Health and Disability White Paper 10.30am Marsha De Cordova
(Battersea) (Lab) (Urgent Question): To ask the Secretary of State
for Work and Pensions if he will make a statement on “Transforming
Support: The Health and Disability White Paper” published by the
Government. The Minister for Disabled People, Health and Work (Tom
Pursglove) Yesterday, the Secretary of State published
“Transforming Support: The Health and Disability White Paper”. This
White...Request free trial
Health and Disability White Paper
10.30am
(Battersea) (Lab)
(Urgent Question): To ask the Secretary of State for Work and
Pensions if he will make a statement on “Transforming Support:
The Health and Disability White Paper” published by the
Government.
The Minister for Disabled People, Health and Work ()
Yesterday, the Secretary of State published “Transforming
Support: The Health and Disability White Paper”. This White Paper
is a significant milestone, demonstrating the Government’s
commitment to ensuring that disabled people and people with
health conditions can lead independent lives and fulfil their
potential. It sets out an ambitious policy reform package that
will transform the health and disability benefits system, and
help disabled people and people with health conditions to start,
stay in and succeed in work.
We will deliver action in three ways. First, we will transform
the future benefits system so that it focuses on what people can
do, rather than on what they cannot, including by removing the
work capability assessment. In our new system, there will be no
need to be found to have limited capability for work or
work-related activity in order to receive additional
income-related support for a disability or health condition. We
will introduce a new universal credit health element that people
receiving both personal independence payment and universal credit
will be entitled to, which will enable people to try work without
the fear of losing their benefits. We will roll this out
carefully from 2026-27, and we will ensure that no one currently
on universal credit and with limited capability for work or
work-related activity will lose out once they move on to the new
system.
Secondly, while de-risking work is one side of the coin in
supporting disabled people and people with health conditions into
work, we know that we also need to provide more employment and
health support for this group. The White Paper sets out how we
will introduce a new personalised approach to employment support
and engagement, with the aim of helping people to reach their
potential and live a more independent life. We are investing in
additional work coach time and tailored support. The Chancellor
also set out yesterday that we will introduce a new programme
called universal support, which will provide wraparound support
for individuals and employers, as well as additional money to
provide more mental health and musculoskeletal treatment for this
group.
Finally, we will ensure that people can access the right support
at the right time, and have a better overall experience, by
testing new initiatives to make it easier to apply for and
receive health and disability benefits. I am certain that our
White Paper reforms will support more people to reach their full
potential and reap the health and wellbeing advantages of
work.
Thank you, Mr Speaker, for granting this urgent question.
Although we know that most of the proposals set out in the White
Paper will not be implemented until the next Parliament, a
significant number of ill and disabled people will be impacted.
We see the Government using a carrot-and-stick approach, which
will leave many sick and disabled people with the stick and the
real threat of the ramping up of sanctions, as indicated by the
Chancellor during his Budget statement yesterday. Just this week
the Information Commissioner’s Office ruled that the Department
for Work and Pensions must release “sensitive” research into its
sanctions regime following the Work and Pensions Committee
report, which found that there is very little evidence that the
sanctions work. Instead, it found that they have a significant
impact on the health and finances of those who have been
sanctioned. There are real consequences to some of the
Government’s actions.
Nobody is arguing that scrapping the work capability assessment
is not welcome. However, relying solely on the PIP assessment is
not the solution, given the current experiences of PIP
assessments, which show that they are deeply flawed; the DWP is
losing or conceding in four out of five appeals. Moreover, the
Institute for Fiscal Studies said yesterday that up to 1 million
people currently on incapacity benefits could lose out as a
result of scrapping the work capability assessment and relying on
using PIP only. Also under the new proposals disabled people will
not automatically be in the “no work-related requirements”
conditionality group and will now be subject to the decisions of
a work coach.
We also did not hear any additional investment in the Access to
Work scheme, so can the Minister say how many people will be
impacted and what the cost is of these new proposals? It is
estimated that 1 million people will lose out. How are the
Government intending to mitigate that? Will the PIP assessment
framework change or stay as it currently is? Given the poor
decision making on so many PIP assessments, what action is being
taken to fix the flawed decision-making process and the
assessment itself? How will the DWP ensure that the policy
proposals do not remove vital protections against sanctions and
risk pushing people further into poverty? Finally, when are the
Government intending to publish the sensitive research into the
sanctions regime?
