still trying to modify the system once we are in the large-scale process of putting existing benefit recipients through the new assessment, that could be a recipe for serious problems. I suspect that that point is likely to be made at the rally and event tomorrow.

There are certainly lessons to be learned from the WCA. Obviously, as the Minister says, I was involved in setting up the employment and support allowance and therefore in setting up the WCA. However, the Harrington review pointed out that the process still needed further refinement. For instance, Professor Harrington found evidence that some mental health conditions might currently be inadequately assessed. It is probably unrealistic to expect any new assessment process to be entirely without fault at the beginning. That is why we need to do everything possible to iron out the difficulties as early as possible in a pilot phase, rather than once the assessment is being used in earnest.

It is of the utmost importance that we identify and address as many problems as possible before the assessment process is implemented across the country. A proper pilot would help us achieve that. Launching into a large-scale exercise of reassessing people who are financially dependent on DLA using a test that had not had the difficulties thoroughly ironed out would create a serious problem. Significant numbers of people would lose benefit unfairly and would be caused a great deal of distress unnecessarily. I hope that the Minister agrees that we should avoid that.

Ian Swales (Liberal Democrat, Redcar)

Will the right hon. Gentleman tell us whether his Government did such a thing when the work capability assessment was introduced. If so, how did it go; and if not, why not?

Stephen Timms (Labour, East Ham)

We did and, of course, the big difference with the work capability assessment is that that has not as yet been applied to existing recipients of incapacity benefit. It shortly will be. By the time it is and the Government have set out their proposals for doing so, we will have had a number of years’ experience of how it works for new applicants. The difference here is that the new assessment will be applied from the start to people who are dependent on disability living allowance.

Ian Swales (Liberal Democrat, Redcar)

I have one point of clarification. Was an initial phase done in a specific geographic area or was it rolled out nationwide?

Stephen Timms (Labour, East Ham)

Once the ESA was introduced in September 2008, if I remember rightly, it went nationwide —but, as I said, for new applicants only. My concern is that what we are discussing will be rather different.

Kate Green (Labour, Stretford and Urmston)

We learned considerably from the experience of the work capability assessment and, in particular, difficulties were uncovered when it was being piloted for roll-out nationally. Does my right hon. Friend agree with the suggestion in our amendment not only that there should be piloting but that full implementation should not take place until the consequences of the pilot and the learning from it have been taken on board and implemented?

Stephen Timms (Labour, East Ham)

My hon. Friend makes an important point. We have a later amendment suggesting a period in which the new assessment should be applied to new applicants before being applied to those currently receiving DLA—but we shall come to that debate later.

A second reason is that, regardless of how effective the PIP assessment process turns out to be, it will be valuable for those affected to have the greatest possible confidence in it. All of us have received correspondence from groups who represent disabled people expressing deep concern about the replacement of the DLA with the PIP. The Government need to recognise that a substantial number of disabled people currently receiving and financially dependent on DLA are terrified at the prospect of the changes proposed.

I am not saying that the Government should back off or not proceed, but they must recognise that a lot of people are very anxious. For a large number of people, the planned new tests will cause a great deal of anxiety, which the Government need to work hard to minimise. Being able to point to proper pilots along the lines I described would help.

The Scope submission quoted one survey respondent who said:

“If I lose DLA, along with the changes to other benefits, I fear becoming homeless.”

Leonard Cheshire Disability quoted someone who said:

“I am happy at the moment in my life; I get to go out and see friends and family. However, if DLA mobility is taken away I will be a prisoner in my home!'”

Those individuals, whose circumstances we do not know much about, might well go through the assessment process and find themselves completely protected, so that they do not lose out at all. However, a lot of people do not feel confident in that. A proper pilot process would help disabled people to feel confident that the new system will be clear, fair and transparent.

Many stringent criticisms have been levelled against the work capability assessment, and Professor Harrington’s recommendations on how it can be improved have been accepted. We have the opportunity to avoid such negative perceptions when the PIP is introduced. While I am talking about what outside organisations have said, I refer to a point made by Mind on the lessons to be learned from the work capability assessment:

“In order to avoid the significant problems that have arisen with the WCA, it is vital that the new PIP assessment is piloted extensively to ensure that it is working fairly and effectively before it is extended to all DLA claimants...it was only when the assessment was independently reviewed by Professor Harrington that the DWP would recognise the flaws in the process. It is of fundamental importance that an assessment of this kind is both valid and reliable, and that any issues flagged-up by such a pilot are properly addressed before moving forwards with full reassessment.”

Charlie Elphicke (Conservative, Dover)

Does the right hon. Gentleman accept that the case put by Mind is that the work capability assessment is somehow ineffective and riddled with problems?

Stephen Timms (Labour, East Ham)

No. What it points to is that the work capability assessment has needed significant modification and refinement since it was introduced for new applicants in October 2008. We have had two and half years’ of experience now, and in the light of that we are able to make some changes to it. I am suggesting that there needs to be something comparable to that with the assessment process for the personal independence payment. Otherwise there will be serious problems when severely disabled people have the new assessment applied to them and it is not quite right.

Charlie Elphicke (Conservative, Dover)

I am loth to pay tribute, but it seems that the work capability assessment was an inspired piece of work by an inspirational Minister. I put it to the right hon. Gentleman, while I am blowing sunshine around the Committee room, that many of the lessons learned from the work capability assessment should in principle be transferable. Is it not the case that many of those things can be learned and taken on board from the improvements that have been made in the past two and half years?

Stephen Timms (Labour, East Ham)

I am grateful to the hon. Gentleman for his kind remarks. I think that it is probably either my right hon. Friend the Member for East Renfrewshire (Mr Murphy) or my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), the former Secretary of State, who deserves his generous tribute.

I agree with the hon. Gentleman—I am glad that the Minister has accepted it as well—that we do need to learn lessons from the WCA process for the one we are embarking on. It seems that the stakes are a lot bigger here, because many people who are financially dependent on DLA feel a good deal of uncertainty about their position once they have been through the new assessment for PIP. Some extra work to reassure them at this stage would be well worth doing. That is the aim of the amendment.

