Mr Deputy Speaker (Mr Nigel Evans) Order. The sitting is now
resumed. The reason for the suspension was because the statement,
which under the ministerial code should have been delivered at a
minimum of 45 minutes prior to the statement being made, was
delivered late; I know the Secretary of State will want to look
into the matter and report back to the Speaker. The Secretary of
State for Work and Pensions (Mel Stride) First, may I apologise
profusely to the House...Request free
trial
Mr Deputy Speaker (Mr )
Order. The sitting is now resumed. The reason for the suspension
was because the statement, which under the ministerial code
should have been delivered at a minimum of 45 minutes prior to
the statement being made, was delivered late; I know the
Secretary of State will want to look into the matter and report
back to the Speaker.
The Secretary of State for Work and Pensions ()
First, may I apologise profusely to the House that a copy of my
statement was not provided to Mr Speaker and indeed those on the
Opposition Front Benches sufficiently in advance of my statement?
May I also take this as my first opportunity in the House to say
how saddened I was by the passing of , a true champion of welfare
reform who was always prepared to work across party? While we did
not always agree on all matters, I share and admire his belief
that welfare means transforming lives.
With permission, Mr Deputy Speaker, I shall make a statement on
the consultation we are launching today on the changes to the
personal independence payment, which aim to create a benefits
system that can best support disabled people and people with
long-term health conditions to live full and independent
lives.
This Government's priority is to make sure that our welfare
system is fair and compassionate: fair on the taxpayer by
ensuring that people of working age who can work do work; and
fair on those in most need of the state's help. Welfare at its
best is about more than just benefit payments; it is about
changing lives for the better.
In recent years the Government have delivered successive reforms
to create a system that is fairer and more compassionate while
providing value for the taxpayer. We have reformed an outdated
and complex legacy benefits system and introduced universal
credit—a new, modern benefit that ensures people are better off
in work than on benefits. Last year we published a landmark White
Paper announcing significant reforms to focus the welfare system
on what people can do rather than what they cannot. We are
delivering our £2.5 billion back to work plan, substantially
expanding the employment support to help more disabled people and
people with health conditions to start, stay and succeed in work.
Our reforms to the work capability assessment will better reflect
the opportunities in the modern world of work and ensure that
more people get the support they need to move into employment,
while protecting those unable to work, and in February we
published the disability action plan to make this country the
most accessible place in the world for people to live, work and
thrive.
In addition, the Government have provided unprecedented help for
the most vulnerable, including by implementing one of the largest
cost of living support packages in Europe, which prevented 1.3
million people from falling into absolute poverty during a time
of global inflationary pressures. We have increased benefits by
6.7% and raised the local housing allowance, benefiting 1.6
million households by an average of around £800 this year.
Our approach to transforming the benefits system for disabled
people and people with long-term health conditions is guided by
three important priorities: providing the right support to the
people who need it most; targeting our resources most
effectively; and supporting disabled people to reach their full
potential and to live independently.
Although we have made significant progress, the disability
benefit system for adults of working age is not consistently
providing support in the way that was intended. It has been more
than a decade since the introduction of the personal independence
payment. The intention was that it would be a more sustainable,
more dynamic benefit that would provide better targeted support
to help disabled people with the extra costs arising from their
disability. However, the nature and understanding of disability
and ill health in Britain has changed profoundly since then, and
the clinical case mix has evolved in line with those broader
changes, including many more people applying for disability
benefits with mental health and neurodivergent conditions.
Since 2015, the proportion of the caseload receiving the highest
rate of PIP has increased from 25% to 36%. Some 7% of working-age
people in England and Wales are now claiming PIP or disability
living allowance, which is forecast to rise to 10% by 2028-29. In
2022-23, the Government spent £15.7 billion on extra costs
disability benefits for people of working age in England and
Wales, and the Office for Budget Responsibility has forecast that
the cost will rise to £29.8 billion in nominal terms by 2028-29.
There are now more than 33,000 new awards for PIP per month. That
figure has almost doubled since the pandemic.
With almost a quarter of the adult population now reporting a
disability—up from 16% in 2013—I believe that now is the time for
a new conversation about how the benefits system can best support
people to live full and independent lives. Today I am launching a
consultation to explore changes that could be made to the current
PIP system to ensure that support is focused where it is most
needed. These options include: making changes to eligibility
criteria for PIP; redesigning the PIP assessment to better target
it towards the individual needs of disabled people and people
with health conditions, including exploring whether people with
specific health conditions or disabilities can be taken out of
PIP assessments all together; and reforming the PIP assessment so
that it is more linked to a person's condition. We are also
consulting on whether we should make fundamental changes to how
we provide support to disabled people and people with a health
condition.
We know that any additional costs arising from a disability or
health condition, which PIP is intended to help with, can vary
significantly and are unique to the individual's circumstances.
Some people on PIP may have relatively small one-off costs, such
as walking aids or aids to help with eating and drinking, or
ongoing additional costs related to their disability or health
condition, such as help around the home or running a ventilator.
Some claimants' costs will be fully covered by their award, while
others may find the current system does not provide enough
support to meet their needs, yet the current system operates a
one-size-fits-all model and does not channel people towards
bespoke support tailored to an individual's needs. We recognise
that better, more targeted support could be provided by other
local services.
