House of Commons Work and Pensions Committee

Government support towards the additional living costs of workingage disabled people: Government Response to the Committee's Seventh Report of Session 201012
First Special Report of Session 2012 13
Ordered by the House of Commons to be printed 16 May 2012

HC 105
Published on 18 May 2012 by authority of the House of Commons London: The Stationery Office Limited 0.00

The Work and Pensions Committee

The Work and Pensions Committee is appointed by the House of Commons to examine the expenditure, administration, and policy of the Department for Work and Pensions and its associated public bodies. Current membership Dame Anne Begg MP (Labour, Aberdeen South) (Chair) Debbie Abrahams MP (Labour, Oldham East and Saddleworth) Harriett Baldwin MP (Conservative, West Worcestershire) Andrew Bingham MP (Conservative, High Peak) Karen Bradley MP (Conservative, Staffordshire Moorlands) Sheila Gilmore MP (Labour, Edinburgh East) Mr Oliver Heald MP (Conservative, North East Hertfordshire) Glenda Jackson MP (Labour, Hampstead and Kilburn) Brandon Lewis MP (Conservative, Great Yarmouth) Stephen Lloyd MP (Liberal Democrat, Eastbourne) Teresa Pearce MP (Labour, Erith and Thamesmead) The following Members were also members of the Committee during the Parliament: Ms Karen Buck MP (Labour, Westminster North), Alex Cunningham MP (Labour, Stockton North), Margaret Curran MP (Labour, Glasgow East), Richard Graham MP (Conservative, Gloucester), Kate Green MP (Labour, Stretford and Urmston), Sajid Javid MP (Conservative, Bromsgrove) and Shabana Mahmood MP (Labour, Birmingham, Ladywood) Powers The Committee is one of the departmental select committees, the powers of which are set out in House of Commons Standing Orders, principally in SO No 152. These are available on the internet via www.parliament.uk Publications The Reports and evidence of the Committee are published by The Stationery Office by Order of the House. All publications of the Committee (including press notices) are on the internet at www.parliament.uk/workpencom The Reports of the Committee, the formal minutes relating to that report, oral evidence taken and some or all written evidence are available in a printed volume. Committee staff The current staff of the Committee are Carol Oxborough (Clerk), Catherine Tyack (Second Clerk), James Abbott (Committee Media Adviser), James Clarke (Inquiry Manager), Emma Sawyer (Senior Committee Assistant), Hannah Beattie (Committee Assistant). Contacts All correspondence should be addressed to the Clerk of the Work and Pensions Committee, House of Commons, 7 Millbank, London SW1P 3JA. The telephone number for general enquiries is 020 7219 2839; the Committee's email address is workpencom@parliament.uk

First Special Report

On 19 February 2012 the Work and Pensions Committee published its Seventh Report of Session 201012, Government support towards the additional living costs of working-age disabled people, HC 1493. On 10 May 2012 we received the Governments Response to the Report. It is reproduced as an Appendix to this Special Report. In the Government Response, the Committees conclusions and recommendations are in bold text. The Governments response is in plain text.

Appendix: Government response

Introduction
1. The Government welcomes the Seventh Report of the Work and Pensions Select Committee on support towards the additional living costs of working-age disabled people and in particular the Committees endorsement of the need for reform of Disability Living Allowance (DLA).1 2. As the Committee recognise, DLA is a benefit that is based on unclear criteria, is not well understood and with no proper system of reviewing awards. The 2004/2005 National Benefit Review found that around 630m of DLA a year is overpaid as a result of unreported changes in circumstances, whilst 190m is underpaid. 2 This is vital support that is not reaching the people to which it was intended. The introduction of Personal Independence Payment will ensure that the Government can continue to support those individuals experiencing the greatest barriers to living an independent life, while ensuring that the benefit continues to remain affordable and sustainable in the future. 3. The new Personal Independence Payment assessment has been developed in conjunction with a group of independent health, social care and disability experts and will be fairer, more objective and consistent. There will be a more responsive and individualised process for ensuring that claimants continue to receive the right level of support and the Department will work to ensure that public awareness of the benefit and the process for making a claim are improved. 4. The Government recognises that further work is required before Personal Independence Payment is introduced in April 2013 and is grateful to the Committee and witnesses for their insight during the evidence sessions, as well as the conclusions and recommendations contained in their report. The Department is continuing to work with stakeholders and experts in developing the way in which the new benefit is delivered and administered. A 15 week consultation on the assessment thresholds recently closed on 30 April.3 In addition, on 26 March, the Department published the consultation document Personal
1 2 3 Work and Pensions Select Committee, Government support towards the additional living costs of working-age disabled people HC (2010 12) 1493 Fraud, error and other incorrectness in Disability Living Allowance: The results of the Benefit Review of Disability Living Allowance, 2005 http://www.dwp.gov.uk/docs/pip-assessment-thresholds-and-consultation.pdf

Independence Payment: completing the detailed design on the proposed rules intended to underpin the new benefit. 4 This consultation will close on 30 June. The Department will consider the feedback received and plan to publish formal responses to both consultations later in the year. The Government will continue to provide further information on processes as it is developed and when appropriate.

Conclusions and Recommendations

[Paragraph 8] As we have taken the relatively unusual step of conducting our inquiry while parliamentary scrutiny of the relevant Bill was under way, we trust that the Government will take our conclusions and recommendations into account in its formal consultation on the revised assessment criteria announced in January and then in drafting the relevant Regulations, which will set out the detailed structure and rules for PIP. The Department can assure the Committee that all conclusions and recommendations made in the report will be carefully considered alongside all other responses received during the consultation on the assessment criteria and the consultation on completing the detailed design. There has been significant interest in the consultation on the assessment criteria and various meetings were arranged with stakeholders to discuss the consultation document, seek views, answer questions and gather feedback. The consultation closed on 30 April. The Government is considering the responses received and aims to publish its formal response later in year in line with normal consultation guidance. The Department has published a consultation on the detailed rules that will underpin Personal Independence Payment which will run until 30 June. Officials will meet and discuss the proposals with stakeholders throughout the consultation period. This will include engagement with the Personal Independence Payment Implementation Development Group.

