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Health and Disability Reform
29 April 2024
Lead MP
Mel Stride
Debate Type
Ministerial Statement
Tags
NHSEmploymentBenefits & WelfareWomen & EqualitiesMental Health
Other Contributors: 31
At a Glance
Mel Stride raised concerns about health and disability reform in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Minister apologises for not providing a copy of the statement in advance and pays tribute to Frank Field. He announces a consultation on changes to PIP aimed at creating a benefits system that can best support disabled people and those with long-term health conditions to live full and independent lives. The Government’s priority is fairness, ensuring people who can work do so while providing adequate support for those unable to do so. Recent reforms include expanding employment support and introducing Universal Credit. Since 2015, the proportion of PIP recipients receiving the highest rate has increased from 25% to 36%, with costs forecasted to rise to £29.8 billion by 2028-29. The consultation seeks views on eligibility criteria changes, assessment redesign, and potential fundamental changes to support provision for disabled people. The aim is to provide more targeted support within the existing structure or through wider reforms.
Alison McGovern
Lab
Birkenhead
Question
The Shadow Minister questions if PIP will be scrapped and which conditions could be exempt from assessments. She also asks about the legal basis for treating physical and mental health differently, costs of any new system, and whether a White Paper will precede a general election.
Minister reply
Minister did not provide specific answers to these questions in the provided text.
Alison McGovern
Lab
Birkenhead
Question
McGovern thanked the Secretary of State but criticised his failure to publish the Green Paper on time. She questioned why the government had not published it earlier, and accused them of avoiding accountability for their policies. She also highlighted that under Labour governments unemployment levels have always risen at the end of their terms.
Minister reply
The Secretary of State thanked McGovern for her response but defended his position by highlighting the extensive consultation process involved in the reform. He pointed out that previous Labour Governments had higher welfare bills and questioned why Labour had no clear stance on PIP reforms, despite its importance to the welfare system.
Caroline Nokes
Con
Romsey and Southampton North
Question
A constituent with cerebral palsy uses PIP to buy mobility aids and live independently. His concern is that changes might push costs onto the NHS, reducing his freedom of choice in how he spends money on his needs.
Minister reply
The Secretary of State reassured Nokes by saying that they aim for the best outcomes through a consultation process. He stated that it's reasonable to explore if cash transfer payments are always necessary, especially given growing mental health conditions. The minister also mentioned interest in situations where individuals have lifelong regressive illnesses and whether continuous reassessments are appropriate.
Kirsty Blackman
SNP
Aberdeen North
Question
Concerns about the impact of changes to PIP on disabled people, particularly those with mental health conditions. Asks if the Secretary of State will ensure that any changes to universal credit eligibility criteria will be fully consulted upon and questions whether he has spoken to the Scottish Government about their adult disability payment.
Minister reply
Reassures that disabled people will be involved in the consultation process, which will last for 12 weeks. Confirms that there will be a review of the passporting of PIP into other benefits, and that discussions have taken place with the Scottish Government regarding their adult disability payment.
Question
Asks if the Secretary of State is considering implementing more tiers in award for PIP to better cater to different costs incurred by disabilities.
Minister reply
States that an open-minded approach will be taken, looking at how other countries organise their similar benefits and whether a one-size-fits-all model is best.
Stephen Timms
Lab
East Ham
Question
Concerns about the lack of assessment for those who are too ill to work but not disabled, asking how their support will be assessed in the absence of a work capability assessment.
Minister reply
Responds that the conclusions from the consultation will address these questions, particularly regarding the replacement of the work capability assessment with PIP assessments.
Question
Asks about how reforms in the Green Paper can help anxiety sufferers to get the treatment and support they need to return to work.
Minister reply
Acknowledges that those who require medical treatment rather than cash transfer benefits might be better served, emphasising that this is one of several options being explored.
Afzal Khan
Lab
Manchester Rusholme
Question
Critiques the Government's narrative around disability benefits as stigmatizing and harmful to vulnerable individuals. Asks if more support for disabled people could be provided.
Minister reply
Reiterates that there is no intention of stigmatising anyone, but rather a recognition that some disabled individuals may require additional help beyond what they currently receive.
