A reply to Matt on welfare by Lib Dem ministers Norman Lamb and Steve Webb: “We believe in standing up for the vulnerable”

This week, Lib Dem Voice published a deeply personal account by one of our readers, Matt: I need the Liberal Democrats to stand up for me when Conservative ministers denigrate me. It was read by many in the party, including two Lib Dem ministers in the Coalition — Norman Lamb MP (Department of Health) and Steve Webb MP (Department for Work and Pensions) — who have co-authored the following response.

lamb and webb

When we read the article posted on Lib Dem Voice on Wednesday by Matt, setting out very personally the distressing and painful experiences he has faced over the past few years in trying to access the welfare and health support he needs, we felt it was important that we respond properly to what he had said.

As Liberal Democrats, we instinctively understand that divisive rhetoric is both unhelpful and inaccurate, and for both of these reasons we should all remain constantly vigilant in challenging those who use this type of language to denigrate any member of our society. We believe in standing up for the vulnerable and providing support to those who are facing personal difficulties in their lives.

The issue of assessment for people with mental health conditions in particular needs to be examined. Matt quite rightly points out that the current Work Capability Assessment focuses strongly on an individual’s physical capabilities and not on their mental health or other extenuating circumstances. The ultimate decision on whether a person’s application is successful, however, is taken by a decision maker within the Department for Work and Pensions, who should take into account other supporting evidence and not base this decision solely on the outcomes of the Atos assessment. It is clear, however, that for people with mental health conditions which affect their ability to work, there are still many problems with the process. 38% of appeals against the current decision-making regime are upheld – all at great cost to the taxpayer, as well as causing distress for people like Matt.

We’ve got to get the process right of how we assess people’s need for support. For example, could we look at working with NHS providers to develop more personal tests to get people a fairer assessment and reduce the costly process of these decisions being overturned in the courts? This could make a particular difference for those with mental health conditions, which can often be difficult to diagnose in a short assessment, and which the current assessment system sometimes misses completely.

Once people’s needs have been assessed, we then need to work much more effectively to support them into work. We should reform the Work Programme so that it makes good use of disability charities and other specialist organisations – including in the health and care sector – to provide support that is tailored to the needs of individuals.

At the same time, Norman has been working at the Department of Health to promote better integration within the health and care sector – launching a programme of “integration pioneers” to showcase and develop best practice between health and care sector and between physical health and mental health, and the recent Spending Review announced £3.8bn of funding which will go to support organisations that are working in more integrated ways. Integrated working will allow care and therapies to be built around the needs – and, crucially, the wishes – of individual patients. Rather than treating people who are unwell as a burden on the state, we must concentrate on enabling them, identifying their strengths and ambitions and providing support aimed at allowing them to live fulfilled lives.

As well as providing more joined-up care, we also need to make the NHS take mental health more seriously. Last year, the first NHS Mandate was published, setting out in writing the Government’s objectives for our health and care system. Thanks to Norman and Paul Burstow, it included a specific statement that mental health must be given equal importance with physical health conditions. Norman is currently working to ensure there are maximum waiting times for mental health therapies in the same way that there already are for physical health treatments, and this Government has also expanded the Improving Access to Psychological Therapies (IAPT) programme. We are also working to improve access to crisis mental health care, and further plans will be announced shortly.

It should be the goal of all Liberal Democrats to create a society where Matt, and the many other people who need our help, can get the support they need from our welfare and health systems without having to constantly fight for it. We are a long way from achieving this, but we are moving in the right direction.

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12 Comments

  • mike cobley 6th Oct '13 - 9:14am

    Interesting response. The 3rd paragraph begins “We’ve got to get the process right of how we assess people’s need for support.” – but the Work Capability Assessment by definition is not focussed on supporting disabled claimants but on determining fitness for work (at least on the surface of it). Clearly there is a serious debate to be had on the purpose of a benefit system in the modern age, whether it is intended to provide for claimants basic living standards or whether its aim is to abrogate a claimant’s right to self-esteem and self-determination through coerced compliance with a range of behaviours and activities.

    Under the Tory-led Coalition the latter doctrine is clearly in the ascendancy, most starkly illustrated by the DWP whose leading minister has not the slightest compunction in giving claimant’s labour away to commercial interests for free.

