text:
Session 2012-13
Publications on the internet
To be published as HC 916
House of COMMONS
Oral EVIDENCE
TAKEN BEFORE the
Work and Pensions Committee
Personal Independence Payment
MONDAY 21 January 2013
Esther McVey MP, Simon Dawson and Dr Bill Gunnyeon
Evidence heard in Public Questions 1125
This is an uncorrected transcript of evidence taken in public and reported to the House. The transcript has been placed on the internet on the authority of the Committee, and copies have been made available by the Vote Office for the use of Members and others.
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Oral Evidence
Taken before the Work and Pensions Committee
on Monday 21 January 2013
Members present:
Dame Anne Begg (Chair)
Debbie Abrahams
Mr Aidan Burley
Jane Ellison
Graham Evans
Sheila Gilmore
Stephen Lloyd
Nigel Mills
Anne Marie Morris
Teresa Pearce
Examination of Witnesses
Witnesses: Esther McVey MP, Minister for Disabled People, Simon Dawson, Personal Independence Payment Policy, Design, Test and Assurance Programme Manager, and Dr Bill Gunnyeon, Chief Medical Adviser, Department for Work and Pensions, gave evidence.
Q1 Chair: Can I welcome the Minister to this oneoff evidence session. I think we had a debate in Westminster Hall just before Christmas where I posed a lot of questions in the hope that you would appear in front of the Committee around the introduction of the Personal Independence Payment, so thank you very much for coming this afternoon. I am glad that the snow has not held you up and that my colleagues who are with me have managed to fight their way through it as well, so that is great.
Sheila Gilmore: Except for Debbie.
Chair: Except for Debbie. She is arriving late. I think she is stuck somewhere where there are no trains. I wonder if you could introduce yourself and your team for the record, please.
Esther McVey: I will. Thank you, Chair. It is a privilege to be here today. With me I have Dr Bill Gunnyeon, who is our Chief Medical Adviser and also Simon Dawson, to my right, who is the PIP Policy Manager, both from the DWP. It is the very first time I have been in front of the Select Committee and I am sure you will take that in consideration and will go easy on me-she jests.
Q2 Chair: We are pleased that you are here this afternoon. I will start with some questions around caseload and expenditure. The first time we heard that there were going to be changes to DLA was in the Budget in 2010 when the Red Book said that there would be a reduction in caseload and expenditure of 20%, a figure that I think we have since realised was perhaps plucked out of the air. However, the DWP's latest projection indicates that the reduction in caseload and expenditure as result of these changes will be around 27% to 28% by the time the PIP reassessments are completed in 2018. Why has that happened and how can you justify going a lot further than the original projections in the budget?
Esther McVey: I would like to put the new PIP benefit into the context of DLA and the need for a change and a need for a new benefit, which I know those on both sides of the House and the Select Committee had welcomed, and that we need to move forward on that for various reasons: the fact that many people did not have medical assessments and 71% of people had lifetime awards. What we were looking for was a fair system and a very clear system so people knew their eligibility, and one that, at this time of fiscal constraint, was workable, manageable and would continue working for the future.
What we had committed to do was continue to spend £50 billion every year on benefits and support. What we said was that we will spend more than the money that was spent in 2009 every year until 2015, and so when we talked about the cuts it was not cuts in the expenditure now; it was looking at the measured increase of the benefits, because it had increased by nearly 40% in 10 years. That level of increase was no longer sustainable, so we had to look at a sustainable benefit.
We know that we are talking about a reduction in growth, not a reduction in the figures. What we did have was a proposed reduction of growth by 20% by 2015, and I am pleased to say that figure is now 14%, so we have reduced that reduction; it will be a 14% reduction of growth by 2015. As for the May 2018 figures, to me they are hypothetical, because we are having a review in 2014, when we will completely review it and really I can only pledge any savings during the time I will be accountable, which is in this Parliament. Therefore, the figures I can guarantee and will be looking at are those up to 2015 and within this Parliament, and that figure is less than the original proposed reduction.
Q3 Chair: Can I just take a few of these things? First of all, on the 40% increase, a large proportion of that was because of demographics, but those who are over 65 and already receiving DLA will not be affected, so that growth will continue because all of these changes will affect those of working age. The reason that the proportion seems to have dropped is that you are delaying the roll-outs, so that is understandable. If we look at the DWP's own figures, when we last looked at this one of the main reasons for reassessing or abolishing DLA and introducing PIP was to get the projected numbers down. So DWP's own figures say that by 2018 there would be 2.2 million people on DLA if nothing had happened. Now your own figures are projecting that 1.3 million will get PIP.
Now, we also know from the figures that we have, and your Department has provided, that half a million will get less support, so there are almost a million who do get DLA and would have got DLA up to 2018, who will not get PIP, and, of the ones who will get PIP, there is another half million who will get a lesser award than they would have done had they been put under the DLA criteria. Now that, to me, appears as though almost two in every three of those who are presently receiving DLA will either lose all of their benefit or lose some of their benefit once all these changes are rolled out. That seems a very high proportion: two out of every three who are presently on DLA or were projected to be on DLA by 2018 could lose either some or all of their benefit. Is that a figure you would accept?
Esther McVey: The figure is that of those being reviewed, so 75% of people will have an award or keep the same award and 30% will get more of an award, because what we have done, which was key to our policy, is focused the most support on those with the greatest need to live an independent life, and instead of 16% getting the higher rate, we now have 23% getting the higher rate. So you are right that within the reassessment some people will have less award and some people will not get awards, but what we have said we will do is focus most attention on those who need it the most. When people do not get an award, we know that means that some of them will have got better. We know from surveys that 34% of people who might have had a condition one year will not have it the next and that was part of one of the problems with DLA: there was no systematic way of reviewing anybody's award, and we have to look at that in the round.
Q4 Chair: But that could have been sorted by just reforming DLA and having periodic assessments. The reason that the percentage has gone up is that the numbers have come down and you are getting rid of the lower rate of care, so there is a whole section that will no longer get an award at all. Of course the numbers who then get the award will be higher in proportional terms than exist at the moment, because the numbers getting any award will be a lot less. My concern is that there will be people who have quite severe needs who will lose as a result of these changes. They may not necessarily lose all of their award, but they will lose some of their award. Is that not perhaps why there is so much anxiety amongst many people, because there has been a lack of clarity from the Government about exactly who the group of people will be who will lose?
Esther McVey: There has also always been lack of clarity under DLA. There were people who never knew whether they were entitled, people who had done their own form of selfcertification. So what we have said within the system is that we will give real clarity on whether you know you are eligible or not. Again-I will repeat-our main focus was on those who have the most need, and that is why we are focusing our attention there, but I agree that within the reassessment some people will not have an award, but some people will have more awards and some people's awards will stay the same.
Q5 Chair: I would be grateful if you could maybe establish whether, of the cohort that would have received DLA in 2018, two out of three will either lose some or all of the amount of money they get from the Government. That appears to me to be the case and it would be useful if you could maybe let us know whether that is likely to be the case or not.
Esther McVey: What I said at the very start, and I will continue to say throughout, is, to me, the 2018 numbers are hypothetical. It is a hypothetical argument. I am dealing with the numbers I will be responsible for, which will happen within this Parliament, and for which we have modelled and assessed for. Beyond that, I do not believe it is correct or fair to talk about because it will be different-hopefully it will be a Conservative Government but it will be a different Parliament.
Q6 Chair: But to be fair, Minister, in your opening answer to me, you used the growth in caseload as a reason for these reforms, so you cannot now say that was hypothetical, when you have used that as your basis.
Esther McVey: No, those growths in awards have happened over the last 10 years. Those growths of awards are going forward. I am using those growth awards to 2015, so I am giving the real numbers that are happening and what we are working to. Equally, the other thing that we have agreed to do in 2014 is have an independent assessment. We know this is a brand-new benefit. We know, looking at things historically, that people change and modify things along the way. That is why we have put in place this full independent review in 2014, when things might change. So I can really only give, with clarity, numbers to 2015.
Q7 Sheila Gilmore: Minister, one of the problems with that is that it is your Department that has issued those figures for the period 2015 to 2018, and I do not think in the way they were issued or in the statement that was made in December that the point was made that somehow we should disregard these. A lot of people, including people who receive benefits, will have read these figures and thought that is what is likely to happen. If you think they are as speculative as you are now suggesting, would it not be sensible to issue a statement of reassurance to people that these are hypothetical, as I think you have said?
Esther McVey: I am hoping that that is what I am doing today, coming before the Select Committee to give clarity and say that those are very much projected figures without consideration of the independent reviews we have said we would do.
Q8 Sheila Gilmore: Could I just ask you about some of the figures you just gave? I may have misheard you, but you seemed to suggest, when you started to talk, about 30% of people getting an enhanced award, but I heard you talk about 70% would not be losing benefit. That comes to 100%; some people will be losing, won't they?
Esther McVey: I said 75%, and I will clarify: 75% of people will get an award-it might be unchanged; it might be less, as you say. I am agreeing with that, but 30% of those will get a higher award.
Q9 Sheila Gilmore: So 30% is of the 75%.
Esther McVey: It is of the 100%, looking at two separate groups. So 30% of the 100% will get a higher and 75% of people within there will get the same award or will get an award. There are two sets of awards going on.
Q10 Graham Evans: You have assessed the impact of the PIP reforms on local authorities and their departments and, indeed, the NHS, in terms of budgets, workload, and the quality of care. What conclusions did you reach? Will you continue to monitor the impacts on the local authorities and the NHS?
Esther McVey: We are working, obviously, very closely with the Department of Health, with local government and with the Local Government Association. We have modelled this, and, as I have said, we are focusing our support on those with the most need. We are running parallel with the changes in social care and also what is happening with local government. Our assessment has been that there will not be an impact, but we are reviewing this and we are working very closely together.
Simon Dawson: As the Minister said, we are continuing to work with the Department of Health, the Department for Communities and Local Government, the LGA and others to ensure that disabled people continue to have access to relevant support. We included information in the impact assessment published in May 2012, and will make further information available as it becomes available. As I say, we continue to work with those organisations to assess the impact, but we do not believe that there will be a material impact as is the case at the moment.
Q11 Graham Evans: There is a lot of change going on in local government, such as Altogether Better, where local authorities are involved far more in public health and wellbeing, so there are changes going on locally anyway. Do you think that, in addition to that change in the way that local authorities will be working, these changes on top are an added extra burden on them at this difficult time when there is an awful lot of change already going on?
Simon Dawson: We do not believe that we are placing an additional burden on local authorities, but clearly that is why we are continuing to engage with them, through the LGA and DCLG, to ensure that both our changes and the changes that are happening in local authorities are best aligned and best coordinated.
Q12 Graham Evans: How are you going to monitor best practice with all these changes? How long do you think it will take to establish best practice in those beacon councils-those councils that understand this and are able, capable and do a very good job, and those councils that perhaps do not do quite as good a job? How are you going to establish that?