I am hugely appreciative of the hon. Lady, who always speaks with
great passion on these issues. I welcome the cautious welcome
from her about the broad thrust of the reform we are trying to
deliver, which is to remove the structural disincentive to work.
That manifests itself in the many conversations I have with
disabled people and their representative groups, when they tell
me that many disabled people would like to try to work, but fear
doing so and then losing their entitlement if it does not work
out. That is not an acceptable situation, and it is right that we
change it. I hope that as a House, as we move forward with these
reforms, we can come together and deliver something that achieves
that objective, which is plainly the right thing to do.
It was before my time in the House, but I well remember debates
in previous years about the work capability assessment. It is
welcome that we are scrapping the work capability assessment
through these reforms. The reforms also offer an opportunity to
focus on quality when it comes to the PIP assessment and on
making sure that we get the right decisions first time. The hon.
Lady will note, for example, that one of the commitments we have
made in the White Paper is trying to match specialist assessors
with people’s conditions. That is another thing people have
regularly been asking for, and we are determined to test that and
see what difference it can make. Again, this is all about being
responsive to the feedback we have received.
On the issue of sanctions that the hon. Lady mentioned, I know
that the legal case she touched on is under consideration by
Ministers elsewhere in the Department at the moment. No doubt we
will come forward and say more about that in due course, but I
want to be clear that it is not my intention or the Department’s
intention to force anyone to do something that is not right for
them. We are committed to personalised, tailored support that
meets individual needs and aspirations. The Secretary of State
will talk about that in more detail during the Budget debate
later. A lot of that will be voluntary. I would hope that people
will want to engage with universal support and will want to
engage with Work Well, because this is about trying to help and
support people. For people with health conditions, for example,
this is a way in which we can work harder and tirelessly with
them to help them get better. Work is of course an important
determinant of better health outcomes. The White Paper is
explicit in saying that we will move forward with this in a way
that is appropriate for individuals. For those where work is not
appropriate, they will not be expected to do it.
It is also important to set out for the House that there will be
transitional cash protection in place. No one who currently has
limited capability for work or work-related activity will lose
out as they move to the new system. We are specifically
protecting those with pregnancy risk or who are undergoing cancer
treatment, and we are also keeping a contributory health and
disability benefit. Of course, what I really want to do—this is
key to all of the work I do in this role—is to work
constructively with the hon. Lady and with disabled people and
their representative groups to make sure that we get this reform
right. This is the biggest welfare reform for over a decade, and
we have to get this absolutely right.
(North Devon) (Con)
I warmly welcome the announcement of the Government’s new
universal support programme. Does my hon. Friend agree that it
will help disabled people in my constituency find an appropriate
job, backed by £4,000 of resources per person? It will further
enhance the exceptional work done by Disability Confident and the
Barnstable Jobcentre Plus. Might he come to visit and see for
himself?
I commend my hon. Friend for the work she does on the ground in
her constituency, working constructively with the jobcentre and
employers to help facilitate employment opportunities. I am
really excited about the opportunities universal support will
bring. We know from existing schemes that where people are
supported in taking and then retaining roles, it is hugely
powerful and effective in bettering their health and employment
outcomes. That is precisely what we are doing through universal
support with those 50,000 opportunities. I am excited to work
with my hon. Friend on implementing that in her area, and I would
of course be delighted to visit and see more of what is going on
on the ground.
Mr Speaker
I call the shadow Minister.
(Westminster North) (Lab)
No one will mourn the passing of the work capability assessment;
Labour has been calling for reform of that for a long time. It
needed to change, because people’s lives do not fit neatly into a
binary system of work or no work. However, disabled people and
those with serious health issues want and deserve support and
reassurance in work and out of it, and what people fear,
understandably, is that under the guise of reform their lives
will be made harder and vital financial support might
disappear.
The devil is always in the detail, so I have a few questions for
the Minister. The PIP assessment is designed for a totally
different purpose from the WCA; how will he reconcile those
completely different systems? What will happen in future to those
people who do not currently receive PIP—those on the limited
capability for work and work-related activity element of
universal credit, and particularly those with short-term and
fluctuating conditions? Unless it is the Minister’s intention
that some 750,000 people will lose £350 a year, an alternative
needs to be in place; what will that alternative be?