Now that the hon. Member for Cardiff Central is with us again, I will repeat the point that I made earlier, that I agree with her about piloting; I am less convinced by what the Minister said about testing. I think she was right to use the word “piloting”, although it may be that we mean the same thing. I look forward to the Minister’s explanation of the testing she has in mind. This needs to be a serious exercise because of how much is at stake. The case is strengthened by the fact that on paper the new gateway looks very like the work capability assessment. I have some sympathy with the assumption made by the hon. Member for Cardiff Central that Atos would apply. She was rebuked by the Minister, because of course there has to be a tendering process. It is difficult to understand who might do it, other than Atos in practice. That is certainly the view of the disability organisations, too. I can understand why the hon. Lady made that assumption.

Another reason why the case for piloting is even stronger is the scale of the exercise—the 1.8 million people to whom it will be applied from the outset. Right from the beginning, the intention is that existing DLA recipients will have this assessment applied to them, not just new applicants. We have a later amendment on schedule 10, suggesting that that will be ill-advised. I will not run through the arguments now. However, that also highlights why the case for piloting is so important. The stakes are very high indeed. If there are any doubts in Committee today, they are likely to be vanquished by the rally and the representations that all of us will receive tomorrow.

There are also financial considerations to be aware of. There is a great deal of concern from people with disabilities that the Government’s approach to PIP is being dictated essentially by a cuts target. The Government have decided that they need to make 20% cuts, and the finer points of how they do that are a secondary consideration. That is the worry for organisations that represent people with disabilities. The truth is that too much is at stake for too many people. The Minister assured us that her approach is principled, and I welcome that, but it was not clear during the debate on ESA. I am pleased that she has been able to affirm that, on this issue, the Government’s starting point is principled, and that the budget consequences must be worked out second, and not be determined up front, which is a worry because that would be the wrong way of going about reform.

There is a danger of rushing ahead too quickly, before the assessment has been properly worked through, and the difficulties identified and removed. There is no point putting people through a flawed assessment process, only for it to be necessary to assess them again, perhaps through an appeal mechanism when the problems have been ironed out. If the Government proceed too rapidly without the necessary safeguards in place, they may waste a lot of money instead of saving it, as well as causing a lot of unnecessary anxiety. The three compelling reasons for proceeding carefully and starting with a proper pilot are to ensure that people’s circumstances are assessed accurately and fairly, to allow disabled people to have full confidence in the process, and to ensure that we do not end up wasting money by implementing a flawed assessment.

The amendment proposes that the pilot should show three characteristics. The first is that it should operate in one or more specified areas. In that way, it should be possible to ensure that the pilot covers a reasonable cross-section of the population demographics and the different circumstances in different parts of the UK. That should be possible by choosing areas.

Secondly, the amendment proposes that the pilot should assess the impact of the assessment process on people with specific types of medical impairment or disability. This is a radical overhaul of access to disability benefit, and there could be types of impairment that are not assessed adequately at the first attempt. The amendment draws attention to two that we have already discussed: fluctuating conditions and mental health impairment. It is right to spend a fair amount of time and effort to ensure that the assessment process works well.

The third characteristic of the pilot is that it should be the subject of a formal response by the Secretary of State. If the pilot is to be effective, there should be a statutory requirement on the Government at least to respond to its findings, and to put them in the public domain. That would help to ensure that the lessons of the pilot were learned and applied instead of being ignored. Perhaps more important, it would help to give confidence to existing DLA recipients and others who will apply for PIP in future that their concerns will be properly addressed.

There is a strong case for a pilot of PIP, given the scale of the proposed changes and the number of people who will go through the assessment. The case for it is very strong and, like so much in the Bill, the effects of precisely what the Government are going to do will hang on the detail. I hope that the Minister recognises that the amendment would take us in the right direction.

Sheila Gilmore (Labour, Edinburgh East)

It is important to look not only at a test—the criteria against which people will be measured—but at the whole assessment process. Some of the discussion has been about the independent test in which people must show how they cope with certain day-to-day activities, whatever they might be. I fully understand that we need to get that correct—deciding what ought to be measured and how to do so—but we must also look at the assessment process, almost from start to finish, to see how it works in practice. A pilot would enable that to be done.

Although the test is different, some of the process could be similar to that of the ESA. The first Harrington report told us about severe flaws not only in the kind of criteria being measured and whether the narrow test was correct, but in the process as a whole, including what sorts of information were looked at, what weight was given to the Atos testing process, Harrington’s criticism that there was too much rubber-stamping of that test when decisions were made, what happened when decisions were made and how few decisions seemed to be given a reconsideration, for example. All that was really about a process.

If we want to get this right, we ought to have the opportunity to see how it works in practice. I suspect that looking at certain small bits and consulting on others will not reveal some of those flaws. Many aspects of the ESA probably looked okay or viable until the new applicants became a pilot. I am not convinced that that was the right thing to do. However, what gave rise to considerable concern among those who experienced the process, the organisations supporting them and many of us who met constituents and dealt with such issues was the fact that, so often, the people who appealed were successful in those appeals, thus suggesting —endorsed by Harrington, I think—that a symptom of something flawed in the process. We sometimes talk too narrowly about that part of the process which is the independent test.

We do not need to get precious, necessarily, about who did what and whether it was right before. When I first encountered people having difficulties with the ESA process, I agreed that we had to take action to reach a situation in which people were not pushed into a siding for a long time, on a benefit perhaps because it was more convenient for them. However, when I recognised that individuals had serious difficulties with the process that they were being put through and that their lives were being made very difficult indeed, I realised that there is a huge difference between having an idea—a good idea—and the practice and implementation.

If we have the opportunity and time to carry out a pilot, it would be a means of avoiding some of the unnecessary mistakes and expense. The expense of the appeal process that might result from a flawed assessment process could be avoided if the work was done in advance. I hope the Minister is prepared to consider the amendment.