Our plans include exploring how the welfare system could be
improved with new approaches to providing support, such as:
moving away from a fixed cash benefit system, so that people can
receive more tailored support in line with their needs; exploring
how to better align the support PIP offers with existing services
and offers of support available to disabled people and people
with health conditions; and exploring alternative ways of
supporting people to live independent and fulfilling lives, which
could mean financial support being better targeted at people who
have specific extra costs, but could also involve improved
support of other kinds, such as respite care or physical or
mental health treatment, aiming to achieve better outcomes for
individuals.
Crucially, we want to explore whether we can achieve our aims
within the current structure of health and disability benefits,
or whether wider change is needed. We are consulting over the
next 12 weeks to seek views from across society, including
disabled people and representative organisations, to ensure that
everyone has a chance to shape welfare reforms that will
modernise the support provided through the benefits system.
We know that these reforms are significant in their scale and
ambition, but we will not shy away from the challenges facing our
welfare system today. We owe that to the millions of people who
rely on it and to the hard-working people whose taxes underpin
it. That is what the next generation of welfare reforms is all
about. These proposals will help to create a benefits system that
can better support disabled people and people with long-term
health conditions to live full and independent lives, and they
are a crucial part of my mission to ensure that the welfare
system is fair and compassionate and that it provides the right
help to those who need it most. I commend this statement to the
House.
4.59pm
(Wirral South) (Lab)
I thank the Secretary of State for his comments about . Both I and my hon. Friend the
Member for Wallasey (Dame ), who is sitting alongside me
on the Front Bench, thought the world of Frank. I thank the
Secretary of State for his tribute to a person who was completely
unique in every way.
With regards to advance sight of the Secretary of State's
statement, I say: apology accepted. Labour will carefully review
the detail of the Green Paper, because the country that we want
is one where disabled people have the same right to a good job
and help to get it as anyone else. We will judge any measure that
the Government bring forward on its merits and against that
principle, because the costs of failure in this area are
unsustainable. The autonomy and routine of work is good for us
all, for our mental and physical health—and more than that, for
women, work is freedom, too.
I have read the Secretary of State's gibes about Labour. He says
that he does not know what our position is on a set of reforms
that he has not set out. The Prime Minister made a speech about
this issue two weeks ago, but every single day since then the
Government have failed to publish the Green Paper. The Secretary
of State wants my views on his, until this moment, unpublished
thoughts. What was the problem? Was the printer jammed? Rather,
was it that the Prime Minister and Secretary of State realised
that, as soon as they published the Green Paper, everyone would
realise the truth about the Government: like the Prime Minister
who leads them, they are long on questions and short when it
comes to the answers?
The Green Paper is not a plan; it is an exam that the Secretary
of State is hoping he will never have to sit. The reason he wants
to know Labour's plan is that he suspects he will be long gone
before any of these proposals are a reality. Will the Secretary
of State tell me where the Green Paper leaves the Government's
earlier half-baked plan to scrap the work capability assessment,
given that the idea behind that was to use the PIP assessment? He
said that some health conditions can be taken out of PIP
assessments. Which conditions was he talking about?
PIP was the creation of a Conservative Government, so where is
the analysis of what has gone wrong? PIP replaced DLA, and now we
are hearing that PIP is the problem. How many more times will we
go around this same roundabout? Do the Government's plans involve
treating people's mental and physical health differently? Can he
explain the legal basis for doing so? Importantly, on health
itself, is this Green Paper not a huge admission of the Tory
failure on the NHS, in that it takes as its starting point the
fact that people today simply cannot get the treatment and care
they need? What will the costs of any new system be, in
particular those of any extra support of the kind he mentioned?
Will we see a White Paper before a general election?
I am standing in today and for the next few weeks for my hon.
Friend the Member for Leicester West (), who believes that health and work are two sides of
the same coin. That is the insight that the Government are
missing today. I ask myself how we got here. The country today is
sicker—that is the legacy of this Government. NHS waiting lists
are longer than they have ever been—that is the legacy of the
Secretary of State's party. If he does not know how bad things
are in mental healthcare, he needs only to ask my hon. Friend the
Member for Central Suffolk and North Ipswich (Dr Poulter). There
are 2.8 million people who are locked out of work due to
long-term sickness. That is the Conservative legacy: like ice on
our potholed roads, the Tories have widened the cracks in our
economy and society, making them all much worse.
With respect to mental health, in recent weeks the Secretary of
State has decided to speak out of both sides of his mouth. On the
one hand, he says,
“I'm grateful for today's much more open approach to mental
health”,
but with the same breath he goes on to say,
“there is danger that this has gone too far.”
He wants it both ways. He thinks that openness about mental
health is good, but then he says the very thing that brings back
the stigma.
Every time the Secretary of State speaks, he makes it less likely
that people will be open about their mental health. On behalf of
all of us who have ever had a panic attack at work, or worse, can
I say that that stigma stops people from getting treatment, it
makes getting help harder, and it keeps people out of work, not
in it? A Labour Government will take a totally different
approach. We will not only ensure more appointments but have an
extra 8,500 mental health staff. The last Labour Government
delivered the highest patient satisfaction on record, and that is
the record on which we will build.
The issue that we are discussing is bigger than just health; it
is also about work. Because of our commitment to serve working
people, we will make work better, too. We will have the new deal
for working people, improving rights for the first time in a
generation, and we will drive up employment in every region
because we will devolve employment support and end the tick-box
culture in jobcentres. We will tear down the barriers to work for
disabled people and provide help for young people. That will get
Britain working again.
