Work and Pensions Committee
Oral evidence: Employment support for disabled people: Access to Work, HC 481
Wedneday 2 July 2014
Ordered by the House of Commons to be published on 2 July 2014.
Written evidence from witness:
Members present: Dame Anne Begg (Chair), Debbie Abrahams, Graham Evans, Sheila Gilmore, Glenda Jackson, Nigel Mills, Anne Marie Morris, Teresa Pearce, Dame Angela Watkinson
Questions 1-51
Witnesses: Mike Adams OBE, Chief Executive Officer, Essex Coalition of Disabled People, and former Chair of the Government’s Access to Work expert advisory panel, and Liz Sayce OBE, Chief Executive Officer, Disability Rights UK, and author of the 2011 independent review of specialist disability employment support, gave evidence.
Q1 Chair: Can I welcome you both this morning to our first evidence session of our inquiry into Access to Work? We seem to be slightly Government-heavy today. I do not know what has happened to my colleagues from the Opposition. We have not heard any of them say they are not going to be here, so hopefully they will turn up as the session goes on. I do appreciate that you are both here this morning. Can I ask you—perhaps starting with you, Liz—to introduce yourselves for the record, please?
Liz Sayce: Thank you very much. My name is Liz Sayce and I am Chief Executive of Disability Rights UK.
Mike Adams: Thank you very much. My name is Mike Adams and I am the Chief Executive of ECDP, which is an Essex-based disabled people’s user-led organisation.
Q2 Chair: You are both very welcome, and here come some of my colleagues. Liz, can I just very quickly ask you, bearing in mind we have a lot more detailed questions, how happy you are with the Government’s response to the report that you published?
Liz Sayce: The Government has taken certain actions in response to the recommendations that I made. For example, Access to Work was extended progressively to different sorts of work experience, supported internships and so on, and I see that as very important because we have a real crisis of young disabled people’s unemployment. It is massively important that people can get those first ways in. If you need an interpreter or something and you cannot get one, then you just cannot do work experience or a supported internship. That has been important. Getting rid of the standard list of things that would not be funded was very useful; getting rid of cost sharing for small businesses was important, so some things have been done. However, some of the recommendations that I made have not been fully implemented, and I could say a bit about that if you like.
Chair: We will go on to that later.
Liz Sayce: I also think that the kind of step change that my report indicated was really talking about an expansion of personalised support, perhaps linking Access to Work to other funding sources, but at least expanding Access to Work. The numbers are beginning to creep up. They were declining, so that is good, but creeping up might be the word. They are really coming up after a decline, so we are not seeing the step change that I would want to see.
Q3 Chair: Of course, before anybody can get Access to Work, they have to be able to source a job. I am just wondering from both your points of view whether you think the protections for disabled people from employment discrimination are actually strong enough, particularly the provisions in the 2010 Equality Act. I do not know if you want to start on that, Liz, and then Mike can follow.
Liz Sayce: I think that there is a difficulty first of all in the implementation of the Equality Act. It is quite difficult to get access to justice. Employers need to see that there really are some cases so employers understand that there are consequences if discrimination takes place. But I also think that it would be very useful to have some other levers. For example, there is a transparency requirement and there is a lot emphasis on how many women are on boards and that sort of thing. It would be useful to have expectations of transparency for employers and also the use of incentives and other levers, like Government procurement and commissioning, as was done in 2012 in relation to the Games: you will only get a contract if you can show that you have good policies on diversity and employment of disabled people. There is much more that could be done by Government to push things forward. The Equality Act has pros and cons.
Q4 Chair: You are not proposing legislation for that? It is more guidance or targets for Government contracts and things, or should it be enshrined in legislation?
Liz Sayce: I do not see much stronger implementation of the existing legislation, including the public sector duty. I think proactive use of legislation rather than just responding after someone has been discriminated against is really important. I would like to see a set of levers agreed with employers. I do not know. I am not looking to specific adjustments to the Equality Act at this point.
Mike Adams: I would agree with Liz, and I think we need to be looking at encouraging employers to provide a whole range of metrics within their annual report that demonstrates progress towards both the recruitment of disabled people and also the retention of disabled people. We will come on to it, but I think one of the areas that Access to Work is increasingly going to need to support is those who acquire an impairment while working.
Q5 Chair: The other thing that often acts as a barrier is the definition of reasonable adjustments. What do you understand by that term?
