Contact: Max Wind-Cowie, Parliamentary Officer, 020 8215 2287
Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205
Welfare Reform Bill 2008
Commons Second Reading Debate
Briefing from Mind
Key points
; Mental health has a significant impact on welfare reform and benefits. Around
40 per cent of Incapacity Benefit (IB), to be replaced by Employment and
Support Allowance (ESA), claimants have a primary diagnosis of a mental
health problem and, if secondary mental health diagnoses are taken into 1account, the proportion increases beyond 50 per cent of the caseload.
; Training and competency of employment advisors: The complexities of
mental health need to be understood, and taken into account, by employment
advisors and other relevant staff. It is unfair and unrealistic to expect
employment advisors to be able to offer real and useful assistance to people
with mental health problems if they have not received appropriate training
themselves.
; Compulsion and sanctions: The welfare to work agenda must not result in
advisors and staff being given disproportionate and unchecked power over
individuals. While these issues are important to anyone claiming benefits, the
potential detriment to people in mental distress is a source of great concern.
; Disabled people and the right to control: People with mental health
problems should be empowered to take control of the services that support
them. Mind welcomes the Government‟s plans around “right to control”.
However, Mind is concerned that the Government may negate the positive
aspects of direct payments by insisting on separate funding streams for
services.
1. Introduction
1.1 Over 200,000 people with mental health problems flow onto incapacity 2benefits each year - this figure has not changed in the last decade. The
Government‟s welfare reform programme has the potential to be of
1 Waddel and Aylward (2005) The Scientific and conceptual basis of incapacity benefits The Stationery Office 2 Dame Carol Black (2008) Working for a healthier tomorrow. TSO.
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Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205 substantial benefit to people with mental health problems and transform lives. But unless this latest programme is carried out with adequate resources and with a proper understanding of the barriers to employment that people with mental health problems face, its effectiveness may be limited. In some cases it may even have the potential to do harm.
1.2 The Welfare Reform Bill and the measures it contains are intended by the Government to realise its aspiration of an 80 per cent employment rate for people of working age. The Government has stated that its intention is a system where everyone has personalised support and conditions to help them get back to work, underpinned by a simpler benefits system and genuine choice and control for disabled people.
1.3 Since the Government published their proposals for consultation in July 2008 the economic climate has worsened. In the last recession, many people with mental health problems were written off as unemployable when they lost their jobs. Another recession will undoubtedly put pressure on the Government's initiatives to support people in finding and holding on to jobs.
1.4 Mind fully supports the Government‟s aims for the Welfare Reform Bill to
achieve a socially inclusive society with opportunity for all. However, a number of the measures proposed seem to be at odds with this principle. Mind has consistently disagreed with the notion of deducting from, or restricting, welfare benefits in an attempt to promote certain types of behaviour in claimants. Benefits are set at a rate deemed sufficient for a claimant to live on, taking into account their personal circumstances. There can be no justification to reduce income levels below what the Government has already decided is the minimum living income. Claimants have a right to the full applicable amounts of benefits they are eligible for. Mind believes it is wholly inappropriate to erode this right in an attempt to manipulate behaviour and infringe on their civil liberties. Further, there is no evidence that conditionality is a necessary element of the reformed benefit regime.
1.5 Mind welcomes the introduction of personalised support. People with fluctuating mental health problems require tailored and flexible support for their needs, and this is often unavailable. However, linking personalised support to increasing conditionality and sanctions is likely to be ineffective in enabling people to take steps towards employment at the most appropriate time and pace for them. In the worst cases it risks pushing people into unsuitable and potentially harmful situations.
1.6 Mind is concerned that the implementation of the new regime will be in the hands of advisors with a low understanding of mental health issues, and may lead to unfair sanctions decisions that put already vulnerable people at greater risk.
1.7 Mind supports the Government‟s objective of supporting people who are in
a position to do so to move into employment, but it is difficult to welcome without reservation a Bill which leaves many of the details of the proposed reforms to be set out in as yet unpublished regulations. Draft regulations for the key proposals outlined in the Welfare Reform Bill 2006 were
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Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205
published in time for the Committee Stage debate and Mind would urge
the Government to do the same again.
1.8 Mind is worried that there is nothing in the Bill to ensure – or at least
encourage – employers to play as full a role as possible in helping people
to move from benefit to work and to remain there. Fewer than four in ten
employers would consider employing someone with mental health issues, 3compared to more than six in ten for physical disability. Mind believes
that employers are key to the success of welfare reform.
1.9 This briefing draws on wide consultation with Mind‟s networks and all
quotes included in the briefing are taken from people with direct
experience of mental distress.
2. Training and competency for employment advisors
2.1 The Bill will give greater flexibility and greater powers to JobCentre Plus
Personal Advisers, to tailor the support they offer to individual‟s needs and
circumstances. Mind is concerned that staff who will be responsible for
supporting people into work are insufficiently trained on mental health
issues. The Bill has no proposals to increase training to support staff who
will have to make important decisions.