    But it is the matter of the treatment of disabled claimants which is most pressing – and the brutish, mechanistic character of assessments dispel any notion that compassion for the disabled played any part in the design of the process, or indeed that it is a priority for those scrutinising applicants. The stress, trauma, pain and despair directly caused by this system is a damning indictment – and we as a party should have no part in it. End of.

  • Robert Wootton 6th Oct '13 - 9:48am

    “Last year, the first NHS Mandate was published, setting out in writing the Government’s objectives for our health and care system. Thanks to Norman and Paul Burstow, it included a specific statement that mental health must be given equal importance with physical health conditions.”
    The government’s objectives for our health and care system? What are the doctor’s, nurse’s and patient’s objectives for our health and care system? Surely these are more important considerations than the government’s objectives, which usually includes cutting costs.
    At present the government is spending £400m to save £2m pa which is the government’s figure for fraudulent benefit claims.

  • ” challenging those who use this type of language to denigrate any member of our society”

    Please give us some examples of publicly challenging the very public Tory rhetoric…. If you are openly challenging them this is not being adequately reported. We have a constant barrage of Tories making out all those on benefits are scroungers – where are the equally numerous and rigorous responses ?

    Also, you are now three and a half years into this government, even taking into account the slow nature of change that should have been ample time to have changed the decision making pathway for mental health conditions.

  • Melanie Harvey 6th Oct '13 - 12:47pm

    Sadly the *vulnerable* also translates to *exploited* .

  • I would like to take the opportunity to thank the Liberal Democrat Ministers Steve Webb & Norma Lamb for responding to my article
    I never expected that my article would reach the eyes and ears of the Liberal Democrat Ministers.
    I am most grateful for their responses, as I am sure many people like me will be also.

    I was relieved to read that they agreed that the divisive rhetoric used by the Conservative Ministers is most unhelpful and inaccurate and Liberal Democrats should challenge those who use this language.

    I welcome the acknowledgements from the Ministers that the current system for testing people for benefits {especially those with mental health} through the WCA test carried out by ATOS is not working and 38% of those who appeal these decisions have them overturned.
    I think the suggestion of maybe looking at working with NHS providers to develop more personal tests to get people a fairer assessment is a great idea. The current LIMA (Logic Integrated Medical Assessment) software system that was developed and is used by Atos is not fit for purpose, especially when assessing the needs and capabilities of people with mental health disabilities.
    I would also like to politely point the Ministers to the Governments own statistics published here https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207857/tribunal-stats-q4-2013.pdf by the Tribunals Statistics Quarterly January to March 2013

    Social Security and Child Support (Tables 2.6 and 2.7)
    Of the 130,517 SSCS cases disposed of in January to March 2013;
    63% were for ESA;
    16 % for Disability Living Allowance
    10% t for JSA.
    The number of disposals for some benefit types have decreased between
    2011/12 and 2012/13.
    For example Incapacity Benefit has shown a decrease of 92 per cent as it is replaced by ESA.
    The number of disposals for ESA increased 31 per cent and those for Pension Credit by 29 per cent.
    Between January and March 2013, 80 per cent of all cases were cleared
    at a hearing, the same proportion as the previous year.
    Of these, 39% were found to be a decision in favour. This means the original decision is revised in favour of the customer.
    This proportion varied by benefit type with
    20% of JSA cases,
    41% of Disability Living Allowance
    43% of ESA cases
    Cleared at hearing having the original decision revised in favour of the customer.

    43% of decisions made by ATOS and the DWP for Employment and Support Allowance are being turned over the by the tribunals in the claimants favor.
    This amounts to a shocking failure on the part of Atos and the DWP. I don’t think any other “private company” which had this level of failings in any other industry would be able to survive.

    I also think Ministers could look at the possibility of introducing a “tell us once” policy for those that are severely disabled and in the (Support Group) of Employment and Support Allowance and for DLA/PIP.
    I recognize that the government needs to reassess peoples disabilities, but the people who are in these groups do have very serious and debilitating illness, surely when the DWP does need to reassess these people, a much fairer and supportive way of doing this would be for the DWP to first contact that persons health care professionals for an update on their disability and how this is affecting them. Doing this would save a lot of stress on the most vulnerable claimants and prevent them from having to go through the ordeal of more form filling and unnecessary medicals.

    I welcome the Ministers comments on better funding for the NHS and Mental Health Care. I also welcome the comments “launching a program of “integration pioneers” to showcase and develop best practice between health and care sector and between physical health and mental health,”
    I hope this would include more communication between a patients GP and therapists. I think it is vitally important that a GP is kept updated with how his/her patient is progressing, but more importantly, they should know the kind of difficulties that their patient has on a day to day basis which would greatly assist with their treatment.

