 Darren Wood. Welcome to the 16th committee of the welfare report committee for 2015. Can everyone ensure that their mobile phones and other electronic devices are switched to airplane mode silent? First item on our agenda is the future delivery of social security in Scotland disability cyfnod i'r ddweud o'r cerddwl i'r ddyfnod ni'n hyffordd i'r oesidio i ddweud i ddweudio、 deiligad, cyfnod i ddweud o'r ddweud o'r cyffredinol ond ond ynches fanodol, ac mae'n credu rhan o'r ffordd eiegeidau i ddiddur i'r ddweud ac mae hi'n gweithio i'r ddweud. Ond, yn牙io, mae'n gweithio i'r ddweud, ond rwy'n gweithio i ddweud i'r ddweud, cyntafant. Rydw i'n gafodd rhai wgwlad yn rhan, ac nondi i gael i'w bwysigol, ond rydw i'w gwbiad gweithio'r rhywbeth, ac mae'n rhaid i chi'w bwysigol i'w bwysigol i'w rhagor. Rydw i'w ffordd aethdo i fel Arddur Rhaid Ibarthu Ardal, os yw'r dirfrwydd meddwl yn defnaeth gwasanaeth cheffiaethol cyntaf, ac yn ei ddif arwecriptionswyr, ond rydw i'w ddig i'w ffordd i'w parlym الغath, Sonia Chowdry, chief executive action for ME. Bill Scott, director of policy for inclusion Scotland. Rachel Stewart, public affairs officer for the Scottish Association for Mental Health. Andrew Strong, policy and information manager for health in social care lines Scotland. Professor Nick Watson, from the Institute for Health and Well-Bean at the University of Glasgow. I don't know if any of our witnesses want to say anything in terms of an open contribution or if not I'll just move to questions, but could I maybe just throw open to the invited guest today? What principles do you think should underpin any new social security system in Scotland? I think one of the key things that we have to look at is in terms of there's lots of different levels of looking at for disability benefit. We need to be looking at issues around providing support and issues around work and sometimes these two are different in terms of what we're looking for and so we have issues around, for example, the disability living allowance which is different from employment support allowance and getting people into work. So I think we need to look at that but for me though one of the key issues that we've got at the moment is that since about mid-2000 we've had a succession of policies that have been aimed at getting people off benefits and making it harder to get on to benefits. So we switched to personal capacity assessment and then from personal capacity assessment we went to ESA employment support allowance which brought in work capacity assessment and all of these increased or made it harder to get on to benefits and also made it easier for people to be pushed off benefits into, for example, work, the work related advisory group, or RAG and so on. I think that the problem has been, the key problem that's been with developing all of these is it's been about that it's located the issue within so work capacity assessment which is based on a model of disability called the biopsychosocial model of disability and I'm sorry to get all technical but it's a model and it is a model that Lord Freud claims has theoretical credibility but nobody else would or very few other people would support that claim and what the model is based on is the assumption that if people with back pain are forced back to work early or are told to move a lot the back gets better and so they've applied that same thinking to mental health problems and to cardio respiratory problems which with back pain make up two thirds of the reason why people are off work and so we've got the emergence of things like RAG which has had evidence to date has suggested that very few people who have been placed in the work related advisory group are moving into work so that isn't working yet the response has been to make RAG temporary so that people have to reapply every year even though it isn't working and I think that the other key problem has been that we've located all the problem for getting disabled people into work with disabled people so what we've done is we think the solution to finding employment for disabled people is to put more disabled people in the unemployed category and somehow or other they'll they'll emerge into work it's very very much this downstream we increase the number of disabled people applying for work they will get jobs rather than actually starting to tackle some of the discrimination that disabled people find in finding work and in terms of work capacity assessment for example it says are you fit for work rather than actually a better thing would be are you likely to find work so for example I can find work very easily but if I had the same impairment that I have but didn't have the didn't have the academic qualifications that I did I'd be unlikely to find I couldn't do manual work so I would be unlikely to find work and I think one of the problems is that we're locating it with the we're seeing individuals rather than saying in the old personal capacity assessment there used to be a category of are they likely to find work and that category's completely gone now so as well as looking at the individual we've got to look at are they likely to find work and in the the model that we might want to look at in terms of work is the Australian model where there've been much there's been much more work with employers about trying to break down the reluctance of employers to employ disabled people and at the moment we've just we're not working on that at all we're just assuming that we make more and more people into a labour market and somehow or other they'll magically get into jobs and the evidence isn't there to support that claim. I think it's a great question to ask you know one of the principles that our systems should be based on because at the end of the day what you're saying is how do you want to be treated as a human being and there are a couple of comments reading through a study that we've just undertaken with people in Scotland about the personal independence payments system people talk about the system the process of applying dehumanising them and there's a great quote I don't want your sympathy just your respect so your question when you ask us about principles it needs to be fair it needs to be equitable I don't think there are many people that would say actually anybody who thinks they're entitled to benefit should get them there has to be a system to share out the limited resources but it's got to be respectful and I think some of the some of the things that Nick was talking about one sort of question if you think about empathy and understanding if you go along and somebody says says to you what is it important for me to know about how your illness affects you so that I can make sure this process is as accessible as I can make it immediately relaxes you and it enables you to engage in a dialogue at the moment we've got people we're told that assessors are reading from screens that they're just reading from a list of questions how is that respectful if I sat here and talk to you from my screen for the next hour and 45 minutes you switch off you wouldn't want to engage with me so I think when we think about principles we should think about what is it that makes us human and makes us caring and sensitive towards others Bill with the idea that the system has to be based on really treating every person that comes into it as a human being like any other and with dignity and respect and I think that's missing from the current system which is all about saving benefits spend and if we embedded that into the system I think we also need to think about what the purpose of the system is and the purpose of the benefit system should be to support disabled people in carers and people with long-term sickness to participate in society because at the moment they're socially isolated it's not just that they're excluded from the labour market they're excluded from normal family life they're excluded from community life they're excluded from political life and all those things lead to them being marginalised and if the system existed to support people to participate in all those things and that's what purpose was then I think we would begin to see a change in societal attitudes towards disabled people and towards carers that would actually lead to greater participation because people would begin to understand some of the barriers that they face in everyday life. I would echo the points that have been made already and very eloquently as well. In the alliance's view we would back our human rights based approach something which Bill referred to some of the rights people have people being socially isolated and actually if you look at people's human rights and basis system around about that then we'd be in a much stronger place than we are at the moment. I think some of the elements of what a system would need to look like would be to include things like accessible information at as early stage as possible. I think a lot of people experienced experience a lot of difficulty around about understanding when they've been asked to come to an assessment what that assessment is about understanding the questions that they're asked during the assessment and I think things like easy read provided before and after the assessment would be really helpful to people. I think also we need to look at an approach which is based on accuracy of assessment rather than targeted means to get people off of benefits so avoiding lengthy appeals rather than avoiding giving people benefits. I think that's an issue because you end up with kind of costly ongoing situations in terms of appeals which are leaving to people becoming more stressed as the process goes on. I think we also need to look at greater flexibility in terms of assessment processes as well. Timings things like that where the assessment is we need to do a lot more of supporting people to be assessed at home where that's possible and I also think that we need to look at appropriately funded sources of support to help people through the assessment particularly independent advocacy. The Alliance and the Scottish Independent Advocacy Alliance have a one-year pilot at the moment which is working in four areas of Scotland and that's supporting people with advocacy support during the assessment process which is a alleviating some of the stress that people are experiencing going into the assessment but it's also mitigating against some of the bad practice that we've heard about during this process some of the things that Sonya is talking about about assessors looking at a screen and typing away and not showing the compassion and I think compassion is the thing that we would really want to see out of any new system. Okay Sonya, sorry Rachel did you want to say something? Well it's hard to add to so many eloquent, well that's a challenge sorry apologies. I think we need to look at the overall context about how some of the challenges and changes are going to be delivered in Scotland in the wider context of how the reserve benefits are also being delivered at present and how those two systems are going to join up and meet together as well as the integration of