Policy objectives
[Paragraph 42] We accept the argument that DLA requires reform. There is some evidence that the benefit has insufficiently clear criteria and is not always well understood. The complex claim form can also make it difficult for people to make a claim. We therefore support the Government's intention to address these issues. [Paragraph 43] There is not a proper system for reviewing DLA awards: 24% of working-age DLA claimants have either had no change in or no review of their award for over a decade. While official fraud and error levels are comparatively low, there is evidence that around 11% of awards may be overpaid due to changes so gradual over time that claimants could not be expected to report a change in circumstances. We accept that there needs to be an appropriate, consistent and clear system for reviewing awards.

http://www.dwp.gov.uk/docs/pip-detailed-design-consultation.pdf

[Paragraph 44] Some witnesses believed that the necessary changes could have been made within the existing DLA structure. The Government's view is that this would have required changes to primary legislation and that there are advantages to a "fresh start". We agree that introducing a new benefit under a new legislative framework could offer the opportunity to improve support for disabled people while addressing the problems with DLA which the Government has identified. However, we believe the starting-point for reform should be to design a new benefit which meets its objectives in recognising the additional costs which disabled people incur. It is unfortunate that a background of budget cuts has created unnecessarily high levels of anxiety about this reform amongst DLA recipients. Following the publication of the Committees report, the Welfare Reform Bill received Royal Assent on 8 March. The Government welcomes the acknowledgment from all sides of the House and the Committee that Disability Living Allowance (DLA) is a benefit that is in need of reform and that introducing a new benefit is the right approach. Reform of the welfare system has traditionally been piecemeal, resulting in a confusing array of additions and exceptions bolted on to an outmoded system. Currently, the entitlement criteria for DLA are set out in primary legislation, have restrictive definitions and provide insufficient flexibility to make change. This inflexibility was demonstrated when the mobility component of DLA was extended to severely visually impaired people the change only coming about as a result of amendments made to both primary and secondary legislation. The systems of administration behind DLA are outdated. The IT system is outdated, claims involve large amounts of paper and administrative processes are labour intensive. There are also no systematic processes in place for ensuring that awards remain correct. Improving the processes for delivering the benefit will help drive efficiencies as well as improve accessibility and claimant experience. These reforms present an ideal opportunity to start afresh, keeping the best elements of DLA that disabled people value, but bringing the benefit up-to-date in order to better reflect 21st century society. The Department would like to assure Committee members that the starting-point for reforms has always been to design a benefit which meets its objectives in recognising the additional costs arising from the impact of a health condition or disability. Like DLA, Personal Independence Payment is designed to make a contribution towards the extra costs that disabled people face. However, it would not be feasible to measure the actual costs that individual disabled people incur. Such an approach would result in a subjective, inconsistent, complicated and lengthy assessment. Instead the Department intends to consider a proxy for these extra costs. DLA uses individuals care and mobility needs as this proxy. With Personal Independence Payment the Department is considering an individuals ability to participate in society. It believes that this is a reasonable proxy for the extra costs caused by disability and the impact of impairments, allowing it to focus resources on those with the greatest need. [Paragraph 45] We are also concerned that the Government is basing its assumptions for the scope for reducing working-age caseload on the fact that there was growth of 29% in total DLA expenditure between 2002-03 and 2010-11. It is important to bear in mind that a substantial part of this growth arises from demographic change, including

the increase in the number of people over state pension age who retain their DLA. PIP will only apply to working-age claimants, where growth is closer to 16% after taking account of demographic changes. We would welcome clarification from the Government on how these statistics can be reconciled with the savings assumption, in response to this Report. The Department has acknowledged the role of demographics in the growth of the DLA caseload in its statistical publications.5 As the evidence presented to the Committee made clear, around one third of the caseload growth can be directly attributed to demographics. The remainder is driven by growth in receipt per head. The assumption of 20% expenditure savings from the working-age part of the DLA caseload was set as a high level assumption in 2010, when the reform was first announced. Since then the Department has undertaken further design work and is currently consulting on its assessment criteria and the detailed policy that will underpin primary legislation. More detailed and updated expenditure savings figures will be provided when benefit rates are announced in due course and the design of Personal Independence Payment is more advanced.

Media coverage
[Paragraph 53] The Government's view seems to be that the negative tone of press coverage of benefit claimants is unsurprising since it merely reflects the public mood about the integrity of the benefits system. However, the Government should not ignore the fact that public opinion can also be positively influenced by the media and we believe it should take the necessary steps to ensure that its own contribution to media stories about benefits is accurate and contextualised. [Paragraph 54] While we accept that the Government does not control the editorial line taken by the media, we believe it should actively encourage accurate reporting of its own statistics on benefits. Direct quotations from Ministers can give undue credence to inaccurate or misleading reports. We recommend that DWP establishes internal protocols to ensure that significant statistical releases are accompanied by a press release setting out the context and providing background explanatory notes, together with quotations from Ministers where appropriate. The Department is absolutely committed to supporting disabled people to live full, active and independent lives and whilst laws are in place to ensure equality, the Department recognises the need to work together and do more to challenge and change negative attitudes towards disabled people. That is why it is in the process of developing a new cross-government disability strategy to give renewed impetus to the Governments commitment to disability equality. One of the key areas that this strategy will look at is changing attitudes and behaviour promoting positive attitudes and behaviours towards disabled people to enable them to
5 http://statistics.dwp.gov.uk/asd/asd1/adhoc_analysis/2011/dla_growth_in_caseload.pdf