Question
Asks how the Secretary of State plans to change employer attitudes towards hiring those with learning disabilities or autism.
Minister reply
Refers to the Buckland review, which addresses many issues regarding accommodating and benefiting from employees who have autism and other conditions.
Wendy Chamberlain
Lib Dem
North East Fife
Question
Commends comments made earlier about PIP and questions how to ensure a better system with fewer errors.
Minister reply
Acknowledges that errors in the benefits system are relatively rare. Emphasises the aim of freeing up the system so people on long-term benefits can try work without fear of losing their support.
Question
Asks for assurances that the Secretary of State will carefully consider tone and language in discussing reforms, ensuring they listen to those with lived experience.
Minister reply
Reassures that questions of tone, language, and careful consideration are at the forefront. Offers to be available for further discussion.
Chi Onwurah
Lab
Newcastle upon Tyne Central and West
Question
There are 4,500 people in Newcastle Central who are out of the workforce and economically inactive due to disability or ill health. The Government have failed them when it comes to the benefits system, supporting them to work, and the NHS. How will the £46 billion black hole in the Government’s plan to abolish national insurance payments enable the Government to fix their failings?
Minister reply
On economic inactivity, it is lower today than under the last Labour government. The aspiration of eliminating national insurance completely is a long-term goal. The shadow party's proposal for £28 billion through energy and net zero policies does not match this realism.
Question
The Secretary of State’s approach to the disability benefits system is realistic, given its current failings. How will the Government ensure a comprehensive delivery of measures across departments, including with the NHS and local authorities? What efforts are being made to engage employers in this process?
Minister reply
We will work closely with the DHSC on proposals for WorkWell and other initiatives. Consultations have been run on increasing occupational health support within businesses.
Justin Madders
Lab
Ellesmere Port and Bromborough
Question
Motor Neurone Disease patients do not need or deserve reassessment. What are the plans to address NHS workforce issues impacting mental health condition assessments?
Minister reply
We will continue to work closely with the DHSC on proposals. The Chancellor has brought forward funding for 400,000 additional NHS talking therapies.
Luke Evans
Con
Hinckley and Bosworth
Question
How can we bring DWP closer to GP surgeries to help patients receive guidance from diagnosis onwards? Will the consultation consider this practical suggestion?
Minister reply
We are focusing on fit note reforms, upon which there is a call for evidence at the moment.
Chris Bryant
Lab
Rhondda and Ogmore
Question
How will we address the issue of talking therapies being least available in areas with the highest levels of economic inactivity? Does the Department know how many PIP recipients have acquired brain injuries?
Minister reply
We are determined to provide as much support as possible for mental health. I will write back to the hon. Gentleman about his specific question regarding PIP and acquired brain injury.
Question
Are my proposals to improve workplace support for mental health essential? Should physical and mental health receive firm parity in HSE guidelines?
Minister reply
We are considering the issue of parity. We have consulted on mental health support within businesses, especially focusing on SMEs.
Kerry McCarthy
Lab
Bristol East
Question
With concerns raised by constituents about disabilities and mental illnesses, how will tailored support be provided to those with fluctuating conditions such as myalgic encephalomyelitis?
Minister reply
We are exploring in the consultation on reducing bureaucracy for those not expected to recover or improve. We aim to avoid unnecessary reassessment.
Question
How will we ensure as many voices as possible are listened to during the consultation, particularly considering individual needs?
Minister reply
The consultation will be thorough and available in accessible formats. We have seen a significant increase in disabled people's employment, with a target of one million more in five years.
Imran Hussain
Lab
Bradford East
Question
Announcing that disabled people suffering from certain conditions will no longer receive support payments, but instead get improved access to treatment, is one of the most absurd policies to have come out of this Government in the past 14 years. The Government plan relies on imagined brilliant mental healthcare support being available. Is the Minister even aware how long people have to wait for treatment after being referred? After 14 years of this Tory Government gutting our NHS and our mental healthcare, even basic access to treatment does not exist, let alone the improved access the Minister is relying on in the fantasy world he lives in.
Minister reply
I simply do not recognise the comments the hon. Gentleman has made about our national health service. There are more people working in the national health service than at any time in its history: 21,000 more nurses and 7,000 more doctors in the past year alone. We are spending a record sum on the national health service.