Harold Wilson said that unemployment, above all else, made him
political. Those of us who grew up seeing people thrown on the
scrapheap in the '80s and '90s feel the same. Every young person
out of work today will never forget whose hand was on the tiller
when these Tories robbed them of hope. It is time for a change,
and a general election.
I thank the hon. Lady for her response and the gracious manner in
which she accepted my apology, which is much appreciated.
The hon. Lady said that she cannot be expected to comment on the
PIP proposals, but I remind her that the work capability
assessment proposals went through a consultation, and we still do
not know where the Labour party stands on those. We have spoken
about fit note reforms, we are setting up WorkWell, and in the
autumn we will trial some of those fit note possibilities. We do
not know where the Labour party stands at all on those
matters.
One would have thought that given the central role that PIP plays
in the welfare system in our society and country, the Labour
party would have some kind of view on that benefit. But we hear
precisely nothing on that matter because the Labour party has no
plan. The consequence of that will be that, as under previous
Labour Governments, the welfare bill will continue to spiral out
of control. That will fall to hard-working families up and down
the country to pay, by way of higher taxation.
The hon. Lady asked about the abolition of the work capability
assessment, which, as she said, is set out in the White Paper.
Those measures will not be due to come into effect until 2026. We
will take into account the conclusions that may be drawn as a
result of this consultation when we consider that matter. She
raised numerous other questions, many of which are included in
the consultation. I am sure that she will actively take part in
the consultation as we work towards the answers to those
questions.
I was rather surprised that the hon. Lady raised the NHS. This
party is spending more on the national health service than at any
time in its history, with a 13% real-terms increase in spending
over the last couple of years, 21,000 additional nurses and 7,000
more doctors in the last 12 months alone, and from next year £2.4
billion additional spend on mental health services, to which she
referred. That is on top of the additional £4.7 billion that the
Chancellor previously set aside for more mental health treatments
and, at the last fiscal event, 400,000 additional talking
therapies within the national health service.
The hon. Lady concluded by referring to Harold Wilson's comments
on unemployment. I simply refer her to the fact that under every
single Labour Government in the history of this country,
unemployment has been higher at the end of their term of office
than at the beginning.
(Romsey and Southampton
North) (Con)
A constituent who has cerebral palsy has been in touch with me
this afternoon to outline how he currently uses PIP. It gives him
the freedom to live independently and work full time, as he uses
it to buy mobility aides such as hoists and wheelchairs. His
concern is that any changes to PIP might push those costs on to
the NHS and reduce his flexibility to choose what to spend the
money on and when. He does not want to be pushed into a cycle of
renewal that may be too rapid and therefore cost the NHS more
money. What reassurance can my right hon. Friend give that this
consultation will enable those sorts of concerns to be
highlighted and that, in the long term, it will give more choice
and not restrict my constituent's freedom?
I thank my right hon. Friend very much indeed for that question
and for raising the issue of her constituent. The reassurance I
can give her is that we are aiming for the best outcomes. There
will be a number of ways in which those best outcomes may be
achieved—that is the purpose of the consultation—but it is
reasonable to at least explore the issue of whether cash transfer
payments are always the right solution, particularly given the
growth in mental health conditions we have seen in recent times.
The final point I would make is that we are absolutely interested
in examples of situations where people have lifelong regressive
illnesses from which, unfortunately, they are not going to
recover, and to ask whether, under those circumstances, it is
right to require them to go through re-assessments.
(Aberdeen North) (SNP)
Following today's statement, the announcement made a couple of
weeks ago and all the proposed changes, people are scared. They
are scared because they rely on these payments, which have
changed their lives. They have been able to access support that
they otherwise would not have been able to get. It is very clear
that the announced changes are not being created by disabled
people, with disabled people at their heart of the
decision-making process. This is a Government consultation and
then people are being asked to input into it. It is totally
different from the situation in Scotland, where the adult
disability payment was created with disabled people in the room
talking about the best way to make the payments work and the best
way to have assessment processes. Basically, the answer that came
back was, “Do not do them anything like the assessment processes
for PIP.”
Everybody should have the income to live with dignity, whether or
not they are able to work. I am massively concerned by the
comments that the Secretary of State and the Prime Minister
allegedly made about people with mental health difficulties only
facing the “ordinary difficulties of life”. It is very clear that
anybody who is able to say that has not suffered from depression,
and has not felt that absolute energy-sapping that comes
alongside suffering depression or anxiety. These are real
conditions. These are real things that people are struggling
with. And the lack of the ability to work is just as serious for
people with mental health conditions as it can be for people with
physical health conditions.
I have a couple of specific questions. In relation to universal
credit, it is a gateway benefit. Will the Secretary of State
assure us that any changes that might be made to eligibility
criteria around universal credit will be fully consulted on and
fully discussed, particularly with anybody who administers
benefits that are allowed through those gateway benefits?
Has the Secretary of State spoken to the Scottish Government
about the creation of the adult disability payment with disabled
people in the room, ensuring that at the forefront of every
decision is dignity and respect? Those are the two key columns of
the Scottish benefits system. The Secretary of State could learn
a lot from that approach.
I thank the hon. Lady for her response to my statement. I
reassure her that disabled people will be very much involved in
the process and the consultation. It will be a 12-week
consultation and of course we will take them, their comments and
representative organisations extremely seriously.