    Thanks again to the Minsters for their responses, Thank you To LDV and Caron Lindsay especially and a big thank you to all of you who have been commenting and bringing this to peoples attention

  • “The ultimate decision on whether a person’s application is successful, however, is taken by a decision maker within the Department for Work and Pensions, who should take into account other supporting evidence and not base this decision solely on the outcomes of the Atos assessment”

    Am I to take it that our ministers actually believe this happens?

    This was theoretically the case when I worked for Citizen’s Advice Bureau before my daughter was born, and she’s ten now. The DWP (DHSS/DSS/whatever) decision maker only EVER rubber stamped the assessment by the Doctor (as it was then) or ATOS monkey (as it is now) because the ridiculous volume of cases they are expected to get through means that they can do little else. Until we are actually prepared to pay for people to take the necessary time over these decisions, and for the assessments to be done by actual doctors and not as a box-ticking exercise by a profit-making company who is determined to rake as much money in as possible from the taxpayer, this situation is not going to get better.

    Of course, this will never happen because the very idea of spending a reasonable amount of money on the decision makers so these decisions can be made properly in the first place, therefore SAVING money in the long run due to a massive fall in appeals, is far too complicated for the likes of the Daily Mail and their increasingly belligerent readers to get their tiny little minds around.

    Perish the thought that if someone is disabled their OWN doctor might be able to issue a certificate…

    This whole system is, and always has been, about demonising the poor and the disabled to give a sop to the right wing voters who bay about scroungers and shirkers. It stinks to high heaven.

  • James Sandbach 6th Oct '13 - 7:47pm

    There is no doubt from their post that Steve and Norman do care and ‘get it’ as to just how bad the assessment process and onward decision-making is and the impact this has. I work on policy for Citizens Advice and the hardest and most heart-wrenching part of my job is sifting through the thousands and thousands of disability benefit cases bureaux deal with in which claimants have been humiliated, treated inappropriately, and denied support where any by sensible standard it is impossible to overcome such serious disabilities (physical and mental) and be fit for work – real life does not work like a tick-box.

    But my question is what are our Ministers actually doing about it other than acknowledging the concerns – they have been in their posts for over 3 years over which period the system has got a whole lot worse, appeals have rocketed and some claimants have been put through some much distress that there are even reported cases of suicide. My organisation have other similar advocacy bodies have routinely presented our evidence to DWP in lots of different forms and ways but are always dismissed. Nothing has been done by our party in Government to follow up George Potter’s motions in 2011 and 2012 – the vast majority of ESA claimants with the most serious disabilities and health conditions (cancers, parkinsons, motor-neurone, lifelong serious learning disabilities) are pushed into the wrag (work related activity group – which assumes quick integration into labour market) in which the allowance paid and support to get any viable work is limited to a year only (even though it’s a ‘contributory’ benefit) – endless re-assessments and appeals take place which cost the state for its poor policy and decision-making…I could go on, but an assessment process that actually makes people more ill cannot be right in principle or practice.

    I appreciate Steve and Norman’s post but I’d rather see action, not words..

  • Martin Caffrey 7th Oct '13 - 3:24am

    I have the Limited capability for work questionnaire in front of me. On page nine it asks if you can pick up a pint of milk and a large light object like an empty cardboard box. So unless you are a quadriplegic, you will probably be classed as fit for work.

    What if in an accident you fracture three vertebrae, damage your sciatic nerve and go through the car windscreen? You may well be in constant pain but able to pick up a pint of milk. But you can’t drive, sit down or stand up for any length of time or operate machinery because the medication you are on make you ‘sluggish’ and a danger to yourself and others?

    The WCA is a not fit for purpose and the politicians know it.

  • Chris Randall 7th Oct '13 - 9:06am

    I find this distressing you may recognise the denigration of individuals and may speak out can I suggest you turn the volume up by a margin from a whisper then, I won’t say anymore because most of it has been said but let me say when you are being investigated for cancer and other illnesses where you end up with using the toilet for 24 hrs a day having some nurse (qualified professional) say really nothing wrong and the so called DWP decision maker hidden 100 miles away where you can’t get hold of them so much for clarity and transperancy. The only answer is to appeal, I have been given to understand that because so many of us won our appeals that right has been stolen from us by this Tory based government.

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