Simon Dawson: I think predominantly through our links with the likes of the Local Government Association, but I also think that the Government's decision announced before Christmas to take a more gradual approach to the migration of the existing caseload from DLA to PIP gives us longer to ensure that our changes have the impact that we assess it will.
Q13 Graham Evans: What sort of timescale? How long are you going to assess it for before you come to a conclusion?
Simon Dawson: We begin with a controlled start this April. We then go to national roll-out in June. We begin inviting claims from people whose DLA awards are due to expire from October. We then start to reassess the bulk of the DLA caseload from October 2015.
Q14 Anne Marie Morris: Minister, you claim that your intention is that the majority of PIP claimants will undergo facetoface assessment. Who do you envisage will not undergo a facetoface assessment?
Esther McVey: To ensure fairness, everybody will be assessed. We will have historical information on people. We will probably have medical information on people. Therefore, where we have gathered all of the information we need and where it would seem only appropriate that a benefit would continue, we will do what we need to do on a paper basis. If you are looking at numbers, in that regard we would consider 25% of people would not need a facetoface assessment.
Q15 Anne Marie Morris: So you are saying that there is going to be a paperbased first stage, because, from what you have said, the only way you could do that is a paperbased sift. What is the type of medical evidence-I presume it is going to be principally medical evidence-that will exclude somebody from facetoface assessment?
Esther McVey: What we would have is information. They would have filled out a form and, as I said, we would have had historical information on them. From that we would have what we would have needed. This is the information that the individual would have offered up on their own behalf.
Q16 Anne Marie Morris: So this is purely based upon information you already have and anything that has been voluntarily submitted.
Esther McVey: Yes.
Q17 Anne Marie Morris: So there is no proactive seeking of information to see whether or not this person can be excluded.
Esther McVey: These are instances where you would have that information, which would be so obvious that it would not need anything else. We can all think of conditions like that where we would not need to bring anybody in. It could be a serious degenerative condition; it could be various other things. We would be able to do that, but everybody will be assessed. I will bring in Dr Bill Gunnyeon on this, who has been dealing with this very closely, but that is the principle.
Anne Marie Morris: It would be helpful, Dr Gunnyeon, to have some clarity on the statement that the Minister just made. I think the statement was that in certain blindingly obvious conditions it would be completely inappropriate, yet, as I understood it, the Government's policy was not to exclude specific conditions, but rather to look on a casebycase basis. If we are looking at conditions then why have the deaf-blind and the quadriplegics not been obviously excluded? The concern and worry they face, wondering whether they are going to fall into this 25%, is extreme
Q18 Sheila Gilmore: A relevant supplementary to that that I can probably ask at the same time is: who will make that decision? Is that going to be made before papers are passed to Atos or Capita or whoever it is, or is that going to be made inside the DWP?
Dr Gunnyeon: Let me see if I can help the Committee. I think it is important perhaps to avoid confusion if we think about what will happen for new claims. I think that perhaps will clarify the process, and then I can say something about those who are being reassessed. Obviously in a new claim we will not have anything previously relating to that claimant. In that circumstance, what we will have as the first set of evidence-apart from the initial information that will be gathered at the point of a claim being made where there will be a little bit about conditions and so on-is what the claimant tells us in the form they complete about how their disability affects them. That looks at their condition; it gathers information on their condition, their disabilities, and how long they have been present, and then it looks at the impact of those disabilities based on the 12 different activities-the 10 for daily living and the two for mobility.
That in itself may give a very clear indication that either there is nothing to suggest that this individual's condition has any impact on their ability to participate in the activities of daily life and potentially a decision has been made at that point. Equally, it may give information that indicates that the impact is such that, for this individual, it is very clear that it is going to be possible to make a recommendation to the decision maker, the case manager that it will be possible to identify relevant descriptors in order to provide the information for this individual. There will be some where what would be helpful is to decide to get further evidence. That may be from the individual's general practitioner or from another healthcare professional, and in that form on how their disability affects them we do ask individuals to let us know who the different people are who would be best placed-particularly health professionals, but others-to tell us about the impact of their condition on them.
Q19 Anne Marie Morris: Are you talking about there being three groups: firstly, where it is blindingly obvious and they are simply inappropriate to have made the claim; secondly, where there is a question mark; and thirdly, where obviously, absolutely, they will need it?
Dr Gunnyeon: There may also be those where there is evidence that it would be extremely distressing for an individual to have to undergo a facetoface assessment. Again, that may be the circumstance where, for example, we want more evidence in order to be able to make a decision, if possible, avoiding a facetoface assessment. Ms Gilmore asked when that would be made. That will be made by the healthcare professional or the provider.
Q20 Sheila Gilmore: Can I ask a followup to that immediately? Is it the case-this is what I have heard; maybe you can tell me it is wrong-that the healthcare provider or assessor, if you want to call them that, has a month from the time they get the papers to make the decision? If that is the case, is that not going to be a very short space of time to do all of that and perhaps get information? We have had evidence from other situations that getting doctors in hospitals, or other healthcare professionals, to have a speedy turnaround of information is sometimes quite difficult. Is it a month, and do you really think all of that can be done, making that first triage and then deciding who you are going to look at?
Dr Gunnyeon: I need to make clear, if there is confusion arising, that the time that the claimant has to return their form is a month, but again it can be extended where there is good reason. Obviously we are particularly clear on those who are particularly vulnerable and require assistance. In terms of the timescale, Simon, can you confirm whether it is four weeks we are expecting before the decision is made on whether or not a facetoface assessment is required?
Simon Dawson: We need to take that one away and confirm.
Q21 Sheila Gilmore: Is it four weeks to decide whether it is a facetoface, or is it four weeks to do the whole thing?
Esther McVey: It is a process by which somebody would fill in their form-
Sheila Gilmore: I know about that.
Esther McVey: That is fine and then-
Sheila Gilmore: So they have four weeks to fill in the form.
Esther McVey: That is right. Or however long; they might need a little bit more. Different people have come in with different kinds of learning difficulties, so they have asked for a little bit longer. That will be provided. For the next bit, as Simon said, we will clarify that. I believe it is a month, but I will clarify that.
Q22 Stephen Lloyd: I understand your conundrum in the sense that you clearly recognise, which is good, that there are obviously some people with some conditions where it is patently obvious-the deafblind, as my colleague mentioned, profound learning disabilities, even quadriplegic-that it would not make sense to bring them in, which is good, and you used a figure of possibly as high as 25% assessments could be paperbased. The conundrum is that the Department is resistant at listing those disabilities, because that can bring its own set of complexities. I understand both arguments, but do you appreciate that what that may well lead to is profound confusion and anxiety for people who are going to be applicants, because they do not really know whether their impairment is sufficient to be part of that 25% or not? My question is: is there any way that, within the guidelines or whathaveyou, the DWP can try to minimise that anxiety?
Esther McVey: We have always said that it is a personalised benefit. Everybody will be assessed-not all then on a facetoface, as we have said, but everybody will be assessed and it is personalised. What we have also said about this benefit is that it is not about the condition; it is about how that condition affects the individual, and those are key to this benefit. It is how the barriers affect the individual, and how the barriers affect them having an independent life.
Q23 Anne Marie Morris: Can you give us an example of a case? Let us take somebody who is deafblind, where their condition is such you would not automatically exclude them?
Dr Gunnyeon: Sorry, can you just clarify?
Anne Marie Morris: You have a points system and there are some tests that have to be applied. You do not want to concentrate on the condition-I understand the ideological reasons behind that-but my problem is that if you look at somebody who is both deaf and blind, and you go through that checklist in terms of preparing food, etc, are you honestly telling me you think there is somebody-and perhaps you could describe what their particular affliction is-that is going to come out of that not needing the benefit?
Dr Gunnyeon: What we are trying to do is to assess the impact of the particular disability on the individual's ability to participate in daily activities. Part of this is about the quality of evidence that we have on which to make a decision. If that evidence is sufficiently strong that we can make the decision, then it will be clear that we will not require somebody to come for a facetoface assessment, but we may not necessarily have that evidence. You may identify a case where we have clear evidence and the information that has been provided to us by the individual or by someone acting on their behalf is very robust, or we have decided we need some additional information and at that point it is clear.
The difficulty is in saying anyone with a particular condition automatically will be exempt from a facetoface assessment, because it is about looking at the individual and looking at all the evidence we have. The clear desire is not to subject people to a facetoface assessment where it is clearly unnecessary to do so, and our guidance for our providers and for the healthcare professionals makes that very clear. At the same time, the intent behind this was, as far as possible, to see people facetoface and be able to get betterquality evidence. It is about the quality of evidence we have at that initial consideration and what further evidence we might be able to get that would help us to make the decision.
Q24 Stephen Lloyd: Can I confirm that in the report back the Department will obviously give the numbers and percentages of people who did not go to facetoface assessment? Even though, as the Minister knows, I am very, very pro the social model, I have to be absolutely realistic here: would the Department also present in the report back what the different strands of disability were? I think that is important. First of all, the percentage of people who do not go through facetoface a year after your annual review. What I would also welcome is some data around what those disabilities are, because it would be unrealistic to completely ignore that, even though I appreciate the social model.
Esther McVey: After we have begun this and as we are monitoring it on a daily and weekly basis, maybe you would think that it would be right in the 2014 independent review-because obviously I would like to work with the Select Committee on that-to consider what it is that we feel the scope should be and what it is we feel we should have reviewed. Do you think that would fit in to that?
Q25 Chair: I sure we will come up with a list for you.
Esther McVey: Yes, sooner rather than later it might come.
Q26 Chair: Dr Gunnyeon, you talked about new claimants. I think again all the members got an email from the Motor Neurone Disease Association who are concerned that their group, who have a fairly rapid degenerative condition, when their time comes, will be reassessed; they will have to go through a facetoface interview, even though they have upperrate DLA both in care and mobility. Can you give that very specialist group of people the assurance that, when DLA comes to an end for them and they are sent the form to reapply for PIP, they are not going to have to turn up for a facetoface assessment?
Dr Gunnyeon: That is an example of a case where the expectation is that the evidence that they would be able to provide-and they are going to be familiar with things having been on the benefit and having been through a system before-is such that it should be perfectly possible to make a decision on the basis of the evidence, but again I would emphasise that it is about the quality of evidence that we have.
One of the things that we will be doing is making sure that people, when the times comes and they are going to be reassessed, will have plenty of warning and will know what it is we need. In fact, there is an information booklet that goes with the form, and it makes very clear the importance of giving us as much information as possible and making clear who the different people are who would be able to give us evidence about the impact of their condition. We are working very hard to try to make sure that this process is as fair as possible and at the same time that it is sound, but that obviously we also behave appropriately in relation to people who are able to provide the evidence and who have the most significant disabilities and for whom, clearly, a facetoface assessment would either be inappropriate or, indeed, would be distressing.