The hon. Lady's comment about the importance of recognising that
many, many people unfortunately suffer from very serious mental
health challenges is extremely well made. I am absolutely
determined that whatever conclusions we draw from the
consultation, they should lead us to a position where the
Government are better able to support people who are in those
circumstances.
On whether there will be questions in the consultation on the
passporting of PIP into other benefits, the answer is yes. That
is something we are most certainly consulting on.
On the Scottish equivalent of PIP—this is, of course, a devolved
matter—yes, the Department has been in discussions with the
equivalent officials in the civil service and the Scottish
Government. We are looking forward to considering, as I know the
Scottish Government will be, the independent review of that
benefit, which is being conducted at the present time.
(Amber Valley) (Con)
May I ask the Secretary of State about his comments on the
one-size-fits-all model not working if people incur very
different costs from their disabilities? Surely he is not
expecting people to send in invoices to prove how much support
they need, so is he looking at having more tiers of award? For
example, disability living allowance used to have three tiers,
rather than two. Is that one of his options for trying to reduce
costs?
By mentioning “one size fits all”, I am saying that we should
explore whether the approach we have at the moment has the best
outcomes. We have much to learn from the experience of countries
around the world that have a similar benefit but go about its
organisation and application in a different way. New Zealand
makes payments based on invoices for equipment submitted by those
who receive the benefit. Norway does not have assessments in the
way that we do; it relies more on evidence provided by medical
practitioners. We should go into this with an open mind. Bear in
mind that there has been no fundamental review of PIP for over a
decade.
Mr Deputy Speaker (Mr )
I call the Chair of the Select Committee.
Sir (East Ham) (Lab)
PIP assessment providers confirm that worsening delays in NHS
treatment are a big factor in the increase in the number of
people applying for PIP. The Secretary of State has confirmed
this afternoon that the work capability assessment is to be
scrapped and replaced by PIP assessments. There are people who
are too ill to work, but not disabled, and so not eligible for
PIP. How will their support be assessed in the absence of work
capability assessments?
As I have set out, we will need to look at the conclusions that
can be drawn from the consultation in the context of the
replacement of the work capability assessment and PIP becoming
the gateway to future universal credit health benefits, as the
right hon. Gentleman mentioned. These are questions that are
being asked in the consultation.
(Rushcliffe) (Con)
In the spring of 2019, before I was elected, I was diagnosed with
an anxiety disorder. I was extremely ill with it, and could not
work for several months, so I know for myself how debilitating
that can be, but I also know that with treatment and support, you
can lead a fulfilling career and a normal life that is extremely
rewarding. I would have been devastated to have been out of the
workforce for the long term. How will the reforms in the Green
Paper help anxiety sufferers to get the treatment and support
that they need to return to work, and also to take back their
life?
I thank my hon. Friend for a powerful and moving contribution to
today's statement. I am pleased that she is in such fine form
nowadays, knowing her as well as I do. The answer to her question
lies in the consultation, and the recognition that the
one-size-fits-all approach is not necessarily right. Those whom
she describes may well be better served by receiving treatment,
rather than cash transfer benefits. That is not a preconceived
outcome that I have in my mind, but it is one of the
possibilities on which we are seeking opinions.
(Manchester, Gorton) (Lab)
The charity Sense has criticised the Government's narrative
around disability benefits, highlighting the divisive and deeply
damaging language used, which further stigmatises some of the
most vulnerable people in society. Disabled people have told
Sense that they are sick with worry about whether they will lose
their personal independence payments, which are vital—a
lifeline—for them. Given the Tory cost of living crisis that we
have been living through for multiple years, does the Secretary
of State not think that disabled people need more support, not
dangerous rhetoric that casts them as undeserving?
We are certainly not stigmatising anybody—far from it. Indeed, in
the consultation, it is explicitly recognised that there might be
some disabled people who need additional help, beyond the help
that they are getting at the moment. I made reference earlier to
those who have lifetime progressive illnesses and conditions
that, sadly, are not going to improve. The question is being
asked: do we need to ask those individuals to attend
reassessments and jump through bureaucratic hoops, with all the
anxiety that may go with that, or should we have a better system
that better looks after them?
Dame (Thurrock) (Con)
I totally agree with the Secretary of State that everyone gets
dignity from being in work, but he will be aware of the very high
levels of unemployment experienced by those with learning
disabilities and autism. Bearing in mind that able-bodied people
over 50 struggle to find work, let alone those with a disability
or long-term health condition, what does he propose doing to
change the attitude of employers, so that they recognise that
everyone has a skill and a role to play, and that everyone is an
asset?
I thank my hon. Friend for that really pertinent question. She
will be familiar with the Buckland review, which has reported. I
was very keen to pursue that review when it came across my desk,
and I made my officials and the necessary infrastructure
available to ensure that it was able to go ahead. It addresses
many of the issues to which my hon. Friend rightly points, in
terms of employers accommodating and benefiting from those who
have autism and other conditions.
(North East Fife)
(LD)
Can I start by commending the hon. Member for Rushcliffe () on her comments? They really
went to the heart of some of what we are discussing. One of the
challenges for the Government in talking about PIP is that they
started this whole conversation by referring to the back to work
plan, which makes many disabled people feel that this is about
getting them back to work and reducing the overall welfare
budget, when PIP is supposed to be about ensuring that they get
the right support for their disabilities. On PIP, a big challenge
that all MPs deal with is the number of errors in the system, and
particularly the number of cases that end up at a tribunal. If we
are looking into having a system that targets support better,
what assurances can the Secretary of State give that it will
actually be a better system, with fewer errors?