Maria Miller (Conservative, Basingstoke)

This is another turning point in our debate. I was pleased to hear the right hon. Member for East Ham say that we had reassured him on taking a principled approach, which is first and foremost in our minds. I am glad that he understands the need for an objective test and for the reform of the gateway. I hope that, in this debate, I can also reassure him about our approach to testing. We all have the same objective: we want the assessment and the process by which it is administered to be effective for disabled people from day one.

At the risk of being pedantic—I hope I did not rebuke my hon. Friend the Member for Cardiff Central, but if I did I apologise profusely; it was not my intention to do so—I simply drew attention to the fact that “pilot” and “testing” apparently do not mean exactly the same thing. My background is in marketing, and I used those terms interchangeably in my previous existence. However, in Government circles, pilot takes on a different legal meaning.

If we piloted PIP, we would have to take legal powers to reassess entitlement to disability living allowance and assess entitlement to PIP by taking an approach termed “testing” as opposed to “piloting”. We could therefore examine the impact of the new assessment on recipients of DLA without withdrawing their entitlement to their current benefits. That is important because, as the right hon. Gentleman drew out very well in his contribution, we are trying to introduce an assessment that will enjoy the confidence of disabled people and not in any way put them in a position of feeling anxious about the support that they will receive.

One of my concerns about taking the right hon. Gentleman’s approach, given the legal implications of a pilot versus a test, is about what would happen to individuals who were reassessed in the period during which we were reporting on the pilot. If we set aside the word “pilot” and consider the content of what he suggested, he might find that there is little difference between our approaches other than that slightly legalistic term. I think that that is the case, and I am sure that he will let me know if it is not.

Our approach to testing clearly meets the right hon. Gentleman’s first two criteria of being able to operate in one or more specified areas and evaluating the impact of the new assessment on specific groups, including people with fluctuating conditions. On the third—to receive a formal response from the Secretary of State—we will publish a report and provide an update to draft regulations in time for that to be discussed in the other place, as I mentioned earlier. We have similar objectives for the next set of activities; perhaps we are just calling them slightly different names.

Stephen Timms (Labour, East Ham)

I am encouraged by what the Minister has said about the clause. Is she saying that some of the testing will have been carried out by the time it is debated in the other place? I am anxious to establish that after the test or pilot, whichever it is—I, too, thought that they meant the same, but I stand corrected by her explanation—a report should be written about the lessons learned from it. Will that document be available in time for the debate in the other place, because that implies that the testing is imminent and will have to be brief?

Maria Miller (Conservative, Basingstoke)

As I have said, in the summer, we want to move forward to testing the draft criteria on current recipients of DLA, and we will consider our findings from that before the Bill reaches the Lords. We anticipate producing information about that testing in advance of the debate there.

It might perhaps help the right hon. Gentleman if I go through exactly what we intend to do in more detail. Drawing very much on the findings of the WCA, our approach will give us far more flexibility than the sort of mass-scale pilot that was done in the past. This week, as he will know, we published an initial draft of the assessment criteria, but that is absolutely not the end of our development work. We will continue to refine those initial draft criteria as we move forward, working with disabled people and their organisations to ensure that the criteria work as they need to.

We will then test the criteria over the summer, to ensure that they accurately and consistently assess individuals, and consider the impact of the assessment. As part of that testing, we will consider the impact of the assessment on specific impairment groups, such as those with mental health conditions, learning disabilities and sensory impairments. The exercise will provide a vital opportunity to learn, early on and without affecting customers’ current benefit claims, how the new assessment criteria will work on the ground. It will be a safe environment in which we can understand how the new assessment will work.

Testing and our work with disabled people’s organisations will inform the next draft of regulations to be published in the autumn and the Bill’s final stages in the other place. We will also consider further testing afterwards along similar lines if we think it necessary. The resulting regulations will, of course, be subject to full parliamentary scrutiny, including debate under the affirmative procedure.

Stephen Timms (Labour, East Ham)

The Minister has set out some of the groups that will be assessed in the test. Will she add people with fluctuating conditions to the list that she read out?

Maria Miller (Conservative, Basingstoke)

It would be almost impossible not to consider fluctuating conditions when considering individuals with mental health problems or, indeed, many of the other impairments that I outlined. I can absolutely and fully assure the right hon. Gentleman that my right hon. Friends the Secretary of State for Work and Pensions and the Minister of State and I will consider the issue closely. We want to get it right from the start, and we will do everything that we can to ensure that.

Ian Swales (Liberal Democrat, Redcar)

On fluctuating conditions, we talked earlier today about advocacy. To what extent will the process take account of relevant medical information? I am thinking of conditions such as ME. Medical records for sufferers would be very relevant to the assessment. Will they be available to the assessors?

Maria Miller (Conservative, Basingstoke)

The hon. Gentleman brings up an important part of the testing process, which will involve ensuring that the right information is available. He will recall from earlier debates today that the Government want to take a flexible approach to what information is taken into account when an assessment is made. Other members of the Committee will consider that issue, particularly as we go through our testing processes.

Alongside that, it is important to pick up on another point, as the right hon. Member for East Ham did in his remarks. This is not just about the assessment; it is about the operational post-processes as well. We are already involving disabled people and their organisations in the development of the benefit’s administration, including the assessment process. We are setting up a dedicated personal independence payment implementation consultation group, as I mentioned, which will draw on a wide number of national and grass-roots, user-led organisations. The first meeting will be held next week. We want to ensure that we involve disabled people at all stages of the operational design. It is no good getting the assessment right if the operation does not work in practice for disabled people.

The group will form part of our development and testing process. That approach is important and has been well thought through as a way of working actively together with disabled people to refine both the assessment and the operational processes with hands-on involvement, instead of simply putting an assessment into a pilot area and then walking away from it for six months and seeing what happens. We will work with people on an iterative and hands-on basis to obtain solutions to the problems that arise, instead of simply walking away and waiting for a report to be written. I think that that is the right approach.