health and social care and self-directed support at local level too. There isn't the same stigma about going to the NHS to get help when you're not well but there is a stigma about accessing benefits when you're not well and I don't know when these two systems were set up at around the same time and linked in very much together why those two directions have diverged. People need the benefits system to live their lives to the best of their capacity and it's something that we in Scotland need to take a more humane approach to than the punitive approach that has been taken to date. Can I pick up on that last point and link it to a comment that Sonya made? Sonya said that we need a system to share out limited resources. Do you think that when we establish our own model of the benefits that will be devolved to us that it should be on the basis of the current expenditure? Should it be on the basis of increased expenditure? Should it be on the basis of just living with whatever you have, which potentially in the next few years is going to be less than what we have just now? Should there be any losers or should everyone have at the very least the benefits that they are currently receiving before the various changes kick in? For me to say, of course, there should be more money. People who are disabled with long-term chronic conditions should get the support that they need and they deserve, but the losers are the taxpayers because I'm paying for a system that puts people through a costly process that dehumanises them and, after 12 months, makes them do that again. Despite having a long-term chronic illness like ME, where people are very severely disabled and are hidden illness, where there are lots of stigma, some individuals, particularly 25 per cent who are bed-bound for years, often decades, are going through a system after 12 months where they have no potential to improve in terms of their illness within that timeframe. So why are they being reassessed after 12 months? I'd be really interested to see how much that process costs from a social return on investment perspective. How am I going to get better value for money as a taxpayer? I think that, yes, we're unlikely to see increased investment. I think that many of us would accept that, but what I want to see is a more efficient service and a more effective service. We know that, by the time that the personal independence payment and DLA are devolved to Scotland, it will be 2017. The roll-out of PIP is due to take place on a wider scale in Scotland from next month. The Scottish Government recognizes that about 100,000 people in Scotland who had previously been eligible for DLA will lose that eligibility with the roll-out of PIP. From that point of view, it's very hard to see how the health and social care costs of those individuals, if they can still qualify, especially for social care costs, how those costs are not going to increase. I think that taxpayers in the round are still going to be paying a lot of money, but the human impact on those individuals' lives, the human impact on whether or not those individuals, if they are employed, because it's not an income replacement benefit, can still stay in work, or if people who would have been filtered on to the work choice programme, which is also being devolved because of their disability, will end up in a more generalised work style programme, which would be less effective for them because of their condition. Before I bring Bill in, Claire. It was just a supplementary on the issue of reassessment. Obviously, for everyone going through that, that's a stressful process, but we've taken evidence that, for people with mental health issues, it can actually make their condition works. I just wondered if you had some evidence on that basis. We've been speaking to our service users in focus groups and the three things that they raise again and again are the impact of the employment and support allowance, work capacity assessment, the fear of sanctions or the impact of sanctions and the looming roll-out of PIP, because they feel 88,000 people in Scotland on the lower care rate of DLA are simply not going to qualify for that, and about 22 per cent of our service users would receive the lower care rate of DLA, so that they probably won't qualify as a result. We have seen more intensive support required from our support workers to our service users in the run-up to an assessment because their mental health is suffering, and we're also struggling to be able—we're supposed to be helping them to recover and we're having to try to work harder to maintain some of them to meet the assessments coming. Some of them, because they're having assessments for the work capability assessment, and they know that PIP is coming too, there is this issue about, I've just had an assessment and I've got another assessment and it's the same kind of questions, and there's a lack of understanding and a lack of clarity. There's a real lack of understanding about their rights. We are on the steering group on the advocacy project that Andrew mentioned from the Alliance and CS project, and that's something that is garnering really good results in terms of helping people to advocate for themselves and providing them with that reassurance and making sure that they're prepared, so that would be something that could help them with a reassessment, but it's almost making people more unwell in the run-up to it. We're a recovery focused organisation and it's distressing for our workers to see. Bill and then? Yeah, I mean, I think that the number of assessments that the current benefits system has are far too many for disabled people. It's the work capability assessment, there's PIP assessments, there's care assessments, etc. Blue badge assessments now as well. So reducing the number of assessments would save the Government money. The new personal independence payment assessment according to the national audit office about 18 months ago cost about £182 per assessment to administer compared to £49 for the disability living allowance assessment. If you're going to spend four times as much on administering the system, you're spending money on that rather than on the benefits, and that works out, I think, about £22 million in Scotland is going to be spent on that by the time you inherit disability allowance and personal independence payment. You could make savings by reducing the number of assessments. DLA was largely paper assessed, and it had a very, very low fraud rate, exceptionally low, below 2 per cent, which compares very favourably with a lot of the rest of the benefits system. So it has very low levels of fraud, which Agony still exists even with the assessment system that we're inheriting. You could save money there, but I'm not going to pretend that I don't know where you're going to lever in £300 million to the new disability benefits budget, because that's how much you're going to have lost. Although it's only 20 per cent of the current budget, it's closer to almost 40 per cent of the budget for working-age disabled people. That's where all the cuts are falling. Pensioners are exempt from the new assessments, and children are exempt from the new assessments. They'll be safe, but in saving them from the cuts, the cuts fall disproportionately on working-age disabled people. Again, to give you another example, 48, 49,000 people on a higher rate disability living allowance are going to lose it. One in three of those people uses their payment to lease a mobility vehicle, and they use that mobility vehicle to get to work. So 16,000 disabled people face losing their jobs because they will not have a means of getting to their workplace, because they'll no longer have a mobility vehicle unless they use their wages to make up the difference in maintaining the lease on the car. It's not only that the changes are failing to move disabled people into work and there's less disabled people in work than they were before the start of the recession, many proportionately less. It's driving people to work. The stress that affects people doesn't just affect people with mental health issues, people with physical impairments, variable impairments such as MEs and MS, etc. Those conditions are affected by stress and they make those conditions worse. There is evidence that those conditions are being worsened by the current work-capability assessment regime. There's good research evidence that that is taking place and that people's physical condition is being affected by their mental health condition. Just before I bring Nick and Kevin and Neiline, you mentioned £300 million that would be lost and you weren't sure how we could replace it. In a sense, that's down to opportunity costs. It's down to political decisions. For us to make, both as a Parliament and as a Government and as a society, £300 million could be found by increasing taxes, but income tax could be found by not paying councils the money that is paid for the council tax freeze, allowing them to use that and using that money for disability. It could be used to keep me a passenger. It could be used—a small business bonus, but there could be a lot of things. It's really down to choices that we make in society and what our relative priorities are. It could be used so that universal benefits to people like me aren't there and are instead targeted on people with illnesses and disabilities? I would want that. Our organisation would want that, but I would want that money to be found from whatever means is necessary to do that. I also know that the Scottish Parliament is going to be facing another round of spending cuts with the spending review, which is aimed at reducing overall Government expenditure by between 25 and 40 per cent. Disabled people and carers are going to be competing with many other groups in society who are going to be losing services and you are going to be faced with extremely difficult choices. It's not just the £300 million. The £300 million will happen if we are the transfer from the LATP, but you are going to have many other benefits being cut and many services facing cuts, including education and health. That is the context in which you will have to think about where the money is going to come from. I agree that the money could come from a number of places. Your fairer system of local government taxation would raise revenue that you could use to increase social participation at a local level. You will provide the services that are being withdrawn at the moment, such as taxi cuts, which are really again essential to assist disabled people in participating in society. Those cuts are happening alongside the benefit cuts. That is what you have to understand. It is not just to take the £300 million and let us find that. We will also find what the cuts will eventually be to spending in Scotland, but they will be substantial. Bill Raid and everyone else raised some really interesting points. First of all, we have been doing work with disabled students last year, and their inclusion is contingent on those benefits. If you remove the benefits, they all describe themselves as very included. Do you want to explain