Simon Dawson: Just to add to Bill's response, let us not forget that the special rules for terminal illness will still apply, as they do in DLA as well, which gives that fasttrack facility.
Chair: I think that will allay some fears.
Q27 Jane Ellison: You have alluded to the fact that assessment is in itself sometimes stressful and difficult for people, but obviously reassessment and frequent reassessments is something that was troubling quite a lot of Members of Parliament in the debate last Thursday, which was about the Atos Work Capability Assessment. There were examples cited of very frequent reassessment. I suppose a big question is about the extent to which the DWP is looking across these two major reforms to make sure that people who perhaps have just been through an IB process, the Work Capability Assessment, and perhaps even been through a tribunal and had a review on their award or not, are not then rapidly called back for assessment and being caused undue distress-if, for example, they have won a tribunal appeal on WCA?
Esther McVey: We have to be mindful of the fact, though, that the ESA and PIP are two very different benefits with two very different forms of assessment. One is whether you can do work, and one is concerned with what barriers you have to overcome and how we can support you in that. I think that has to be put aside. What I can say is that when we award terms we will be looking carefully at that-the length, the duration, what we can do-because again, with all the information we have gathered, it would only be right and appropriate to the claimant that their condition is taken into account. At the moment, we are looking into the guidelines about that. We are looking for further representations on that. Simon is taking this through at the moment, but that really is key. We know we have to be measured on that, and that we have to really rather thoughtful and caring about what we do there.
Simon Dawson: Yes, and certainly what I would add to what the Minister said is that although we do expect to review entitlement to PIP awards, I do not think that we would be seeing reviews of quite as short duration as they are on ESA, for the very reason the Minister said: they are very different benefits. Entitlement to PIP is based on someone satisfying a 12month qualifying period. Therefore, it is more about people with longerterm conditions. Therefore, we would expect to need to review their entitlement less frequently, but clearly more frequently than we have previously done for DLA.
Q28 Jane Ellison: Could you confirm that 71% have never been reassessed?
Esther McVey: They are on a lifetime award. Our view on that is that some of them-50%-never had medical supporting evidence. What we are saying now is one of the positive things about PIP really is to look at a systematic review and, as we say, see how can we help, because our view is the very opposite way: if you have put these people on benefits for life, what are we doing as a society to help and enable those people? Yes, I appreciate some people's conditions will not get better, and maybe some will get worse, but there is a percentage of people who will get better, and we have to be there for them in a very different way. How can we help them to progress, to take an active part in society?
Q29 Jane Ellison: I have a last question on reassessment just within the PIP process. Has the Department modelled how frequently that might be? I presume, to be able to model the costs and so on, there must be some sense of how often that reassessment on PIP would take place, if at all.
Esther McVey: Sorry, is this for an award?
Jane Ellison: Yes.
Simon Dawson: We have done some work on that, but we have not yet done the detailed work that would mean that we were in a position to publish that, but as soon as that model is complete we will commit to letting you know.
Jane Ellison: I think that would be of great interest to us.
Dr Gunnyeon: It also helps reassure and it is also true in relation to the issue of paperbased assessments. Clearly, when we have evidence from live running we will be able to learn from it; one of the things we are absolutely committed to doing is making sure that as we go along we gather information and we look at what that is telling us. That will be true for prognosis as well-for what our expectations are, because it is not an exact science, for individuals as to when it is reasonable to review them and whether in practice that has turned out to be right or not. That is a huge source of valuable information, which will then allow us to refine our processes to make sure that we do not review people more frequently than necessary, but equally we do review people in the appropriate timescale.
Q30 Nigel Mills: Can you be transparent with individuals about what review period they can expect? I think if you told someone "You have motor neurone disease; you will have a review in five years or three years," they would be a lot more comfortable with that than just this hanging "less frequent" in the air. If you say "You have X condition; we will need to review you every 18 months," at least they know what is coming, rather than it just suddenly appearing through the door every so often.
Dr Gunnyeon: Our intention would be to indicate, obviously, at the time that they get the award what the review period would be, absolutely.
Esther McVey: But again it will not be with a condition; it is for the individual, which we have always said, but yes, they would know when the review would be likely.
Q31 Chair: You inadvertently suggested that the DLA acts as a barrier to work, Minister, because you talked about if they got better and how you wanted to help these people. If you were on PIP or DLA and you got better, that would not preclude you from getting on with your life or getting into work, because it is an inwork and outofwork benefit. I am sure you did not mean to imply that, but that is how people will potentially understand your words, but I am sure that is not what you meant.
Esther McVey: No. If I misled anybody, what I meant is for some people who have been maybe put on a lifelong benefit-what are we doing to help them? How are we looking to engage with them? For me, that is key: to make sure that everybody, as best they can, takes an active part in life and the community, and any which way we, as a Government, could do that, I think is a really important thing that we do.
Q32 Sheila Gilmore: How does a test telling you that you are not entitled to a benefit help people? Will you be then referring them on to some other kind of help-to their local authority, to a voluntary organisation? We are discussing here whether and how frequently people need to be reassessed, and you are saying that if you do not reassess them you cannot give them help. Is it the intention that if people are reassessed and no longer need the benefit-because that is what the test is for-that at the same time there will be some mechanism for referring people on for other help?
Esther McVey: No, I do not see it from that viewpoint. I mean that this reassessment, getting in touch with people-and, by the way, some people, because they have lived with the condition, their condition could have got worse; they might need more support in other ways. It is not about removing it from them; it could stay the same-and that sort of continual contact, allows us, in a way, to say, "Here we are. What is it about? How are you getting on?' and just to me, I think that is an important part.
Q33 Sheila Gilmore: How does that translate into practical help, because this is a test about eligibility for a benefit?
Esther McVey: Yes, and it is about that and a person understanding their condition, it is about us understanding their condition, and it will be about putting people together, maybe recommending and advising stuff. As I said, for me, it is really key that we stay in contact with everybody and just assess them and have as much contact as we can to help them in their life.
Q34 Sheila Gilmore: So the DWP will intend, when it sees people and keeps in touch with them, to help them find help and support. So that will be an integral part of what you are doing.
Esther McVey: When you are assessing people and you are meeting them for an hour, as these meetings would be, then you have an overview and you will engage in a conversation with that person and, yes, of course you will, in an hour's conversation, be talking about different things within that-how best you can get support and help. Of course you do; anybody would do that.
Q35 Sheila Gilmore: That is not what happened, with all due respect, in the testing that has happened on-okay, a different benefit, but how is that going to be built in and will we see that in the guidance, so that that is part of the healthcare assessors' duties, because you are suggesting it would be?
Esther McVey: I am suggesting that the ability to stay in touch with people, rather than, as I see it, so many people having a lifetime award and not having any contact with anybody, has-in a way, I would say people have been abandoned; yes, I would, and I believe what we are doing with this systematic assessment and with this engagement is a positive thing. We just maybe see things in a different light.
Q36 Sheila Gilmore: Are you aware that some people with lifetime awards are reassessed? It is not true that everyone with a lifetime award is never reassessed. Are you aware of that, Minister?
Esther McVey: I am aware of how the process works, yes.
Q37 Sheila Gilmore: Because you constantly suggest that somehow they are never seen again.
Esther McVey: Yes, and I am saying what we are doing, though, and the whole dynamics of what we are doing as a Department very much is about engaging with people and seeing how best we can support people, and that is what we are doing.
Sheila Gilmore: We look forward to seeing it perhaps in the guidance in due course.
Q38 Stephen Lloyd: On a very important issue around fluctuating conditions, I am aware the Department did listen to a lot of the submissions made by me and many others, and I welcome the approach that the Department took to assessing the ability to complete activities safely, reliably, repeatedly and in a timely manner-a phrase I am sure, Minister, you have heard numerous times over the last few months. But my question is: why limit this wording to the guidelines and not include it in the face of the regulations?
Esther McVey: It was put in the guidelines because we believe it is key to an assessment. It is also in the contract with the people who are doing the assessment and it has always been key that those have been used in making an assessment. Throughout the whole process, activities have been always been reviewed against the criteria of safely, repeatedly and in a timely manner. However, because people like your good self have made representations on that, we will be seeing whether this is something that we can put into regulation, if it is helpful to do so, and it does not become restrictive within that. I know Dr Bill Gunnyeon has specifically been looking at this, because what might seem a positive introduction to regulation might be limited, and we believed it would be better in guidance and the contract, but I will bring Bill in on this.
Dr Gunnyeon: Perhaps I can reassure that this absolutely was the intention as the assessment was developed. In fact, this is probably one of the most critical parts of the assessment, because it deals with issues across a range of things-pain, fatigue, all sorts of things. The ability to do things reliably is absolutely critical, so it has been core all the way through and, therefore, whether it is in regulations or not, it will happen and it is core to the whole process.
Q39 Stephen Lloyd: I dispute that, because if it is not in the regulations and in the guidelines, I think sometimes it will not be observed; there will be more appeals that will go through the courts and case law will determine which route is followed, rather than Parliament. I really do believe that by not having it in regs and guidelines, while the spirit and intention may be appropriate and right for DWP, it means it does not have to be followed, and that is where we would develop some very serious problems.
Dr Gunnyeon: I did not mean in any way to dismiss your concerns. I do understand the concerns. What I was trying to do was, firstly, reassure you that, certainly from the point of view of the assessment, which is the bit that obviously I have responsibility for, that is absolutely core to it and it will absolutely be applied, because the assessment does not work unless you do.
But I think the issue about putting it in regulations and, as the Minister said, obviously the Minister has given a commitment to look at this, the only thing we have to be cautious of-and this is my one concern-is that when you start to put things into regulations they have to be drafted in a way that the lawyers feel will not be open to any misinterpretation. The words that we have in the policy intent are not entirely easy to translate into legal language. That is the only issue and that is why, as the Minister said, the slight concern we have is to make sure that if we are doing that we do not create the opposite of what you have perfectly reasonably identified, which is that there is a risk that, if it is not there, tribunals and so on may interpret things. What we want to be sure is that if it is there, the wording can be such that that same thing will not happen, so that is what we are looking at, at the moment.
Q40 Stephen Lloyd: That is very encouraging. Therefore, will you also accept that if that safely, reliably, repeatedly and in a timely manner was, for instance, put in the regulations around the change from 50 to 20 metres, a lot of the concerns that people have would be obviated? Would you recognise that as a reasonable statement?
Dr Gunnyeon: That is, in fact, the case, whether it is in the regulations or not, because that is absolutely the way the criteria in activity 12 would be applied. It would be dependent on people being able to do it safely, reliably, repeatedly and in a timely manner.
Q41 Stephen Lloyd: Reading slightly between the lines, would it be fair to say that obviously you are looking at that very closely at the minute, and could I-as the Minister is here, which is an excellent opportunity-ask that perhaps in the very, very near future a statement will come from the DWP specifically on this and possibly a statement that will assuage a lot of the fears and anxieties that people have?