Do the Government believe that it is fair that the hundreds of
thousands of people with disabilities that prevent them from even
engaging in work-related activity should receive less financial
support through UC than people who are entitled to PIP, and if so
what is the basis for that justification? If the intention is to
allow work coaches to use discretion in all such cases, how will
we ensure consistent decision making and decision making that is
based on a proper understanding of serious health conditions and
their impact on daily life? What provision is made within the
Department to ensure that capacity for that is in place?
As transparency and openness are so essential in building
confidence, will the Minister now publish the report on the
operation and effectiveness of sanctions? By publishing the White
Paper, the Government have started this debate; the minimum we
need now is openness and clarity about how those ideas are
intended to work in practice.
May I first welcome what I think is a cautious welcome from the
Opposition for the reforms that we are seeking to advance? I
think it reflects some of the utterings that we have heard from
Labour Members over recent weeks and months about the direction
of travel they want, recognising that there will be people for
whom work is not appropriate. I repeat the point that, where that
is the case, we will not be expecting people to engage with this
support, but it is right that that structural impediment to work
is removed from the system, that those who want to work are
supported in being able to do so, and that we make sure that we
have a system that is responsive to that and that also has health
as a focus. I hope we can move forward on a cross-party basis on
those terms.
On the specific point about PIP, again it is important to
recognise that we will look very carefully at whether those
individuals who are not currently in receipt of PIP meet the PIP
criteria, and we will act accordingly. Also of course, anybody
who thinks they may be eligible for PIP is able to apply for it.
I would always encourage people who might be eligible for any
given benefit to apply for it.
On the point about the health top-up, I can confirm that the
award rate for the new UC health element will be at the same
level as is currently awarded to those who have LCWRA. I again
make the point about the approach that we intend to take: the
reform will be carried out on a staged geographical basis,
beginning with new claims in 2026-27. Of course, legislative
steps will need to be taken to bring this reform to fruition, but
there is much to welcome and I hope we can come together. On the
point about the legal case, as I said earlier, colleagues
elsewhere in the Department are considering next steps and will
come forward in due course.
(Chingford and Woodford
Green) (Con)
I welcome the announcement in the Budget. As my hon. Friend will
recall, I wanted to introduce the universal support package
alongside universal credit. Its purpose was to intervene and help
to change people’s lives, which was what was missing for all
those years and needs to be there now. It was intended to replace
what has been a very difficult benefit, originally introduced by
Labour along with the work capability assessment. Throughout that
time, I wanted to see universal credit together with universal
support to help people get over their difficulties.
According to a recent survey on sickness benefit, 700,000 people
want to find work, but the limits to what they can do seem so
difficult that they fear losing their benefit. This measure,
hopefully, should change that. However, I urge the Government to
do the final bit, which is to bring in the other group who are
still receiving employment and support allowance and not yet
receiving universal credit, so that the interventions can help
them and we can have a progressive, positive way of helping
people with sickness or disability to fulfil their potential and
lead productive lives, because work is a health treatment.
My right hon. Friend speaks with passion and authority on these
issues, and he has a wealth of experience of delivering
meaningful change in the welfare system that has improved the
lives of millions of people. This is the next chapter—the next
step in that journey—and one thing I know for sure is that I
shall want to draw on my right hon. Friend’s experience and
expertise and hear his ideas about how we can get this right.
Like him, I am excited about the opportunities that universal
support can provide in matching people to roles and supporting
retention, with all the wraparound care and support that goes
with that. There is a great deal of best practice from which we
can learn. I was in Tower Hamlets yesterday, and saw a fantastic
example involving NHS talking therapies. I want to ensure that
more people are able to engage with that sort of support.
Mr Speaker
I call the Scottish National party spokes- person.
(Motherwell and Wishaw)
(SNP)
Why do this Government intend to expose more disabled people to
the punitive benefits sanction regime? It does not work, and the
automation of sanctions will make the position even worse.
