Monday, 21 March 2016

My response to the PIP consultation to reduce the points for aids and appliances

Iain Duncan Smith resigned this week, ostensibly over the plans announced by George Osborne to reduce the score for claimants who need to use some aids and appliances in Personal Independence Payment.

IDS implied that this was a new policy that had taken him by surprise.

This is odd because his department had announced such a policy in December 2015, and had made it clear that the initial plan was for a larger reduction than was ultimately agreed following the public consultation. In fact, the final proposal he apparently considered unconscionable was more generous than any of the five options offered in December.

This was my response to the consultation in December:-

Response to Consultation — Aids and Appliances in Personal Independence Payment

From the Welfare Rights Department of  --------

Issue one – the number of claimants scoring solely through aids and appliances

1.       We note that one of the concerns raised by the consultation is the number of claimants scoring all of their points through a need for aids and appliances. Our experience of PIP assessment reports suggests that this figure may be misleading because of a trend for assessors to favour the aids and appliances descriptors over descriptors indicating a need for help from another person, where both descriptors are met.

2.       At present the difference is frequently not material to the outcome, and where this is the case, goes unchallenged. Should the qualifying criteria be changed in any of the ways suggested, we would anticipate that a significant proportion of those presently being scored as needing only aids or appliances would have grounds to challenge the selection of the aids or appliance descriptor. An example would be a client of ours who could not cook and prepare food for himself safely (due to blackouts) being scored as needing an aid or appliance. Because he was happy with the overall award level, there was no need for him to challenge this descriptor.

3.       We would also note that Paul Gray’s Independent Review does not specifically raise this as an area of concern in the sense implied. The Review raised a concern that claimants might be awarded a scoring descriptor where they had chosen to use an aid or appliance but did not need to use one. This is a valid operational concern, as the PIP criteria already do not support an award in those circumstances. We do not consider that the Review was recommending any change to the qualifying criteria.

Issue two — the claimed broadening of the meaning of aids

4.       The consultation raises particular concern that the meaning of ‘aids and appliances’ has been broadened by upper tribunal decisions. We do not agree that this has occurred.

5.       The PIP2 form has acknowledged from the beginning that a perching stool is an aid or appliance, as did the 2012 consultation on the criteria, so it is clear that seats and chairs were intended to be included in the definition. Lighter pans are also mentioned specifically. The important question is whether the claimant needs to use the aid to achieve the relevant, fairly undemanding, daily activity and not whether they possess or have paid for one.

6.       We would also note that it was clear to the drafters of the regulations that ‘spectacles or contact lenses’ would come within the meaning of aids or appliances if not specifically excluded from Activity 8. The decision not to exclude chairs, perching stools, and other everyday devices was therefore a deliberate policy choice.

7.       In conclusion, we do not agree that this premise of the consultation is factually accurate.

Issue three — the assessment of extra costs

8.       One of the solutions raised by the consultation is to replace the daily living component with a lump sum payment to purchase aids and appliances. We consider that this reveals a misunderstanding of the concept of extra costs, which was perhaps prompted by a single sentence in Paul Gray’s Review.

9.       It is made clear in the 2012 consultation that the criteria for PIP are considered to be a proxy assessment of a representative cross section of the claimant’s functions:

38 The activities have been carefully selected to act as a proxy for participation, levels of need and likely extra cost. We have not sought to assess each and every activity an individual might perform on a daily basis but rather we have selected a range of activities which cumulatively act as a good proxy. For example, individuals who have difficulties dressing and undressing are likely to have difficulties in other areas that involve bending and reaching, while individuals who have difficulty preparing food are likely to have difficulties carrying out other activities that require manual dexterity.

10.   The intention appears to be that a claimant who has some difficulty bending and reaching, for example, should score under dressing to reflect this limitation in bending across daily life.

11.   The extra costs may come in an almost open-ended number of ways such as needing to have purchases delivered, to shop locally at higher cost, to pay for domestic help, gardeners, simple home maintenance, heating, extra living space, taxis et cetera; combined with probable reduced earnings and reduced opportunities for work. The PIP assessment is the proxy for qualification but is not an assessment of the amount of the costs.

12.   The Review (somewhat by the way) mentioned the low cost of purchasing some aids and appliances, and this appears to be have been taken up by this consultation in its claimed Illustrative Examples. However, PIP is not intended literally to reflect the cost of purchasing aids and appliances, but to reflect extra costs in general via a proxy assessment of functional difficulties. In the examples given, needing to sit to prepare a simple meal, breathlessness dressing, and needing to use a sink for support just to get off the toilet are indications of significant disability rather than direct financial costs. To suggest otherwise is to misuse the nature of the assessment within its own stated terms.

Issue four — the options

13.   In light of the above, we consider that options one to three are flawed as they are founded on mistaken premises that the rate of PIP is related to direct financial need arising from activities 1-12. (There would presumably be no equivalent mechanism under these options for people who can demonstrate that their direct financial costs from these activities are in excess of £139.75 per week to claim for these costs through PIP.)

14.   Options four and five are logically valid if the aim is simply to restrict the number of people who qualify by raising the bar. Provided this is openly acknowledged to be the aim, this may be a legitimate policy but will cause hardship. We would suggest that two of the stated changes in PIP: face to face assessments and regular reviews, have found more people to qualify than was assumed would be the case and that this should also be openly acknowledged for any changes to have a legitimate foundation.

15.   We would however urge for proper consideration to be given to an option of making no changes to the criteria, along with an acknowledgment that the original assumption that face to face assessments alongside regular reviews would lead to a large reduction in awards appears now to have been incorrect.

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