Question
I would like to give the Secretary of State the benefit of the doubt, and he has made a number of important points, but those 2.6 million people and their families who will have heard his statement will be absolutely terrified. A lot of them will feel that the reforms are just about providing some kind of cuts to services. I believe that we need to try to support those people and put compassion at the heart of our welfare system. There are reports of up to 2 million people waiting for mental health treatment at the moment, so does the Secretary of State believe that in this “compassionate” review, where we are going to have a “grown-up conversation”, we will be able to see more money invested to ensure that those 2 million people can get more mental health support?
Minister reply
My hon. Friend raises important points that are core to the consultation that is being carried out. The corollary to my hon. Friend’s argument is that we should not do anything and stay with a system that has not been revisited for over a decade, despite the fact that the terrain has changed substantially, not least in terms of the increase in those suffering from mental health conditions.
Sammy Wilson
DUP
East Antrim
Question
The Minister is right: economic inactivity rates have soared because of ill health, and where possible we want those people to get back into work. It is for their own good. It is also for the good of the hard-working taxpayers to have those costs minimised. However, given that these proposals come at the tail end of a Government who have just weeks or months to go, I doubt very much that the measures will become a reality for many people. I have one question for the Minister: as this issue is devolved to the Northern Ireland Assembly, has he had any discussions with the Executive about these proposals? If he has, what response did he get? Should the Executive go in a different direction, what will the economic consequences be for the Northern Ireland Executive’s budget?
Minister reply
The right hon. Gentleman is absolutely right to talk about the importance of work in the context of mental health. That is my strongly held belief. He is also right to raise the issue of the fiscal sustainability of our welfare system.
Hayes and Harlington
Question
The Secretary of State has said that the Government’s approach is fair and compassionate. Can he tell me what is compassionate about the language used by the Prime Minister over the past fortnight, when he has referred to a “sick note culture”, implied that people who are forced to rely on benefits do so as a lifestyle choice, and, today, talked about the arrests, seizures and crackdowns on benefits claimants? The Disability Poverty Campaign Group, which comprises the major charities that we have all worked with, described the speech as “chilling”, “threatening” and “stigmatising”. Does the Secretary of State not realise that the language that the Prime Minister has used increases prejudice against disabled people and contributes to the escalation of hate crime against disabled people?
Minister reply
The Prime Minister shares my view, which is that it is really important that we achieve the best possible outcomes for the people whom we are discussing in this statement. He cares a great deal, and I think he said at the end of his speech that he wanted to help many people.
Neil Coyle
Lab
Bermondsey and Old Southwark
Question
The Secretary of State has upset many disabled people and organisations with his clumsy, negative and juvenile approach. Mind, for example, has asked for a grown-up conversation. Furthermore, the Secretary of State said at the Dispatch Box today that there has never been a review of personal independence payments, but there have been two independent reviews commissioned by the Department, so perhaps he could correct the record when he gets to his feet. PIP is not an out-of-work benefit, so when will the Department publish its assessment of the impact of these latest cuts on disabled people using PIP to support themselves in work?
Minister reply
It is the case that there has not been a fundamental review of PIP on the basis that that has subsequently led to a change in that benefit. Therefore, it is the case that that benefit has remained fundamentally the same for more than decade—it actually came in in 2013, as the hon. Gentleman will know.
Nadia Whittome
Lab
Nottingham East
Question
Members of this House may remember that I had to take a leave of absence from this role three years ago because I have post-traumatic stress disorder. I can tell the House that the insinuation that mental health conditions are not debilitating, do not affect people’s ability to go about their daily life or to go to work, and do not incur additional costs could not be further from the truth. The Prime Minister’s comments about so-called “sick note culture” and the changes that the Government are proposing will do nothing to help people with mental illnesses, and will just make their lives harder. Why are the Government setting back the clock on the acceptance of mental illness as a disability instead of truly tackling the crisis in mental health support?
Minister reply
I am at pains to say this: every time I have come to the Dispatch Box this afternoon, I think I have made it extremely clear that serious mental health conditions are very real. I take them very seriously, as I think does everyone in this House.