Liz Sayce: What I understand by that term is that an employer has to make an adjustment if it is reasonable, and it is reasonable for that employer given its size, given its budget and given the nature of its business. It is something that an ordinary person would think is reasonable. So if you are a large global company, clearly it is reasonable that you invest some money in the right sort of computer software and all sorts of other adjustments. If, however, you are the corner shop and have an upstairs room, it may be very difficult for you to afford to install a lift. The difficulty for people who want to absolutely nail down what it means is that the problem is that it is different for the corner shop and the global corporation.
Q6 Chair: So would it be impossible to get an objective definition across all different sectors—all the different sizes of companies—of what is a reasonable adjustment?
Liz Sayce: I think it is quite tricky. I am not a lawyer and you might want to ask that question of legal experts on the Equality Act.
Q7 Chair: Is that not part of the problem? A small employer is going to be confused by all of this. They will not know what is reasonably to be expected of them. They might want surety when they employ someone that they are not going to find themselves falling foul of the Equality Act.
Liz Sayce: The guidance is spelt out quite clearly through examples and through looking at the different parameters of the size of the budget and the nature of the business, because there may be a reasonable way of managing, let us say, what is viewed as a risk—a health and safety issue or something. Then again, there may not be for someone with a particular impairment in a particular business. Usually there is and usually people are much too cautious about that. You can spell out the dimensions on which this is decided, so the size of the budget, the nature of the business, and you can give very good examples. I am not sure how much further you can nail it than that, but other people may have other thoughts to add to that.
Mike Adams: Liz is right. It is really difficult to be able to define it totally because there are so many variables that will have an impact. Certainly you will see that, with the growing number of small to medium-sized enterprises, you may want a threshold that encourages them to employ disabled people and not act as a barrier, whereas your multinational companies would see the support of their staff in a different way, with their HR departments, etc.
The other point is that, clearly, if you look at the numbers, many organisations employ disabled people and make those reasonable adjustments every day without any recourse at all to Access to Work. Access to Work should be used for where the equipment or support that is required is over and above what you would reasonably expect an employer to provide.
Q8 Chair: So, you think, therefore, that for those with more severe disabilities it will take a lot more money to make the adjustment to allow them to work, and that actually they really are only going to get jobs from large employers and not from small ones?
Mike Adams: No. For me, Access to Work is a way of levelling that playing field. It should not be that disabled people only consider working for big employers because they think that is where they are going to get the support. It is interesting if you look at the average adjustment and the expense. I know from Barclays that their average adjustment is £210. People perceive any adjustment as a ramp or a lift, whereas actually most of the adjustments can be made very quickly and very inexpensively, so we do not want a situation—and this is where Access to Work can really help—where disabled people are steered towards big businesses.
Q9 Chair: The thing that I think you said in your report, Liz, is that Access to Work is the Government’s best-kept secret, and that it is the larger companies that know about Access to Work. Is there not slightly a double bind there? They are the ones that are more likely to be able to afford to make the adjustments, but they are the ones who know about Access to Work, so they are more likely therefore to make an application to Access to Work when, in fact, as you just said, Mike, Access to Work perhaps should be there as the bit in the market, or the bit that is the market failure, if you like, or the bit where the small employer could not afford it without Access to Work. Is that something you recognise?
Liz Sayce: Absolutely. One of the things I recommended was that there should be much more assertive promotion of Access to Work to SMEs and to some other groups, but certainly to SMEs, because that is really where it is needed most but that is not where it is most used.
Q10 Chair: The more you advertise it, the more the bigger companies will know about it. Therefore, is that not a problem, in that the more the bigger companies know about it, the more they will use it, rather than making the adjustments themselves where they can well afford it?
Liz Sayce: The big companies on the whole know about it already as they have HR departments and they have equality leads and so on. On the whole, the big companies and the big public-sector organisations are familiar with it. Small organisations are not familiar with it and you can target advertising to them. You can go through the people they rely on: their solicitors and accountants. You can do it through HMRC. There is a range of ways you can get the message out to small business quite specifically and through, of course, the Federation of Small Businesses and the chambers of commerce and so on.
Chair: Thank you very much.
Graham Evans: I had a question about the relationships with the Federation of Small Businesses and chambers of commerce, so you have just answered it. Thank you.