Why was there no guidance in the White Paper on statutory
timescales for reasonable adjustments to enable more disabled
people and those with long-term conditions to work? The SNP and
many stakeholders continue to call for urgent improvements to end
the payment gap. Why is there no mention of that? Why will the
Government not ensure that flexible working is a day one right by
default, rather than the onus being on the worker? Why is there
no uplift for legacy disability claimants who were missed out
during the pandemic? PIP assessments are already failing many
disabled people and forcing them into challenging decisions which
are ultimately overturned. Why is more being added to PIP
assessments?
Will the Minister consider using dignity, fairness and respect as
the White Paper proceeds into legislation, as the Scottish
Government do?
I would argue that dignity, fairness and respect underpin all the
work that I do as Minister for Disabled People, Health and Work,
all the work of my colleagues in in the Department for Work and
Pensions and, of course, all the work of our officials, who
approach their responsibilities with real seriousness and want to
help and support people in a way that is appropriate for them.
That goes to the heart of these reforms.
This is about a tailored approach, whereby people are helped into
work when that is appropriate for them. When we can improve
people’s health outcomes, we ought to be doing so in a joined-up
way. No one will be forced to do anything that is not appropriate
for them. As I said earlier, I want people to feel that they
would want to engage with the employment support we are offering,
and that is reflected in the fact that so many disabled people
tell us that they wish to try these opportunities, but fear
losing their support if it does not work out.
The PIP journey is now down to 14 weeks, but there is more to do
in that regard. I am not complacent about it, and I want to drive
forward work on digitalisation. Let me also say that I have a
very constructive working relationship with the Scottish
Government Minister with responsibilities in this area, and I
absolutely commit myself to working with him as we deliver this
reform. I know I am set to meet the hon. Lady next week, when we
may be able to follow up some of these points.
(Christchurch) (Con)
The Government’s initiative to emphasise the need to improve
health outcomes is fundamental to this. May I draw my hon.
Friend’s attention to today’s edition of the Daily Express and
its Justice for Jab Victims crusade? A two- page article
describes the problems that thousands of people are experiencing
as a result of receiving covid-19 vaccines that have not worked
out in the way they had hoped.
I appreciate my hon. Friend’s welcome for our proposed reforms. I
have not seen the article to which he refers, but I will
certainly have a look at it once I have left the Chamber, and I
shall be happy to speak to him separately about it.
Mr Speaker
I call the Chair of the Work and Pensions Committee.
Sir (East Ham) (Lab)
There are very welcome measures in the White Paper, although a
lot of the detail is still missing. The work capability
assessment is to be scrapped, starting in three or four years’
time, and replaced with
“a new personalised health conditionality approach”
to assess entitlement to what the Minister just referred to as
the “health top-up” in universal credit. That sounds like a new
assessment of some kind. Can he tell us what it means?
I suspect that these issues will come up when I appear before the
Select Committee along with my hon. Friend the Minister for
Employment in a few weeks’ time. I look forward to that
opportunity to delve into these reforms in some detail. The
detail of our proposed approach needs to be worked through. I am
clear that stakeholder engagement, working with disabled people
and hearing views from this House will help to inform that. I
want people to feel that they can engage with the programmes
announced in the Budget, as well as with the existing provision.
That will happen on a voluntary basis, but we need to move the
reform forward in a pragmatic way. We will say more about it as
we move forward with implementation.
(Workington) (Con)
I thank my hon. Friend for bringing forward steps to abolish the
work capability assessment. Does he agree that that will enable
more disabled people in my constituency to take up work without
fear of losing financial support?
My hon. Friend hits the nail on the head about what we are trying
to achieve with these reforms. He is a passionate campaigner for
employment opportunities in Workington, and has had considerable
success in that regard during his time in this House. I
appreciate his welcoming the reforms, which are about helping
people to achieve their aspirations. If work is something that
people want to do, Government ought not to put barriers in place
to prevent that. That is precisely what we are determined to do
away with.
(Vauxhall)
(Lab/Co-op)
I thank my hon. Friend the Member for Battersea () for asking this
important urgent question.
The sanctions do not work. Measures to tackle disability
employment gaps are way overdue, and I pay tribute to many groups
across Vauxhall, including Autism Voice in Clapham, which I
recently visited. They do a lot of work to try to help disabled
people back into the work market but, sadly, the employment gap
is still there. Many employers discriminate and are not prepared
to give disabled people an opportunity, because of the widespread
perception that disabled people are less capable, regardless of
whether they are the best candidate. What are the Government are
doing to tackle negative attitudes about disabled people, which
are preventing many of them from fulfilling the opportunities
that they should be taking?