Esther McVey: I will be giving clarity, as soon as I have that, about exactly what we are doing, and, as I have said, it is with the lawyers at the moment checking that it will do what you hope it does, and does not in any way create any greater barriers. That is being looked at; as soon as I know, you will know, and I will write to you-maybe it is correct to go via the Chair of Select Committee.
Stephen Lloyd: I am glad to hear, because I am sure the Department agrees with me that when groups such as the Disability Benefits Forum, which is a very, very responsible representation of a lot of the different disability groups, have these sorts of concerns they really do need to be listened to.
Q42 Chair: The regulations have already been laid. That is the concern; we are up against a really tight timescale and they cannot be amended as they are at the moment.
Esther McVey: We have looked into that as well: how they would be laid in the Lords and the Commons. The process by which those regulations could be added to is also being reviewed, so yes. So it is possible, but we will see whether it is beneficial.
Q43 Mr Burley: Can I just ask a question related to fluctuating conditions? It is around permitted work regulations. One fluctuating condition is multiple sclerosis, and I have had a constituent write to me who said that he signed up to do some examinvigilating work. He is an MS sufferer. He had only done it for 14 hours in total throughout a whole year, but was told that because he had registered to do it for 52 weeks, if he continued to do this examinvigilating he would start to lose his benefits. I am sure you would agree that we want people to have purposeful activity. Could you just explain a bit more about permitted work regulations; is he right to be worried about losing benefits and does it relate to whether his work is paid or voluntary?
Esther McVey: That does not work with DLA and PIP, because it is a nonmeans tested benefit, and you can have it whether you are in work or out of work. This is really purely how your disability affects you and how we help people overcome those barriers in life, so it will not be dependent on whether you are working or not. You can get this benefit irrespective of being in work or out of work.
Q44 Mr Burley: He says that he was told by his advisor that because he had registered for 52 weeks he could not continue to do this, even though he had only worked for 14 hours.
Esther McVey: But not for DLA or PIP; that would be a different benefit. That is totally separate. You get this irrespective of working or not.
Chair: Just to be clear, I should have made a declaration at the beginning that I am in receipt of higherrate mobility DLA-although generally people do not say they are in receipt of child benefit.
Q45 Sheila Gilmore: Directly following from Stephen's questions, is there going to be an opportunity for the stakeholders-that could include the Select Committee and clearly the disability groups that Stephen described-to have an opportunity to scrutinise the guidance before it is finalised?
Esther McVey: That is what I thought the Select Committee would be doing anyway, so, yes, I would expect you to be scrutinising it and looking at it.
Q46 Sheila Gilmore: So when can we expect it?
Esther McVey: When will that further guidance be-
Dr Gunnyeon: This is the guidance on-
Q47 Chair: We are really keen that the guidance is published before the regs are agreed. Now, what we understand at the moment is that the regs will go through the Commons and Lords and be agreed, and then the guidance will be published, so from the kind of assurances you have give us, we do not know-
Dr Gunnyeon: The most recent iteration of the guidance will be available very shortly, so it will be accessible.
Chair: So before?
Dr Gunnyeon: Yes.
Q48 Sheila Gilmore: A question arose from something that was said earlier. Minister, you were very clear that ESA, the WCA and the PIP assessment, in your own words, were two very different assessments with two very different purposes. Can you, then, give us an assurance that, in terms of the initial PIP assessment, perhaps when they are deciding whether people should or should not be eligible, that one will not be used in the other, because at the moment there are people who are having their application for DLA turned down, the decision for which has been influenced by a WCA, and sometimes-this is particularly worrying-when that WCA has been overturned by an appeal, but that information did not seem to be passed on. So if they are two very different assessments, can we have an assurance that that will not happen-that a WCA will never be used to make a decision on PIP?
Esther McVey: What I will obviously confirm is that you are quite right: they are two different benefits amd two different assessments, and what I will now seek to clarify here is whether information could be moved across between the two. Before I say that, Simon, go on.
Simon Dawson: Just to clarify the position, it is difficult to say "never" in these occasions, because there may be evidence from one assessment that could indicate either an increase or a decrease in needs for someone's entitlement to DLA currently or in the future. Therefore, I am slightly nervous about saying that we would never do that, because that may in some way work to the detriment of the claimant, and we would not want claimants to go through unnecessary assessment when there was information that might support their claim or their reassessment for Personal Independence Payment. But I think your point is a wellmade one; we should not simply be routinely taking the outcome of a WCA and then applying it willynilly either to a DLA assessment or, in future, to a PIP assessment.
Sheila Gilmore: It might perhaps be useful if we had more information on the degree to which that does already happen in the DLA, because certainly advisers in my area have reported that that has happened on numerous occasions.
Q49 Jane Ellison: I was quite heartened to hear you say you would not necessarily rule it out completely, because one of the things that constituents have often raised with me is that if they have assembled complex medical evidence, for example, and submitted it, they are sometimes driven to distraction by the fact that two parts of the same Department cannot sometimes share something that they took a lot of time and effort to assemble. Is that the sort of circumstance in which you could imagine some readacross?
Simon Dawson: Exactly. That is the sort of thing that we do want to build in to the design, because we do not want to be asking people to provide duplicate information from essentially the same organisation.
Q50 Sheila Gilmore: That is the sharing of information, which is not necessarily the same as the point I was making.
Esther McVey: To be fair, I think the points raised here are points that we should take on board and I think that we will look at that, because, yes, you do not want duplication, but nor do you want wrong information. That is something that we should be mindful of.
Q51 Sheila Gilmore: If I could turn to the change, which many disability groups think is a change, in the threshold for enhanced mobility under PIP. The original consultation draft referred to not being able or cannot move up to 50 metres without using a wheelchair propelled by the individual, and then there was a lot of debate about wheelchairs and so on. But the final regulations are very different. They say, "Can stand and then move more than one metre but no more than 20 metres, either unaided or aided". Why has this changed and why was there no consultation on such a big change?
Esther McVey: There is not a big change, but there was a definite a lack of communication or correct communication about what was happening here. One of the biggest inconsistencies was with the eligibility for higher rate Motability, because there was no clarity on what really that was. The original tension was "unable to walk or virtually unable to walk", but over time it has gone to 50 metres, but within that 50 metres some people could get higher rate, some people could get standard rate. So what we sought to do was to give that greater clarity and so what we said-and I believe the policy advisers and the medical advisers had seen it as a positive advancement-is that automatically for 20 metres you would be entitled, and then, with the rest, we would assess according to the "safely, reliably, repeatedly" criteria being used across the full 50 metres, so you could get enhanced mobility within the 50 metres, but we were looking to-
Q52 Stephen Lloyd: Do you see why it has to be a regulation, because if it is just a guideline then I think the real danger with the assessor is that some assessors will not follow it as rigorously as they would have to if it was a regulation? I am absolutely convinced of that.
Esther McVey: I do not agree with that per se, once it is in the guideline, once it is in your contract, and once that is noted as fundamental to how you give an award, but, like I said, I have taken on board whether we would put it in regulation. What I am saying is we sought to clarify what was otherwise a very vague criterion for giving mobility, and that is what we looked to do. So everyone thought it was positive.
Sheila Gilmore: Now I am very confused, because you seem to be now suggesting that someone who cannot move more than 20 metres, which is a very, very short distance, as I am sure, Minister, you are aware. It would not take me from even halfway to the nearest bus stop from my house, in fact not even a quarter of the way to the nearest bus stop.
Chair: It would not take you from here to the lift.
Q53 Sheila Gilmore: And it does say "no more than 20 metres". You then seem to be saying that there is another criterion somewhere in the background about safely, reliably and so on, which could extend that to 50 metres.
Esther McVey: No, I am saying there has been much confusion within the 50 metres as it stands now under DLA; some people might get enhanced allowance, some people might get standard. What we sought to do was to give people certainty within that criterion. We are seeing that as a positive announcement.
Q54 Sheila Gilmore: So the 20 metres, and the safely, reliably and so on criteria are really not particularly relevant here, are they, to this particular criterion? It may be relevant to others.
Dr Gunnyeon: Let me perhaps help a little bit, because I was responsible effectively for the second draft of the criteria. Whenever you are doing something-and this has been an incredibly difficult assessment to develop, as I suspect many of you recognise-however well you try and do it and however well you think you have designed something and however well you think you have drafted it, with the benefit of hindsight, when you look back on something, you suddenly think that really was not as clear as we thought it was. I would put my hands up and say that, in relation to the second draft of the criteria around activity 12, we knew what we meant, but it was not clear. We probably got more significant feedback about the lack of clarity on this than on anything else in the assessment. Therefore, on that, we failed to communicate it clearly.
We tried to do it in a way that we thought was helpful by trying to relate it to aids and appliances, which actually caused more confusion. Therefore, having taken all the feedback, we sat down and looked at it again. Within those who could not manage to walk more than 50 metres, our intention was always to identify those who would have the greatest difficulty, because that is the whole purpose of the assessment.
Can I say that the "safely, reliably and repeatedly" would apply across the distances? You may be able to walk 20 metres, but if you cannot do it safely, reliably and repeatedly you would qualify.
Q55 Stephen Lloyd: Your mistake there was that as soon as I saw it, I knew what was going to happen. With respect-I have been an MP for two and a half years now, and I have finally said "with respect"-if you had checked with a couple of those mobility and disability charities, they would have told you instantly that a quarter of a million people are thinking that they will lose their Motability car.
Esther McVey: We say, "Mea culpa." It was the communication, not the intention. That is correct.
Q56 Sheila Gilmore: Is it not the case potentially-and the way it was drafted at first-that somebody who could walk, say, 30 or 40 metres would have been eligible, whereas now they are not eligible.
Dr Gunnyeon: They would have been eligible for one of the rates. The important thing to remember is that what we have now is made it possible for people with physical limitation to get the standard rate in PIP. It was not possible to get the standard rate in DLA with a physical limitation.
Sheila Gilmore: The wording of the consultation draft says, "Cannot move up to 50 metres." 50 is mentioned. It is mentioned very specifically, not as a proxy for "virtually unable to walk", which is what has happened. With DLA, clearly, the wording was "unable or virtually unable", and through case law and so on, "virtually unable" tended to become a proxy for 50 metres. This consultation draft, however, does mention a very specific distance. Many of the groups feel that there is a big difference between that first formulation and the second formulation. That was not consulted on in between those times. You did not come back and say, "We now think we have got this slightly wrong"-maybe in October or November-"and this is what our next iteration is before publishing the final recommendation".
Dr Gunnyeon: What I am saying is that the policy intent was clear all the way through. The issue was one of confusion and a lack of clarity. We listened to consultation. This is the way we decided to clarify it and, in then looking at testing and modelling that, it is clear that the numbers of people who score 12 points on activity 12 are broadly the same under the second draft of the assessment criteria and the final criteria.
Sheila Gilmore: The policy intent may have been clear in DWP's head, but it certainly does not seem to have been to a lot of people during the consultation.