what way the participation is going to be? Without it, if we take away their mobility allowance, they cannot get in and out of the university. If you take away their support, they cannot do what they need to do as students and their personal support. It is key for people to be disabled, but I think that one other thing that we have to recognise as well is the knock-on effect that pulling large amounts of money from disabled people will have on the communities that they live in. One of the things that we have to remember is that impairment and disability is very linked to poverty. In our poorest environments, there are the highest levels of disability. If we start taking £200 million out of the very poor communities, those communities will become even poorer. People will be employing local people as carers or as PAs or in other areas. We start removing that money, so it is not just—clearly it will affect the disabled, but it will also greatly affect those communities around where disabled people live. Pulling out however many million from Scotland's poorest areas, we did a piece of work looking at it a few years ago, just looking at some raw figures. We were estimating that between one and £2 million a year would be taken out of Parkhead and about £200,000 a year taken out of Hillhead. Hillhead can afford to lose that amount of money, but you take that amount of money out of Parkhead and shops will close. It is just that the long-term effects that removing benefits from disabled people will have not just on them but on the communities that they live in that need to be looked at. We have taken a fair amount of evidence in the committee at your sessions about how benefits ensure that folks can go to work. The Tory has said that the reasons for the changes to social security are to get folk into work, but we see the adverse effects on disabled people who are working at this moment in time. We had somebody who is a net contributor at the moment, a high-level DLA, who pays more into tax and national insurance than they get in that DLA, but would be unable to work if they did not get that DLA. Bill mentioned that there were some 16,000 folks who were reliant on most ability to get to work. I wonder whether folk around the table have done any analysis on what effect that is on tax and national insurance that is no longer coming in and what that will cost if all the so-called reforms go ahead? Beyond that, that is the monetary cost, but the human cost of folk no longer working and all the rest is going to be even greater. I would be grateful to the panel if we could expand that out and how we can create a system that has some common sense and logic to allow folk independence to go out and work. Neil Johnston In relation to claims and how someone goes through a claim, how many or what percentage of people who go through the process successfully, say for DLA, do that on their own without any advocacy or help? Is that what you know? Sonia Cymru In terms of the research that we have done with people with ME, the majority of people with ME do not get any support whatsoever. The majority of people with ME that have responded to our consultations are not accessing mainstream services. They are very busy, there is high demand, and for people with ME who are so severely ill, they are not able to get to the services, they are cognitively challenged, and they also experience something called post-exertional relays. Coming along to talk today for somebody with ME could cost them three weeks, three days, three months, maybe even longer because of the payback that they experience physically. Asking for support can be very difficult because of the physical challenges. We run a specialist welfare advice service and some of our callers are not able to talk on the phone for more than a few minutes. There is a very strong cost for people in terms of accessing support, even if that existed. There needs to be a creative solution applied to providing its advocacy support for individuals. What appears to be happening is that we are institutionalising advocacy and support, because the only way that we can get through the system successfully is through having advocacy and support. Surely that is not right, but the average person in the street should be able to fill in a form and successfully provide the information that is necessary in order to get a successful claim. Is it the case therefore that people have to get advocacy? Certainly in my experience, dealing with the benefits system as a housing official, it got to the stage where we filled in every single form for every single tenant, otherwise it was a problem. That should not be the case. The system should not be so complex that an ordinary person in the street can not fill in successfully. There are particular issues in terms of the complexity of the forums now. Everybody would say that, and I am an expert welfare rights worker. Anybody who gets support in filling in a forum stands a better chance of getting the benefit. On top of that, anybody who is accompanied to an assessment stands a better chance of getting the benefit. Even if the person accompanying them is not a welfare rights worker, it is about the fact that there is a witness who can corroborate what was said. All those things can influence the eventual outcome of the claim. However, one of the things that you have to bear in mind is that we still live in a society where the functional literacy rate is around 1 in 5 of the population, but they are not evenly spread throughout the population. They are concentrated among those who are most likely to claim benefits. That is why there is a greater need for advocacy for that group. We, West Lothian Council, local advice agencies, carers organisations and so on, have set up training for our volunteers to accompany people to go to assessments. I think that that has been quite successful. We would like to see that sort of thing build in social assets, because there are many people in the communities who would want to help and do where a minimum amount of training could actually act as an advocate for somebody. We also encourage peer advocacy. Disabled people themselves can often be the best supporters of another disabled person, because they understand the condition that that person has, because it is the same one that they have. We are seeing almost a professionalisation of that happening because the system has become more complex. Before I was a welfare rights worker, I worked for the department employment when it was called that, but before it became the DWP. We used to issue letters explaining what the outcome of the claimants' claim was that were a page to two pages long. We now see letters coming out from the DWP that are 40 pages long. I defy anyone, even a graduate, to go through that and understand fully what they are being told. The computers are generating information that is absolutely unnecessary, complex and makes it very difficult for people to understand what the outcome of their claimants is, whether they have money or not. Usually, the first thing that they know about is when they do not get the payment. We need to reduce the complexity in the system so that people can use it. That would reduce costs, because there would be less reviews, less appeals and so on, because people would understand what they are being told by the social security system. The aftermath that I was doing with a case yesterday of a constituent who receives housing benefit, council tax benefit, is a receipt of tax credits. Because of changes to her income, the system now deems her to have been overpaid. I know that others might think that I am stupid. I do not regard myself as stupid. I was a welfare rights officer for 14 years. She came to me with the assessments and the results generated by the computer, saying how much she has been overpaid in each of the periods. It is unbelievable. I can understand that, in the irony, when she went to the council to get an explanation, no one there could explain it either. We are left with people who are now helpless because of the complexity of the system, even when they can receive advocacy. I am the greatest supporter of advocacy services. You mentioned the fantastic advice shop in Great Work being done, but the fact that it is there and is rammed to the door seven days a week or however many days it opens is just indicative of the complexity and the problem that we are wrestling with. Had that been happening in isolation, that would have been bad enough for disabled people. What is happening at the same time is the front line fight against poverty and inequality, which is local government. Do not care what MDC says, local government is the front line, is being absolutely having the heart ripped out. I think that they are getting a double treble quadruple whammy in terms of what is happening to disabled people in all those support services that are going on. The small groups, the day centres, the fruit and vegetable co-ops, all that kind of stuff that is the infrastructure, the scaffolding around about disabled people is being taken away as well. The combination of the two is catastrophic for a number of disabled people. You mentioned the disabled groups and carers will be competing with other groups for scarce resources. That is absolutely right. They will be, but when you look at how competition for scarce resources usually pans out, I am pretty cynical about how successful disabled and carers will be when you compare it to more middle-class areas and welfare areas who will be competing for those resources. My question to Olivia is, do you think that the political will is there with any of the political parties to prevent that happening? There are a few challenges because of the way that disabled people are being portrayed in the media and in political discourse as skivers avoid work rather than unable to work. Because of those attitudes in society and they are much more widespread than they were a few years ago, every opinion poll that you look at says that there is a widespread belief that fraud levels are at the astronomical level within the social security system. With those beliefs in people's heads, it is politicians who have to appeal to that public to give them the support for what they are doing. They have a mountain to climb in overcoming the attitudes that are being created by programmes such as Benefit Street, the poverty porn that is on television. You will face very difficult challenges, and I am cynical about our ability to compete for those scarce resources, because those with the loudest voices are usually at the front of the queue. When that competition occurs, disabled people are stuck in their homes unable to get out because they have not got their mobility any more, they have not got the taxi card system, etc. They are not at the public means where local taxpayers are shouting the odds that they would rather have cuts to services rather than paying more. We need to be realistic about what we can do to begin to change those attitudes. I honestly think that promoting the idea of social participation should not everybody have the right