participate in community life and wider society, tackling discrimination and harassment wherever they occur. The Department is also developing a case study approach to illustrate the contribution disabled people make to society through, for example, work and volunteering. The aim is to provide a more coherent and consistent story about disability, by working closely with employers and other stakeholders to provide positive images to counter negative reports and help influence public perceptions in the long term. Recent examples include features in two of the biggest selling national newspapers on Access to Work with case studies of disabled people in mainstream employment, placed by the Departments press office. In addition to this, the Minister for Disabled People writes regular features in two of the major disability magazines recent articles include subjects on Disability Hate Crime and reforms of Disability Living Allowance. The Department has a robust process for releasing new statistics into the public domain which conform with the Code of Practice for Official Statistics. Each new set of statistics is accompanied by a published ad hoc statistical note which is quality assured by a senior statistician. These notes set out background and context for the new information in an impartial manner. As there are a large number of DWP analytical and statistical publications every year, it would not be appropriate or proportionate to issue a press release for every one. Following assessments by the UK Statistics Authority, the amount of commentary accompanying our National Statistics is being increased to help users better to understand and interpret the statistics. Furthermore, benefit statistics are freely available for everyone to access on our website.6 Our press office operates a 24/7 service so there is always someone available to help explain the statistics to journalists and help ensure accurate reporting. The Department is also in regular dialogue with journalists to correct inaccurate reporting. [Paragraph 58] We look forward to the publication of the new UK Disability Strategy. It provides an opportunity to address the apparent growth in negative perceptions about disability. We recommend that it contains proposals to tackle negative reporting of disability in the media and a Government strategy to get the message across that disabled people can and do make a positive contribution to society, very often as taxpayers. The Government recognises that promoting positive attitudes and behaviours towards disabled people is vital to ensuring disabled people are able to participate more fully in community life and wider society. This is something the Government will seek to drive through a new cross-government disability strategy which we aim to publish in late spring or early summer. In addition, on 14 March the Government launched Challenge it, report it, stop it, a new action plan for tackling hate crime. This includes actions to challenge the attitudes and behaviours that drive hate crime against disabled people.

http://www.dwp.gov.uk/

Communication and consultation

[Paragraph 63] The Chancellor of the Exchequer's announcement of the intention to reform DLA made the Government's communications task a difficult one. This difficult beginning was compounded by the poor initial consultation on the Green Paper which was not only shorter than recommended by the Government's own Code of Practice on Consultation but also took place over the Christmas period. The Bill was published before the consultation period ended, and well before the responses could be analysed. The Government's published response appeared not to reflect the full extent of respondents' concerns, and the full responses were not published. The Governments Code of Practice on Consultation recommends a minimum 12-week consultation period for public consultations, unless there are good reasons for a limited consultation period. While the Department fully aspires to the Government Code of Practice on Consultation and recognises that a 12 week consultation would have been preferable, it was felt that a 10 week consultation period on Disability Living Allowance (DLA) reform was adequate in this instance.7 The consultation itself was limited to general principles of reform only and was preceded by extensive engagement with a wide range of stakeholders and disabled people. The Department was clear from the outset that responses would be used to inform secondary legislation on the detailed design of the benefit. The Department has committed to publishing a full set of responses to the DLA reform consultation, including those from organisations and individuals, after taking steps to anonymise and redact any sections that may compromise personal data. The Department intends to begin publication within 6 months and to complete the process by the end of the year. Since the Government published its response to the DLA reform consultation in April 2011 it has continued to engage with disabled people and their representatives to ensure that they have the opportunity to collaborate on the development of the detailed design of the new benefit. A 16 week informal consultation on the initial draft of the assessment criteria carried out over the summer of 2011 has been followed by a formal 15 week consultation on the second draft that started on 16 January and closed on 30 April. Since the Committees report was published, the Government has begun a further consultation on the detailed design of Personal Independence Payment. This will run for longer than the normal 12 weeks and will close on 30 June. [Paragraph 64] Since then, DWP has taken steps to involve disabled people in the process for devising and implementing PIP and this has proved to be effective to some extent. The Department has listened to many concerns: it dropped the proposals to end payment of the DLA mobility component for care home residents after the Low Review and to extend the three-month qualifying period under DLA to six months under PIP. It is important that DWP now puts even more effort into engaging disabled people in the introduction of PIP and that it clearly demonstrates the extent to which it has responded to their legitimate concerns.

The consultation period ran from 6 December 2010 and closed on 18 February 2011.

The Government welcomes the Committees recognition of the steps it has taken to involve disabled people in developing Personal Independence Payment and the way it has listened to and acted upon concerns. In addition to the work carried out prior to and during the consultation on DLA reform, the Department has continued to engage extensively with organisations that represent disabled people through its Implementation Development Group since May 2011. This group has over 50 members that represent a broad range of national and local disability organisations. This work will continue throughout 2012 as design of the benefit and implementation arrangements are finalised. This includes testing claimant notifications, such as assessment invitations or award notifications that will be being sent to claimants to ensure that they are clear and easy to understand. The Department has contracted an independent contractor (IFF Research) to undertake research with disabled people to help inform the design of Personal Independence Payment and to ensure that products, such as claimant notifications, and processes work effectively. 1,000 disabled people have been recruited to take part in regular focus group sessions and interviews throughout the design of the new benefit. The Department has undertaken this research in order to gather views from disabled people on how Personal Independence Payment should be designed. This has provided an opportunity to test versions of the first part of the claims process and discuss how current DLA claimants should go through the reassessment process. This research and testing will continue as Personal Independence Payment is developed in advance of its introduction in April 2013. The Department is committed to working with a broader range of disabled peoples user led organisations and local disability organisations throughout 2012 and beyond. Work is progressing on a number of fronts to involve them in delivery of the new benefit, with a particular focus on how they can help ensure that the Department reaches those claimants who may need additional help to find out about Personal Independence Payment and who may need specific support through the new claims or reassessment process. The Department will engage with these organisations to involve them in early implementation lessons learned from April 2013 and during initial reassessment activity from October 2013. The intention is to involve them in ongoing and continuous activity for Personal Independence Payment including, for example, supporting and advising claimants, coproduction of claimant materials and independent reviews. This engagement at local and national level will ensure that the operational design, implementation and ongoing operation of Personal Independence Payment considers the informed perspectives of disabled people and their representative organisations.