Mind is calling for safeguards that will ensure Personal Advisers will
have sufficient mental health awareness training.
"Advisors, employers and work colleagues still lack understanding of
mental health issues - stigma is alive and kicking. Just because my
disability is not visible it's just assumed I was work shy."
2.2 Where a claimant is not complying with requirements and they are not
addressing their main barriers to work, such as skill needs or problem
drug use, the Bill will allow Personal Advisers to decide the appropriate
activity they should undertake. In these cases, claimants will be required
to take part in the specific activity their advisor has chosen. Judging what
will be appropriate will require significant knowledge of people‟s conditions
and needs. Personal Advisers must not be expected to make clinical or
therapeutic decisions that are entirely inappropriate for their role.
Mind is calling for safeguards that will ensure a Personal Adviser will
have sufficient training to understand the implications for someone’s
mental wellbeing.
“Forcing distressed people to do anything will only increase their distress.
It is not laziness or lack of skills that prevents people with mental health
problems from working. It is either that they cannot work or that employers
stigmatise against them.”
2.3 The Government‟s intention is that all claimants receive personalised
support, with a responsibility to engage with this support on their own
journey back to health and work, or face sanctions. The Bill states that
people will not be sanctioned for not undertaking any required activity if it
3 DWP (2001) One Evaluation
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Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205 is demonstrated that they had good cause and they have contacted the Department for Work and Pensions (DWP) within five working days. Mind remains concerned about the potential inappropriate use of sanctions for people with mental health problems who may be unwell and unable to contact the DWP within the prescribed time.
Mind is seeking an amendment to secure an explicit safeguard for people with mental health problems and/or fluctuating conditions who have good cause.
“When in a severe, depressed state one can hardly get out of bed in the morning and care for oneself.”
2.4 The Bill states that any direction a claimant will be asked to undertake must be reasonable, having regard to the person‟s circumstances as
outlined in Clause 2, section 2F.
Mind is seeking an amendment that explicitly states that having regard to a person’s circumstances will include having regard to that
person’s mental health.
“The variability of functionality of those experiencing mental health issues
will not be taken into account. The thought of having to do these things may drive people into even greater distress. They may be working with people with no training or understanding of mental health issues.”
2.5 The definition of social security information is to be broadened to include information relating to employment or training through Clause 25. For
example, regulations could permit a person delivering a training course to a Jobseekers Allowance (JSA) claimant to provide information to JobCentre Plus (JCP) about the claimant's record of attendance and levels of attainment.
Mind is calling for safeguards that any staff expected to supply social security information under this broader definition will have sufficient mental health awareness training.
2.6 The Bill inserts new section 18C to the Jobseekers Act 1995 which defines the circumstances in which claimants may be sanctioned for failing to satisfy conditionality requirements. Subsection (2) provides that a claimant is in breach of a jobseeker‟s direction if he or she has, without good cause,
refused or failed to carry out a direction. The Bill states that regulations must provide that those claiming JSA without having to satisfy the jobseeking conditions are not sanctioned for leaving employment after taking a job and for not completing a training scheme. Mind welcomes this, however, other safeguards are needed in relation to mental health.
2.7 New section 18D describes circumstances in which a person who does have to satisfy the jobseeking conditions is not to be regarded as breaching a jobseeker‟s direction, a training scheme requirement or an employment programme requirement under section 18C.
Mind is seeking an amendment that a person is not to be regarded as breaching a requirement if it can be demonstrated that the person has voluntarily left employment because their occupation was causing damage to their mental health, and insufficient support to ensure that person’s safety and wellbeing has been put in place.
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Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205
“A lot of people including employers do not understand about mental
illness and would not be able to deal with an employee who suffers mental health issues.”
3. Compulsion and sanctions
3.1 The Bill will allow Personal Advisers to decide the appropriate activity a claimant should undertake. It is wholly inappropriate for this power to be used to require a claimant to access healthcare provision, take medication and/or access psychological therapies. To do so would blur the boundaries between health provision and social control. It is a general principle of law that people with capacity to make decisions about medical treatment should not be subject to compulsion, and, where this is permitted, these powers are subject to stringent safeguards (notably, within mental health and mental capacity legislation).
3.2 The Government had made a commitment that a clear and
comprehensive set of safeguards would be built in to ensure claimants are not required to undertake inappropriate activities. Yet the White Paper describes what can constitute work-related activity and it can include any activities a person undertakes to manage their health for work, for example, condition management programmes, drug and alcohol
rehabilitation, „Progress to Work‟ for drug misusers, or therapy or physiotherapy for a common health condition.
Mind is seeking an amendment to ensure these safeguards include an exclusion of any compulsory requirement relating to a person’s
mental health.
Mind is calling for the parts of this Bill that would introduce a power to require claimants to undergo treatment to receive close scrutiny.