The hon. Lady is right to raise this issue. We all have a duty
and a responsibility to be brilliant advocates and allies of
disabled people, promoting opportunities for them at every turn.
I expect that we will be in a position to say more about autism
specifically over the coming weeks—something that I feel very
passionately about as Minister for Disabled People. We are doing
work on perceptions, and there is more work to be done over the
coming months. We have a campaign that I expect to come to
fruition in the not-too-distant future. I want to see more
employers sign up to schemes such as Disability Confident. There
is more to do, although we have seen real strides forward, with 1
million more disabled people in employment achieved five years
early, but we must take the next steps forward. There is so much
untapped potential from people who can contribute and offer so
much to their workplaces.
(Ruislip, Northwood and
Pinner) (Con)
I welcome the focus in the White Paper on people with learning
disabilities. For many years my constituent Jeremy Child has run
the project Community ConneX, formerly Harrow Mencap, which
supports adults with learning disabilities to grow their
confidence with a view to entering the workplace. Does the
Minister agree that such projects are a critical part of the
infrastructure that will make this White Paper a success in
practice?
I thank my hon. Friend for raising the work of Community ConneX,
which makes a huge difference in his community. I see that
replicated in many of the visits that I undertake in this role. I
was in Bristol just before Christmas and it was inspiring to see
the work experience placement opportunities that are being
provided, often by charitable organisations. I want to work with
them to translate those early steps towards employment into roles
in other workplaces—full-time work if that is appropriate for
someone, or part-time work if that is appropriate in other
circumstances.
There is so much that we can do, and I want to place on record my
thanks to everyone who works in those initiatives—they are often
charitable endeavours, as I say—for everything that they to do
help to facilitate this. Working with them will be a key part of
how we move this forward.
(Ellesmere Port and Neston)
(Lab)
May I suggest to the Minister that, as part of this, he looks at
reforming statutory sick pay? The pandemic laid bare the
inadequacies of that system. Millions of people do not qualify at
all, and the rate is one of the lowest in Europe. If we are
genuine about getting people with long-term health conditions
into the workplace, we need a proper safety net for when they
fall ill.
I appreciate the hon. Gentleman’s thoughts on statutory sick pay.
If there are particular ideas or suggestions that he would like
me to consider, I would be very happy to do so.
(Bosworth) (Con)
I am really pleased that the Government are dealing with the
issue of an ageing population and the difference between good
health and poor health. The reality is that many people will live
with long-term health conditions. I have seen at first hand that
when someone has a heart attack or a stroke, they struggle to get
back into the workplace. Is this part of changing the environment
to make sure that people have support all the way through, from
diagnosis to desk? If so, how will my hon. Friend ensure that the
environment is compassionate and supportive all the way through
to getting people back into work?
Compassionate and supportive is precisely the approach that I see
when I carry out my visits and look at the employment support
that is being provided. As I said, I was at the NHS talking
therapies service in Tower Hamlets yesterday, and I saw that for
myself. It was inspirational to hear the testimony of people who
have been through that service about the difference that it has
made for them. It has supported those with mental health
conditions, in particular, by seeing work as a real determinant
of better health outcomes for them and supporting them to
work.
My hon. Friend knows more than many Members in this House just
how valuable better health is for people. The work that he has
done in his professional life means that he has a lot of
experience in this area, which I am keen to pick up. I know we
are due to meet, and I would be keen to hear his ideas.
(Luton South) (Lab)
Waiting times for Access to Work grants have skyrocketed under
the Conservative Government, with the average clearance time now
more than two months. Although plans to enhance the Access to
Work support offer are welcome, how does the Minister plan to
reduce waiting times so that disabled people can access the
support that is available before an employer pulls a job
offer?
I am not satisfied with where we are in relation to Access to
Work, and that is why I am driving a real effort within the
Department, which is resulting in more staff being dedicated to
it. We are refining our practice, streamlining processes and
reflecting feedback, particularly on workplace assessments and
travel claims. Those are two areas where some really constructive
ideas have come forward and we are now looking to roll them
out.