Payment of DLA mobility component to care home residents

[Paragraph 71] We welcome the Government's decision not to proceed with its plans for withdrawal of the DLA mobility component from residents of publicly-funded care homes. We congratulate all involved in Lord Low of Dalstons review, which established a lack of evidence for the measure and a need for clear guidance to local authorities. We recommend that the Government now issues clear guidance about funding mobility needs and the role played by DLA and PIP mobility. We believe that this sequence of events clearly demonstrates the need for the Government to conduct thorough research, including detailed impact assessments, before the announcement of measures

that could have a negative impact on disabled people. However, we accept that the Government listened to the representations of those affected. The Government welcomed the input of Lord Lows Review as part of the wider debate around the provisions for mobility needs of those in residential care. Before making the announcement not to remove the mobility component of Disability Living Allowance and Personal Independence Payment, the Minister for Disabled People and officials met with disabled people and their representatives to listen to their concerns and gather further evidence. Officials from the Department of Health have met with the Low Review secretariat to discuss the recommendations and have agreed to consider improvements to the guidance provided to local authorities.

Assessment of the impacts of the introduction of PIP

[Paragraph 75] We believe that the Government cannot fully assess the potential knock-on impacts of DLA reform on other providers of services for disabled people. There is evidence to suggest that DLA plays an important role in helping recipients to manage their conditions, thereby reducing the need for other services. If a DLA recipient is found ineligible for PIP, yet still needs support, we would not agree with the Minister that there is already an adequate alternative package of support available to all current working-age recipients of DLA who may be affected by these reforms. [Paragraph 76] DLA is unique in providing a universal benefit specifically designed to contribute to the extra costs of disability. If it is removed from some claimants who still have these extra costs, they are very likely to need to draw on services provided by other public agencies. We recommend that the Government carry out more detailed assessment of the wider impacts of DLA reform and consult further with local authorities and the NHS on the implications for their provision of services for disabled people, now that the updated impact assessment has been published. The Government recognises the important role that Disability Living Allowance (DLA) plays in ensuring that claimants are able to live full, active and independent lives. The Department has been working closely with other Government departments and the Devolved Administrations to identify impacts that reforms may have in a wider sense to ensure disabled people continue to receive the support they need. Following the announcement of reforms to DLA, the Department set up a Cross-Whitehall group to consider issues arising from reforms as well as to provide a forum to oversee and contribute to policy, stakeholder engagement and the approach to communications. DLA is a non-means tested cash benefit which is designed to contribute to the extra costs of disability that claimants face and allow them to spend the money in a way that they choose. The Department does not currently monitor what claimants spend the benefit on and there are no plans to do this in the future under Personal Independence Payment. The Department will continue to work with the Department of Health and other Government departments to ensure that disabled people continue to have access to relevant support. Reforms will help to ensure that those claimants who face the greatest barriers to living full, active and independent lives continue to receive the right levels of support.

[Paragraph 93] DWP has described other organisations projections of the likely impact of DLA reform as simply speculation. However, accurate analysis by interested bodies has been extremely difficult and claims have been made devoid of any factual basis in the absence of DWP impact assessments. Until very recently, the information released by the Government included no estimate of the number of people likely to be affected or any scenario modelling to indicate the likely impacts on different groups. [Paragraph 94] The fact that Government information has been released at a late stage, and the consequent speculation by interested bodies, has also exacerbated public concern about the likely impacts of the introduction of PIP and worked against the Governments aim of reassuring disabled people that reform is intended to be a positive step for them. It is important that the Government and interested bodies learn from this. In future, major benefit reform proposals should be accompanied by detailed and comprehensive analysis of the likely impacts as soon as practicable. The Government recognises the importance of providing analysis of impacts of reforms and that this should be made available as soon as practicable. It is important that the Government strikes the right balance between consulting on the detail, developing policy collaboratively on an iterative basis and providing accurate information on the impacts at an appropriate point. The Department has published analysis at a number of stages throughout the policy development process on the reform of DLA and will continue to do so as new information becomes available. It is not yet possible to present analysis on all aspects of the possible impacts on disabled people because some decisions have yet to be made on the implementation of Personal Independence Payment. It is important that when analysis is reported to the public that it is based on the most accurate information possible, thoroughly checked and quality assured. As the Committee is aware, the Department has recently published new information on the likely impacts on carers and those in receipt of disability premia as part of their income-related benefits. 8 [Paragraph 95] We are unable to ascertain, from the latest figures released by DWP in January, from which DLA rate combinations the projected PIP caseload reduction of 500,000 claimants will come and therefore which current DLA recipients are likely to have their benefit withdrawn altogether. We recommend that, in its response to this Report, DWP sets out further case studies to show how the introduction of PIP is likely to affect current working-age recipients of each rate combination of DLA. In January, the Department published breakdowns of the combinations of Personal Independence Payment claimants were estimated to be on in 2015/16, including information on gender and age. As part of the consultation and policy development process the Department is continuing to refine these estimates. More details will be available when the rates of Personal Independence Payment are announced at the Autumn Statement later in the year.

http://www.dwp.gov.uk/policy/welfare-reform/legislation-and-key-documents/welfare-reform-bill-2011/impactassessments-and-equality/

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The Department has carefully considered the Committees request to set out further case studies. While it would be possible to produce additional case studies, the Department does not feel it would be helpful to provide case studies for each DLA rate combination along the lines that the Committee have requested. While case studies do provide a useful illustration of how the assessment criteria will work in practice, they cannot be representative of how particular groups of individuals will fare under Personal Independence Payment. This is because the assessment will look at individual circumstances and all disabled people are different. To show the likely effect of Personal Independence Payment on the current recipients of any particular DLA rate combination would require very significant volumes of case studies to be produced and would provide an inaccurate illustration of how the introduction of Personal Independence Payment is likely to affect current working-age recipients of DLA.