3.3 Claimants are to be sanctioned one week‟s benefit if they are cautioned about an offence involving violence or harassment towards a DWP employee through Clause 20. There needs to be adequate safeguards to prevent this being misapplied through potentially broad interpretations. It is extremely worrying that people will have their benefits reduced without due process.
Mind is calling for adequate safeguards to be built in, especially in relation to claimants who are defined as a Vulnerable Adult who should be provided with an Appropriate Adult when cautioned.
3.4 In 2007 the DWP launched a pilot to test the effectiveness of Voice Risk Analysis (VRA) technology in detecting benefit claimants who might be subject to a more through assessment of their claim. When a person calls to make a benefit claim VRA monitors a person's voice during the call. A baseline tone is established and any deviation from that as the call progresses is taken to indicate that the caller might in some way be suspect. Mind raised concerns about this as people with mental health problems will often be anxious and even more so when in contact with their local authority or JCP, so their tone may fluctuate in a way that might be assessed as being suspicious. Mind argued that the DWP had a duty
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Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205 to carry out a disability impact assessment of the proposals being piloted but this never happened.
3.5 In May 2008 the DWP announced that there will be funding for a further 15 local authority pilot projects to test the VRA technology. In December 2008 the Government announced that its intention to implement this technology nationwide.
Mind is calling for the DWP to carry out a disability impact assessment of the proposals before the technology is fully
implemented.
4. Disabled People and the right to control
4.1 Mind supports the Government's proposals to introduce a right to control in employment support services. Pilots in social care have shown that personalisation can improve outcomes for people with mental health problems and that direct payments are cost-effective. However, too few people with mental health problems receive direct payments and individual budgets in social care. A continuing lack of support for those who do means that for many people taking control can seem like a daunting prospect.
Mind is calling for the Government to show strong leadership to local authorities piloting the right to control, and introduce a range of supports for those offered direct payments, if this right is to become a reality.
4.2 The aim of the right to control is to give disabled people greater choice in relation to, and greater control over, the way in which relevant services (as defined by Clause 29) are provided to or for them. Mind is therefore disappointed that community care services are to be excluded. A survey carried out by Mind in 2008 highlighted that people with mental health needs find the division between social care services and health services, and the division between social care and employment services, an arbitrary one.
4.3 Recovery from a mental health problem can and often should involve a complex range of interventions to alleviate symptoms, tackle social exclusion, and support people into suitable and sustainable employment. It can be frustrating and unhelpful to need to undergo different assessments, meet different eligibility criteria, and access services in different ways when seeking support from health, social care and employment services. Introducing a right to control in the Welfare Reform Bill offers Government the opportunity to streamline independent living support, by eradicating unnecessary barriers between social care and employment support funding streams and allowing both to be provided through a single direct payment.
Mind is tabling an amendment to include community care budgets within the scope of DWP direct payments. Mind is seeking to encourage debate on whether the Government can align the budgets, rather than reproduce in a new system the existing bureaucratic barriers to support.
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Contact: Max Wind-Cowie, Parliamentary Officer, 020 8215 2287
Emma Mamo, Senior Policy and Campaigns Officer, 020 8215 2205
4.4 Mind accepts that local authorities need to ensure that the introduction of direct payments does not leave them out of pocket, at a time when budgets are being squeezed. However, the current safeguard in the Bill, which allows authorities to decide not to introduce direct payments where it is not cost-effective, provides too big a loop-hole for local authorities who are unconvinced of their benefits. Setting up direct payments will involve start up costs, and potentially some initial increased investment for each individual, but these costs may well be balanced out by the savings made by the success of direct payments, in terms of increased engagement with services, improved wellbeing and as a result, greater numbers of people successfully returning to work.
Mind is seeking an amendment to ensure that local authorities make decisions based on long-term cost/benefit analysis, rather than short-term outlay.
4.5 The Bill provides for mandatory „work for your benefit‟ programmes to be piloted for long term jobseekers through Clause 1. The aim of these programmes is to help people who have been out of work for a long time to learn or regain work habits and routines. The DWP have acknowledged that many people will face significant barriers to work and it is envisaged that they will provide support to address these barriers alongside full-time work-related activity. The DWP have also stated that the possibility of attending mandatory full-time activity will act as an effective deterrent for those who may be „playing the system‟.
4.6 It is difficult to know how these programmes will impact on people with mental health problems. It is likely that the number of people with a mental health problem currently claiming JSA is relatively small, although accurate figures are not available for this group. However, given the tightening of the assessment process and the removal of the „exempt group‟ – which currently means that many people with a mental health problem are exempt from the current Personal Capability Assessment (PCA) – it is likely that there will be an increase in the number of people with a mental health problem claiming JSA. It is therefore essential that the arrangements under JSA take into account the needs of people with a mental health problem.
Mind is calling for rigorous monitoring of the work capability assessment (WCA) by impairment group in order to accurately track the impact of the assessment on people with a mental health problem specifically and to establish numbers moving onto JSA or ESA.
“It will force those that are maybe not well enough to work full time into participating in an activity that may be detrimental to their wellbeing.”
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