There were two points there. First, errors in the benefits
system—overpayments, underpayments and so on—are relatively rare.
Secondly, on how we approach those who have long-term sickness or
disability, the hon. Lady will see, if she refers to the back to
work plan, that we are giving the 2.8 million people on those
long-term benefits the opportunity to try work without fear of
losing those benefits at all. We have made that extremely
explicit. That is simply freeing up the system, and trying to get
rid of some of the barriers that those people otherwise face.
(Colchester) (Con)
I need to read the detail, but on the face of it, there is much
to be welcomed in the Secretary of State's statement. However,
there are 2.6 million DLA and PIP working-age recipients and
their families who will no doubt be concerned about the future of
their support, so can my right hon. Friend assure the House that
he will tread carefully and think really carefully about tone and
the language that we use, and that we will listen to those with
lived experience and the charities that support them?
I thank my hon. Friend; he has done a great deal in the important
area that this statement and consultation are addressing. As he
knows, my door is always open to him, at every step along the
way, so that I can listen to his thoughts. I can assure him that
questions of tone, language, and treading carefully are
absolutely at the forefront of my mind.
(Newcastle upon Tyne Central) (Lab)
There are 4,500 people in Newcastle Central who are out of the
workforce and economically inactive due to disability or ill
health. The Government have failed them when it comes to the
benefits system, failed them when it comes to supporting them to
work, which is so important, and failed them when it comes to the
NHS. How will the £46 billion black hole in the Government's plan
to abolish national insurance payments enable the Government to
fix their failings?
On the hon. Lady's political points, I should point out that
economic inactivity is lower today than in every single year of
the last Labour Government—that is our record, compared with her
party's. She will know full well that reducing the £46 billion
national insurance figure still further, and finally eliminating
it, is a very long-term aspiration. I understand why the Labour
party tried to make it more than that. What is more than that is
the £28 billion that her party suggests will be made available
through its energy and net zero offering, which it is still
talking about to the electorate.
(Norwich North) (Con)
I commend the Secretary of State's approach as being entirely
realistic, given that the disability benefits system is not
consistently providing support in the way that it was meant to.
He is also right to take a strategic look, because he is correct
that the understanding of disability and ill health has changed
quite significantly in Britain, in some ways for the better, and
there is an imperative to consider that, in the light of our
labour market and the broader economy.
The Secretary of State is also correct to be comprehensive in his
approach in today's Green Paper, the prior White Paper and other
connected work. Will he also be comprehensive in delivering on
those measures, across Government? Can he give us assurances
about the way that he is setting up for the work that will need
to be done if this is to be a success, including with the NHS and
local authorities, for those who need support with their
disability or ill health? It is my understanding that the NHS
perhaps knows less than it could about how to help people,
holistically and individually, to move back into work, or with
the things that they need and care about.
Finally, how is the Secretary of State working with employers to
ensure that we unlock the workforce productivity needed in this
country?
I thank my right hon. Friend for her very astute comments, which
are built on her great experience of the exact issues that we are
discussing, both as Secretary of State and, before that, as a
very successful Minister for this area in the Department for Work
and Pensions. She is absolutely right to recognise that society
has changed a great deal in the 10 years since this benefit was
fundamentally reviewed. I will, of course, continue to work very
closely with my colleagues in the national health service and the
Department of Health and Social Care. We collaborated on setting
up WorkWell, which will be rolled out in 15 of the 42 health
areas of England this autumn, bringing together the world of work
and healthcare.
The White Paper specifically invites thoughts on how local
authorities could be more involved in PIP or any successor. My
right hon. Friend is absolutely right to mention employers, and I
have no doubt that she is aware of the two consultations we have
run on increasing occupational health, in which employers have a
particularly important role to play.
(Ellesmere Port and Neston)
(Lab)
The Secretary of State questions the need to reassess certain
groups. After visiting my local Motor Neurone Disease Association
support group, I can tell him that those with motor neurone
disease are one group who absolutely do not need or deserve
reassessment.
On the wider point about mental health conditions, I hope that
the Secretary of State will talk to his colleagues in the
Department of Health and Social Care. I have had many experiences
of constituents waiting months, if not years, for the assessment
of neurodivergent conditions or mental health support. We clearly
cannot address the issues that he wants to address in the
consultation if we do not fix the NHS workforce crisis.
The hon. Gentleman raises a very important point about mental
health, and I can reassure him, as I reassured my right hon.
Friend the Member for Norwich North (), that we will continue to work
very closely with the DHSC on the proposals as they emerge. In
response to an earlier question, I mentioned that the Chancellor
has brought forward funding for 400,000 additional NHS talking
therapies, for example, which may be an important part of what we
develop.
Dr (Bosworth) (Con)
Compassion has to be at the heart of this consultation. I have
seen patients who had to be reassessed repeatedly, which does not
seem fair, but I have also seen patients who do not engage with
services and do not take medication, yet are signed off, which is
not compassionate either. One practical way forward is to bring
DWP closer to GP surgeries, so that people can have their hand
held when they get to a diagnosis, whether it is of anxiety or a
physical complaint, or whether they are recovering from an
operation. Will the Minister consider that in the consultation?
DWP joining up with primary care would be a fantastic way to help
GPs help their patients—and to help the DWP.