Dr Gunnyeon: I think I accepted that.
Q57 Sheila Gilmore: Numbers have changed substantially in the projections in the intervening period as well, between the first draft of the regulations and the final draft. We are back into the hypothetical 2018 stuff, but nevertheless, in the first draft of the regulations the number of people expected to lose or not to get enhanced mobility was stated to be 280,000; following the final draft, the figure is 428,000 fewer people. That is a substantially different number. Is that as a result of this change? Why has that number changed so much? Clearly, a lot of people looking at this are thinking, "Draft 1 said this. Draft 2 said that. Draft 1 suggested the numbers not getting enhanced mobility would be fewer by this. Draft 2 says it would be fewer by that." Is there no relation between those two? Is it purely coincidental that the numbers who are not going to get this are now higher than they were previously?
Esther McVey: Once again, you have gone to the 2018 figures, not the 2015 numbers, which I said very clearly at the beginning are what I am working to.
Sheila Gilmore: Minister, I am sorry to cut across you, but these are comparators that, on both occasions, you have given. I do not think you can completely say, unless you now want to scrap all of these 2018 figures altogether, that there is not a comparator there.
Esther McVey: No. What I am saying, and which I made very clear at the top, is that the figures I will be working to are those to 2015. We have agreed that it is within this Parliament. We have also agreed to the independent review, where things might change. What I am saying is that I will work to those figures, and within that, they have remained as we had said prior to that.
Q58 Sheila Gilmore: They have not. The figure for 2018 and the end of the process of assessment was that 280,000 fewer people would get enhanced mobility. The figure now for the end of the reassessment process-or reapplication process, as it truly is-is 428,000. That does seem to be a big difference. A lot of commentators have associated that with the change in the draft regulation.
Esther McVey: We said at the beginning that if I was here to add clarity, which I am, then I would not talk about hypothetical figures, because I do not know where they will be by then; I can tell you where they will be by 2015. What we had was the same sort of figure for reassessment. I would sooner keep to what we know will happen, rather than what we do not and what we are speculating about, because I do not want to mislead anybody who was taking information from today.
Q59 Sheila Gilmore: Before, the 280,000 was for the whole caseload. You are now saying that a similar number are going to not be getting it by 2015, which is far less than the entire caseload. It is still a different number.
Esther McVey: It would now be 200,000 by 2015. That is what we were looking at.
Q60 Sheila Gilmore: When that figure was given previously for the end of the process of reassessment, that was not just new applicants but everybody currently in that age group who has DLA going through the process of having to reapply. If it is 200,000-let us say it is 200,000, although I think it is now 280,000-that would be in comparison with the entire numbers we have been dealing with, whereas by October 2015 new claimants will have been assessed and about 500,000 people, we are told, who currently have DLA will be reassessed during that period. It is a far smaller group. The numbers are still not comparable, however you present them.
Esther McVey: As we have said, the intention was the same from the second to the final draft. Those figures remain roughly the same from the second to the final draft, showing that it was a change in communication, as we have said from the beginning, not a change in intention. Those figures remain the same.
Q61 Sheila Gilmore: What is this figure of 428,000, then, which is in your own figures that you have presented to Parliament in a statement in December? The figure of 428,000 was given.
Esther McVey: No, I know we are going over the same ground. I want to tell you what is happening, not what is hypothetical and could happen after 2015, when, as we have said before, there is a general election. We have to have independent reviews. There might be alterations. I do not seek to give misinformation out to people who it means a lot to and who could be watching this. I am giving you the facts to 2015. I hope we can stay there. I want to make sure people who are watching this and people who read the news after this know, with certainty, what is happening to them in the next couple of years. I really do not think it is correct to pursue those incorrect numbers.
Q62 Sheila Gilmore: Why were those figures given to us in a statement to Parliament? There does seem to be a difference. You seem to be now trying to say they are the same because in the period between now and October 2015 there will be fewer people going through assessment, because you are slowing the process down; however, you think the number of those who will not get enhanced mobility is going to be about the same as the number you anticipated previously would not get it when you had done the whole caseload. I am obviously not making myself at all clear.
Esther McVey: It is less. It is 200,000. I am saying we should deal with the figures that we have got and that we know, which were the same between the second draft and the final draft. We can then work around those. Please, let us not bring in a set of figures that is not relevant to today or to this Parliament, and for which I am not responsible.
Sheila Gilmore: Perhaps you should not have published them. We did not publish those figures.
Q63 Chair: Can I perhaps bring it back to a more practical level? We received a brief from the MS Society, who are very exercised by this change. They are incredibly exercised by this change. On Saturday I saw someone with MS, who was attending the same meeting as me. The disabled parking was 30 or 40 metres from the door. He got out of his car and walked with his walking stick. He stopped more than twice and was absolutely exhausted by the time he got into the meeting. By the criteria here, that means he would only get 10 points, because he can move more than 20 metres. Actually, he probably managed 50 metres and he could probably do more than 50 metres, but from his first step-
Dr Gunnyeon: Chair, can I clarify? The issue of safely, reliably, repeatedly and in a timely manner would become highly relevant here. You have identified the fact that not only did it take a while, but there is an issue about his being exhausted at the end of it. That is why that ability is so important throughout all of the descriptors. Somebody may be able to do it, but if they are then not able to do anything for the next few hours or are exhausted the next day, clearly they are not then considered able to do it and they would actually get the points.
Q64 Chair: Where does the measure start? If he could walk the first 30 metres comfortably and then struggle, would that mean he ends up not getting the enhanced rate? Is that right?
Dr Gunnyeon: If that is correct and there are no other factors around the safely, reliably and repeatedly, then yes, that would then be the case.
Q65 Chair: It is from the first step. The other thing is that quite a number of people-in fact, it is more than 50%-who use wheelchairs can actually walk a bit. If you put buggies in, it is probably an even bigger proportion of people can walk. Lots of people, who use wheelchairs outdoors or to do the shopping and so on, do not use them in the house. There is a feeling again that anyone who is mobile without a wheelchair around the house-because they have handles or whatever and can actually manage quite well around the house-are not going to get enhanced mobility. Is that right?
Dr Gunnyeon: No. It is going to depend. Remember, you have to be able to stand and you have to have one normal foot on the ground. Bilateral amputees, for example, clearly would not be in that category. You have to be able to stand, move that distance and do it safely, reliably and repeatedly. That is the issue. The issue is also whether somebody could only do it with particular aids or appliances as well.
It is about looking at the individual case. It is very easy to generalise. What we have done here is tried to provide clarity so that the assessment and descriptors can be applied consistently and, as far as possible, can identify correctly those who face the greatest challenges in terms of being able to participate in the activities and that are within the two mobility activities.
Remember, of course, the decision on mobility is a combination of activities 11 and 12; it is not just activity 12.
Q66 Chair: In your response, you say that the reason you have chosen 20 metres-I will come back to whether or not it was consulted on-was because 20 metres would get you to the door of the supermarket. However, how can the person who can walk to the door of the supermarket get around the supermarket? How do they get back on the other side?
Dr Gunnyeon: That was the 50 metres, not the 20 metres.
Chair: If 50 metres gets you to the door of the supermarket, how do you get around the supermarket? 50 metres is not a great distance. It does not allow someone to do a supermarket shop, for instance. Yet they will only get 10 points; they will not get the enhanced.
Dr Gunnyeon: Under the policy intent in DLA, they would not get anything at all-if the intent was being adhered to. Here, they would get the standard rate.
Q67 Stephen Lloyd: That is good. I do not want to go in circles, but you are clearly picking up how anxious we are about this. That is why the disability bodies approved of the timely, safely, reliably and repeatedly criteria; their anxiety is that being in the guidelines does not give them enough clout. I know you have heard us.
Dr Gunnyeon: I understand that.
Chair: Where did the 20 metres come from? The feeling is that was plucked out of the air. It certainly did not appear in any of the evidence we took when we looked at this as part of our previous inquiry. Nobody had mentioned 20 metres. With hindsight, I can look back: there were exemplars given of what people would get under PIP. One of my criticisms was that they did not know what we would have received under DLA. There was a chap who was an ex-miner with arthritis in his hips. He could not use a wheelchair or a walking stick because his hands were too bad. He did not get the enhanced rate, and I thought that was unusual when I read that as a descriptor, but it fits in with what you now have here. That was not in any of the consultation papers.
Dr Gunnyeon: We were seeking to clarify and try to achieve the policy intent-and doing it in a slightly different way. The issue here was one where we might have communicated this differently; I am sure the Minister would agree. It was not our intention to do anything different and it was a response to the comments we received in what was quite an extensive consultation, to which we did listen.
Q68 Chair: Can I ask about passports? Out of a lot of the upperrate mobility passports, the thing I find most precious of all is my blue badge. It is the most important thing. It gives me access to the wider bays and stops me having to travel quite the same distances in wheelchairs. However, the automatic entitlement to a blue badge only comes with an upperrate mobility DLA. There will be people who have very limited mobility, who are only getting 10 points under these new descriptors, but will not automatically qualify for a blue badge. They will not qualify for a Freedom Pass or a railcard without going through another assessment, potentially. For all of these other organisations that do not have to reassess people-because they have the upper rate mobility-DLA acts as a passport. What is going to happen?
Esther McVey: We are working on the passporting at the moment. We are looking at working with various different Departments to see how we can best enable people with the passporting.
Simon Dawson: We have maintained the passports that existed under DLA and translated those over into Personal Independence Payment. Clearly, if people do not qualify for Personal Independence Payment, they will have to apply separately for a blue badge.
Q69 Chair: Who is going to know they have scored 10 points? There is a big difference between that and eight points, which gets you the standard rate. They have actually overscored on that, but they have not scored enough to get the enhanced. They have overscored, so they obviously have some quite severe limitations on their mobility, but-
Simon Dawson: Sorry to interrupt, but individuals will get their pointsscores. We are introducing it in notifications from October next year. People can request it before then, too. People will have pointsscores. They could use that in support of any separate claim for benefits and services to which they would not be passported.
Q70 Teresa Pearce: Can we just move on to the actual contracts themselves? The contracts have been given in regional lots. One contract has gone to Atos and one to Capita. Did you consider commissioning more than one supplier in a region so that you could compare performance?
Esther McVey: We were looking at several things here. Obviously, we need consistency, but we were also looking to see whether we could develop best practice and learn best practice across different providers. We knew that before we could go to multiple providers we would like to ensure that we had managed to develop this in different regions. There were many thought processes that had gone into that. We had many bidders and various people on the framework. We looked at which was the best quality, which was the best service and who we were going to work with, but we had to make sure this worked and that we could roll it out. As it came back, we have our providers and we have them in the different regions. We thought that was the safest way forward.
Q71 Teresa Pearce: In the work programme, you have multiple suppliers in the same region. Did you not see any advantage at all in having more than one supplier so that they actually bring each other up to speed in many ways? They could share best practice.