Of course, we are seeking to learn from our experience of the WCA, and as part of that we are looking closely at the processes used in ESA, particularly the pilots around Aberdeen and Burnley. We are also drawing further on Professor Harrington’s report to see how we can ensure that we have maximised PIP’s design beforehand.

Stephen Timms (Labour, East Ham)

Will the Minister indicate the envisaged scale of testing? Are we talking about dozens or hundreds of people? What is the approximate order of magnitude?

Maria Miller (Conservative, Basingstoke)

As the right hon. Gentleman will expect, I need assurance that our testing is robust and will provide the sort of evidence that the Government can have confidence in. I will write to him with more details, but I anticipate that it will involve many hundreds of people—several hundreds, I am told. He may be aware that we have done some initial probing work with DLA recipients already, as part of the initial criteria development phase. This is something that we are putting at the heart of our work.

I want to drive home the point that we are undertaking a more holistic, end-to-end test of the process. Picking up on the points made by the hon. Member for Edinburgh East, we are ensuring that we know how the process will work end-to-end before it is introduced in April 2013, again reflecting some of the lessons learned from the Harrington review and involving co-production with disabled people.

In addition to those assurances, the Bill requires the Secretary of State to commission an independent report on the operation of the assessment when it has been implemented and to lay that report before Parliament. That thorough and fully independent review will allow us properly to decide how the assessment is working and its impact, thus allowing us to refine it if necessary. In contrast with DLA, providing the assessment criteria in regulations will enable us quickly to change things as and when we believe it would be prudent to do so. That is an important innovation that PIP offers.

I hope that my comments reassure the right hon. Gentleman that, although we do not intend to pilot, we intend to achieve the objectives that he set out in his amendment before we implement PIP, utilising the experience of disabled people, and to evaluate its impact after implementation. Adding formal pilots would delay these important reforms and the important benefits that they will bring for disabled people. On that basis, I hope that the right hon. Gentleman will find it appropriate to withdraw his amendment, but I will listen to his comments.

Stephen Timms (Labour, East Ham)

I do not agree with the Minister’s final point. It is so important that the assessments are right that if the price is a bit of delay that is well worth having, because proceeding with a flawed assessment would do so much damage. Nevertheless, the Minister has made some helpful points and provided some information that I was not aware of. I should like to reflect on what she said. I do not know whether she will write to me, but if she does, perhaps she will reflect on that information as well and consider whether the proposals that she has set out this afternoon are sufficient for the job that needs to be done. For that reason, I will not press the amendment to a vote and beg to ask leave to withdraw it.

Stephen Timms (Labour, East Ham)

I have a question for the Minister. The clause is about the ability to carry out daily living activities or mobility activities. The note that we were sent at the end of last week explains that the proposal is to focus, under the daily living heading, on key everyday activities essential to enabling participation and independence. We have been told in the briefing that there are nine such activities: planning, buying food and drink, preparing and cooking food, taking nutrition and so on.

The Disability Benefits Consortium, which I think only saw that note yesterday when it was made more widely available, is—as the Minister will know—critical of that approach and has described it as a “tick-box approach.” It has made it clear that it would prefer what it describes as a more holistic approach. However, it says that given the Government’s commitment to a set list of criteria, it has proposed an alternative set of eight criteria, which it argues assess the wider range of activities necessary to leading an independent life. They provide a more accurate measure of the costs faced by disabled people. Those eight criteria are, first, maintaining a clean and safe living environment; secondly, preparing for the start or the end of the day; thirdly, social participation; fourthly, communicating with others; fifthly, preparing and consuming food and drink; sixthly, maintaining health and condition management; seventhly, dealing with utilities, such as gas and electricity; and eighthly, adaptations.

Looking at the consortium’s list of eight there clearly is not surprisingly some overlap with the Government’s list. However, it is clear that the consortium’s list is wider in scope than that of the Government. It could be argued that the consortium’s list contains a more rounded appreciation of what is involved in securing independence and is perhaps a fuller list of the things that ought to be considered when dealing with what the Minister has said she wants the assessment to take into account. The Government’s list, which was sent around at the end of last week, by contrast, is rather narrower. The consortium’s list is a more rounded set.

Is the Minister in a position to comment on why the Government’s list of nine is better than the consortium’s list of eight? I could ask a similar question about the mobility assessment—where the Government have two criteria; the consortium has come up with three. There is a bigger issue in the context of the activities of daily living. Can the Minister say something more about the rationale for the list of nine that the Government have come up with in contrast to the alternative proposal?

Maria Miller (Conservative, Basingstoke)

I thank the right hon. Gentleman for initiating this stand part debate and for giving us the opportunity to talk a bit more broadly about such matters, although I will focus my remarks on the issues he has raised about the activities that are included in the assessment criteria. The assessment criteria that we have put forward have been developed by an independent group of specialists in health and social care and disability. That group includes a wide-range of professionals who have looked at what they feel are the most important proxies for assessing somebody’s care and mobility needs. The activities that they have chosen—and I emphasise that they have chosen them, because we wanted that sort of independent advice on this—provide a more holistic assessment of the impact of disability than the existing DLA criteria, considering the impact of the full range of impairment types. For example, the introduction of communication, as has been mentioned, is a significant departure.

I have only just seen the Disability Benefits Consortium submission, but we welcome the active involvement of such groups in the discussion that we will have on the assessment criteria. I welcome the time that the consortium took to look carefully at our proposals to see whether there are other areas that might need to be addressed. I can assure the right hon. Gentleman that we take all such submissions very seriously, and we are looking carefully at whether there are other ways that we can hone and shine our assessment criteria to ensure that they are the best that they can be. I underline, however, that we are not trying to be able to take into account every aspect of an individual’s life, and I am sure that the right hon. Gentleman would agree that that would be unmanageable. We are looking for a reasonable set of proxies to assess the abilities of an individual to participate in everyday life.

