PIP consultation on assessment thresholds

I’ve been looking at the new PIP consultation paper released yesterday - see Rightsnet news. Not only does it look like 500,000 people will lose entitlement to benefit altogether, but the tables on pages 9 and 10 suggest considerable changes in the numbers qualifying for specific components.

1,040,000 working age people were projected to qualify for the high rate mobility by 2015. However under PIP only 760,000 are expected to get the enhanced (i.e high) rate for mobility. This is a reduction of 280,000 (27%)!

Presumably many of those claimants will get the standard (i.e. low rate) instead. Given this it is a bit of a surprise to me that the number claimants on standard mobility rate is also expected to see a huge drop - from 900,000 to 550,000.  If we assume that many of those on high rate mob move down to the standard rate under PIP, this in turn suggests that an awful lot of those on low rate are at risk of losing all help with mobility. 

Turning to the DLA care component and it’s equivalent daily living component under PIP, the number of claimants getting either the middle or lower rate of DLA care was projected to be 1,470,000 by 2015. However only 690,000 are expected to get the standard rate for independent living i.e. a drop of 780,000.

However in terms of those getting the high (enhanced rate) for care there is likely to be an increase of 10,000 under PIP i.e up from 530,000 to 540,000.

So the big losers in all of this include those currently receiving the lower rate care component - no surprise there. However it appears that many others on middle rate care may also lose entitlement (i.e. even if all of those on the low rate care ( projected to be 690,000 by 2015) failed to qualify for the PIP independent living component this would still require another 90,000 claimants failing to qualify for the standard rate for independent living. Admittedly some of these may move onto the enhanced rate high - but this is unlikely to account for more than 10,000 of that number.

Perhaps more surprisingly it also appears that a large number of those who currently get the high rate mobility will be at risk of a drop down to the standard rate for mobility under PIP.  This seems likely to include a lot of individuals who are currently considered virtually unable to walk but whose mobility problems do not require them to use a wheelchair or other motorised vehicle to cover distances of less than 50m (and those with a severe visual impairment). Alongside this huge numbers of those on low rate mobility also seem set to lose all entitlement to help with mobility under PIP.

Derek

Bit surprised no-one has responded on this as the whole threshold document raises more questions than it answers. Even the briefest glance at the DWPs own case examples suggest

a) they don’t know how their own scoring system works.
b) there will be huge inconsistencies.
c) interestingly there may well be huge scope for challenges and the appeal system is highly likely to have an ESA part 2 scenario i.e. loads of appeals and loads of decisions overturned.

Just to let you know that GMWRAG have updated the site at http://gmwrag.wordpress.com to enable members in the North West contribute online to an intended response well within the 30th of April deadline.

I agree that the draft regs are a mess. Rather late in the day I’m trying to get to grips with them, and I find I’m losing the will to live, or at least to read.

My current sticking point is the first mobility activity, which reads in part:

—
b. Needs prompting for all journeys to avoid overwhelming psychological distress to the claimant. (4 points)

c. Needs either –
(i) supervision, prompting or a support dog to follow a journey to an unfamiliar destination; or
(ii) a journey to an unfamiliar destination to have been entirely planned by another person. (8 points)

d. Cannot follow any journey because it would cause overwhelming psychological distress to the claimant. (10 points)
—

Even taking into account the new definition of ‘prompting’, and of supervision as being ‘continuous’ etc, I’m at a loss to explain the construction above. It seems to suggest, for example, that someone who ‘needs [...] prompting [for no specified reason, which presumably includes the risk of overwhelming psychological distress] [...] to follow a journey to an unfamiliar destination’ scores 8 points and qualifies for the standard MC. Whereas someone who ‘needs prompting for *all* journeys to avoid overwhelming psychological distress’ [my emphasis] only scores 4 points and does not qualify.

I get the feeling I’ve missed something here, or that someone else has. If it’s me, I’d be grateful to anyone who can help me locate my missing understanding. (I could ask a similar question in respect of many parts of the regs, but best stick with just the one for now.)

Stuff designed by committee - does it get any worse? The assessors get richer and the poor get poorer. The DWP stuck in the 1970s thinking they can match people up against ‘scores’. Will they ever learn how to stop wasting public funds and get to grips with reality? Are they also seriously going to make claimants go through two medicals too, one for ESA/Universal Credit and one for PIP?

How is the assessment contract going to be awarded? If Atos get it there is scope for one extended ‘assessment’, but if another contractor gets it there will have to be two separate medicals with all the extra costs. Now that raises all sorts of questions about the bidding process, or is that too commercially sensitive to mention?

No, they’re not going to make people go through two medical, at least not in the longer term.