Q11 Dame Angela Watkinson: This might be an unanswerable question because it is asking for a best guess, but can you estimate the total number of adult working-aged disabled people who might need additional support to reasonable adjustments, and would therefore benefit from Access to Work? I do not know who would like to take that on; it is really the scale of the challenge.
Liz Sayce: In our written submission, we drew on some research that suggested that about 4% of working age disabled people needed aids and adaptations or health-related inputs in employment.
Dame Angela Watkinson: That would come under reasonable adjustments?
Liz Sayce: This is the problem. Some of that might do. It is a really difficult question to answer. I am sorry.
Dame Angela Watkinson: It was not fair to ask, probably.
Liz Sayce: Aids and adaptations will include a lot of things that would come under Access to Work, so things like, for example, specialist equipment or indeed communication support and interpreters and so on. If somebody needs, for example, an interpreter, that will often be beyond what would be considered reasonable to provide. Equally, aids and adaptations does not include travel to work, which Access to Work does cover; it does not include having a personal assistant. It is very complicated, but if you use that as a proxy, you would see that the 31,500 people getting Access to Work is a relatively small proportion of those who would benefit from it. That is borne out by our experience of advising disabled people, talking with disabled people all the time. A lot of people are not working. They say, “Well, I am deaf and I do not see how I can work,” or “I have been turned down for this training course because they do not know how to make the adjustments,” and so on. Actually, Access to Work ought to be able to resolve that problem. We think that Access to Work needs to be stepped up significantly.
Q12 Dame Angela Watkinson: Mike Adams, would you like to add to that?
Mike Adams: Liz has talked about Access to Work supporting 31,500 people. We also know that the differential between disabled and non-disabled people working is about 2 million. We know that there is a huge quantum of disabled people who are out there in the labour market working. What we do not know, and cannot quantify, is how many of those could have applied for Access to Work and received Access to Work, and for how many of those the relationship between the employer and the disabled person means that that never became an issue. There was some research when we were doing the panel that said that 45% of disabled people who were in receipt of Access to Work believed that, if they had not received Access to Work, they would not be working.
Dame Angela Watkinson: That is a very useful indication of the value of that scheme.
Q13 Glenda Jackson: To go back slightly on the issue of how Access to Work is more widely publicised, it should not necessarily, should it, be the exclusive responsibility of the DWP? If one is looking at the issue of people with disabilities who are being denied work at the moment, setting aside cataclysmic accidents, presumably these disabled people have had these disabilities all their lives, and there have been things within their lives that have assisted them. I am just thinking of disabled students; we are going through a big row at the moment about the kind of support they are getting. Essentially, what I am trying to say here is, should not all the organisations who work for and on behalf of people with disabilities—including the National Health Service and the whole range of Government Departments—be saying, “When you get into that age where you go to work, there is something called Access to Work that could facilitate you,”? I think for the big issues, as you were saying, that it is simpler, but for the smaller ones, it seems to me that should be where the push to advertise Access to Work should be coming from.
Mike Adams: I agree with you. I would probably go further. One of the recommendations in the panel’s report is around pitching marketing of Access to Work to disabled people and empowering disabled people to understand that, as they move into the labour market and they move into jobs, there is a Government programme that enables them to have a conversation with a potential employer that says, “Look, here are what I think are going to be my needs, and here is a programme that will support me financially meeting my needs, so me coming to work for you will be”—
Glenda Jackson: Cost-effective?
Mike Adams: Well, cost neutral.
Glenda Jackson: Absolutely.
Mike Adams: As part of Liz’s work, and as part of our work, we have looked at printing off a letter that talked about Access to Work. Without saying, “If I got a job with you, I would have this,” it gave some assurances both to the disabled person and the employer. To take Liz’s point, disabled people need educating that there are programmes around that will support them into employment, so they do not sit there and go, “Well, I am deaf or I am blind; I cannot possibly go and work for an employer.” It would also give assurances to employers, whether they are large or small, that there is a programme that enables that disabled person to work.
Q14 Glenda Jackson: Do any figures exist on the reluctance of employers initially, just on the whole issue of employing disabled people? You have already given the example of some disabled people who say, “I can’t work because I am this or I am that.” That seems to me to be in a way easier to concentrate on than the reluctance of employers, given the variety of size and stuff of employers. Is there any evidence to show that?