Stephen Timms (Labour, East Ham)

I appreciate that the consortium list is new—of course, I think that the consortium did not see the Government list until yesterday. The consortium list contains communicating with others, which is also in the Government list, but separately, its list contains “social participation”. It struck me, looking through the other items on the Government list, that there is not really anything that addresses that, apart from the point about communicating. I think that one can see the reasons why one might want to consider the ability for people to participate socially in a broader way, and I wonder whether the Minister thinks that there may be some merit in that.

Maria Miller (Conservative, Basingstoke)

Behind some of our thinking on communication is the very issue that he raised—the ability for an individual to communicate with people who they know well, and those who they know less well. Some innovations that we have been discussing on mobility will also have a beneficial effect on people’s ability to be part of their community. An important part of that is being able to have that social interaction, and, because the DLA does not adequately take into consideration some of the mobility problems that people with sensory impairments have, the lack of social interaction can be a casualty of that.

I absolutely want to look carefully at all submissions on the assessment criteria that we have put forward, whether they are from disabled people’s organisations or from disabled people themselves, and we would want to do that anyway, even if the right hon. Gentleman had not raised that point in the stand part debate. As I have underlined throughout this debate, it is about getting this right. I believe that the invaluable help that we have had from the group of independent experts in developing the new assessment criteria has been extraordinarily useful, and I hope that they will be able to work with us further on looking at suggestions such as those that the right hon. Gentleman has cited in the debate today.

With that explanation, I hope that hon. Members are happy for the clause to stand part.

Clause 79

Margaret Curran (Labour, Glasgow East)

I beg to move amendment 220, in clause 79, page 56, line 45, leave out ‘6’ and insert ‘3’.

James Gray (Conservative, North Wiltshire)

With this it will be convenient to discuss the following: amendment 221, in clause 79, page 57, line 3, leave out ‘6’ and insert ‘9’.

Amendment 222, in clause 79, page 57, line 15, leave out from ‘previous’ to second ‘months’ and insert ‘3 months means the 3’.

Amendment 223, in clause 79, page 57, line 17, leave out from ‘next’ to second ‘months’ and insert ‘9 months means the 9’.

Margaret Curran (Labour, Glasgow East)

The amendment would retain the three-month waiting period that claimants must wait before they are eligible to receive the personal independence payment. However, the proposals would go on to extend the period that the claimant must show that they will be with that disability to nine months, rather than six months, which is currently the case with the disability living allowance.

We agree with the extension to a year. We are just arguing for a different balance within that year, because we believe that this is a question of fairness and balance in reform and I will explain why, hopefully quite briefly.

I repeat the point that this change is a part of the reform process that we support. There is a clear case for reforming the gateway to the personal independence payment, to ensure that the new benefit goes to those who need it. I think that we all agree on that. Unlike the Government, however, we do not believe that the right way to do that is to make disabled people wait for six months before they are given the support that they clearly need to help them to meet the extra costs associated with living with a disability. We do not think that that is the right way to go about reform.

We believe that it would be better to keep the initial three-month waiting period before people can apply for PIP and instead extend the time after they receive the benefit during which they must show they have the disability. That period should be extended from six to nine months. Essentially, that is what this amendment seeks to do.

To be clear, we would also extend the required period condition that currently exists around DLA, extending it from nine months to a year under the PIP. However, we would extend the provision after the receipt of the benefit rather than at the beginning. That is the fundamental point, because we believe that extending the waiting period at the beginning unfairly penalises those disabled people who need extra help to cope with their disability early on in their treatment. Ultimately, the change that we are proposing could lead to a reduction in costs. If we move in quickly to help people and give them the support they need, that can stop their condition deteriorating. If their condition deteriorates, that would sometimes require other expenditure from other parts of the state, as it were.

Charlie Elphicke (Conservative, Dover)

I am sure that the hon. Lady can predict what I am going to ask her. Can she tell the Committee what the direct cost of this group of amendments would be?

Margaret Curran (Labour, Glasgow East)

I thank the hon. Gentleman for putting that question. I was feeling very neglected by him. He had not intervened on me once and I was feeling very disappointed about that. I am glad that I attracted his attention sufficiently for him to ask a question.

Of course, the hon. Gentleman is raising a very serious point and in preparing the amendment we have of course given some serious thought to the associated costs. There are two points that I want to raise with him. First, I pursued the Minister and the Department to try to get some figures about the cost of these measures but the cost is quite hard to determine, because we cannot actually determine the costs. If someone claims the benefit at three months, how would we then assess the costs? What would the journey be to six months? That information is quite hard to extract. What we have tried to do is to balance the fact of earlier application and earlier eligibility by extending the period after an application to nine months. I will go on to say that a number of the organisations in the sector substantially agree that we can save money if we intervene early. That is prevention. Sometimes, if we do not intervene early, a person’s condition deteriorates and we might have to provide substantially more support, particularly social care support. So there is a complex argument about costs that the Government, a number of organisations and I myself are involved in.

Secondly, many charities are deeply concerned by the Government’s decision to make disabled people wait for six months before they can apply to receive help. The Centre for Mental Health, Mind, Rethink, the Royal College of Psychiatrists and the Scottish Association for Mental Health issued a joint statement, which said:

“The early stages of a mental health problem are the vital point for intervention to take place and support from PIP at this time could have a hugely beneficial and preventative effect.”

The Multiple Sclerosis Society has similar concerns, saying:

“We are concerned that this will unfairly disadvantage people with sudden-onset needs who will have to wait an additional three months to get the vital funds to help them manage their condition, for example those with MS who experience a bad or disabling relapse. By the time that they are able to apply for PIP, the period of the greatest need may well have passed. They may well have experienced significant costs and generated significant debts and difficulties.”

That quote from the Multiple Sclerosis Society makes it clear that this issue is not just about ensuring that people get the help they need when they need it. There is also an argument for preserving the preventive mechanism, to ensure that the impairment of a disabled person is not allowed to worsen as they sit and wait for half a year before the Government take note and help them. It is not only an issue of cost but a health issue, in terms of assisting disabled people.