to participate in society the same as everybody else, is one that will appeal within Scotland, because we have an understanding of fairness and justice and the idea that we can help people to contribute in whatever way they are able to contribute. That does not always mean work, it could mean being a volunteer down at the local community centre, it could mean going on a college course. I know Neil, but what I am saying is that, if you begin to promote the idea that people should be able to do what everybody else does, takes for granted, that might begin to change some of the attitudes that have been fostered over the past few years to justify benefit cuts. John Lennon and Andrew Nick Thank you. I want to move the discussion on a little bit. John Lennon, hold on. If there is a different point, John, there are a couple of people. John Lennon We are just about the delivery of benefits, and it just picks up a wee bit on Neil's point about whether, in the last week, we had a good discussion about whether councils should be the principal body. John Lennon Can we just hold that just now then? I think that Andrew and Nick wanted to come in on the present issue. I just wanted to come back to a couple of the points that Neil had made. Neil talked about local authority funding and the difficulties there. We need to keep in the context that, with disability living allowance, lots of disabled people use disability living allowance to pay for social care, so that non-residential social care is funded partly through that. As a result, people coming off of that, the pressure has increased on social care. In terms of the point about advocacy, I do not know exact numbers of the number of people who need advocacy to go through the process. Some of the evidence that we are getting back from our project is suggesting that people would not go to the assessment without an advocate there with them, so they would not get the benefit at all. They would not actually even go. That is an issue that we need to consider. We also need to think about professionalisation and professionalisation in a couple of different ways. Advice and information in advance of the assessment is different from advocacy during the assessment, so getting support to fill out the forms and all of that is a separate thing from support during the assessment, given the people, the prompts during the assessment and supporting that way. I think what is becoming clear from our project is that having someone knowledgeable about the assessment there with people is making a massive impact on the outcome, not just the outcome in terms of whether they get the benefit, but also the tone of the assessment, the treatment that people get, even just that knowledge of the person who is the advocate can say, well, you can take a break now, because people might not know that you can take a break during the assessment. They might not know in advance that you can request a change and date twice, but you can do it once. One of the other things that we also need to consider is whether we need to make sure in future that there is GP and medical advice and social work advice in advance of those assessments happening so that reasonable adjustments can actually be made to the assessment process. We heard an example from one of our advocates earlier in the week of someone who has a range of multiple conditions, a mental health problem, but they also have a learning disability. In order to understand and articulate their own condition, it is quite difficult for them to do that in a face-to-face assessment, so they need support and prompting. They need the right kind of support about what this process is going to look like in advance and the knowledge of what it is going to look like, and then tailored advocacy support during it. I do not know how you create a system that ffends those issues off, to be honest. I want to pick up another point that Neil made about the perfect storm that is facing disabled people. The other thing that we are seeing is a huge cut in the number of people employed through the public sector. Disabled people, like most minority groups, are more likely to be employed in the public sector than they are in the private sector. To tie in with what Bill said, we did a bit of work a few years ago called Bad News for Disabled People, where we compared the way the media talked about disability in 2004 with 2011. There was a huge change in the way of talking about skivers, lazy, good for nothings, people on benefits and so on. When you start to look at that, if you are a private sector employer and somebody comes to you and they have been on ESA for two years and every time you have read in the press that they are lazy, effective and good for nothings and you have somebody else to employ, you are not going to employ somebody who has been on ESA because you think that they are only skiving. Bill's point about higher levels of perception of skiving, we ran a series of focus groups. Most people thought that fraud on disability living allowance ran at about 40 per cent up to 75 per cent, yet, as Bill says, official figures are under 2 per cent. When people spoke about it, they all spoke about a relative or somebody they knew who had real trouble getting benefits because they know that getting benefits is hard for their family but somehow or another they think that there are lots of other people who it is very easy to get benefits for because they are told about it in the media or it is on a benefit street or some other programme like that. It is creating this real problem for disabled people to get the support and to receive the support that they need. It is not what people do not choose to go on to that lifestyle. Joan, is it this issue or is it a different one for you? It was about the benefits that are being devolved and reserved. Can we come back to that then? Kevin, is it this particular issue? The question I already posed, which really folk did not get the opportunity to answer, is about those folks who are currently on work, who, if they lose their DLA, will probably then be unable to work and about the costs, the lack of common sense in those reforms and what that does in terms of the human cost to them. I would like to hear if there has been any analysis done by folk around about those 16,000 people who, if they lose their benefits, are likely to lose their employment, which will set them back greatly, I would imagine. There has been some work done on that at UK level, so I can probably do a breakdown of the figures and get back to you, Kevin, about what the likely costs are in terms of national insurance contributions and income tax, et cetera, in terms of those losses. I think that that is possibly doable. On that particular issue, on the mobility component of DLA, there has been good work done on that, but, across the board, it is more difficult, because, as we have to keep on saying, it is not just each individual cut, it is the cumulative impact on people. Certainly, there are fewer disabled people in employment now than there were at the beginning of the recession, even although employment rates for the general population have recovered to almost the same levels, although there is more part-time and self-employed work now in the system. However, for disabled people, employment rates in Scotland fell from about 48 per cent, down to under 42 per cent. We have basically lost a part of the workforce that has been, as Nick has said, from the public sector and the third sector, where there were a lot of disabled people employed, but there are fewer of them employed now. John Swinney My point was about the delivery of benefits that are moving forward in Scotland. We had a useful discussion about that last week in terms of the role that local authorities and councils will play in that. It was a division of opinion in terms of whether people thought that was a good idea or whether it was a bad idea, particularly with the possibility of introducing some sort of post-scored lottery in terms of entitlement. I wonder whether the panellists had a view on that. We have been talking about this issue in terms of the delivery of employment programmes, which are very much linked with future benefit devolution, and whether or not they should be taking place at a national level or through local authorities. We would have concerns about local authority delivery because of the post-scored lottery and the inconsistent approach that some local authorities might take. It is difficult because we want to support localism and we know that local authorities should know on the ground what is required from an employment point of view or what community support is required for people with disabilities. However, in practice, we have seen social care charges at different rates from different local authorities and how that can impact on people's lives and their finances. Self-directed support is another issue. The delivery of welfare funds has been applied in different ways, so we would be slightly concerned at the present time and with the imminent changes of health and social care integration about an immediate delivery of those benefits. Possibly in the longer term, it might be something to consider about more local delivery, but at the moment we are not convinced. It is a really interesting question because, if you look at the devolution of public spending that is happening in Manchester, there is a real opportunity for better integration of health and social care and support that disabled people can receive, but we have yet to see that. There is also what we have heard in terms of post-code lottery. We know that there are varying differences in terms of health support that individuals get, access to social care assessments despite being severely disabled. We know that there are differences even within the current system of people waiting anything from five weeks to eight months to get the outcome of an assessment. When you think about the extra cost commission research that was done with people with neurological conditions, where their cost was an extra £200 per week, somebody waiting eight months for the outcome of an assessment, that is an extra £6,400 that they are going to incur in terms of cost, as opposed to the £1,000 that somebody might incur waiting five weeks. If we end up with a fairer, more equitable, more consistent service to people overall or process overall, that is fantastic, but at the moment I would question where the evidence basis is for that. You have concerns about the local delivery of services because of the inconsistencies. If we had a system that was predicated on national assessments but local service delivery, would that also cause problems or are you talking about the same level of service delivery across the country, which would inevitably mean a national agency to deliver the services and taking the responsibility away from the local authorities? Which model would it be? It is quite hard to answer that question because, in some senses, I want to say that you need a mix of both. You need local solutions for specific issues and difficulties, but you do need some