Esther McVey: Having the ones in different regions, we can get best practice there. Two different companies are going to be doing it in different ways.
Teresa Pearce: You will be able to compare the different regions against each other, rather than different programmes.
Esther McVey: Yes. We will also be able to compare what different services people are offering. Whereas you will find that Atos is working with different health providers so that their clients will be going to local clinic centres and hospitals, you will find that, say, Capita have said that what they will look to do is do a significant number of home visits. We are working out what the best route is. Capita has said it would employ 60% of people with disabilities, so we are looking at what is best practice and how we could share that, while still maintaining a very coherent assessment across the whole of the country.
Dr Gunnyeon: One of the things, Minister, that might help is that, of course, there is quite a difference between the work programme provision, which is very much blackbox. It is for the providers to be able to decide how best to work with people to help them return to work. In a sense, they have complete flexibility. When we are looking at this assessment, we actually need this assessment done by providers to a very fixed protocol so that we get consistency across the piece. There is a challenge in jumping too quickly to too many providers, until we know we can manage quality and consistency across multiple providers.
Q72 Teresa Pearce: I hear what you are saying. One of the key points is that Capita has said they expect a large number-not just a number, but a large number-of consultations will be done as home visits. Yet this is something Atos does not really do, apart from extreme circumstances, normally, under the Work Capability Assessment at the start. They have said they do not really plan to do that going forward. Does that not mean that in different regions people will get a different service? Lots of people would want a home visit, yet it is not going to be available.
Esther McVey: They have developed differently; you are quite right. Atos thought that perhaps the claimant would want to go to locations that they knew well and could get to. Capita have viewed it in a different way. Equally, I think I am right to say that these are in different geographical locations. It could be easier in some to do home visits. It is, however, about best practice here. It is about learning about how we can take this forward. We welcome that people are doing it differently so that we can monitor both, which we will.
Dr Gunnyeon: What is important to remember, though, is the actual assessment that is being done, whether it is being done in a clinic or at home, is exactly the same. How the assessment will be done, how the evidence will be gathered and how the criteria will be applied has to be the same, wherever. The issue of home visits is a matter of claimant experience. That is obviously the benefit of innovation and different providers. The actual assessment, however, has to be the same, wherever it is done. We have to go through the same process.
Q73 Teresa Pearce: Dr Gunnyeon, at the very beginning you talked about people who would not have to come for face-to-face assessment and doing a paperbased assessment. You talked about people who find face-to-face assessments extremely distressing. One of the things that people find extremely distressing is actually getting to the centre. What I am trying to say is that Capita are expecting to do a number of home visits; Atos are not. Will people have the right to ask Atos to visit them at home, if they find it extremely distressing?
Dr Gunnyeon: Yes, absolutely. There will be very clear circumstances where it is entirely reasonable, and indeed appropriate, for an individual to have an assessment done at home. Atos will do those on those occasions. Obviously, in the guidance we will be looking at the sorts of criteria for these.
Q74 Teresa Pearce: It is my experience with the Work Capability Assessment that they are quite resistant to home visits. For this particular group of people, it is important that if they-knowing their own condition and how they manage it-deem it necessary, it should not be that they do not get that just because they are in a geographical area where they do not have Capita but have Atos.
Esther McVey: You are quite right. We would expect that about 8% of assessments will be home visits. I think I am right in that figure. It might be less and it might be more.
Dr Gunnyeon: It might be slightly more in practice, actually.
Esther McVey: Yes. That is irrespective of provider. That would be Atos, too. That is what we have seen.
Q75 Teresa Pearce: Mr Dawson, you talked earlier about people having to go back for reassessment, and Jane and somebody else asked you a question about how often that would be. You said you were still doing some modelling. You know the number of people who currently claim DLA and you will have some projections for new claims. Without knowing how frequently people are reassessed, how can you make sure this contract is good value for money? You must have had some numbers in there to know the number of assessments.
Simon Dawson: Yes. In the technical briefing document, published on 13 December, we published the number of assessments we expect to do on a quarterly basis from now through to 2016. That information fed into assumptions we made about volumes in terms of the contracting process.
Q76 Teresa Pearce: When you modelled that, to be able to put the contract out, to know whether or not it was good value for money and whether or not they could deliver, you must have had some idea about how frequently people would be reassessed?
Simon Dawson: We will have made some relatively highlevel assumptions, I think.
Teresa Pearce: That could vary quite a bit, in reality.
Simon Dawson: It could, but the contract is, as I understand it, a fixedprice contract, so it is not affected by the volume of assessments. I would probably need to defer to Dr Gunnyeon on the information about assessments.
Q77 Teresa Pearce: Is it a fixedprice contract for a number of years?
Esther McVey: It is a fiveyear contract with additions by two year. The ones I have the figures for are lots one, two and three. They are £598 million for the full five years.
Q78 Teresa Pearce: That quite significantly differs from the Work Capability Assessment contact, where they are paid for the number of people they see. In this, they are just paid to deliver the service. Is that what you are saying?
Esther McVey: It is quite a complex contract that they have entered into.
Teresa Pearce: I bet it is.
Esther McVey: Within that there are various levels, but that is the costing over the five years. Yes, they would have modelled what they have done and worked out how they would have come to that conclusion. As I said, 19 bids came in from six different organisations. We looked at quality, we looked at deliverability, and we looked at costing. That is how it was fixed. Beyond that, I do not run the commercial project but I know that is what they are doing.
Q79 Teresa Pearce: It has been reported that Atos Healthcare are going to subcontract the delivery of the PIP assessment in Scotland to an arm of the NHS. Would it not be more cost-effective to just contract directly with NHS suppliers? Was there something that meant you could not do that with the public sector?
Esther McVey: People applied to go on what would be the framework. Different people applied to go on that. In that case, in Lanarkshire, they did not apply to go on the framework but they could have bid to have done it. What people have decided to do is what they could bid for and what they felt they wanted to bid for. In that case, as the providers will be working closely with health professionals and organisations, that is what Salus in Lanarkshire decided to do. They decided themselves not to bid for the entire contract, so that makes sense.
Q80 Teresa Pearce: In the framework, was there anything that prohibited publicsector organisations?
Esther McVey: No.
Teresa Pearce: It just happens to be that they did not bid.
Esther McVey: Yes.
Q81 Sheila Gilmore: Could that be to do with the size of the contract? Salus is not the whole of the NHS; it is a relatively small arm, is it not?
Esther McVey: That might well be, but it is up to an organisation, a business or an individual to say, "What could we do? What would we like to get involved with? How can we do that?" That is what they have done.
Dr Gunnyeon: It would not have precluded consortia, for example, of smaller organisations coming together.
Q82 Teresa Pearce: One of the key complaints about Atos at the beginning of the Work Capability Assessment was the fact that some of their assessment centres were not accessible. We heard, only in November last year, that still some are not accessible. What steps are you going to take to make sure that this group of people that we are now going to be assessing will be able to get to the centres? If there is a centre that is not accessible, will they be automatically given a home visit?
Esther McVey: They would not be going to that centre. They are all accessible. It is all ground floor; that has been done carefully within the contract. That will not happen here.
Teresa Pearce: Do Atos 100% agree with you that this will not occur?
Esther McVey: Yes.
Teresa Pearce: That is good.
Stephen Lloyd: Do you mean for PIP?
Esther McVey: That is what we are talking about today, yes.
Q83 Jane Ellison: We were all rather horrified, were we not, that there were six centres that were responsible for 73% of the inaccessibility assessments, when the Minister for Employment gave evidence. We would be especially keen to know they are not being used.
Esther McVey: No. It is totally separate. It is a totally separate part that is doing this.
Jane Ellison: Given that it is the same provider, you can see why we would ask the question.
Dr Gunnyeon: Atos are not going to be using any of the centres they use for WCAs for PIP.
Q84 Debbie Abrahams: Can I ask about monitoring of the quality of the process? You will be aware from the debate last week on the Work Capability Assessment process that there are issues about the quality of the process. People are describing it as degrading, dehumanising and getting things wrong. I had a constituent on Friday who said that her father, who was going through a process, was told he was in the middle of a heart attack as he was in the process. He was told they had to stop. When it came to the actual results from that, it was said that he had left the assessments and, as a result, he was sanctioned. They got personal information wrong, saying he had sons, rather than daughters. It was an absolute mess.
You mentioned before, in terms of the assessment, how important the judgment in getting things right would be. How will you be monitoring quality to make sure that you are getting it right first time? People are really anxious about this. How will you make sure people are not going to be traumatised, as they have been going through WCA?
Esther McVey: I would like to put this in context, too. We have said very clearly that they are different benefits with very different assessments. You are quite right: there were failings in the ESA. That was something we inherited; that is something we have tried to put right. We put Professor Harrington in place and we said, "Look, this came in under a previous Government, but let us get this right". We have put it up for review and we are still trying to get right. However, as this is a totally different assessment and benefit, we have put in stringent conditions and stringent monitoring. You are quite right: we will have learned from what had gone on in the past. We are ensuring that there are also, with the service levels, guidelines that people cannot go above and below on any failing rate. It is totally, closely monitored with very high specifications for getting this right.
Bill, you might have some of the levels there. I was looking at the various criteria beyond which they could not fail.
Dr Gunnyeon: One of the important things here is that, having designed a new assessment, the competencies and the training of the health professionals who are going to be doing it is absolutely critical. We are working very closely with the providers as they develop their training programmes. We will agree how they will assess competencies. We have a robust process before anybody is going to be allowed to undertake assessments. They will not only have to go through the training; they will have to demonstrate their competency before they start to do actual supervised assessments. They will then have a period of supervised assessment before they are able to undertake unsupervised assessments. For a further period all their assessments will be audited. There will be ongoing random audits. We will be looking at this very closely.
The IT tool that the assessment providers will be using is also designed to try to gather comprehensive data about performance and help us to be able to monitor as well. Consistency of application and the quality of reports are important, but so is the claimant's experience, and getting feedback on that.
Q85 Debbie Abrahams: Are there sanctions or penalities built into the contract if this is not delivered?
Esther McVey: Absolutely there are. There are remedial contract stipulations throughout. Obviously, the ultimate sanction would be losing the contract altogether. Yes, there are.
Q86 Debbie Abrahams: At what level of dissatisfaction?
Esther McVey: I was looking through my notes there; I do not have the numbers here. For example, the level is something like 0.5% for customer service. Should anybody have any higher dissatisfaction than this tiny percentage, these stipulations will come into place. Again, on medical reports it is about again 5%. Should anybody have levels higher than those-these have been set to be very stringent-these stipulations will come into place. Obviously, there will be redress on any failings.
Dr Gunnyeon: There are issues here. Obviously, we can do things about healthcare professionals' performance and we can do things about the more general contract performance. Obviously, our objective will be, if at all possible, not to get into that position and to work very closely with providers on a daytoday basis to try to identify any problems that are occurring and solve them quickly. Having to get to the point where we have to resort to contractual sanctions is clearly not ideal. However, they are there in a very strong way.