Liz Sayce: There is some evidence on employers’ attitudes.
Glenda Jackson: Yes.
Liz Sayce: It tends to vary by the type of impairment that a person has. For example, with somebody with a mental health problem there is much more worry from the employer’s point of view. There was one study—it is now about a decade old—that said that only about 38% of employers said that they would take on somebody with a mental health problem. They really had anxieties about it. In relation to disabled people more generally, the figures are better than that. I could send you something; I have not got the figures to hand. There has been some slight improvement. You also need to look at what people actually do as well as their attitudes. Sometimes in surveys, people give the answer that they think is expected, or they may have the intention of employing people but they do not actually employ disabled people. We need also to look at the trends. The trends for about 10 years from 1998 were that the gap between disabled and non-disabled people’s employment was closing slightly. It closed by about 10% over a decade.
The other positive indicator is educational qualifications for people aged 19: that gap is just beginning to close a bit. Some things have been moving in the right direction; however, it seems to have stalled a bit, and obviously we had a recession. We need to look at behaviour and actual outcomes as well as the attitudes. You are absolutely right about the NHS, incidentally. Also, when people have that accident, or get the diagnosis of MS, at that point you should be told, “And there is this scheme to help you keep your job.”
Glenda Jackson: Absolutely.
Chair: That brings us very nicely on to Dame Angela’s next question.
Q15 Dame Angela Watkinson: This is about the employment rate of disabled people, which stands at about 50%, which is 25 percentage points below the rate of the rest of the population. Do you think there should be a target for the employment rate for disabled people and, if so, what should that target be?
Mike Adams: I am not sure that there should be hard targets. Clearly, as pointed out in the panel report, there are issues that you can do to affect demand in terms of encouraging and supporting disabled people to want to go into employment. It is really important to say that, from all the evidence we gathered, having a job and being employed is the default position for disabled people. What we need to do is create an environment where they feel able to go into employment without fear of being disadvantaged in that labour market. Access to Work is a flagship programme to do that. Of course, you then need to address the supply, and that is around the cost of equipment and the engagement of employers and other stakeholders in understanding the kind of employment environment.
I have always said that the primary relationship has to be one between the disabled person and the employer and everything else is an enabler to that happening. I said earlier that companies should be encouraged to be explicit around their recruitment and their retention in all sorts of areas about disabled people, and they need to include initiatives and what they are doing in order to encourage access to a greater talent pool. I am not sure whether setting targets particularly is the right way to go about it.
I would just go back to the point Liz made. You need to break down the disabled population in employment by impairment groups, and what you start to see is an under-representation of individuals with mental health and with learning disabilities. In terms of Access to Work, clearly there is a correlation between that and employment. You may need some short-term targets to stimulate areas where there is greater under-representation.
Q16 Dame Angela Watkinson: That leads in to my third question, which is, despite the very strong overall recovery in employment levels, research by the disability charity Scope has found that 220,000 more disabled people fell out of work than moved into employment in 2013. Do you have any idea what the reason for that was and what the Government might be able to do to reverse it?
Liz Sayce: We have seen this pattern before post-recession. One small positive was that, in the recession, the gap did not get worse. Disabled people at that point did not seem to be falling out of the work force more than non-disabled people; they might have done. In previous recessions as well, disabled people have not benefited to the same degree as others when the recovery comes. I think that we need a much more proactive and strenuous disability employment strategy, and I know that Government has been working on that, but there are a number of proposals that some of us have made for really personalising support. I do not know if you want me to go into this, but some of the big programmes, like the Work Programme, are not working for disabled people.
The Government can do much better by enabling individuals and employers to come up with bespoke solutions that really work rather than relying on these big companies through incentivising them. It does not seem to be working—not for disabled people. We need a very different strategy, and I would want to include in that really incentivising employers. In Australia, they have been setting out challenges to employers, saying, “Well, how come your employment rate is only this? Why don’t you aim for a 10% rate?”
It is very difficult to say what the national target should be, because the way the workplace operates changes over time. In Austria, for example, they have flexible apprenticeships, so if you need to spend longer over your apprenticeship, or you need to do only certain modules because of your impairment, that can all be catered for, and that is a requirement of all apprenticeship providers and employers. If you do things like that, suddenly people who think, “Well, I can’t do an apprenticeship,” can do an apprenticeship.