consistency. Why should somebody living in one street get one form of service and greater support and the person in the street next to them not be entitled to the same support and yet they might have exactly the same disability, they might have a similar impact in terms of that illness, so there does need to be some consistency there. There are savings by having a national approach if you think about the back office costs and your overheads. Equally, if it is not delivered locally, how would people, for example, with their me, if they had to travel, as they are now, 40 or 50 miles to an assessment centre, which costs a huge amount of money, as well as having a major disabling impact in terms of their condition? There has to be a better approach to what we are delivering at the moment that is fairer and more equitable, but I have not got all the answers. I do not mean that. I see that locally in the contrast between those living in the Remshire Council area and Glasgow City Council, and it is just yards that separate them. The issue of assessment for mobility in national centres is a different one from the assessment or once there is an assessment for entitlement for the judgment and the decision about what level of service goes in, which is then down to the local authorities. How do you eradicate that without removing that decision from the local authorities and setting up a national care agency? It is a real problem about how we tackle it. In a way, if different local authorities opt democratically to fund different priorities, it could be seen as acceptable that this is what the local people choose to devote, but the real problem would be, of course, that we know that there are certain groups who will do better out of, you know, disabled children always do very well when they get to 18, they do less well. We know that. We know that people with a mental health problem will face stigma when it comes to accessing services or to people providing them with services. It is not like you are trying to say that you do not want to be democratic, but there is such stigma attached to some groups of disabled people that we cannot go around saying that we will put this down. There has to be a decision sometimes that is taken about. It feels that we are going to fund people with a mental health problem and we are not going to put it out to say, should we be funding disabled children or should we be funding people with a mental health problem? If we went to a democratic vote, we would know which one would win. Someone has to make a decision where the need is greater and how you meet that need. What are we talking about? Are we talking about national decisions or local decisions? We specifically asked that question last year during the Smith commission deliberations as to whether welfare benefits should be devolved to Scotland and if they were devolved who should administer them. The overwhelming response was that yes, they should be devolved and that the Scottish Government should administer them, not local authorities. Again, we asked that question at the AGM this year. Again, the overwhelming response was that it should not be local authorities. You might be suffering from disabled people's perception of the care system and how unfair that can be, but people do not want to see that form of localism brought into benefits decisions. They want to see a consistent standard. The evidence is even from the Scottish welfare fund that there are huge variations across Scotland and whether the money is even spent. We know that poverty exists in every single corner of Scotland and yet it is not being spent where it is needed to be spent on the people it needs to be spent on. That is with national guidelines in place. Disabled people are very suspicious of it being set down to local authorities and then not ring-fenced as well. It gets spent on road repairs or whatever rather than on disabled people's needs. Unfortunately, if you were to take a strophold of disabled people, you would find overwhelming opposition to local authority delivery. That does not mean that you do not need local delivery of service—I think that you do. I think that that is part of the loss of humanity. It is a person at the end of a phone in Newcastle that you are having to deal with at the moment rather than somebody who knows the local situation and what you face every day. That is the one that you are communicating your experience to. The return to ring-fencing? I am saying that that is what disabled people's fear is—that the money would not be ring-fenced. You are saying that it should be ring-fenced? Benefits expenditure at the moment is ring-fenced in that sense. It is not spent on anything else. You do not set aside your social security budget and then say that we are going to spend it on education or health. If you are saying that a disabled person in Glasgow could be told, well, you are not getting any of whatever the new disability benefit is, because we have decided to spend that on the roads, I think that that would be decidedly unfair because you would be saying to disabled people that your human rights, we are going to ignore them because the taxpayers have told us that there are other priorities. I think that that is going back to where we started from Andrew's point of view. That has to be based on human rights. If there is a human right to participate in society, that is not local. That is across Scotland. That is not whether you live in Inverness or Glasgow. You should have the same right to participate wherever you live, and that means that the benefits band has to be ring-fenced. On the issue of bringing in Christina, I will move on to John. To pick up on Bill's point and to pick up something that Rachel said earlier about a more effective and more efficient service, it ties into the argument about local versus national. I do not think that there is an argument there. I think that there is room for a mix of that system. How do we make it more effective and more efficient? One of the biggest fears of all the people that I spoke to in the roundtables that we have had and the have-your-sayes and the constituents that come through my door is that they feel when they are assessed. The person that assessed them has no understanding of what the impact of their disability has on their everyday ability to do what they need to do. One of the biggest issues was the fact that a lot of them felt that their own GP's assessment or consultants were completely ignored and not taken into account when that assessment was made. Would a more effective and efficient service be delivered at local level with taking into account all of the medical information that someone has got for their particular needs, assessed by an occupational therapist, locally, to then make a decision on what somebody's eligibility would be and what level they require to function at that level, whether it is to stay and work or to do something worthwhile that they feel works for them rather than just being saying, you have been put in that category, therefore you better get on at the system and you better get and find a job, which seems to be just people are brushed aside like that now. Having that sort of a local information used to determine a personal profile basically for that person and then delivering that effectively. I think that a transition cost to that would be quite substantial but the actual impact of it would be that more effective and more efficient system, maybe not the opinion. The capacity assessment used to take account of people's own doctors and GP's and consultants. The ESA, the work capacity assessment stopped primarily, I mean I don't know but you might say that it was because it was felt that people's own doctors might be too sympathetic to their own views. I can't comment on that but it was so that it would take an idea of this dispassionate view that you didn't know who the person was and you would just come out with this alleged objective measure of what it was but I think that going back to including and allowing your own GP's or your own consultant's evidence to take part would be a very welcome way of resolving some of the problems in. Do you think that that system has what's created the inefficiency and as much as a huge amount of these people go back on appeal and won the appeals because the original decision was the wrong decision? I think that it would be a much easier, much more likely to be able to say that this is genuine and that my patient has these reasons and that there would be a much more longer term view and if we were taking account of people with fluctuating conditions for example how somebody on a single assessment can tell that whereas a GP or consultant would be able to take that into account so it would make life much simpler and much straightforward. I think that again you need a combination of both because we talked to GP's who will say well I can assess somebody in terms of their health needs but how that then translates into their actual workplace and whether they're able to go into work and function in work I'm not equipped to assess that so you could look at something like access to work where you'll have an OT that will come and look at your workplace environment, will look at your specific needs, will take into account consultants letters, GP letters those kinds of things and make recommendations so yes there is a case to be made that if you have a system that takes on board and seeks the medical evidence and other evidence and at the moment it's not we've got examples in Scotland where somebody was asked to pay £100 for a GP letter and evidence and you've got medical advisors and GP's who are refusing to provide letters because they can't cope with the demand and they're being faced with stretched services and cuts themselves so if you have a system that looks at the individual that looks at their specific condition and how it affects them in their specific circumstances then you are going to get to a better place I think and you know going back to my example earlier if you are paying for somebody to go repeatedly through a process when really they shouldn't be let alone the human cost and there is a massive human cost but the financial cost cannot be justified and I really do think there is a call for some actual economic evidence that looks at that in detail because we're talking about should there be extra money or should it be localised or should it be held at a national level what you want is something is going to create savings so that those people that need a service and need support and need benefits will have that support and that funding available to them because you've freed it up and you've not wasted that funding. Just before I bring Bill in could I just stick with a point you raised there about someone being charged £100 and others being refused should there be a recommendation that as part of any system that there's a change to GP contracts to require them to provide those letters support? I think if people are able to provide medical evidence then the system should support them to enable them to get that. I think what we