Chair: Getting it right first time is important; we are now onto appeals.
Q87 Nigel Mills: We have all dealt with people who have had to appeal assessments elsewhere. What kind of level of appeal by people who do not get the result they want are you expecting to run from PIP?
Esther McVey: Did you say the appeal numbers that are coming through or what will monitor that on?
Nigel Mills: What are you expecting to see as appeals under PIP?
Esther McVey: We are working on to ensure that you probably have the right structure and right support in place. Obviously, we are working closely with the MoJ. We are looking at the number of appeals that are coming through at the moment for DLA. We will look at a worstcase scenario and work on that. You are quite right: you do want to get it right first time; you do not want people to go through an appeal process, but, obviously it is there because you need to have that. An important addition to this is the introduction of mandatory reassessment, which will be easier, quicker and will allow people to reassess the facts straightaway, rather than having to go through an appeal process. If you think more information should have been taken on board, we can then do that during this reassessment process.
Chair: I think you mean "reconsideration process".
Esther McVey: Reconsideration, sorry.
Q88 Nigel Mills: I have two questions. That mandatory reconsideration process has not been a roaring success elsewhere, has it? I have never seen a constituent have their decision changed during that process. I hope you can make it more effective for this than it has been.
Secondly, you said you were looking at what the worstcase level of appeals would be from current data. Could you tell us what you think that worstcase appeal rate is going to be?
Esther McVey: Yes, at the moment the worst case would be 80,000 a month, I think I am correct in saying.
Simon Dawson: We are assuming, from 20132014, 44,000 per annum rising to 80,000 per annum by 20162017, under those projections for PIP. As the Minister says, however, we have based those assumptions largely on the experiences of the DLA and ESA. They are necessarily pessimistic so that we can prepare, with our colleagues in HMCTS, for the worst case.
What we would hope is that the mandatory reconsideration process has been introduced in a strictly mandatory and more systematic way for PIP and other benefits from October this year. I know it has existed before, but has not necessarily been applied consistently across the Department. We are hoping that this process will give claimants a better opportunity to raise queries, a better opportunity for decisionmakers to take into account new information rather than it going into appeal and, also, for decision-makers to clearly explain reasons for decision, because a proportion of appeals are driven by people not understanding the decision and the reasons for the decision that they have received.
Q89 Nigel Mills: When you are preparing for these appeals with HM Courts and Tribunals Service, what length of time are you targeting to hear the appeal? Are you targeting for it to be less than eight months? Will it be less than 12 months? Are you trying to get that down to something much more reasonable?
Simon Dawson: Yes, we are. At the moment, for DLA it is running at around about 21.29 weeks. I am afraid I will have to write to you separately on what we are projecting in relation to Personal Independence Payment. We would hope to reduce that time. We are also introducing, from April this year, direct lodgement of appeals for PIP with HMCTS as well. We would hope that the combination of that and mandatory reconsiderations will reduce overall appeal waiting times.
Q90 Sheila Gilmore: Is there going to be a time limit on reconsiderations? There is a fear, as somebody expressed, that this will become a black hole into which claims fall. Presumably, people will have lost their DLA; the longer these periods go on, the more difficult it is going to be.
Simon Dawson: I will need to confirm, and write to the Committee separately about, whether or not that will be a time limit in a mandatory sense. However, if there is no limit there will be an internal management target for that period. I need to confirm which of those it will be.
Q91 Sheila Gilmore: To be clear, when people get their letter telling them that DLA is stopping and then go through process of assessment, does the DLA stop at that point completely? Will they be getting no money?
Simon Dawson: As is now, when someone receives a notification that their DLA is ceasing-we announced this in December-there will be a onemonth run-on of their DLA to allow them to manage the change.
Q92 Sheila Gilmore: There is going to be a gap, anyway, even without a longish reconsideration period.
Esther McVey: What do you mean?
Sheila Gilmore: If I have DLA, I receive my letter telling me my DLA is finishing; I have a month to put in a fresh application. My DLA will run on for that month, but after that I will have no DLA until and unless I qualify for PIP.
Simon Dawson: There is no limit on stopping you reapplying for PIP in the meantime.
Sheila Gilmore: People will cease to have money for a period of time.
Q93 Jane Ellison: People don't get assessed for PIP if you currently get DLA-that is what you are talking about. We are trying to understand what the elapsed periods would be. Presumably, that must be part of the financial modelling, because, for example, there is the elapsed time to go to appeal and then the backdated claim, or whatever. That must all be part of quite sophisticated modelling.
Esther McVey: Apologies; I was not sure where the question was going there. You can apply for reconsideration straightaway. As you say, there is a month where you get the money continuing on, but you can reapply.
Q94 Sheila Gilmore: But there has already been a gap. If I am in receipt of DLA, I get my letter telling me it is going to stop, but it may run on for a month. I have a month to put back my form. I take the full month to get my form back in, or maybe even longer, because I am given the concession of longer because I have some difficulty getting it in. There is going to come a point where I cease to have my DLA and I have not been assessed for PIP yet. I am then assessed for PIP and am refused. I ask for a reconsideration.
Esther McVey: That does not happen at all.
Simon Dawson: We must be at cross-purposes, because one of the things we have always committed to is that people's DLA will continue until they have received their first decision in relation to PIP.
Sheila Gilmore: So as long as they get that form in, their DLA will not stop.
Chair: Their DLA will not stop until they have received a determination.
Q95 Sheila Gilmore: It is only people who do not get the form in whose benefit will stop.
Simon Dawson: If people choose not to return the form, after four weeks we would suspend entitlement. We would not withdraw it but suspend it. A further four weeks after that, benefit entitlement would cease. That is for people being reassessed from DLA to PIP.
Sheila Gilmore: Somebody is reassessed; they have their form in, so their DLA goes on being paid; they have their assessment; they are refused PIP at that point and they ask for reconsideration. Will they have no money in their reconsideration period?
Sheila Gilmore: This is why I think a time limit is quite important. That was all.
Q96 Mr Burley: Just on the back of that, I have a similar concern to Sheila, in that I think there is a concern, certainly amongst some of my constituents, that in a sense people are not planning to stop receiving something. It is when it suddenly cuts off that they suddenly realise they want to make changes to their lifestyle. There is perhaps a wider question about how we mitigate people not planning for a big change that they, for whatever reason, do not factor in or do not understand until suddenly the money stops and they have not planned for that. Has the Department thought about that? That is something that I have seen.
Esther McVey: In this case they no longer get their award-as could happen now if you have your award reviewed; you might get it, you might not. In that instance, they will go to the Jobcentre, they will seek out advice, and they will be given information on what other support they might need. It could be Access to Work, it could be ESA, or it could be something within Universal Credit. There will be signposting in that regard, yes.
Q97 Mr Burley: But they only have four weeks to deal with that. They have been on DLA, they continue to get DLA whilst they are having their PIP assessment, the PIP assessment is negative, they decide not to appeal, and they accept it. From that point on, there is four weeks' runover, to use your term, when they are still getting the old DLA, after which they need to adjust to the new landscape. That is quite a short period of time.
Simon Dawson: Yes. Without wishing to get into very detailed mechanics, as individuals are typically paid fourweekly in arrears, depending on when their last payday was, and they got their notification, I suppose it could theoretically be up to-and they will get the four weeks' runover as well-eight weeks if they have just been paid. You are quite right, however; it is a short period.
Q98 Mr Burley: Building on that, the process of reassessing all the remaining workingage DLA claims was originally scheduled to begin in October 2013, and is now not planned until 2015.
Esther McVey: October 2015.
Q99 Mr Burley: What convinced you that it was necessary to delay the bulk of those reassessments from 2013 to 2015?
Esther McVey: Because it was a new benefit we wanted to ensure that all our intentions there were being fulfilled. Hence, it does start with a sample area, then we roll out nationally, then we have new applications. Really it was to ensure that the purpose of the benefit was fulfilled, and within that something we had committed to do was to have these reviews. We felt really we could not continue assessing the DLA until we had those reviews done, and that one is in 2014. We need to learn from it and ensure it is right before we proceed further. I think that is only correct and right.
Q100 Mr Burley: I would agree with that, but the question still remains. What you describe is understandable-that you would want to have the review in 2014 and then make changes in 2015. In that case, why was it originally envisaged for 2013, before the review was even scheduled to take place? It seems a very different timescale.
Esther McVey: A bit like anything, the consultation period for this, when we were taking advice-whether it was from lobby groups, charity groups, or various other people-we listened to what they said. One of the key concerns was the speed with which we were rolling out this new benefit, and we agreed that was correct and this was what we would do, and this is how we would do it. There were various other things that happened over those 18 months, but I think that goes to show that it was a proper, full, consultation.
Q101 Mr Burley: Then there is another timescale, is there not, which is that the initial implementation of new claims in northern England is in April 2013, and the processing across rest of Great Britain is just two months later, in June. That almost goes against the philosophy you have just described, of waiting, assessing, listening to people, having a review-
Esther McVey: No.
Q102 Mr Burley: It is only two months. It seems a very short period of time to roll it out nationally.
Esther McVey: I think they are very different. These are new claims coming on. One was, as you say, limited geographically, then it was rolled out, but these were all new claims coming on.
Q103 Mr Burley: There are still lessons to learn, though, are there not?
Esther McVey: There is a significant difference within the numbers, really, so I do not think so.
Dr Gunnyeon: That period is less about learning about the assessment than about confirming that all the processes actually work before we start to roll out more widely.
Q104 Mr Burley: And if the process does not work, is two months enough time to sort it out?
Dr Gunnyeon: Obviously there is a huge amount of work going in to try to make sure that the processes work before we get to that point, but clearly it is a beltandbraces approach and allows the opportunity to pick up any final problems of process. It will not be enough time to tell us about the assessment itself, clearly.
Q105 Mr Burley: The counterargument is that you could have a bigbang approach, and just roll it out nationally straight away.
Esther McVey: Well, no.
Q106 Mr Burley: Are you going to be able to do much in the two months?
Esther McVey: That is something we would not do. Simon, you might want to come in there, but that certainly is something we would not want to do.
Simon Dawson: I was going to say that you are right that it is a short period, but in that period we believe we can certainly test things like the telephony system, the way in which the telephony system and the telephony process link to the benefits processing activity, and we will clearly also have a clear picture of the way in which the IT is working. 5,000 claims in a month is sufficient to be able to ensure that that is working in live running, and being clear we will then be able to ramp that up in June to the national rollout.
Q107 Debbie Abrahams: Mine is a broader question around independent evaluation of the scheme as a whole, and particularly relates to the first section of questions you had. What independent evaluation will you be doing on the broader effects of the introduction of the PIP, around, for example, additional people on disabilities in poverty, effects in terms of their physical and mental health, their social health in terms of, for example, isolation, usage of the NHS and social care services, and also the costs associated with that? Is that something you will be doing? Is that already being planned? Now is the time for this type of work to be planned.