Some people work to annualised hours. If you have a fluctuating condition, maybe you can only work so many months of the year, but it is much better you work those so many months of the year than you are out of work altogether. We need to change the world of work. If you changed it absolutely radically, you could really get towards equalising the levels of participation, but for the moment what we want to see is year-on-year improvements. For the last couple of years, there have not been improvements, and we need a much more strenuous—
Dame Angela Watkinson: Sustainable improvement rather than peaks and troughs because of outside influences?
Liz Sayce: Exactly.
Q17 Dame Angela Watkinson: Do you think more flexibility is needed to take account of the different sub-groups of disability, which Mike Adams referred to?
Liz Sayce: Yes, and incentives and levers used with employers: not just talking to employers about it as a good idea, but actually—
Dame Angela Watkinson: Making sure they do it?
Liz Sayce: Yes.
Q18 Chair: We will be coming back to employment support for disabled people later, unless you have got something related to that you wanted to say, Mike?
Mike Adams: I was just going to make the point that, in terms of your specific question and some of the factors, there is a particular issue around retaining people who acquire an impairment while in work and making sure that they remain in work rather than drop out of the labour market altogether.
Q19 Dame Angela Watkinson: There are people with conditions that fluctuate, for example. Is that one of the reasons relevant to retention, do you think? They go through periods when it is much more difficult to go to work?
Mike Adams: There is an issue for people who are in work and acquire a disability and then stay in work. Liz is talking about someone who may have had a fluctuating condition for a long time but that has not been accommodated in employment, and therefore they end up being forced out or decide to leave employment.
Dame Angela Watkinson: Thank you.
Q20 Debbie Abrahams: Can I just take you back to the point that was made about the gap in employment? In Oldham, only just over 40% of disabled people are in employment, so there are regional fluctuations. Rather than focusing on targets, what would you think is a reasonable gap? Is it 5%? What should we be looking at? What is reasonable? I personally think that 25% is just totally unacceptable—to have that gap. I would like to know from your perspective what you think the gap should be.
Mike Adams: My own view is there should not be a gap.
Debbie Abrahams: Right.
Mike Adams: But I understand for all sorts of historical reasons why a gap has occurred, and I think we are now in a position to be driving pretty forcefully. I would turn the argument around and say it is critically important that employers are able to fish from the biggest talent pool possible, and disabled people should be part of that talent pool. There is always going to be a level of unemployment; there is always going to be a level of under-employment, but I do not think we should accept at all that disabled people by definition should not be in the labour market as much as their peers.
Q21 Debbie Abrahams: That is fine. You may not be able to answer this now, but I would be very interested in data around the sectors and the size of businesses where there are particular issues, so where there are bigger gaps than you would expect—even bigger than the current one. I came in when I think Mike was making the point about empowering people with disabilities so that they go armed when they are searching for work and so on with the knowledge of what is available to make employment easier. Again, what percentage of disabled people would be aware of Access to Work? Similarly, in our recent JCP work, we were surprised by the number of JCP advisers who were not aware around Access to Work grants as well. Could you comment on those?
Liz Sayce: In terms of sectors and size of organisations, perhaps counter-intuitively, small employers actually have a slightly better record on employing disabled people than large employers. Sometimes it is because they do not have the complex recruitment processes. When you measure people very precisely as you recruit them, sometimes the fact that somebody has had a previous disadvantage in life counts against them, even though it is supposed to be a fair and equal opportunities kind of recruitment, whereas the small business person might just take somebody on, if they seem to have the skills needed, and give them a chance and so on. I am not saying that all small businesses are fine at this, but, attitudinally, sometimes the processes are easier.
In terms of sectors, that data is available and I can certainly give it to you. Knowledge of Access to Work: the Scope research suggested that the levels of awareness among disabled people have not changed very much over the last decade, I think it was. Again, I can check that figure. The DWP did a marketing campaign a year or so ago, and it would seem likely that the fact that the numbers of people using Access to Work rose around that time and just afterwards was probably partly because that marketing happened. Marketing of the programme has been very low. It would appear to be because it is a budget-capped programme. If people know about it, more and more people are going to apply and there is only so much budget.