Qualifying period
[Paragraph 102] We welcome the Government's decision to support a three-month qualifying period for PIP rather than extend it to six months. However, there is evidence of significant financial hardship caused during the current three-month DLA qualifying period, particularly for those with sudden onset conditions such as the loss of limbs after a car accident. We see no reason why claimants with sudden onset conditions, which medical evidence can show to be likely to last at least 12 months, should not receive support immediately. We recommend that DWP implements a facility for early eligibility which could operate in the same way as that for terminal illnesses. The Government is grateful for the Committees support of its revised approach to the required period condition. The principal aim of extending the qualifying period from three to six months was to align the definition of long term disability with the Equality Act 2010. The Government did not expect this measure to provide any significant savings. As the Committee will be aware, the required period condition is intended to bring a principled approach to identifying, assessing and paying a valuable, cash benefit for long-term rather than short-term needs and when the financial costs become burdensome to all regardless of income. The Government has listened carefully to the arguments presented in support of those who suffer sudden onset conditions such as a stroke or traumatic injury. Whilst the immediate effects of such a sudden onset condition may be highly debilitating, the Departments view is that it is for the National Health Service (NHS) to provide support for in-patient care to stabilise, treat and rehabilitate the individual whilst their condition remains acute. Where their position is less acute, and treatment and rehabilitation can take place on an outpatient basis, a range of means-tested and non-means-tested support is in place to help people through some of the shorter-term burdens, both financial and practical. Support provided in these circumstances may include, but may not be limited to, statutory sick pay, healthcare travel costs, free prescriptions or aids and appliances provided by the NHS or the Local Authority. Individuals may also be entitled to a range of social security benefits and support depending on their circumstances and whether they are able to hold down a job during this period, including Employment and Support Allowance.

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The few months following a sudden onset condition or injury, and the treatment or rehabilitation someone has had or is having, provide vital evidence on which to determine whether someone will have long-term needs. This may not be clear in the more immediate term following onset. It is important to note that during this same period the qualifying period can also start to be satisfied; the qualifying period does not start from the date a claim is made. This means that for anyone requiring in-patient treatment following a sudden onset condition they will have begun, or may even have satisfied, the qualifying period by the time they are able to return home. The Government is therefore satisfied that the current arrangements for people with sudden onset conditions provide adequate support in the short-term before Personal Independence Payment may become payable. The Department has no plans to implement a facility for early entitlement to those with sudden onset conditions and will continue to monitor these arrangements.

The draft PIP eligibility criteria

[Paragraph 128] We welcome the changes made to the first draft of the PIP assessment criteria. We believe they demonstrate that the Government has listened to concerns expressed by disabled people and their representatives. DWP deserves credit for the way it has involved them in the "co-production" approach it has adopted to the development of the PIP criteria. [Paragraph 129] We fully support the Government's intention to ensure PIP is fairer, more consistent and takes a more holistic, "social model" account of the impacts of disability. One of the Government's declared aims for PIP is to improve on the assessment used for DLA. So far, mobility descriptors still concentrate heavily on ability to move a fixed distance and do not include barriers to accessing public transport, or the difficulties of some locations for individuals where routes to shops, public transport etc are particularly hilly or stepped. The PIP assessment criteria, as drafted, tend towards the medical model of disability. We recommend that, as part of the consultation with disability representative organisations on the second draft of the criteria now under way, the Government considers how activity descriptors could take account of the impact of such factors as housing, access to public transport and hilly locations. [Paragraph 130] We recommend that the Government undertakes a further trial of the assessment criteria once they have been revised following the consultation and that the results of the trial are published before the criteria are laid down in Regulations under the Welfare Reform Bill. The Department welcomes the Committees recognition of the process it has undertaken to ensure that disabled people have been involved in the development of the assessment and of the significant changes made to the second draft of the assessment criteria. Working with disabled people and their representatives has added real value to the development of the assessment and wider benefit proposals and will continue to do so. The Department has carefully considered whether the assessment criteria, including the mobility element, could be modified to focus more on social and environmental factors

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such as housing, access to transport and location. However, as set out in the explanatory note supporting the second draft of the assessment criteria, published in November 2011, it believes that doing so would create a more subjective and therefore inconsistent assessment.9 It would also create an assessment that delivers varied outcomes depending on location, which would be inconsistent with the universal nature of a national benefit. The Department continues to believe that the approach of focusing on assessing ability to carry out key everyday activities is the right one and will lead to effective prioritisation in the benefit based on individual barriers and need. The Department will, however, consider the wording of all descriptors in light of the ongoing consultation on the assessment and make any changes that are appropriate. As noted by the Committee, the Department has undertaken significant consultation, coproduction and testing as it has developed the assessment criteria. Should there be a need to carry out further testing as a result of any changes made following the consultation, the Department will ensure that this is done in full. However, it is not anticipated that further testing will be necessary due to the wide range of information gathered during the initial testing activity, where around 900 sample assessments were carried out in Great Britain. The information gained from the initial testing should allow the Department to re-model the impact of any amendments made to the assessment criteria and allow us to test whether the assessment is working effectively.

PIP eligibility assessment

[Paragraph 139] We were encouraged by the language used by the Minister in describing the PIP assessment as a conversation between claimant and assessor. It is vital that the PIP assessment does not take the same mechanistic approach, based on an inflexible computer system, originally adopted for the WCA in 2008. We believe that healthcare professionals administering the assessments should take an empathetic approach that allows claimants to describe the impacts of their disabilities or health conditions on their everyday lives. We recommend that DWP sets out this principle in the published guidance for healthcare professionals on the assessment process. This approach will have implications for the time allowed for face-to-face assessments, which in turn must be reflected in the contract arrangements with the third party providers of the assessments. We would seek assurances from the Government that this will be taken into account in the contracting process. The Department is absolutely committed to ensuring that the assessment and claims processes for Personal Independence Payment are empathetic and supportive of claimants, and give them the opportunity to tell their story and set out the impact their health conditions and disabilities have on their daily lives. It has learnt from the experience of delivering the Work Capability Assessment and from the recommendations of the Harrington reviews and is building these into the design of the new benefit. The face-to-face consultation, as part of the Personal Independence Payment assessment, is fully intended to be a two-way conversation between the claimant and the health professional, allowing a detailed exploration of how the claimants health condition or disabilities affect their day-to-day lives. The discussion at the consultations should not be
9 http://www.dwp.gov.uk/docs/pip-second-draft-assessment-criteria-note.pdf