One particular group who are deeply worried—I am sure that the Minister is aware and has had representations as we have had on this side of the House—are cancer charities. In an open letter to the Secretary of State, a group of cancer charities highlighted why the change is especially problematic for cancer patients:

“Firstly, we are very concerned by the proposal that people with cancer will have to wait six months before they claim the new Personal Independence Payment (PIP), which will replace DLA. We know that even the existing three-month wait for DLA is extremely problematic for people with cancer. Cancer treatment often starts very quickly following diagnosis and the needs associated with cancer can escalate rapidly. In the first six months following diagnosis, people with cancer face dramatically increased outgoings to cover expenses such as travel and parking for hospital appointments and extra fuel costs. Without support for these costs as soon as need arises, people with cancer will face increasing levels of hardship and some will get further into debt.”

Without straying too far on to that subject, I know that the Government are concerned about debt.

The briefing note from the Department has released further details about that and about the required period condition. I think that the Minister will argue that they will go some way to address the point I have just made about up-front costs, particularly for people with hospital appointments. The Government acknowledge that there are extra costs at the start, particularly in cases of a serious illness such as cancer, or indeed a disability. The briefing note goes on to say:

“While we acknowledge that some impairments or conditions may appear long-term at their outset, and that additional costs may arise as a result, this may not always be the case. Where disability-related costs do arise early on, for instance as a result of having to make frequent hospital visits for treatment, additional support mechanisms provide an element of coverage before the qualifying period is satisfied, for example through the NHS travel costs scheme or other social security benefits.”

Of course, other interventions are there through the NHS and through other benefits and such like, and we recognise that. The cancer charities, however, will tell us that that is a particularly narrow example and a very limited definition, which shows a very limited understanding of the costs involved when people experience cancer, sadly. They particularly emphasise issues such as new clothes, extra fuel costs, aid adaptations and things like wigs, shoes and special diets, which, if someone is experiencing cancer and having to pay those costs without much money, really do matter. I ask the Minister for her thoughts on that.

The Minister and the Government argue that this is a proper recommendation because it aligns DLA with the waiting period for attendance allowance. I have to ask whether it is right to apply that to people who are working, many of whom face sudden onsets of conditions that no one was expecting. I do not know whether that parallel is quite as sound as the Government suggest. Many we know would argue that it should be the other way around—that the attendance allowance should be aligned to the three-month period, rather than doing it the other way around. I am sure that the Government and the Minister are aware of that.

Elsewhere in the briefing note it states that, in practice, most people will have completed some or all the qualifying period of the required period condition when their claim is submitted. I am not quite sure what is meant by that. Is that the six months, or the three months? I presume that that is the three months, but even if it is, I think that adding another few months to that exacerbates some of the conditions that many people face. Throughout the briefing note and, as I said earlier, throughout many Government submissions on the introduction of PIP, the emphasis is on those with the greatest need. If the Government intend to shift the goalposts with DLA eligibility fundamentally, they must move the supporting structures that go with that, and shifting the waiting time from three to six months does not do that and, in fact, could undermine and counteract the proposal for people with the greatest need, because sometimes those with the greatest need are captured within that three-month period.

Essentially, we recognise the overall framework that the Government are introducing within the year. I think that some of the charities recognise that shift. We would be willing to go with that shift, but there is a question of balance. It is that critical period of three months. We will lose many, many people. Many people will go into debt. Many people will face enormous difficulty at a time when they are already facing difficulty in terms of disability and ill health. I do not think that there is a proper balance and that underlines yet again the deep concern people have about the scale and pace of change. The amendment asks the Government to reconsider.

Yvonne Fovargue (Labour, Makerfield)

I want to reinforce my hon. Friend’s remarks. Often, for people who experience a sudden catastrophic event, the costs come up front in the first three months. I will give an example of someone who is personally known to me who was mugged and dragged in front of a car. She suffered a serious brain injury. Not only did she have to cope with the costs of dealing with that and adapting her house, but her mother had to give up work to look after her. They waited three months, the qualifying period, before her mother could claim carer’s allowance for looking after her. To wait six months would have meant an incredible and catastrophic drop in their income.

The qualifying benefits that people get from carer’s allowance and from local authorities are important in that time, and the loss of income by anyone who suffers an illness can be very detrimental. Citizens Advice has said that one fifth of people who get into debt, and such serious debt that they end up in court with mortgage arrears, do so because of an illness. To extend the qualifying time to six months at a time when there are extra expenses and when extra emotional and physical support is needed from partners and family will put people in an incredibly difficult position, and I urge the Committee to support the amendment.

Maria Miller (Conservative, Basingstoke)

We have reached one of the difficult points in our debate on disability living allowance and the new personal independence payment. We are dealing with difficult issues, as the hon. Member for Makerfield pointed out. I will outline the Government’s intention on clause 79 regarding the amendments, and I hope to provide some clear and genuine reassurance to the hon. Ladies who have spoken.

The measure to increase the existing qualifying period from three to six months is not meant to be a punitive one, denying disabled people access to support. It is our view that support in the short term should be met by existing, albeit mainly means-tested, support mechanisms, with PIP kicking in at a stage when additional costs become burdensome to all regardless of income. It is about balancing the needs of those who can be reasonably expected to meet some of their needs in the short term with the needs of people who cannot.

Margaret Curran (Labour, Glasgow East)

Can I recast the question that the hon. Member for Dover asked me? Do the Government anticipate savings from the proposal, and if so, what is the scale of the savings?

Maria Miller (Conservative, Basingstoke)

I will be honest and open with my answer. I would like to reassure the hon. Lady and my hon. Friend the Member for Dover that the principal aim of extending the qualifying period from three to six months is not about savings. We do not expect the measure to provide any significant savings. It is a principled measure to bring PIP in line with the common definition of disability used in the Equality Act 2010, to provide an appropriate measure of long-term disability that can be robustly assessed, and to align with the qualifying period for attendance allowance. The hon. Member for Glasgow East asked in the beginning what I have learned from the consultation. What we learned was that people appreciated and welcomed the simplification of the definitions, which is important for the Committee to note.