We would really like to see it as a real investment. It is one of the very few disability employment programmes where we actually have an evidence base that it works. Pathways to Work did not really work in the end. The Work Programme is not working. Work Choice we could discuss, but this one works, so if Government is serious about more disabled people working, this is an investment in making that happen, and there is a return to the Treasury for every pound spent. It should not be viewed as something to be rationed and only meted out very cautiously. But it is, and therefore it is not promoted, and therefore people do not know about it.
Chair: We will be coming on to exactly that in the next question.
Mike Adams: I think you talked about the Government’s best-kept secret. We think that is with employers, but actually it is with disabled people as well. We need to be promoting that. We need to be in sixth-form colleges and universities as people move, knowing and understanding what programmes are out there to support them into jobs. I would say, and we will probably come on to this, there is a real need to focus on pre-employment, and that is around the raising of expectations of disabled people in the labour market, and Access to Work has a great role to play there. We are pleased that the Government accepted the recommendation in the panel report to extend Access to Work to formal work experience programmes: the Youth Contract, work experience traineeships and, going back to your point, focusing on sector-based work academies, so looking at it by sectors and trying to stimulate an understanding of disability and Access to Work.
Q22 Graham Evans: Debbie’s point was about the sector looking at employers that are particularly good at taking disabled people on and, indeed, whose business suits people with disability. For example, I remember blind people being used as receptionists and also in call centres. It is a wonderful working environment, with very good international employers, and it is a win-win—very good contributions. Do you look at those sorts of sectors—those sorts of companies—and see if all members of that sector participate in this sort of thing?
Also, do you look at all areas of the country where there are examples of good practice and they are above the average in terms of taking on disabled people? In my experience, what you often find is that it is the people running the schemes, engagement with the employers and the local authority, and there is an all-round good network of placing people with disability with employers. I do not know; shall I use Cheshire as an example, because that is where I come from? You can say, “What they do in Cheshire is they do this, and they are above average.” This is Debbie’s point about looking at the data: analyse what it is they do in Cheshire that could be then used in Essex and elsewhere and so on and so forth, so using positives, and thinking, “Why is it that Cheshire can do that?” I am not saying that Cheshire is wonderful, but there is some good practice going on in Cheshire. “Why can it not be duplicated elsewhere? What is it that they are doing?” Perhaps ask those people if they could write a pamphlet or booklet of best practice.
Liz Sayce: It is a really good point. There are certainly employers and particular sectors that are doing well. I think we understand some of the keys to what doing well is. There are some large organisations that are often quoted in this area and, to give one example, one of the things that BT does is rather than just ask people, “Do you need any reasonable adjustments?” they ask all people coming in to the company, “Is there anything you need to perform to your best?” It goes back to the discussion about reasonableness in a way. So rather than thinking, “Have I got to do this under the law?”, the concept is that, if you request a particular kind of flexibility for any reason, if the company can easily do it, it meets business need—it may be that you are working at home a lot, working different hours or you want some different sort of management support or whatever—and they can easily accommodate it, they just do it. They do not ask any more questions. They do not need to find out if you are a disabled person or not, because there might be other reasons why you need exactly the same thing, like you are a carer or whatever. It also normalises the experience. We are all different, and in as far as companies can accommodate that, then great.
Clearly not all jobs fit that level of flexibility, not even in BT. It is a matter of pulling out those nuggets of what makes that work. Two other things are done in some of the companies that have very good records: one is very good support and information and training for the line mangers—the front-line line managers. It is easy for corporate executives to say the right things and have great policies, but it is the day-to-day line manager who has to deal with the fact that perhaps somebody’s performance is variable or whatever. That support to enable them to keep at it is really important.
Q23 Graham Evans: I think there is something in this, Liz—using the telecommunications industry perhaps as an example—because the company I was thinking of in my constituency, O2/Telefónica, have a very good track record of engaging with disabled people and employing disabled people. They delegate the recruitment of the teams to the line manager, relatively low down, so they do the interviewing with the HR department. That is a very good point, but perhaps that is a certain sector. Make sure you work with all the players within that sector and say, “O2 are doing this, and Telefónica are doing that,” to make sure they do something similar to maximise the employability of disabled people.
Liz Sayce: Also, they can work with their supply chains. They are in positions of real influence; just as Government can use procurement, companies can.
Graham Evans: Yes. Thank you.