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mechanistic and should be tailored to individuals. This is being clearly expressed to potential providers as part of the tendering for Personal Independence Payment assessment contracts and will be set out in detail in the supporting guidance for providers and their staff. The guidance will stress the importance of positive interaction throughout all aspects of the assessment. The contract will require assessors to have excellent interpersonal and communication skills, including the ability to interact with people sensitively and appropriately. The Department is not placing targets on the time required for face-to-face consultations and is making clear to potential providers that consultations will need to be as long as necessary to reach evidence-based conclusions on individual cases. [Paragraph 152] We agree with the Government that more reassessment of claims is necessary than has been the case with DLA. However, too frequent reassessment risks wasting public money and causing stress and anxiety to disabled people. The personal interview should play a part in assessing many PIP claimants. Face-to-face assessment should include the option for home visits where this is agreed to be appropriate. These steps may help to avoid cases going to appeal, with the accompanying costs and delays in resolving claims. [Paragraph 153] We consider that there is a case for automatic entitlement for some claims. The WCA is being carried out annually in a number of cases, which can cause considerable stress for some people. The case for annual assessment is less compelling for PIP than for WCA which is judging people's ability to re-enter employment. We recommend that there should be flexibility in the frequency of PIP reassessment and that the Government monitors the impact of this. The Governments intention has always been that entitlement to Personal Independence Payment will be based on the degree to which individuals are able to participate in society, not on their health condition or impairment. Health conditions and impairments, including degenerative ones, can affect people in a range of different ways. For this reason, decisions on award durations will be based on individual circumstances, following appropriate consideration of all the evidence that has been provided. Decisions on award durations will be taken by DWP Decision Makers following advice from trained health professionals. In some cases awards may be fixed for a short period of time such as one or two years. In others, longer term awards of five or 10 years may be more appropriate. It is anticipated that ongoing awards would be used in cases where changes in need, either positive or negative, are unlikely. This approach will help to ensure that claimants are not required to go through unnecessary or inappropriate assessments. It is important to ensure that claimants continue to receive the correct level of award and that Personal Independence Payment reflects changes in our society and advances in medicine or support, including treatments. There is a duty to both claimants and the taxpayer to ensure awards stay correct throughout. All Personal Independence Payment awards will therefore be reviewed at appropriate intervals. The frequency and format of reviews will vary depending on the individuals circumstances and the likelihood of the impact of their health condition or impairment changing. These reviews could involve gathering evidence from various sources, including self-report forms,

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information from relevant professionals who support the individual and face-to-face or telephone discussions. This will depend on the individual circumstances. The Government is committed to co-producing guidance with appropriate experts on the duration of an award of Personal Independence Payment, including the review frequency for awards. The Department welcomes the Committees endorsement that a face-to-face consultation should play a part in the assessment process. It considers that for most claimants these will be essential for gathering sufficient information about the impact of the claimants health conditions or disabilities on their life and how this will relate to their entitlement to the benefit. However, the Department intends to deliver the Personal Independence Payment assessment in a sensible and proportionate way. In some cases, such as an individual claiming under the terminal illness provisions, or where the Department has gathered enough evidence from the claimant and professionals involved in supporting them, a faceto-face consultation may not be necessary. The Department is not mandating where consultations should be carried out and it will be for potential Personal Independence Payment providers to develop proposals around this as part of their bids. The Department has asked providers to be innovative in their approaches and have set out clear requirements around accessibility of any consultation locations. The Department has also made clear that providers strategies must include provision for home visits where claimants are not able to attend other locations on the grounds of their health condition or disability. The final approach has not yet been decided and will depend in a large part on the proposals made by potential providers of Personal Independence Payment assessments.

Face-to-face assessments
[Paragraph 154] Once the initial assessments for PIP have been completed in the first geographical area, we recommend that the Government looks again at the value of faceto-face assessments for PIP claims where the condition is severe and unlikely to change. The Government should reconsider whether, in many cases, reliance on medical evidence gathered over a period of time and based on detailed knowledge of the claimant would have more validity than the snapshot of a claimant's condition and its impacts on their ability to participate in society which can be gained in a relatively short interview with a healthcare professional who is not an expert in their condition. As stated earlier in this response, the Department believes that face-to-face consultations with a trained health professional should be a key part of the Personal Independence Payment assessment process for most people, providing an invaluable means of exploring individuals circumstances and how health conditions and disabilities affect their everyday lives. The consultations are not intended to be snapshots and when carrying out assessments, assessors will consider the impact of impairments over a year-long period. Consultations are also only part of the evidence gathering process. Full consideration will also be given to information provided by claimants themselves and from professionals, including specialists, who have been involved in supporting them. Claimants will be encouraged to provide evidence they think helpful and to tell the Department which professionals are best placed to offer advice. This will ensure that assessments are fully

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evidence based. In some cases, where sufficient evidence already exists on which to carry out the assessment, face-to-face consultations will not be necessary. The Department will require that health professionals carrying out Personal Independence Payment assessments meet strict criteria around professional qualifications, experience and competence. Each assessor will need to be individually approved by the Department and any who do not meet these standards will not be. New claims to Personal Independence Payment will begin to be accepted at Bootle Benefit Centre from April 2013 in advance of full national roll out once the Department is satisfied that processes are working as intended. It is anticipated that this controlled start will generate around 5000 new claims per month which will be monitored and evaluated in a variety of ways to ensure the Department can identify and resolve problems in advance of national roll out in June 2013. The evaluation will include the collection of feedback from claimants, scrutiny of the Independent Assessor performance and monitoring of the new IT system being used to support the Personal Independence Payment process. Lessons will be learned from the controlled start evaluation and will provide a platform for continuous improvement for both claimants and operators when necessary. The Department will ensure that throughout the initial and ongoing implementation of Personal Independence Payment there will be continuous and thorough monitoring of all aspects of the claims process, including the assessment. Changes will be made where necessary. The operation of the Personal Independence Payment assessment will also be subject to two independent reviews, reporting to Parliament within two and four years of implementation.