have to understand is that GPs are under considerable pressure and so they have to have time to be able to provide that evidence and to be able to see their patient and it has to be fair in terms of the amount of money that they get recompensed for that because it will have a knock-on effect elsewhere. It's just one of these bureaucratic things that has to be dealt with separately. You don't deal with that as part of the benefits system, you'll have to deal with that as part of the negotiations with GPs but if we are looking at redesign then perhaps maybe that's something that we should recommend to make sure that everyone has access to that without charge. Absolutely and it goes back to your whole point about integration. There's a lot of evidence for the benefit of integration so given that there's a real opportunity here in Scotland to look at and do things differently then integration should be the heart of it as should participation. I think I made the case earlier on that the disability living allowance assessment regime was very different. It was largely based on a paper assessment and it was largely based on a self-assessment of how the person's illness or impairment impacted on their daily lives. The difference with the personal independence payment is that it identifies certain tasks and asks, are you able to do that without assistance or not? It's essentially a functional test about those tasks and you only score points if you cannot do those things unassisted. With disability living allowance it was much, much greater scope to actually say how does this impact on my daily life. There was a story being told and somebody looking at that could say that's a high-level impairment or that's a medium-level impairment or that's a low-level impairment and it's going to have different impacts on their lives. I would like to see that but I think also that there is scope, much, much greater scope for an integrated system where information is shared because people are undergoing care assessments by occupational therapists. Are those care assessments shared with the benefit system? No, they're not. You've already got an assessment that probably says that this person is not fit for work, unlikely ever to be fit for work, and those are the barriers that they face even in their home which we are going to recommend how they can overcome those barriers. There's a lot of information in the system at GPs, consultants, health visitors, et cetera, that could be shared with any new benefit system that was set up and again reduced costs by reducing reviews by reducing the number of appeals because people wouldn't need to go to that because the person making the initial decision would have much more evidence to base it on and much more likely to make a decision that's near or closer to being correct. I was just going to make a very similar point to that just to say that there's lots of disabled people, people with long-term conditions go through the health and social care system and experience lots of disjointed discussions and kind of this assessment process is all over the place where Bill talked about lots of those different assessments that people are going through and we need to consider this in the wider debate that's going on in terms of health and social care about data sharing between professionals because I think there's something to be added around about what welfare comes into that and I think we need to come up with a solution which is about building the most accurate possible picture of someone's life whilst reducing the number of assessments and how many times they're asked that question but what I would say is that there are polarized opinions about data sharing so I'm not sure what the answer is. Rachel? I think that GPs are so often the gatekeepers and we see welfare through a very employment focus and through the job centre and we actually need to start thinking about health and welfare and employment in a much more integrated way. We are working with the Alliance and GPs at the deep end at the moment in terms of pilots at GP surgeries where people who are unwell and presenting with a low-level mental health problem can be triaged and given support and community-based social prescribing support and a lot of the reasons that people are actually presenting are work-related and if people can access support upstream before they become very unwell it's something that could actually prevent them falling out of work in the first place or requiring extra help and more intensive social care support in the longer term. I think we do need to think about things in the round and the person in the round and how their life could be affected and promoted through a much more preventative system. I think that it's important to be in mind that we're looking at the future of social security delivery and in Westminster Parliament the Scotland bill that will decide what powers we're going to have is still going through the Westminster Parliament so we can live in hope of changing it. I was struck by the evidence by Inclusion Scotland where they were saying that they were disappointed that the Smith commission proposals failed to address the key concerns and aspirations of disabled people, particularly in relation to powers of welfare and taxation and the national minimum wage. Is that still your position? It is. Right. We've consulted again since the Smith commission and we get back the same response that they would much prefer to see all of welfare spending devolved to Scotland apart from pensions. There's slightly less support for pensions coming here but because of the complexities of the system and the way that benefits interact with one another it causes problems when you divorce means-tested benefits from disability benefits. If I could just tease that out a wee bit because obviously the big benefit that disabled people rely on employment support allowance is going to remain as part of the Westminster system and it's going to be part of universal credit and understand that there'll be a work preparation group as part of that ESA that relates to the existing WRAG group. Now Ian Duncan Smith has said that there's going to be more pressure put on that particular group to find work and that means more conditionality and I assume more sanctions which are also reserved to Westminster. What is your response to that? What kind of problems could that create for disabled people? I think that Rachel and I will be in total agreement on this that particularly for people with mental health issues, behavioural problems, learning difficulties, those are the people that are being sanctioned on ESA at the moment. 60 per cent of all sanctions fall on that group and that is again because of perceptions of people who administer the system that they're not really ill they just pull themselves together, they could work or do certain things and largely it's because people don't understand the system they're dealing with or can't cope with the system they're dealing with because it makes them more ill and therefore it really is a horrific situation that we're going into because up until now we've recognised that some illnesses are long-term and affect people their whole lives, people with ME, MS etc and now we're going to pretend that people can get rid of those illnesses within a year and they can't but after that year's up they will go down to the same rate as an unemployed person whereas unemployment benefit as it used to be in Jobseekers allowance as it is now was always intended to be a short-term benefit that assisted people when they fell out to work but with the expectation that they would go back into work whereas sickness benefit and incapacity benefit you know invalidity benefit is predecessors from employment support allowance they were always intended to be long-term benefits for people who were unable to work and to say to somebody in their 50s we are chronic condition like asbestosis that it's fine we'll give you the support to return to work when you know they could be dead in two or three years it's just completely unrealistic and you know we as a society really need to look at ourselves and say is that what we are condemning people to is poverty when they become ill because that is that is what the outcome of cutting your ESA down by 20 to 30 pound a week will be for that group in the work preparation group and as you say all the sanctions it's gonna fall in that group as well completely unfair and you know we were talking earlier about people assessing you who had some understanding of problem a court has found that only people with experience treating people with mental health illnesses should really be doing those assessments for people with mental health conditions is that happening no it's not Rick the courts your decision is basically being ignored by the DWP it is not happening in practice that every person in a mental health condition is being assessed by somebody who's got who's got a speciality in mental health I said at the beginning that you know the evidence around bragg that people being placed in workers work what a bragg work readiness assessment group assessment group are is that they're not being returned to work very very few people are being returned to work and that it's it's actually failing as a policy and most of the most of the research is suggesting that people being placed in rag are too far from the labour market to be ready to go for work that they're being placed in rag and that and it's failing them and they're then going up you know that the OECD published a big report in 2014 looking at the UK's activation policy it was very very critical of its use of rag saying that it wasn't working and all that the government's response has been well we're cut down the level of time people are getting to rag not looking at the categories of why why is it that people that people in rag aren't finding work and it's because that the old PC personal capacity assessment would have discovered that people were too far from work to be placed in rag but that's not there and I think that that's one of the big problems we've got with the ESA and at the moment it's the the placing of people on rag is that wrong groups for people have been put into the work and possibly because wrong too many people are being placed in rag it means that the resources that are available to provide employment support and to get people involved are too stretched so rather than being able to concentrate on a smaller number of people who might be closer to work it's actually having to spread out of a far too many people many of whom aren't close enough to to the labour market yet and I think that that's the problem that we need to be addressing okay John sorry did you want to come in there just to reiterate those points we know that the two employment programs the work choice program which is specifically for people with disabilities is so much more effective because they have smaller caseloads they have more specialized support they have you know a case worker for work choice is meeting with the disabled person once a fortnight at the minimum