I should thank Macmillan Cancer Support and Disability Alliance for their immense work in providing briefings for hon. Members who are participating in the debate. I would like to thank them for actively doing that. I would also like to thank the hon. Member for Glasgow East, in tabling the amendment, for so explicitly accepting the principle that PIP is to be paid to people who have long-term conditions. PIP cannot be all things to all people. It is there to provide support for people who have long-term conditions and who are facing some additional costs associated with that, and PIP will go some way to try to ameliorate that situation.

With disability living allowance, people must satisfy a three-month qualifying period, as the hon. Lady pointed out, and a six-month prospective test. Those rules were put in as something of compromise when the old attendance and mobility allowances were merged in 1992, and, as the hon. Lady pointed out, attendance allowance continues to apply a six-month qualifying period to this day. While those rules have operated for nearly 20 years—much longer in the case of attendance allowance—we must consider what an appropriate measure of long-term disability is in the 21st century, which should form part of the gateway to a valuable and universal cash benefit. It is our view that the proposed six-month qualifying period and the six-month prospective test meet the appropriate criteria and are consistent with the definition of long-term disability used for the purpose of the Equality Act 2010 and recently issued guidance connected to it. I know that the increase in the qualifying period has caused a great deal of comment and concern among disabled people and their representatives. Equally, as I have said before, it has actually found some support as well, because of how it simplifies the approach to how we define disability.

I want to take the opportunity to stress that most people will not have to wait six months before they start to receive PIP. That is because the six-month qualifying period starts at the point when somebody is first entitled to PIP, regardless of whether a claim has been received. Perhaps I can provide a practical example of how that works by using the case of somebody who suffers a serious stroke. From the point of the stroke onwards, they could be meeting the conditions of entitlement for PIP and would theoretically pass the assessment conditions. In my example, the person has had a stroke, but does not submit their claim form until they have completed extensive in-patient hospital treatment and rehabilitation, which may take five months. That would mean that five months of the qualifying period have already elapsed at the point that they make their claim, and they would be in receipt of the benefit soon after. It is an important point, and one that is often misunderstood, that most people will not be submitting a claim on the day that they become entitled to that benefit. In fact, the research that we have suggests that few people currently make a claim for DLA before the existing three-month qualifying period has been met, and many put their claim in long after that. We would expect the same sort of pattern of behaviour with PIP.

As we have heard today, there have been examples of how those rules already affect many disabled people, and I appreciate that, in some instances, there may be immediate costs that people incur in the early months when a disabling condition or impairment begins to have effect. Clearly, that is something that we need to take into account, because, as I said at the outset, it is our view that support in the short term for people who have sudden-onset conditions can and should be met from existing means-tested support, leaving PIP to do the job that it was designed for, which is to ensure that the financial support is in place when those costs become too burdensome for somebody to deal with.

After having set our thinking out, I hope that I can provide the hon. Lady with the reassurance that this is an absolutely clear way to pull PIP and attendance allowance into alignment with the Equality Act 2010, which was enacted under her party’s Government. That provides some consistency, which is unfortunately not always the case in this area.

Sheila Gilmore (Labour, Edinburgh East)

There have been a number of occasions when fairness and equalities have been prayed in aid of certain changes. It would be equally reasonable to equalise things in a different way. Just because attendance allowance has a six-month period, why is that being equalised to six months rather than attendance allowance being equalised to three months? Has the Minister also considered the concern of cancer charities that there are considerable additional expenses that are not met by other sources?

Maria Miller (Conservative, Basingstoke)

I understand the hon. Lady’s point. The definition of long-term disability in the Equality Act is consistent with our approach. We are taking our lead from the pretty fundamental pointer in the way that Parliament has chosen to define disability in the past. The hon. Lady may not agree with the Equality Act—I do not think she was in Parliament when we debated it in detail before the general election—but that is certainly the principle that we are following. I hope she will think that is an appropriate thing for us to do.

Another point that I should clarify, as it is something that the hon. Lady picked up on, concerns people who have to reapply for PIP, which is particularly pertinent for individuals whose condition may deteriorate following a period of remission. An individual in that situation will not have to fulfil the qualifying period again. Hon. Members may be aware of that but I want to make it absolutely clear. I hope that with that set of comments the hon. Lady will feel it appropriate to withdraw her amendment.

Margaret Curran (Labour, Glasgow East)

I thank the Minister for the many points of clarification that she offered this afternoon. I pay tribute to her good manners. I should also thank all the organisations for their briefings. The Opposition do not enjoy the same level of support as the Minister does from her officials, so those briefings are greatly appreciated. That is evident today from the way we have used them. May I also thank the Minister for clarifying the point about savings? This is a debate about how we manage the reform. There is some disagreement between us on that, but I appreciate her clarification that this is not a drive to save money and that essentially we are having a different discussion about that.

I am not broadly persuaded by what the Government are doing. With the greatest respect to the Minister, I do not think that she realises the scale of concern that organisations have about the measure and the personal impact it will have on a number of people who have had experiences in this area. My hon. Friend the Member for Makerfield made a significant point and gave a graphic illustration quoting the evidence from Citizens Advice about the reality that people face. The Government should be guided by that reality.

Perhaps the argument is about what is short term and what is long term. It seems to me reasonable to stay with three months and balance it out by nine months. As I understand it, we would be consonant with the requirements of the Equality Act if we went for three months and nine months, rather than six and six as the Government propose. The Minister made my argument for me in some ways with her example of a stroke victim. I have not heard anything to convince me that it is reasonable for a stroke victim to wait six months rather than three months. If someone has the full impact of a stroke and it has incapacitated them, it is reasonable for us to continue to set their eligibility at three months.