Contracting
[Paragraph 159] We recommend that DWP contracts with private companies for delivery of the PIP assessment directly link the payment of public funds to the production of reliable assessment reports that are right first time. We welcome the framework approach which has now been adopted for benefit assessment contracts and request further details about how it will operate, in response to this Report. The Department will ensure that the need to produce high quality and consistent assessment outcomes is reflected in the ongoing work to develop the funding model and key performance indicators which will be used to monitor quality and performance and to pay for services from the suppliers of the Personal Independence Payment assessment. [Paragraph 160] Experience with the Work Capability Assessment has demonstrated the need for large Government contracts with private suppliers which involve sensitive health and disability assessments to be properly monitored. We therefore request further information on how the Government plans to oversee and regulate the contracts for the PIP assessments. We would also like to see the contractors communication with individuals who are deaf-blind reflecting their communication barriers. The Department fully recognises the need to ensure that the delivery of assessments by third-party suppliers are robustly monitored, that appropriate action is taken to improve performance and claimant experience where needed and that best practice is shared. The

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detailed proposals for ensuring the quality and consistency of assessments are still being developed. They are likely to include the quantitative analysis of management information provided by providers and qualitative audit of assessment reports. More information will be provided to the Committee when it is available. As the tendering process for the Personal Independence Payment assessment has not yet been finalised, the Department is not able to share specific details on contractor communications. However, the contractor must provide, on request, materials in alternative formats to meet the needs of claimants with a wide range of disabilities and health conditions in line with the Disability and Equality Act 2010. This must include, but is not limited to, the provision of large font material, Braille or audio format for visually impaired claimants.

Implementation of PIP
[Paragraph 165] The high number and cost of appeals in the original WCA process highlights the risk in introducing a new benefit assessment without full consultation and thorough testing. The challenge of accurately assessing DLA/PIP claims is arguably greater than incapacity benefit claims. The WCA simply assesses capacity to work. The PIP assessment will need to provide an accurate indication of the impact of complex conditions and combinations of conditions on participation in society in a variety of life contexts. It is therefore essential that DWP allows itself sufficient time to get the assessment right and to be able to convince disabled people and their representatives that this is the case. Implementation timescales should not be driven by artificial deadlines set by HM Treasury before the details of the reform were known. The Department has developed the assessment criteria in collaboration with a group of independent specialists in disability, health and social care, including representatives of disabled people. As referred to earlier, significant consultation, co-production and testing has already been carried out and this is ongoing, with the current consultation on the second draft assessment criteria running until April 30. The Department will carefully consider all of the responses received, alongside this report, before finalising the criteria and laying draft regulations before Parliament. Further testing may be carried out should it be needed. The Department is therefore confident that the assessment criteria will be working effectively prior to introduction in 2013. Meanwhile, the procurement processes to identify suppliers to deliver the Personal Independence Payment assessment has begun, with providers expected to be in place by the end of July 2012. The Department is again confident that there is sufficient time for providers to prepare for the implementation of the new benefit. The planning to ensure that the Department and in particular the Decision Makers, are ready and fully trained for Personal Independence Payment has already started. In addition, the implementation planning for the controlled start incorporates activities to gather assurance and evaluation on key aspects of the claimant journey and operational processes. This will allow the Department to refine and improve products to ensure we are getting the end to end delivery of Personal Independence Payment right.

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[Paragraph 166] We welcome the Minister's confirmation that DWP does not intend to press ahead with a big bang approach to implementation of PIP and his commitment to begin with new claims only from April 2013. We note that the Government plans initially to introduce new PIP claims in one geographical area. The area should be selected on the basis of carefully defined criteria. The period prior to national roll-out should be used to prepare a methodology for monitoring the early lessons to emerge from implementation and to ensure that recommendations for changes can be made quickly, in consultation with interested bodies. [Paragraph 167] We welcome the Governments decision to bring forward the first independent review of the PIP assessment to within two years of the assessment Regulations coming into force and to have a second independent review within four years of that date. Bootle Benefit Centre will administer the first new claims from spring 2013 from areas including Merseyside, North West England, Cumbria, Cheshire and North East England. People in these locations will be the first to claim the new benefit. The primary reason for selecting the Bootle Benefit Centre is that it handles DLA new claims in volumes that will provide a robust test of Personal Independence Payment processes and new computer systems. During this initial period, new claimants in all other parts of the country will continue to claim DLA as now. The controlled start in Bootle Benefit Centre allows the Department to gather and evaluate initial data. Some claims will continue to be closely monitored throughout the full Personal Independence Payment process. Findings will be evaluated and the Department will introduce early process improvements where necessary.

Reassessment of existing claims

[Paragraph 168] As has been shown with the WCA/ESA process, reassessment of existing claims is even more complex and challenging than dealing with new claims. We therefore believe that reassessment of existing DLA claimants should only proceed once the Department is confident that the assessment is accurate. [Paragraph 170] The phasing in of the reassessment for Personal Independence Payment should take account of the timing for individuals of the Work Capability Assessment for Employment and Support Allowance. There is likely to be a significant overlap between the two groups of claimants and many disabled people may already have had one or more WCAs by the time the PIP reassessment is introduced. The cumulative impact of frequent reassessment on a vulnerable group of people should not be underestimated. The Government acknowledges the additional challenges of reassessing existing Disability Living Allowance (DLA) claimants for Personal Independence Payment. Because of this, the reassessment of these claimants will only start once the processes, including the assessment, have been shown to be working as intended for new claims. Reassessment is due to start in autumn 2013 for those claimants who report a change in their condition or whose DLA award is due for renewal. This will be achieved through managing low volumes of these cases at around 10,000 per month for the first three months of the

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reassessment period, again checking that processes are working as intended, before increasing numbers early in 2014. The Government is aware of the particular challenges for claimants who may experience multiple assessments for different benefits over a short timeframe. Detailed processes are still being developed but, where possible, the Department will seek to ensure that claimants undergoing reassessment for Incapacity Benefit and DLA are not called for multiple faceto-face assessments in close proximity. To support this, the Department is exploring options for sharing information across the benefits to reduce the need for more than one face-to-face assessment.