I think I’ve said this before on here but you can pretty much map out the thinking on this. It is a small step to conclude, quite logically (albeit that logic is flawed in the first place) that sending people for two medicals for two benefits both based on points scoring does not make financial or practical sense. Therefore, it’s hardly a radical leap to assert that, at some point, one or all of the following will be suggested.

- one medical which acquires evidence for both benefits.
- an alignment of the points when the above produces significant inconsistencies.
- the consumption of PIP by ESA i.e. the latter becomes a subsidiary of the former.

However, we can at least look forward to around two to three years of utter chaos before this particular penny drops with a rather large thud!!!

I would put money on ATOS getting the contract.

I think one of the problems with private provision of things like medical tests and work programmes is that the providers use the profits from their contracts to lobby for reform of the system in a way which will ensure they get even more contracts.

Remember the work programme providers “trade union” arguing that people should be referred to the work programme earlier and that jobcentres should be privatised? http://www.rightsnet.org.uk/news/story/next-logical-step-in-reform-of-welfare-to-work-provision-is-to-privatise-jo/

I wonder which of the current crop of ministers will end up with nice non-executive director positions on the boards of these fantastic companies?

Yes, I think the word ‘lobby’ is highly significant here. DWP will be aware of the EU competition laws, so it will be interesting to see what follows next!

I think a major issue with the PIP descriptors is how many people with mental health probelms who are currently on middle-rate care and - to a lesser extent lower-rate mobility - may end up getting no benefit at all.

If someone has severe depression or anxiety which is at a severe level a majority of the time, they may just qualify under the daily living component because they need constant encouragement. I’m not sure that the rules on the PIP mobility component will cover these people if they literally speaking have the capacity to plan and follow a journey unaided and what stops them actually doing it on their own is severe anxiety that falls short of them losing track of where they are.

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But: if someone is not depressed or anxious enough to need encouragement most of the time, but have a condition that means they or others could be in serious danger at any time (schizophrenia, epilepsy, strong suicidal tendencies), such that they would qualify for middle-rate care on the grounds of supervision at the moment, they may well score nothing. Imagine if you will a man with severe schizophrenia who is fine caring for himself 30 days out of 31 a month, but on the 3rd… or 8th… or 19th… or 28th…(who knows?) day may without warning decide that he needs to stab someone. This person will get nothing under PIP as it now stands.
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Since March 2011 I’ve been doing a job as a part-time benefits and debt adviser to people with mental health problems. I’ve seen 75 clients in this time, and even though only about half are on any rate of DLA, I’ve identified TEN who currently get lower-rate mobility and middle-rate care who I think may get nothing at all under PIP - they are all people with schizophrenia or considered at significant suicide risk.

I urge you to jam the e-switchboards of the DWP with your disgust at this:

E-mail: .(JavaScript must be enabled to view this email address)

Steve

Steve - I’ve not had time to fully digest the draft PIP scores (too many ESA cases), but as I understand it, PIP is meant to take a 6 month view of one’s needs. I can think of a client with schizophrenia who, at a medical, would come across as very stable, however, knowing him as I do, I know also that he needs endless reassurance to prevent a deterioration in his health. Supported with good evidence, I would assume he would get through.

Unfortunately, as stated previously, I believe a ‘scoring’ model is waste of public money and I have little confidence in that whatever is devised will be holistic enough to be effective for claimants - especially in mental health terms. In fact I can think of numerous reasons why the whole concept is flawed, but of course the whole exercise is about reducing expenditure and has nothing to do with ‘addressing the additional costs of disability’ I’m sure it will deliver on the promise. The additional costs that advice agencies will incur, will never be recovered, of course.

Unfortunately, when I looked at the last PIP consultation, needing someone to “monitor a health condition” gets you only 2 points, and needing someone to “monitor your medication or treatment” gets you 1 point. As you need 8 points for the lower rate of “daily living” component, I think your chap is liable to get nothing at all. None of the case studies on the latest publication have a supervision need such as schizophrenia or high suicide risk. Case study 5 says she “gets warnings of epilepsy and her colleagues know what to do”, so nothing at all for her (2 points only), Case study 4 gets mobility but no daily living and has fits most days.

Time I had a good look, have been putting it off in case I get too depressed!

Put a post up on this thread (or so I thought). Either I didn’t post it properly or it was pulled. Second attempt at incompetence then!

I think there are grave dangers in accepting the line that because PIP is an attempt to reduce the DLA budget/caseload by 20% that tthe hardest hit will be those on the lower rates of DLA. A glance at the PIP regs suggests this is anything but the case. As an attempt to create consistency (as opposed to what was already pretty consistent) has resulted in what might be described as a random distribution of results. I wouldn’t get too hung up on the lower or middle rates to be honest. I suspect we’re going to be seeing an awful lot of people who go from higher rates to zilch.