I thank my hon. Friend for a sensible set of questions. He refers
to the importance of bringing GPs together with advice and
support to get people into work. That is very much the focus of
our fit note reforms, upon which we have a call for evidence at
the moment.
Sir (Rhondda) (Lab)
I am grateful to the Minister for his swift response to my
request earlier this afternoon for support for the people at
Everest in Treherbert, who look likely to lose their jobs in the
next few days.
Depression and anxiety are real, are they not? It is not just a
question of people pulling up their socks, as some in the
crueller parts of the commentariat have suggested. All too often,
talking therapies are least available in the areas with the
highest levels of economic inactivity, so how are we going to
change that?
On the intersection between mental health and physical health
that is acquired brain injury, does the Department even know how
many people who have had an acquired brain injury are in receipt
of PIP or of universal credit? If the Minister does not know the
answer today, will he write to me? If both he and his Department
do not know the answer, as I bet is the case, will he make sure
that the Department finds out before it implements something that
could provide even more problems for people who are trying to get
their lives back together?
First, I thank the hon. Gentleman for his comments about the jobs
situation in his constituency. Let me reassure him that my
Department will do whatever it can to assist with those
circumstances.
The hon. Gentleman rightly points out that depression, anxiety
and mental health conditions are very real, and in many cases
extremely severe, which is why I am absolutely determined that we
should do whatever we can, where appropriate, to provide as much
support as possible to people. As for his question about acquired
brain injury and how many PIP recipients are in that situation, I
do not think he would expect me to know off the top of my head.
It would be rather impressive if I did know. I will, as he has
suggested, write to him.
Sir
You have never impressed me before, and I have known you a very
long time!
That is probably fair. As the hon. Gentleman points out, he has
known me for a very long time, and I recall that when we were at
university together he was a young Conservative, as I was. How
things have progressed, or perhaps I should say regressed, since
then?
(Watford) (Con)
Does my right hon. Friend agree that my proposals over the past
few years to improve support in the workplace for mental health
are essential as part of this programme of work? Does he also
agree that one aspect of that, which I have raised repeatedly in
my work and suggestions, would be to make sure that physical and
mental health are given firm parity in the Health and Safety
Executive guidelines? I believe that would help both employers
and employees, both in my constituency and nationally.
We are considering the issue of parity that my hon. Friend has
raised. He is absolutely right to raise the issue of mental
health support—occupational health support—within businesses,
which is why we have consulted on that matter. I am particularly
keen to see what we can do not just for large companies, but for
small and medium-sized enterprises, to make sure that they engage
more fully in that respect.
(Bristol East) (Lab)
A considerable number of constituents have already contacted me
because they are worried about what the Government are proposing;
the key message they want to get across is that having
disabilities or a serious mental illness is not their choice and
not something they have control over. The Secretary of State
mentions tailored support an awful lot in his statement. My
experience is that when people with disabilities have engagement
with the system and have to go through the process of making an
application, being assessed and so on, that is a cause of great
anxiety and often the decisions are wrong. If he is proposing
more tailored support and more engagement with bureaucracy,
particularly for people with fluctuating conditions such as
myalgic encephalomyelitis, how is he going to get it right? He
has not managed to get it right so far.
I am absolutely determined that we are not going to be seeing
more bureaucracy. Indeed, I set out that one question we are
exploring in the consultation relates to those who, sadly, have
conditions from which they are not going to recover or improve.
In those circumstances, I want to see less bureaucracy and a
system where we are not having to reassess people in a
superfluous way, causing anxiety and putting them to that
inconvenience. The other points that the hon. Lady raises are of
course exactly the kind of questions we are asking in the
consultation, and I urge the constituents who have written to her
to engage in that consultation process over the next three
months.
(Harrogate and Knaresborough)
(Con)
My right hon. Friend is right to emphasise the importance of
focusing on what people can do, rather than what they cannot, and
it is worth noting that there are 2.2 million more disabled
people in work than 10 years ago. However, as he mentioned, the
benefits system is not just about work; it is about ensuring
people live full and independent lives. He said that during the
consultation there will be engagement with disabled people and
their representative organisations, which is critical, but each
individual's needs are personal to them, so how will he ensure as
many voices as possible are listened to during the
consultation?
The consultation will be very thorough. It is available in
accessible formats to ensure we cater to the greatest extent that
we can, and that we get the best possible and most universal
feedback. I am pleased that my hon. Friend spoke to the issue of
the employment of disabled people. In 2017, we set a 10-year
target of a million more disabled people in employment; we broke
that target in five years rather than 10.
(Bradford East) (Lab)
Announcing that disabled people suffering from certain conditions
will no longer receive support payments, but instead get improved
access to treatment, is one of the most absurd policies to have
come out of this Government in the past 14 years. The Government
plan relies on imagined brilliant mental healthcare support being
available. Is the Minister even aware how long people have to
wait for treatment after being referred? After 14 years of this
Tory Government gutting our NHS and our mental healthcare, even
basic access to treatment does not exist, let along the improved
access the Minister is relying on in the fantasy world he lives
in.
