Control over some disability benefits (including personal independence payment (PIP), disability living allowance (DLA) and industrial injuries benefits, amongst others) will soon be devolved to Scotland. This blog looks at some challenges the Scottish Government faces in designing an assessment system that meets its policy objectives, yet supports robust decisions.
The Scottish Government’s intention is to deliver disability benefits via the new social security agency “by the end of this parliamentary term”.
Work to develop a new assessment process is being informed by the assessment workstream of the Disability and Carers Benefits Expert Advisory Group (DCBEAG).
Social Security (Scotland) Bill amendments dealing with disability assessments
The Social Security (Scotland) Bill (“the bill”) provides a framework for devolved “disability assistance”, but does not give any details of the assessment process. A key Scottish Government aim is making benefits assessments more effective and less stressful for applicants.
A Government amendment to the bill prevents applicants from being required to undergo an assessment by someone employed in the private sector. People can still submit evidence produced by private sector workers in other contexts, should they wish. The amendment was agreed to by division at the Social Security Committee meeting on 1 February 2018.
Opposition amendments on this subject were debated on 22 February 2018. These sought to:
- make detailed provision for assessments, aimed at restricting their number
- ensure those assessing people with mental health problems have relevant expertise.
Both were withdrawn after other members expressed concern about their wording.
The Minister for Social Security (“the Minister”) offered to work with opposition MSPs to resolve these issues before Stage 3, bringing forward further amendments if required.
Stage 2 was completed on 1 March 2018, meaning that the Stage 3 debate is likely to take place sometime in April.
The assessment process
There are broadly three sources of evidence currently used to decide entitlement to disability benefits:
- forms completed by the claimant
- further evidence requested by the DWP (or provided by the claimant)
- assessments (normally face-to-face) against the entitlement criteria.
Giving evidence to the Westminster Work and Pensions Committee on 24 January 2018, the Minister gave some details of her plans for devolved disability assessments. She covered all three areas above. The evidence session was actually part of the Committee’s universal credit rollout inquiry. But it has also recently reported on its PIP and employment and support allowance (ESA) assessments inquiry, criticising a number of aspects of the current system.
In context probably referring to PIP, the Minister explained that “the form” will be redesigned, shortening and clarifying it.
There are currently a range of forms for the different benefits to be devolved. The DLA form and attendance allowance (AA) form are both lengthy. The PIP assessment questionnaire is already significantly shorter, and focused on the specific activities which are relevant to entitlement (a very different approach to the DLA and AA entitlement conditions). Industrial injuries benefits have different claim forms for claims for “industrial accidents” and “industrial diseases”.
The Scottish Government intends to initially keep the same entitlement conditions for disability benefits. So there will presumably still be different forms in the short term. The aim of simplifying forms will need to be balanced with the information required to make an entitlement decision.
The Disability and Carers Benefits Expert Advisory Group (DCBEAG) are considering how use of existing information might reduce the burden on applicants to supply evidence. At Westminster, the Minister for Social Security mentioned some of the challenges, including:
- developing systems for secure data transfer
- ensuring that only relevant information is disclosed.
DCBEAG published their initial thoughts as an Annex to their February 2018 minutes. They were also concerned that, amongst other things:
- health records “may not be relevant or useful for assessment purposes as not for that purpose”
- social care information will not be held on those refused support, the threshold for which is very high in some areas.
The Scottish Government aims to use fewer assessments than take place in the current system. Answering a parliamentary question on 7 September 2017, the Minister said that face-to-face assessments will be:
evidence based, fair and most certainly fewer in number because we will get our decisions right first time.
Where a face-to-face assessment is needed, the Minister suggested to the Westminster Work and Pensions Committee that there will be:
a pool of individuals … otherwise employed in the public sector, …[with] the right clinical or professional expertise for the condition … being assessed.
It may be a logistical challenge to ensure that assessors with appropriate expertise can assess people with rare conditions, particularly those who live in remote areas.
It seems that assessments could not be carried out through GP surgeries, seen by many as the public face of the NHS. Most GP practices in Scotland are independent private contractors, providing services to an NHS board. But individual staff might choose to seek additional employment for the social security agency.
Decisions on entitlement
The assessment function will be separate to the role of “decision maker”. The decision maker, employed in the social security agency, would use the form, and other evidence (including any assessment) to make an entitlement decision. This arrangement essentially replicates the current system.
One question is whether sufficient evidence will exist for decision makers to make entitlement decisions with fewer face-to-face assessments (particularly if the forms are shortened). When introducing PIP, the UK Government underestimated the number of assessments that would be required. Unless the evidence gathering system works as intended, a shorter form and less face-to-face assessments could potentially lead to less robust decisions.
Assessments by tribunals
Applicants will be able to appeal to the First-Tier Tribunal against entitlement decisions (after requesting a re-determination). The draft tribunal rules are currently being consulted on. They provide that tribunals can order a medical examination “if necessary”. It is not clear who would carry out these examinations, but they would have to be independent of the social security agency.
Jon Shaw, Researcher, Justice, Health and Social Affairs Research Unit