Esther McVey: Yes, we are looking at all of those things; of course we are. That was part of the reason that we are doing the review in 2014, to take all of these factors into consideration. As I said at the start of the meeting, we have very much a blank piece of paper at the moment for how we will do that review in 2014, and we would like to work closely with the Select Committee to see what our priorities would be in those.
Jane Ellison: I think it might be worth saying that we did push the witnesses earlier on those areas. I think we did some probing on that.
Q108 Debbie Abrahams: Can I just add a plea, then, as a former academic researcher in health, that this is the time for it to be done. You want to be doing it as you are planning the system, rather than when it is being introduced.
Esther McVey: Yes, and that is why we said at the beginning that we are working very closely with the Department of Health. We are working closely with local communities, and the Local Government Association; all of those things are being done, and with that, as I have said, we have the review in 2014.
Q109 Jane Ellison: Just a quick one, which I think you kind of answered earlier, about people getting extra time if they needed it to send their form back: there were concerns particularly raised by National Autistic Society about that, and I think you might want to reiterate what you said-that people would be able to ask for more time, particularly if it was obvious they needed to consult and get support from carers.
Simon Dawson: Absolutely, and we have actually built that into process. We are anticipating that people can routinely, and in a far more straightforward way, get that extra time that they need, and that will be built into the process and also into the guidance for our decisionmakers as well.
Q110 Jane Ellison: This is a linked question. You have obviously engaged, I imagine, with that society, amongst other applicants, but there are a number of points in relation to autism, and particularly some thoughtful points made in the debate last week-the Work Capability Assessment debate-about the nature of some people with autism seeking to, if you like, overestimate their own ability to do certain things. That could prejudice them in certain assessments. Is that something you have taken into account? Have you looked at the evidence that has been submitted?
Esther McVey: Yes, and I think it is for that reason that you can go to the assessment with somebody. We have taken that into consideration, and I met with some of those groups only the other week as they raised their concerns. It is a fair point, and we have built that into the assessment. Bill, you are nodding there; did you want to add anything?
Dr Gunnyeon: It is actually an incredibly important group, and at all stages of the process-not just at the outset, but all the way through-we need to make sure that we actually recognise their particular needs during the assessment itself, and indeed in subsequently communicating the results of the assessment.
Q111 Stephen Lloyd: I have a specific question around deafness. I am a little concerned that DWP may not quite understand the different strands of deafness, in the sense that under activity 7, if an individual needs communication support to express or understand basic verbal information that scores them eight points. Case study 9 in the original consultation features a deaf young person who uses sign language as his main form of communication. He is considered unable to understand basic information, hence scored eight points. I think that is great. What I would just flag up is that there are a very large number of people who are often defined as "deafened"-not someone like myself, who is hard of hearing, but someone who is profoundly deaf but does not use sign language.
Many tens of thousands of people are in that situation either middleage deafened, where they lost all their hearing overnight, or profoundly deaf young people who do not come from a sign language background and use oralism. As I am sure you are aware, that means that their ability to communicate is very poor, and my anxiety is that because they do not use sign language it may be assumed that they do not get the eight points because their communication ability is good. It is not; it is actually shockingly poor in that situation, so I would like some sort of reassurance within either the guidelines or rates that DWP understands when it comes to PIP, people who are deafdeaf, but not sign language users, are also recognised as having profound communication challenges.
Dr Gunnyeon: That is something that we will make sure is absolutely captured in the guidance, and how that activity is to be applied.
Stephen Lloyd: Good. I would happily advise, if you wish, as well.
Q112 Chair: Minister, you said that, for people who lost the help that they presently get through DLA because they do not qualify for same level of PIP, Access to Work might come into play. Have you done any assessment about how much the Access to Work budget would have to increase, if that were the case? Would Access to Work pick up all the shortfall? I have had someone who lives in a rural area, depends on his Motability car to get to work, and taxis would be £30 a day; would Access to Work make up that shortfall, if he is someone with MS who has 10 points instead of the 12 points? Will Access to Work be able to pick up that, and how timeously would Access to Work be able to do that assessment and pay out the money? If it is going to be three or four months-and sometimes it is up to six months with Access to Work at the moment-that person has lost their job.
Esther McVey: We have done a lot of work on this, on who the people would be and how they would be affected. Do you have that report in front of you, on who would be affected and how it would affect them?
Simon Dawson: What I can say is that we have been doing some work with Motability and the Access to Work people, and we are trying to work out ways in which we can ensure there is a smooth transition, so that people will still have their Motability vehicle until the Access to Work support is put in place, which hopefully provides some reassurance.
Q113 Chair: The idea of the example I have just given you is that the amount they would have got through PIP is a lot less than it will cost Access to Work to send them to work in taxis.
Esther McVey: Yes. What I was looking to there was the work we have done on DLA and work, the exploratory research and evidence review on who would be in work, who would have needed the support, and whether DLA appears to have been of any help or support for those people. This is the report I was looking at, and those findings showed it had not. Equally, we have also been doing work with Access to Work to find out whether they could pick up, and they can. We are extending Access to Work to help more people.
Q114 Chair: But the budget would have to increase in order for that to-
Esther McVey: But that is what is happening at the moment with Access to Work.
Q115 Sheila Gilmore: Is that budget supposed to increase, for example, to help other people? Do you think the increase you have put in place is enough to cover the situation?
Esther McVey: Yes, I do.
Q116 Sheila Gilmore: Will you publish any of this work you have been doing in a way that people could read it?
Simon Dawson: We have already published the DLM exploratory research that the Minister mentioned. That was published in July 2010.
Sheila Gilmore: That was a long time ago, and it was not about PIP. It was about DLA, clearly. Presumably it was done before any of this was even a glimmer in anybody's eye, because something that was published in July 2010 was presumably commissioned a good deal earlier.
Q117 Chair: With all due respect, the last thing you want to happen as Minister is that people lose their PIP and they lose their job as well.
Esther McVey: Yes.
Chair: If headlines start appearing about that, that will not be very comfortable.
Esther McVey: The report actually shows, and this is what I thought you were-
Simon Dawson: The point I think I am trying to make is that the evidence suggests that very few people in receipt of DLA are actually in employment, and in fact there is some research that suggests that DLA in itself is a disincentive for people to seek employment.
Esther McVey: From that evidence, we were looking at how to support people and, if it did impact on people who were in work, how we could support them. Yes, I am confident that that would come through Access to Work, as that is where I would be directing them, and as we are opening that up as an award and expanding it, I feel confident that that would be the way forward and the support.
Q118 Chair: Another thing that is confusing and seems to have changed is the position of people turning 16. I am pretty sure that we as a Committee got the assurance from your predecessor that 16yearolds would not be part of the first migration on to the new PIP; in fact they would be the last cohort whose DLA would be stopped and who would be put on to PIP. From the sheet that the DWP has put out about the implementation dates, it appears that people turning 16 will be classed as a new claimant, and therefore will have to apply for PIP from October 2013.
That puts them at the sharp end of the implementation of PIP. They will be disproportionately the largest group that will be coming onto PIP, because obviously it is an age cohort rather than a geographic area. Why has that changed? There are a lot of charities dealing with children-because after all, at 16 they are still children, especially as the education leaving age is to go up to 18-saying that the children will face this cliff edge, and will be the guinea pigs for the introduction of PIP. Why did all that change?
Esther McVey: I do not believe they will be the guinea pigs for PIP, because on the numbers, eight out of every 100 will be the new 16yearolds applying. We are making this transition as smooth as possible, with as much notice as possible, and giving all the support that was there. We felt at that age, which is the age where you are thinking of adulthood, it is about support, and we believed that was the correct way forward. It certainly was not about anybody being a guinea pig. It was about a smooth transition and support going to these people.
Q119 Chair: But these children will still be in education. In fact, the sizable part of this cohort have an education leaving age of 19, not 18, so they are in the middle of their secondary education. The whole basis of the benefits, that is probably the thing that is most valuable to family in helping to support them, will potentially change or in fact disappear, because they will be moving from the child DLA to PIP.
Esther McVey: Many children will think that journey into adulthood does start at 16 as they prepare for adulthood; many things would happen at 16. We felt that was the age we could support them the best, and, as I said, we are looking for a smooth transition for them.
Q120 Sheila Gilmore: Would you consider asking your providers to carry out their assessment in and with the schools that these young people attend? These are the people who know these young people the best. Would you consider asking for that? Is that in the guidance?
Esther McVey: We could ask that. Obviously these children would bring their parents; they could bring a carer; they could bring whoever. As we know, it could be a home visit or it could be at a location they know, so I feel that could be a fair request.
Dr Gunnyeon: It may be that schools would be a source of useful evidence, and perhaps that is something we need to think about in the guidance, as one of the potential sources of evidence about the impact of disabilities on young people.
Q121 Stephen Lloyd: That is a very good idea by my colleague: the SENCO officer in each of the schools will have details on a lot of the youngsters with disabilities heading up that age. It would be a classic example, if we do not take advantage of that, of the right hand of Government not listening to the left hand of Government, because they would have copious files. I think that is a very good suggestion to take on board.
Esther McVey: I have said I will take that back.
Q122 Sheila Gilmore: Could I just ask about older people? It appears that people who turn 65, when this all starts, will be reassessed. Is that correct, even though the assessment will not start until later?
Simon Dawson: Yes. People who turn 65 and are in receipt of DLA after 8 April this year will be still in the reassessment pool, so will be selected for reassessment at some point between then and when those reassessments start in October 2015 and October 2017.
Q123 Sheila Gilmore: We were originally told that that age group would not be affected.
Simon Dawson: I think we have always made clear that for people over age of 65 who are in receipt of DLA, from April, PIP will not be applied to them. It is those in the reassessment pool, I think, to whom this applies.
Q124 Sheila Gilmore: If you are 65 in May this year, or when this starts, you can be reassessed.
Simon Dawson: If you are in receipt of DLA.
Sheila Gilmore: Yes, if you are in receipt of DLA now, if we had not had this change, you would go on getting DLA into retirement. You are now saying that that group will be reassessed, which is, I think, different from what people had understood to be the situation.
Simon Dawson: Can we take that one away?
Q125 Chair: Can you take that one away, because that is actually quite important. Does that mean that somebody who is 60 today, who is already in receipt of DLA, will-no, I suppose everybody would be assessed anyway. It might be worth clarifying exactly what is happening.
Simon Dawson: We will clarify that.
Chair: Again, can I say thank you very much. Time has flown past; it may not have felt quite that way for you, Minister, as we pile on. We do have a lot of questions, but there is a lot of concern amongst not just the population that receive DLA, but their carers and people who support them, and they are very, very worried, so anything you can do to help allay some of those fears would be much appreciated. Thank you anyway for coming along this afternoon and answering questions.