Motability
[Paragraph 172] We recommend that the Government clarifies, in response to this Report, which rate of PIP mobility component will confer eligibility for the Motability Scheme. It should also clarify whether a three-year lease for a Motability car, signed when the claimant was a recipient of higher rate DLA mobility component, will be terminated if that person is found ineligible for the Motability Scheme under PIP. We believe it is important for the Government to provide certainty on these issues before reassessment of the working-age DLA caseload commences. Motability is an independent charity and is wholly responsible for the administration of the scheme. Currently, eligibility to the Motability scheme is dependent upon a person being in receipt of the higher rate mobility component of Disability Living Allowance (DLA). If a scheme customer no longer meets this criteria then Motability will seek to withdraw the vehicle in accordance with their rules. Following conversations with Motability, the Department can confirm that the enhanced rate of the mobility component of Personal Independence Payment will act as the gateway to the Motability scheme in the future. All claimants who have been selected for reassessment under either natural or managed reassessment will be told that their DLA will be ending and that they can instead make a claim to Personal Independence Payment. Should a person not satisfy the eligibility criteria for the enhanced rate of the mobility component in Personal Independence Payment, then eligibility to the Motability scheme will cease and Motability will, as now, terminate the lease regardless of duration. Motability advise that customers in this situation will not be liable for any remaining lease payments after the allowance ceases to be paid, and subject to the vehicle being recovered promptly and in reasonable condition, the customer would not be subject to any penalty payments. Any advance payment made to Motability would be returned on a pro-rata basis. The Department is continuing to work with Motability to ensure they are well placed to manage any changes as a result of the introduction of Personal Independence Payment. This includes the way in which these changes are communicated to their customers.

Child and young adult recipients of DLA

[Paragraph 176] We welcome the Government's decision not to include child recipients under 16 years of age in the current DLA reforms. We believe that DLA for children should not be considered until the reassessment of working-age claimants has

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been completed and fully assessed. For clarity, we recommend that the Government give a commitment that it will conduct a full and separate consultation on any future changes to DLA relating to children. The Government has made clear through its response to the Disability Living Allowance (DLA) reform consultation and during the passage of the Welfare Reform Act that it will not extend Personal Independence Payment eligibility to children when it is introduced in April 2013. The Governments response to the DLA reform consultation set out its intention that children below the age of 16 will still be able to claim DLA. The Government recognises that childrens requirements are different to adults, and has committed to consulting formally before extending Personal Independence Payment to children. [Paragraph 177] We welcome the work DWP is undertaking on the specific needs of young disabled people aged 16 to 25. We recommend that this cohort should be the last to be migrated to the new benefit. We also believe there is a strong case for 16 to 18 year-olds to be treated as a distinct group from the rest of the working age population. One option which should be explored is for the reassessment at the time of the migration to PIP to take place in, and with the assistance of, the young persons school or college. The Department is continuing to explore the specific needs of young people and how they should be supported, both within their claim process and afterwards. To help enable this it has set up and met with a sub-group of the Implementation Development Group called the Personal Independence Payment Young Persons Panel. This group includes a number of charities and organisations with an interest in young people. The Department has held one-to-one interviews with young people and is also working with focus groups as part of the approach to designing processes based on young peoples needs. The Department has informally consulted on the transition for young people and developed the process collaboratively. The Department will test products such as letters with them to ensure they are fit for their purposes. The Department also recognises that as young people transition to adulthood they will all have specific aspirations about what they want to achieve, such as remaining in full time education at school or college, taking up training or entering employment. It will be a principle in Personal Independence Payment that a young person will be invited to make a claim in their own right as soon as they reach their 16th birthday, unless they are determined as being incapable of managing their own affairs due to their disability and therefore requiring another adult to be appointed to act for them. This will help enable them to achieve the aspirations as they move to adulthood and make decisions about other aspects of their lives. Every DLA claimant aged between 16 to 64 on 8 April 2013 will be entitled to claim Personal Independence Payment and will be assessed for that benefit when they do so. The basis of determining who will be invited will be random computer-generated selection and evenly spread geographically. While there is provision for certain groups to be held until last in the reassessment window, for example those in receipt of the Special Rules for the Terminally Ill entitlement, young people have not been identified as needing such ringfencing. This is because age 16 is seen as a natural point in which a child transitions to

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adult rules. So long as the young person meets the eligibility criteria they will have no gaps in payment and continue to benefit from passporting arrangements. The assessment criteria have been designed for the needs of people from age 16 upwards. The Department recognises that young people with disabilities are encouraged to regard their disability in a positive way. The face-to-face consultation will support this. As will be the case for people of all ages, young people who require support will be able to bring someone with them to the face-to-face consultation to help them express their needs and the assessors will be trained to deal with younger adults. We are exploring a range of options for how the Department delivers Personal Independence Payment, including the location of assessments. Personal Independence Payment consultations must be carried out in an appropriate venue, taking into account the needs of the claimant, the health professional and the security requirements. The options for this will be fully explored during the procurement process for the Assessment Provider, and will take into account the needs of young people. Amongst these are security and confidentiality requirements. The introduction of Personal Independence Payment will ensure that the Government can continue to support those people who face the greatest challenges to living an independent life, whilst ensuring that the benefit continues to remain affordable in the future. The Government welcomes the Committees recognition that DLA needs to be reformed but recognises that there is further work to do before Personal Independence Payment is introduced in April 2013. The consultation on the draft assessment criteria has only recently closed and the consultation on the detailed design of the benefit is ongoing and the Department will continue to engage with stakeholders as Personal Independence Payment is developed. This work will not stop in April 2013. The controlled start will provide valuable information and an opportunity to identify and resolve problems in advance of a full national roll-out. The operation of the Personal Independence Payment assessment will also be subject to two independent reviews, reporting to Parliament within two and four years of implementation.