I simply do not recognise the comments the hon. Gentleman has
made about our national health service. There are more people
working in the national health service than at any time in its
history: 21,000 more nurses and 7,000 more doctors in the past
year alone. We are spending a record sum on the national health
service. I will not give chapter and verse, as I did earlier, as
to the other things we are doing, but we are completely committed
to the health and mental health of people up and down the
country. There will be new ways of doing things. If we do not
have a grown-up conversation, as I describe it, about those
matters, we will not discover those new ways. WorkWell is a
completely new way of addressing issues, such as mental health,
and encouraging people to stay or go back into work. It did not
exist 18 months ago; it came about because we consulted people
and came up with a solution.
(Stevenage) (Con)
I would like to give the Secretary of State the benefit of the
doubt, and he has made a number of important points, but those
2.6 million people and their families who will have heard his
statement will be absolutely terrified. A lot of them will feel
that the reforms are just about providing some kind of cuts to
services. I believe that we need to try to support those people
and put compassion at the heart of our welfare system. There are
reports of up to 2 million people waiting for mental health
treatment at the moment, so does the Secretary of State believe
that in this “compassionate” review, where we are going to have a
“grown-up conversation”, we will be able to see more money
invested to ensure that those 2 million people can get more
mental health support?
My hon. Friend raises important points that are core to the
consultation that is being carried out. The corollary to my hon.
Friend's argument is that we should not do anything and stay with
a system that has not been revisited for over a decade, despite
the fact that the terrain has changed substantially, not least in
terms of the increase in those suffering from mental health
conditions. I say no to that. We need to have a grown-up
conversation about these matters if we are to provide better
support for the people whom hon. Members across the House care
about.
(East Antrim) (DUP)
The Minister is right: economic inactivity rates have soared
because of ill health, and where possible we want those people to
get back into work. It is for their own good. It is also for the
good of the hard-working taxpayers to have those costs minimised.
However, given that these proposals come at the tail end of a
Government, who have just weeks or months to go, I doubt very
much that the measures will become a reality for many people. I
have one question for the Minister: as this issue is devolved to
the Northern Ireland Assembly, has he had any discussions with
the Executive about these proposals? If he has, what response did
he get? Should the Executive go in a different direction, what
will the economic consequences be for the Northern Ireland
Executive's budget?
The right hon. Gentleman is absolutely right to talk about the
importance of work in the context of mental health. That is my
strongly held belief. He is also right to raise the issue of the
fiscal sustainability of our welfare system. If the public are to
continue to have confidence in that system, we must get the
balance right between the requirements of the taxpayer and our
absolute determination to support those most in need of help.
The right hon. Gentleman asked a specific question about the
Northern Ireland Executive. He is right: it is possible for
Northern Ireland to decide to manage its benefits in a different
way to England. That is not traditionally what has happened.
Traditionally, Northern Ireland has followed the moves that we
have made. As to discussions, absolutely, there are always close,
ongoing discussions between my Department and our counterparts in
Northern Ireland.
(Hayes and Harlington)
(Lab)
The Secretary of State has said that the Government's approach is
fair and compassionate. Can he tell me what is compassionate
about the language used by the Prime Minister over the past
fortnight, when he has referred to a “sick note culture”, implied
that people who are forced to rely on benefits do so as a
lifestyle choice, and, today, talked about the arrests, seizures
and crackdowns on benefits claimants? The Disability Poverty
Campaign Group, which comprises the major charities that we have
all worked with, described the speech as “chilling”,
“threatening” and “stigmatising”. Does the Secretary of State not
realise that the language that the Prime Minister has used
increases prejudice against disabled people and contributes to
the escalation of hate crime against disabled people?
The Prime Minister shares my view, which is that it is really
important that we achieve the best possible outcomes for the
people whom we are discussing in this statement. He cares a great
deal, and I think he said at the end of his speech that he wanted
to help many people, some of whom are watching the screen
flickering away while their opportunities drift off into the
distance—or words to that effect. That speaks from the heart.
That says that we have a Prime Minister who cares deeply that
opportunities in our society should be made as widely available
as possible. That is a view, a characteristic and a quality that
I admire and that I share with him.
(Bermondsey and Old Southwark)
(Lab)
The Secretary of State has upset many disabled people and
organisations with his clumsy, negative and juvenile approach.
Mind, for example, has asked for a grown-up conversation.
Furthermore, the Secretary of State said at the Dispatch Box
today that there has never been a review of personal independence
payments, but there have been two independent reviews
commissioned by the Department, so perhaps he could correct the
record when he gets to his feet. PIP is not an out-of-work
benefit, so when will the Department publish its assessment of
the impact of these latest cuts on disabled people using PIP to
support themselves in work?
It is the case that there has not been a fundamental review of
PIP on the basis that that has subsequently led to a change in
that benefit. Therefore, it is the case that that benefit has
remained fundamentally the same for more than decade—it actually
came in in 2013, as the hon. Gentleman will know. On what
assessments may or may not be made available, I think they will
come at a point when the Government arrive at their conclusions
having conducted the consultation.
(Nottingham East) (Lab)
Members of this House may remember that I had to take a leave of
absence from this role three years ago because I have
post-traumatic stress disorder. I can tell the House that the
insinuation that mental health conditions are not debilitating,
do not affect people's ability to go about their daily life or to
go to work, and do not incur additional costs could not be
further from the truth. The Prime Minister's comments about
so-called “sick note culture” and the changes that the Government
are proposing will do nothing to help people with mental
illnesses, and will just make their lives harder. Why are the
Government setting back the clock on the acceptance of mental
illness as a disability instead of truly tackling the crisis in
mental health support?