whereas on work program where people on employment support allowance in the rag group tend to be filtered through it is a much less intensive support and and only about five percent of or so of people with rising to about nine percent over time for people with disabilities who are actually getting a job outcome after two years we know that this is going to be devolved to Scotland so obviously there's a chance for a bit more of a revolving revolution within how it's delivered and hopefully a more humane approach but we do hope that the cap that currently exists with work choice because so many people as Nick said or put on the work program rather than work choice it actually benefit from a more specialized approach and yet there's a huge number of people who have a disability in the employment market but just aren't actually getting that specialized support. It's not just about supporting the worker who's going into work the work from disabled people where they were this is about supporting employers about because a lot of employers in that it's the same that's used with you know bringing people from people who've been in criminal justice system people who've been in care it's about supporting it's about you've got to support employers who many of whom will not have employed disabled people before and it's providing that support and that's what works and I think that the interesting thing about this local national debate actually employment support is much better localised because it is the local employment center aware of the local employers and the local employment market and we could look at that being being more sort of localised in the delivery. Point about the Scotland bill going through changes one of the things that's missing from the Scotland bill which actually should be based on what the Smith commission recommended in terms of employment programs coming to Scotland is that access to work isn't currently involved isn't currently included apologies within the bill and ourselves and inclusion and most people around this table would be I think in your in action for ME's mission to or supportive of access to work being devolved as well in terms of being able to support employers to make whatever changes are necessary to workplaces to be able to facilitate people with disabilities being employed. One is I would absolutely agree with with Nick in terms of employment support we've just set up a specialist pilot employment support project in the Bristol and surrounding areas and that's integrated within the healthcare provision and what we're seeing already is that that localised service has been able to meet the needs of some people with ME who are well enough to work or to consider working that that's different from the support they're getting from employ and from job centre plus etc so I think that's really important to consider. I think the other the other point is that it comes back to the your very original question which was about principles and we've got to remember that we're talking about disabled people they're not a homogeneous group some disabled people are much more badly affected by the stigma the lack of understanding the lack of awareness the way in which society operates than others and you know we've had some statistics around individual groups that are that are more badly affected but you know we represent a group of people that are so badly stigmatised and the ignorance and neglect that they experience is just compounded by the health system by the social care system and by the benefit system so I think it's really important we don't slip into thinking about this as one group of individuals actually it's a group of individuals where there are lots of subsets of conditions and illnesses and needs etc. What I'm getting at is is the failure to devolve ESA how is that going to affect our ability to deliver the system we spent a lot of time talking about how we're going to deliver benefits for disabled people but the main benefit of disabled people is going to remain reserved and can we realistically devise the kind of system we'd like to devise when that remains with Westminster? It's really difficult to devise a system that really is a wraparound fully supportive system because all of these benefits as they interact with one another you know the rates that are paid through income support as it is now housing benefit as will be universal credit are affected by your entitlement to disability benefits to carers benefits etc so if you want you know a fully functioning system that you can plan properly you want the lot however having said that we're getting what we're getting we would like to see more still access to work for one we would it's a very very small amount of spending by the UK Government at a Scottish level six or seven million pounds a year compared to what we are being devolved very little but it's not being devolved and yet it's one of the key tools that can open up workplaces to disabled people because it can support disabled people to get into work by providing adaptations for a new entrant to a workplace but it can also support disabled people who are in employment whose impairment becomes worse or or they have an acquired impairment so that they can be supported to remain in the workplace rather than falling out of work because if they do fall out of work the chances get back into work are extremely low so you want that too and we've had meetings with Treasury officials where we've said look we're talking about a tiny amount of money why is it that the Treasury and the DWP seem so keen to hold on to this oh it's administered by job centre plus no it's not it's administered by call centres you know in england it's not administered by job centre plus and you know if we could get access to work honestly that that is one of the smallest amounts of money that you can get but we're one of the biggest potential for transforming Scottish society because for small employers the extra costs that they take on a disabled person can be the barrier let's face it you know that somebody's facing three, four, five thousand pounds costs on top of the wage bill no it's not going to happen when they're comparing it against somebody that's got to cost them nothing so you need that in place to overcome that financial penalty particularly for small and medium sized employers Thank you. I think Rachel and Bill have in some way answered part of my question but given that we're not getting everything that was even recommended in Smith and the Joseph Rowntree Foundation said at that time that the proposals would land some way short of a great leap forward in poverty reduction or having any control of of that inequality that we've talked about a bit today I would just like to ask if there are any concerns about the vetoes that have written in to the Scotland Bill and whether you can see a position where perhaps Scotland would be ever able to introduce new benefits in this area and just if there was any recommendations from those areas. We're concerned about some of the inability to top up benefits within the Scotland Bill at present especially if the individual has been sanctioned. We know that half of sanctions on ESA are overturned on appeal so they're not being well applied and they're having a massive impact at the time and in the weeks following the sanction itself until that money is processed and returned and that's only if the individual is actually well enough to go through an appeals process and has the support that they often need to navigate and negotiate such a stressful procedure when they have already lost a lot of their income. One of the big impacts about inequality is going through alongside the Scotland Bill, the welfare reform and work bill is going through Parliament at the moment and a lot of their changes will come into place from April 2016 to next April. People in GSA, housing benefit, income support and the employment support allowance, work-related activity group, those benefits are going to be frozen for the next four years and people who have been new applicants for ESA and I don't know if that includes people who have just got to the end of their 12 month period and need to go through an assessment period again. We'll also lose about £30 a week despite having the additional costs of their condition so from an inequality point of view that's going to have a massive impact and we're very concerned about how that I think that's going through committee stage at the moment in the House of Commons so it's a big challenge because that will also then affect their ability to pay for social care services and be fully participating in society. About the delays that the Secretary of State could impose on any positive changes that the Scottish Parliament and Scottish Government wanted to bring about because although they said that they wouldn't reasonably do anything, the universal credit system, as we can see, is having enormous teething difficulties so making changes which will impact on that system which doesn't work at the moment, the Secretary of State is going to be able to delay changes potentially and definitely that you might want to make which could have a positive impact on the lives of carers or disabled people because they will impact on entitlement to universal credit. Either the housing element or the former income sport element could be affected by how you decide who is entitled to disability benefits or carers allowance. Again, on those benefits, we do not think that you are getting complete devolutionary power. It's all shrouded round with all those conditions that the person must, if carer, they must not be in work, they must not be in full-time education, they must not. That is not devolution, I'm sorry. That is not full devolution. On sanctions, at the moment, the Scottish welfare fund can make a payment to somebody who has been sanctioned to relieve their poverty. Once the Scotland bill is passed, they will not be able to do that because it precludes a payment solely on the basis of a person having been sanctioned. It's tough to have some other emergency that would justify the payment from the Scottish welfare fund. The Scottish Parliament's ability to relieve poverty is not going to be increased in the area of the Scottish welfare fund that is going to be reduced. In terms of delivering on Smith, I think that that is completely at odds with what Smith said, where it said that, in the area devolved benefits, you should have complete discretion. I was wondering if I could get maybe a quick response from our panel this morning on the coroner's verdict from London this week, which found that the withdrawal of ESA resulted and the actual verdict resulted in a man's suicide, and whether you've got a comment to say about that and where you go from there. The other thing was about a pick-up on Joan's question about the tensions between devolved benefits and reserved benefits and some of the issues in that. I see that the cabinet secretary this morning, Alex Neil, has announced that the Scottish Government will abolish the 84-day rule for children with long-term conditions