Question
My constituent Elizabeth has been a very hard worker, but also someone who has suffered from ill health. She came to see me at my surgery on Friday to express her alarm about the Prime Minister’s speech on 19 April, his proposals for sick notes, and what she sees as his lack of respect for the professionalism of general practitioners. If the issue came up in the Chamber, she asked me to ask the relevant Minister this question: how can a random DWP assessor, faced with a complete stranger, based on the briefest of interactions, be relied upon to produce a more accurate and objective assessment of a patient’s condition than her own general practitioner?
Minister reply
I know the Prime Minister shares the view that we owe a huge debt of gratitude to our GPs, right up and down the country. They have a highly pressurised job, and they do it extremely well.
Salford
Question
The Secretary of State must understand that the rhetoric coming from the Government over the past few weeks has been brutal, divisive and inducing unimaginable terror in the two thirds of people already in destitution who have a chronic health condition or disability. The prospect of further cuts is making the situation worse. Can he confirm whether he expects overall Government PIP spending to be reduced and, if so, by how much, and what assessment he has made of how his proposals will affect those who are already in material deprivation?
Minister reply
The presumption that the hon. Lady makes is that the alternative to consulting on a different and potentially much better way forward is to do nothing at all.
Liz Twist
Lab
Blaydon and Consett
Question
Language matters, as we have heard, and the Government have been warned that the language and rhetoric—perhaps not from the Secretary of State himself but from others—risks minimising the impact of mental health conditions, which are real and serious. What are the Government’s plans to ensure that proper treatments are available—not just talking therapies but whatever treatment is appropriate—to ensure that people with mental health conditions are treated appropriately?
Minister reply
The hon. Lady raises an extremely important point: the prevalence of mental health conditions in our country has grown. There are many reasons for that—I know the Labour Party like to say it is all about the NHS, but it is about many other things, not least social media among young people. The consultation will look at exactly the question she quite rightly raises. She mentioned the NHS talking therapies; I think that, particularly for some less severe mental health conditions, combined with work, they can make a real difference. I was very pleased when my right hon. Friend the Chancellor brought in 400,000 more of those talking therapies at his last fiscal event.
Hitchin
Question
Back in 2018, a bad concussion left me out of work for several months. Over time, I became deeply depressed, worried and anxious that I would never get back to full-time work at all. I was lucky that my employer was able to find and to pay for me to get the support I needed to get back to work, and I am lucky enough to be here today. However, for many across the country that simply is not the reality they face. Why are the Government not focusing on making sure everyone has the support they need to get back into work, rather than falling back into the kind of political posturing that will only add to the stress and anxiety that thousands already feel?
Minister reply
If I may say so, first, I am very pleased that the hon. Gentleman is now fit and well and I am sorry he went through the difficult time that he describes. We are doing a huge amount; he may or may not be familiar with universal support, which is there not only to place the kind of people he has described into work, but, critically, to stay with them for a period of up to 12 months to make sure they have the support to hold that job down. We know that work is good for those with mental health conditions. I have already referred to WorkWell, which brings together those who have mental health challenges and work coaches who are able to see how work can fit within their recovery programme.
Question
Today’s statement has been made necessary by the huge deterioration in the nation’s health and mental health since the pandemic. I think the whole House has to take responsibility, because this House voted for draconian lockdowns that devastated mental health, particularly among the young. This House voted to mandate untested experimental treatments, threatening people that they would lose their jobs if they did not take them, while giving immunity from prosecution to the manufacturers for their dangerous and defective products. Will the Minister do the best thing he can for public mental health by assuring the British public that these mistakes have been learned from and will never be inflicted upon them again?
Minister reply
I am afraid I simply do not subscribe to the theories that the hon. Gentleman promotes. I think it is probably best to leave it at that.
Shadow Comment
Alison McGovern
Shadow Comment
The Shadow Minister thanks the Secretary of State for his comments about Frank Field and accepts the apology for lack of advance notice. Labour will judge the Government's measures on their merits, aiming to ensure disabled people have equal rights to employment support as others. The Green Paper lacks a clear plan; it is an exam the Government hopes not to sit. The Labour Party aims to provide more mental health staff and improve work conditions for disabled individuals. They criticise the Government’s failure in addressing NHS waiting lists, long-term sickness absence, and mental healthcare stigma.
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