Yvonne Fovargue (Labour, Makerfield)

Does my hon. Friend agree that when the argument about aligning through attendance allowance is examined more fully it does not hold up? People who claim PIP are more likely to be earning, and more likely to be in work and to lose that income, than people who claim attendance allowance, who tend to be older. Therefore the loss of income for people who are claiming PIP in the first three months is likely to be much greater.

Margaret Curran (Labour, Glasgow East)

I thank my hon. Friend for making that substantial point. It goes some way to confirm my hesitation about the Government’s approach.

Maria Miller (Conservative, Basingstoke)

I am sorry to interrupt the hon. Lady, but I want to make it clear that PIP is not an income replacement. If an individual loses earnings, they will be able to apply for the appropriate out of work benefits. I wanted to make that clear because there is so much confusion about the role of DLA, and I do not want that confusion to roll over into PIP.

Margaret Curran (Labour, Glasgow East)

Of course, the Minister is right about that, but I think that my hon. Friend was making a slightly different point, although it was connected.

Kate Green (Labour, Stretford and Urmston)

Does my hon. Friend share my puzzlement at that remark from the Minister? DLA and PIP are not means-tested, as the Minister said, yet she implied in her remarks earlier this afternoon that need in the first three months will be met by means-tested support. I am not sure what she is talking about.

Margaret Curran (Labour, Glasgow East)

That question of other support is why I am so troubled by the Minister’s contribution. It is clear to me—it is a hard reality that we were obliged to address in government—that many people in that three to six-month period will have no other support available. That is what the cancer charities have laid out in graphic detail. Some support might be available, such as NHS support for travel costs, but substantial support is not. The charities tell us directly that if we take away that benefit, restrict it even more or change the period from three months to six months, people will be in substantial need and will fail to have that need addressed.

The Minister said that the measure is not about savings and that there is no drive to make the Government do it. I cannot see that there is any strong rationale for the measure other than tidying up, which seems to be the argument that she is making. Given that, I do not think that we should take this step. It would have such a negative impact on the circumstances of people in particularly difficult need.

Lilian Greenwood (Labour, Nottingham South)

I want to pick up on the point about consistency with the Equality Act. Is it not the case that conditions including HIV, cancer and multiple sclerosis are automatically included in the definition of disability under the Act from the point of diagnosis, with no waiting period of three, six or 12 months?

Margaret Curran (Labour, Glasgow East)

Yes. That reinforces the point that I was about to make in conclusion. The measures are a significant part of the Bill and have raised considerable concerns, as the Minister recognised in her introduction. Disabled people will be looking closely at what we decide today. On that basis, I will push my amendment to a vote.

James Gray (Conservative, North Wiltshire)

Order. Before we come to amendment 199, we have decided to press on this evening. If that is all right with the Committee, perhaps Members could be brief and to the point. I will try to keep them absolutely in order, if that is all right all round.

Jennifer Willott (Liberal Democrat, Cardiff Central)

I beg to move amendment 199, in clause 79, page 57, line 6, at end insert ‘, or

(c) for persons who experience a sudden onset physical or mental condition, whether, as respects every time in the next 12 months, it is likely that if the relevant ability were to be assessed at that time that ability would be determined to be limited or (as the case may be) severely limited by the person’s physical or mental condition.

‘(11A) Regulations must make provisions as to—

(a) what conditions are to be considered “a sudden onset physical or mental condition”;

(b) the amount or rate of payment which can be made under subsection (1)(c) above.’.

I will be brief. The amendment looks specifically at people with a sudden onset condition, such as a cancer diagnosis, a car accident or a stroke. As has been discussed, there is a clear start to the condition rather than a slow build-up. It is already hard for people with sudden onset of a disability to have to wait three months to get disability living allowance. Only a small number of people are affected, but I want to read briefly an account by Karen, who has been diagnosed with cancer, which was passed to me by Macmillan. It clearly explains the issues:

“When you are diagnosed with cancer the last thing you need is money worries. You need to focus on getting better, but cancer is expensive. I had to leave my job when I started chemotherapy and immediately the costs started to mount up. I was paying to travel to and from hospital to get treatment and had higher energy bills because I was at home more. Before long I was really struggling to pay my bills and was getting into more and more debt. Despite needing help straight away, I had to wait three months before I could get my DLA. Eventually I got my DLA and it made a massive difference. As well as the DLA I was able to qualify for the disability premium on tax credits and got more council tax benefit and housing benefit. If I had had to wait six months there is no way I would have been able to cope financially. I would have got further in debt.”

For many people with a sudden onset condition, the first six months is when the costs are greatest. That is why there is concern about the proposal. For example, cancer patients have to pay for travel and parking at hospital. The average cancer patient makes 53 trips to hospital, costing on average £325. That is a huge amount of money for a lot of families. For children with cancer, specialist units are sprinkled around the country, and there is often much further to travel, which increases the cost of petrol and brings additional potential costs such as accommodation, child care for siblings and so on.

There are also the other costs associated with having a disability. However, for people with a sudden onset condition, items such as special adaptations come all at once and at the beginning. They have a very heavy up-front loading of the costs associated with their condition and disability. Such costs—travel, extra heating bills and adaptations—are exactly the sort that PIP is designed for. We have just had a discussion about whether PIP is an income replacement, which clearly it is not. The considerations I am talking about are the things that PIP is designed to cover.

The Government said in their consultation on PIP, and the Minister has repeated today, that there are other sources to pay for those additional costs in the first six months, such as NHS travel costs, employment and support allowance, social services support and so on. However, they are either means-tested or are not available for people who are in work or on statutory sick pay. It often takes a long time to get through the assessment process for social services support from local authorities. Extra support at the beginning would not be there through those methods either.

The amendment is only one way forward; I accept that there other ways. I also accept that the wording is probably not perfect. I found it difficult to express in a helpful way. It is not the wording one would want to see in the Bill.

The rest of the debate is in Hansard.