who find themselves in hospital for longer than 84 days. That 84-day rule is that they lose their DLA in some other benefits if they are in hospital longer. Sometimes, in a situation where the parents are under more stress and they have more costs because they are visiting, they are taking shifts, basically, to sit in hospital. My question is that the Scottish Government made that announcement this morning so that they have good control of the DLA. Of the other benefits, attendance allowance, severe disabled men allowance, carers allowance, are there any other aspects of those that you think immediately some things could be changed? I know that that is a tinkering with the current system rather than developing a new system, but there may be things that we could do almost immediately that will alleviate some of that problem. The two issues are the coroner's verdict and whether there is any other scope within the devolution of further benefits to do something like abolishing the 84-day rule. I was just going to say something about the first one of those rather than the second. Obviously, we have talked a lot today about some of the impact of these assessments on people. We have, through our project on advocacy, seen lots of people who are very nervous, experiencing panic attacks and things like that, and they feel that their mental health is being put at risk. What needs to be put in place is something after an assessment. In our view, there needs to be something in place after an assessment that has not resulted in someone receiving the benefit, too. If someone has been assessed as not being eligible, there needs to be some sort of process of signposting or support somewhere. There needs to be some kind of—well, you have not received the benefit, but here is what is out there in the local community, for example. We have a links worker project that works in 7GP practices in Glasgow, which is about supporting people to find community-based solutions to particular health issues that they might have. Something like that in place across Scotland might be something that we could support or suggest. I was just going to come back to the point that you made about the coroner's report. Sadly, it is something that we do here, particularly with their me, but across the field in terms of the disability group, we sit on the disability benefits consortium and we look at the organisations that are supporting disabled people. It is a really sad thing that you hear on too many occasions. I think that there are some lessons in that that need to be learned. I think that there is also an interesting point that Andrew has just made in terms of how do you support people once they have had a no? That has not been something that has been explored, certainly in the responses that I have read online and in talking with other organisations. I think that that would be something that you could consider moving forward. On the coroner's verdict, it is the tip of the iceberg, unfortunately. Black triangle, one of the groups that we work with, has compiled a list. It is over 80 people who have committed suicide after an adverse benefit decision. Nobody? No, it is right in the UK. However, those are based on press reports of what the relative said about the condition of their mind. Suicide is very complex. We never reduce it down to an adverse benefit decision. When a coroner makes that verdict, it is because that is what the balance and evidence that was presented to them suggested was the reason. We do not have coroner's inquiries for every death. That is why I am saying that it is the tip of the iceberg. What I can say is that I have had engagement events that we have organised on the phone to the office. I have had people who are suicidal about the benefit decisions that they have faced. It is going back to their dignity and respect that that has been robbed from them. They have been reduced to feeling a less valuable human being than everybody else in society. That is happening on a daily basis. I am not hearing it all. We are not a front-line organisation in the sense that we provide advice and information to people who are doing it. That is people coming to us because of their wits end, because they have nowhere else to turn and they have met us before at an engagement event. It is incredibly difficult for us to cope with people who are suicidal on the other end of the phone. It has a real impact on our ability to function, think about what it is for them. I have heard people who have really been reduced to nothing by the system. That is why we have to reform whatever we get so that it works for people. Going back to being centred on dignity and respect, one of the things that we could do again with whatever system is devised is to ensure that everybody who is involved in administering it understands the group that they are working with in the sense that they understand disability better. We would argue that everybody should undergo disability equality training, where people's discriminatory attitudes are challenged and they are made to look at what the basis of their beliefs are and try to overcome them. Without that challenge to exist in beliefs, I do not think that we will get a proper change in the system. The coroner's report is the first time that we are officially recognising that this is happening. I cannot say that it is welcome, because it is something that we should be using to challenge the system. In terms of what we can do immediately, I think that some of the key areas that we can look at is around providing support for people undergoing sanctions or for assessments. If you look at areas such as POSL, where there are very high levels of people without any form of qualification and with relatively high levels of literacy, a lot of those levels of literacy, I think that we might be looking at dyslexia as a result, but then being given benefit conditionality that involves filling in forms online means that you are not going to be able to complete it. We know that middle-class children are much more likely to be diagnosed with dyslexia than people from areas of high social deprivation. I recently examined a PhD, which virtually concluded that looking at dyslexia, middle-class children get diagnosed at age 8, working-class people get diagnosed in prison. It is just that that is putting it very crudely, but there is that real disparity. I think that lots of people will be given benefit conditionality that they cannot complete. They then get sanctioned. It is not just the one-off sanctions of 28 days. They are bad enough, but when people are being sanctioned for up to three years, these are the real, which can be done without recourse to court of law. One way to get around this is for us in Scotland to provide support and to start looking at why our people are unable to fulfil their benefit conditionality. What is it that is happening? If people are unable to fill in forms online, we should be saying that under the Single Equality Act you cannot set people conditionality because it is unfair on grounds of disability. We could be looking at that. That might be one relatively straightforward way. I do not know, but it is something that we could look at. Why are people being sanctioned and what can we do to keep them level of sanctioned? If we cannot stop the sanctioning or we cannot give people money if they have been sanctioned, the thing to do is to stop the sanctioning in the first place and to think upstream and see what we can do to prevent that. If the money is not devolved, it might well become something that is a good preventative measure and it might well be cost-effective in that local authorities will not have to meet housing associations. Sanctioning is affecting housing associations and their ability to meet costs and so on. It is a long-term preventative strategy that would be a good thing to do. The coroner's verdict about the individual who died by suicide. I echo what Bill said in terms of the complexity around suicide and how difficult it is to attribute one reason. We know from supporting the people, our service users, that we have had to make interventions to prevent suicide. We did a snapshot poll of our services a couple of years ago and, over the course of a month, there have been six interventions. We know that it is the stress and the financial anxiety and the fear of losing our support and fear of how that will affect their ability to pay for social care services, too. All of those issues are really affecting people's mental health. I recall that the Mental Welfare Commission published a report in the spring of 2014 about an individual who had died by suicide. It was as they had attributed it as a result to them losing their benefits. I do not know if it was through a sanction or through the ESA process. There has been some evidence in Scotland of that happening. I echo Nick's point about trying to alleviate the challenges that people are facing following sanctions and how we can support them better. From an immediate point of view, we are going to see so many people by the time those benefits are devolved to Scotland who lose their DLA, who may also lose their carers allowance if those individuals on lower-rate carer DLA are not going their carers, when they will no longer be able to claim carers allowance, and how the carers bill in Scotland could deal with that as well. Okay. Anyone else who has not contributed? I had begun to say earlier that carers allowance should probably be addressed because carers allowance is falling behind the other income replacement benefits such as jobseekers allowance and ESA. It is lower than both of them. It should be addressed because if it is an income replacement benefit, why are you penalising carers? I think that there is scope there to address that. Of course, carers live with disabled people, so it affects household income, so in supporting carers, you also support the disabled people in that house. We have heard other comments as well. It is not just about the level, it is also about how restrictive it is in terms of eligibility. Thank you very much for illuminating an informative session. I would say this as somebody who does research, because we want the business, but if we make changes or get issues, we need to make sure that they are evaluated and that we are looking at what is happening. We do not just roll them out, which is what is happening. It is about making sure that the changes that we make work. We have to make sure that we set up systems to evaluate what we are doing. We do not just roll it out. We have the capacity to make changes to things such as carers allowance. If we make those changes, we need to make sure that they are evidenced and that we are doing them in a way that will make a difference and is making a difference to people's lives. As somebody who does research, I will try and promote it, but I think that we need to make sure that we are keeping a grasp of what we are doing and that the changes are working in the right way. Once again, thank you for your contribution. It has been invaluable to us. With that, we will move into private session.