As I said in relation to PIP, digitalisation is key to this. It
is about making sure that processes are easy to access and
navigate. When we bring those factors together, they will help us
to make a meaningful difference in shifting the dial on Access to
Work applications.
(Keighley) (Con)
I welcome this health and disability White Paper, because we know
that health issues may mean that people feel unable to carry on
working or struggle to continue in the working environment. I
thank my hon. Friend for the Government’s new £400 million fund
to increase the availability of mental health and musculoskeletal
resources. Does he agree that this support will help people
across the country, including in Keighley and Ilkley, who need
such support to stay in work for longer?
My hon. Friend is a brilliant champion for his constituents, and
he is always arguing for improved employment opportunities for
residents in his area. The Budget commitments, which my right
hon. Friend the Secretary of State will no doubt touch on during
today’s debate, amount to more than £500 million of employment
support by 2025-26. That very much reflects the best practice
that is being delivered out there in the country, building on it
and cascading it further. I think it is fair to say that my hon.
Friend’s constituents and mine, and those of hon. Members across
this House, will feel the benefit of this work in the years
ahead.
(Strangford) (DUP)
I thank the Minister for his answers on this important issue.
Large numbers of my constituents have disabilities and are on
benefits, and have understandable concerns, so I seek some
reassurance. Will he outline whether greater financial incentives
can be offered to employers to take time to put in place
procedures to allow disabled people to be part of the team yet
work from home? That would allow more people to overcome their
physical restrictions and be a huge asset to a team, and thereby
gain confidence and independence through employment.
The hon. Gentleman is right to touch on the fact that disabled
people contribute so much to our workplaces, and I want to extend
their contribution further so that we can unleash the potential
in our society. With the right help and support, we will build on
the successes that we have seen in getting people into work. The
target of getting 1 million more disabled people into work was
met five years early, but that is not the end of the story.
We need to continue to move forward, which is why the hon.
Gentleman is right to also touch on the support that we have in
place and our work with employers. Access to Work is an important
part of that, because it supports the physical things that people
need in workplaces to facilitate employment opportunities.
Another area that I am passionate about and want to look at
closely, and relates to what the Chancellor said yesterday about
occupational health, is what more we can do to improve soft
skills for employers to ensure that they have good-quality
workplace conversations to best support those who are coming to
work for them, and those who work for them already.
(Cleethorpes) (Con)
The report points out that autistic people are the least likely
of all disabled people to be in work. It goes on to reference the
nine local authorities where there has been a pilot, which is to
be extended to a further 28. Does that 28 include the nine? Can
the Minister outline the criteria for local authorities to
participate?
I am happy to provide further detail for my hon. Friend
separately. We recognise that there is real value and opportunity
in having locally led and locally initiated employment
opportunities and support that are tailored to meet localised
needs on the ground and that work closely with the health system.
That is reflected in our announcements. We need to take that
forward in a joined-up way and work across Government. There is a
real determination from not just Ministers in the Department for
Work and Pensions but the Prime Minister, the Chancellor and
Ministers in the Department of Health and Social Care—this is a
cross-Government effort. I am happy to provide him with more
background about the work that we are doing.
(Harrogate and Knaresborough)
(Con)
It is fantastic that we have seen 2 million more people with
disabilities enter the workplace in the last decade and that, as
my hon. Friend said earlier, those who want and are able to work
are supported to do so. I have spoken before about my support for
the Disability Confident and Access to Work schemes. The White
Paper builds on all the progress made thus far. Can he outline
more about how the Access to Work scheme will evolve with an
enhanced package and about the flexibility? Basically, can he
update the House? The programme is fantastic, but there needs to
be significantly greater awareness.
It is fair to say that the Access to Work scheme is a flagship
scheme that has made a big difference over the years in helping
to support disabled people into work. As we move forward with the
reforms, we want to look at how we can be more ambitious on
Access to Work and, as I touched on earlier, what more we can do
to support employers to have those soft skills so that they have
good-quality workplace conversations with employees about how
they can be best supported. We also want to ensure that we
deliver digitalisation to bring waiting times down. Frankly, I do
not want anyone to have to wait longer than necessary to start
work, if that is something that they want to do. We must support
people to retain their roles.
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