I am at pains to say this: every time I have come to the Dispatch
Box this afternoon, I think I have made it extremely clear that
serious mental health conditions are very real. I take them very
seriously, as I think does everyone in this House. I say to the
hon. Lady—[Interruption.] This is where we need a grown-up
conversation. [Interruption.] This is really important. We need a
proper conversation about this, because if at every stage,
whenever a Minister suggests that we need to look at a particular
area, their motives get impugned in the way that the hon. Lady
has—[Interruption.] She inferred that I am actually saying that
mental health conditions should be trivialised in some way. I am
definitely not saying that.
(Edinburgh South West)
(SNP)
My constituent Elizabeth has been a very hard worker, but also
someone who has suffered from ill health. She came to see me at
my surgery on Friday to express her alarm about the Prime
Minister's speech on 19 April, his proposals for sick notes, and
what she sees as his lack of respect for the professionalism of
general practitioners. If the issue came up in the Chamber, she
asked me to ask the relevant Minister this question: how can a
random DWP assessor, faced with a complete stranger, based on the
briefest of interactions, be relied upon to produce a more
accurate and objective assessment of a patient's condition than
her own general practitioner?
I know the Prime Minister shares the view that we owe a huge debt
of gratitude to our GPs, right up and down the country. They have
a highly pressurised job, and they do it extremely well. DWP
assessors are highly trained individuals, and there are very
clear guidelines on how assessments should be fairly conducted.
They are, as the hon. and learned Lady will know, open to appeal
where that is necessary. She mentions GPs. As part of the
assessments, which are concluded by a DWP team member, rather
than the assessor themselves, taking into account all the
evidence, it may well be that GPs have an input into many of the
decisions.
(Salford and Eccles)
(Lab)
The Secretary of State must understand that the rhetoric coming
from the Government over the past few weeks has been brutal,
divisive and inducing unimaginable terror in the two thirds of
people already in destitution who have a chronic health condition
or disability. The prospect of further cuts is making the
situation worse. Can he confirm whether he expects overall
Government PIP spending to be reduced and, if so, by how much,
and what assessment he has made of how his proposals will affect
those who are already in material deprivation?
The presumption that the hon. Lady makes is that the alternative
to consulting on a different and potentially much better way
forward is to do nothing at all. To me, that is unacceptable. In
terms of ensuring that we truly support all those who need
support, I have already given that reassurance from the Dispatch
Box. It is made very clear in the consultation that we recognise
that there will be people who need more support than they are
receiving at the moment, but we need to have that conversation in
order to get the best outcomes.
(Blaydon) (Lab)
Language matters, as we have heard, and the Government have been
warned that the language and rhetoric—perhaps not from the
Secretary of State himself but from others—risks minimising the
impact of mental health conditions, which are real and serious.
What are the Government's plans to ensure that proper treatments
are available—not just talking therapies but whatever treatment
is appropriate—to ensure that people with mental health
conditions are treated appropriately?
The hon. Lady raises an extremely important point: the prevalence
of mental health conditions in our country has grown. There are
many reasons for that—I know the Labour Party like to say it is
all about the NHS, but it is about many other things, not least
social media among young people. There are many causes. The
consultation will look at exactly the question she quite rightly
raises. She mentioned the NHS talking therapies; I think that,
particularly for some less severe mental health conditions,
combined with work, they can make a real difference. I was very
pleased when my right hon. Friend the Chancellor brought in
400,000 more of those talking therapies at his last fiscal
event.
(Mid Bedfordshire)
(Lab)
Back in 2018, a bad concussion left me out of work for several
months. Over time, I became deeply depressed, worried and anxious
that I would never get back to full-time work at all. I was lucky
that my employer was able to find and to pay for me to get the
support I needed to get back to work, and I am lucky enough to be
here today. However, for many across the country that simply is
not the reality they face. Why are the Government not focusing on
making sure everyone has the support they need to get back into
work, rather than falling back into the kind of political
posturing that will only add to the stress and anxiety that
thousands already feel?
If I may say so, first, I am very pleased that the hon. Gentleman
is now fit and well and I am sorry he went through the difficult
time that he describes. We are doing a huge amount; he may or may
not be familiar with universal support, which is there not only
to place the kind of people he has described into work, but,
critically, to stay with them for a period of up to 12 months to
make sure they have the support to hold that job down. We know
that work is good for those with mental health conditions. I have
already referred to WorkWell, which brings together those who
have mental health challenges and work coaches who are able to
see how work can fit within their recovery programme. We are very
much doing those things. If he would like to see me at some point
after this statement, I would be happy to sit down with him and
talk him through some of the other approaches we are taking.
(North West Leicestershire)
(Ind)
Today's statement has been made necessary by the huge
deterioration in the nation's health and mental health since the
pandemic. I think the whole House has to take responsibility,
because this House voted for draconian lockdowns that devastated
mental health, particularly among the young. This House voted to
mandate untested experimental treatments, threatening people that
they would lose their jobs if they did not take them, while
giving immunity from prosecution to the manufacturers for their
dangerous and defective products. Will the Minister do the best
thing he can for public mental health by assuring the British
public that these mistakes have been learned from and will never
be inflicted upon them again?
I am afraid I simply do not subscribe to the theories that the
hon. Gentleman promotes. I think it is probably best to leave it
at that.
Mr Deputy Speaker (Mr )
I thank the Secretary of State for his statement and for
responding to questions.
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