DEPARTMENT OF SOCIAL SECURITY

Richmond House. 79 Whitehall, London SW I A 2NS

Telephone 0171 - 238 0800

From the Parliamentary Under Secretary of State for Social Security


P05(5)3509/134

Harry Cohen MP

Dear Harry

As you know, your letter of 17 May to the Department of Environment, Transport and the
Regions on behalf of Ms Louise Fish was transferred to this Department for reply.
I am sorry for the delay that has now occurred.

Ms Fish is concerned about the effects of the Government's Welfare Reform on people who suffer with ME.

The Government recognises that ME is a condition which can cause a wide range of disabilities from mild to severe. Decisions are not biased against people with ME, or any other particular illness. However, regular reviews in most claims to Incapacity Benefit (IB) and Disability Living Allowance (DLA) are an important part of the arrangements.

Ms Fish is concerned about our proposed changes. I will ñrst explain our proposals for the changes to the all-work test in IB. The Welfare Reform and Pensions Bill presents our proposals for replacing the test with a Personal Capability Assessment which, as well as focusing on what people cannot do, will provide information about the person's capabilities which can be used to help them plan a return to work. The reform of the all-work test is an important part of our strategy for helping people who have long-term ~ or are disabled, to become more independent. The eligibility criteria for lB. however, will not be changed.

We recognise that people who are so ill or disabled that they qualify for lB need to be confident that they will not put their benefit at risk by exploring the extent to which they might be able to work. The new test will not make it harder for people to qualify for lB. Their claims will be assessed on the same criteria of functional incapacity as now.

Arrangements for medical testing take into account the effects of variable conditions such as ME and will not change. The treatment of such cases is covered in the training and guidance given to Medical Services doctors who provide advice for adjudication officers (A0s) who decide whether a person is capable of work. The doctors are trained to base their advice on the level of function that the claimant is capable of most of the time. In particular, they look at the proportion of time a claimant is affected, to ensure their opinion is not based on a snapshot of the person at the time of assessment. This means that the advice provided by examining doctors should reflect a person's disability over time. AOs apply the provisions of the relevant legislation to the facts of the case, including the information supplied by the claimant, their GP and any other doctor involved in the case. There is a right of appeal against an unfavorable decision.
The current all-work test will continue until its replacement is properly developed. The requirement for examining medical staff to be properly trained in dealing with illnesses such as ME already exists, and there are already some claims that are exempt from the review arrangements.

There will of course be some difficult cases. in these instances, AOs can seek the advice of medically qualified personnel if they need further guidance. Full account is taken of advice from medical experts, including the doctors who visit people in their homes. However, it is the adjudication authorities that make the decisions, drawing on medical and other recommendation.

With regards to DLA we have already introduced a new system of periodically reviewing awards across all rates and components. The new arrangements for medical testing will take into account the variable conditions of ME.

We hope the new processes will ensure that people receive the right benefit from the outset and continue to do so, and this may involve awards going up or down. They will he monitored very carefully and changes made if they become necessary.

Staff and medical services doctors involved in the new processes will receive full training before commencing these new arrangements and we are well aware of the need for the effects of diseases such as ME to be taken into account.

The review process will involve gathering information by postal enquiry and home visits. These methods of approach will be applied across a range of people on all rates and components of DLA contacted to help identify the best means of approach in individual cases. The process will be evaluated after six months of operation and the findings used to continue to improve the process to make it more sensitive to the circumstances of the individual contacted. In addition, we will be testing new ways of gathering evidence in connection with DLA claims. This, plus information from the new review activity, will be used to help shape an active modern service for the future.

We are still considering the final details of the new system, and will continue to consult with representatives of disabled people on these details.

Finally, the proposed arrangements, previously known as the Single Gateway, will now be known as ONE to reflect the unified approach that will be applied. Meetings with personal advisers form part of our new service for new benefit claimants. ONE is at the very core of our Welfare to Work reforms. Under the present system, far too many people who want to
work are written off and consigned to a life on benefit, whilst others take it for granted that State support will automatically be available without any reciprocal duty on them. ONE will, for the first time, help all people of working age achieve their potential. We believe it is important that people should be encouraged to use their skills and talent to the full. That is why we are investing almost £80 million in the single gateway pilots.

Under ONE, working-age benefit claimants making new or repeat claims will be asked to take part in a meeting at the start of their claims before receiving benefits. While a familiar requirement for jobseekers, this will be a new procedure for sick or disabled people. The arrangements are being piloted in four areas of the country, with others to follow later in the year.

Our proposals for welfare reform envisage that people with disabilities Will be required to take part in meetings with personal advisers to explore the possibility of work and the help the Government may be able to give. No disabled person will be required to take employment if they do not want to do so. Their benefits will not be at risk if they decline work in these circumstances. People claiming benefits on the grounds of sickness or disability will not be forced into work.

The pilots, such as the one being launched in your area, will help us to develop some of the detailed arrangements under ONE. However, there are some things I can give you an assurance on. We will, for instance, ensure that personal advisers are equipped with sufficient skills and knowledge to deal effectively and sensitively with everyone, particularly ME sufferers. This will include identifying the areas where more specialist help and support is necessary, and making arrangements to enlist that support on behalf of the individuals concerned. We will also ensure that disabled people are given sufficient time to make arrangements to attend meetings; are given sufficient opportunities to attend; have access to specialist communicators where necessary and have the opportunity for meetings to take place at home where necessary.

I hope I have explained the current position for Ms Fish.


HUGH BAYLEY