Mike Adams: I do not know whether it is a coincidence, but there is a very strong disabled people’s user-led organisation in Cheshire. There is a correlation between having strong user-led groups in a community and its relationship with employers. In Essex, we engage with a whole range of employers and we have our own employment programme. What that has told us is exactly what you have said: in terms of making it work for disabled people, it is about working alongside the line manager. There is no point going in and just having that discussion with the chief exec. That might be the way in, but if you are going to make it work, you make it with the line manager.
In the programme that we are running, we support not only the disabled person while they are on placement but the line manager; what that is doing is translating at the end of the programme into the offer of a full-time job, because the line manager is feeling more confident. One of the things we have learnt is that then exudes to colleagues who have been working with that disabled person. You have the benefit of them understanding disability, understanding the disabled person, and that is a way in to changing and understanding the perception and culture of that organisation.
Chair: Sheila, do you still want to come in?
Q24 Sheila Gilmore: Yes. Despite all of these good practice things and what we should be doing, that figure about the number of disabled people being out of employment exceeding the number going in, in the last year, is extremely concerning. Is either of our witnesses aware of any research findings as to whether there were any particular sectors there; whether it is the result, for example, of the closure of things like Remploy? Has that contributed to that? What is actually going on here, because we can talk all we like about how we should talk to managers and get people in, but the statistics are pointing in the opposite direction, and that is not particularly healthy.
Liz Sayce: It is a complicated picture. Clearly, you have the fact that disabled people are slightly more likely to work in the public sector than the private sector. Public sector cuts have been kicking in and are still kicking, so that is having potentially a disproportionate effect on disabled people. You also have a significant impact on young disabled people at the moment. We are really worried about young disabled people, because there is structural youth unemployment in our economy anyway that pre-dates the recession; as we all know, there is a youth employment problem. But then if you are a disabled young person, there are multifarious other issues, including how do you transition from education into employment? How does the support work for you? If the gap is 25%, the last figure I saw for 24-year-olds is 36%.
Something is going wrong for disabled people in early adulthood. This is why I think things like flexible apprenticeships and traineeships and really good work experience, not tokenistic work experience, and links between schools and colleges and employers at local level are so critically important. I think a real push on young disabled people’s employment is very important; otherwise we are going to see another generation out of work for decades, and people in 20 years’ time will be sitting here thinking, “How did we let this happen?”
Q25 Sheila Gilmore: So that would be a group for which there should be a specific strategy at the moment?
Liz Sayce: I believe so, yes.
Q26 Chair: Do you think we just make it too difficult for disabled people either to remain in work or to get work? You have to be very single-minded and very determined to keep going in a way that people without disabilities might not need to.
Liz Sayce: Just to talk about Access to Work for a minute: one of the things we are concerned about is that although, as I have said before, there have been some positive moves, what our members are telling us, and what disabled people are telling us, is that actually what is happening on the ground is that often it feels like huge hurdles that you have to get through to get Access to Work.
In theory, if you are going for a job with a small employer, there should be no cost sharing, but actually you are being asked if perhaps the employer can make a contribution and, if not, why not, and asking for documentation of that. When you go for your three quotes for your piece of equipment or whatever: “Why can’t you get it any cheaper?” “But cheaper won’t get me what I need to do this.” There is lots and lots of backwards and forwards and backwards and forwards. People are saying to us that this kind of emphasis on cost containment has become stronger recently. I do not have stats on that. It is anecdotal, but certainly I think the way you describe that feels right to me: that you have to be quite determined to get it.
Of course the problem is that in the economy at the moment sometimes what you are going for is short-term work. It might be a short-term contract or it might be work experience or something. If there is going to be lots of delay and complexity, the thing will be half over before you have got what you need in place. There are some issues with Access to Work that need to be sorted out. It seems to come from a drive for cost containment. Of course, if it is public money, it needs to be spent well, but not to the point that it is becoming difficult for people to get it and get into their jobs.
Chair: I think we have some more questions on that from Anne Marie.
Q27 Anne Marie Morris: We do. There are probably three things, and this is really all about the whole funding piece. The first is really the challenge of setting that budget. In a way, what you have articulated today is that we have a programme that is very effective—probably one of the best things we do for those with disabilities. If you like, the philosophy behind it is anybody can have it if they need it. As I understand it, if you have a disability and there is a particular piece of equipment that will help you to do the job you have been able to get, there should be no cap, limit, whatever. If the job earns you £30,000, but the resource you need—maybe it is a number of support workers—is £100,000, all of that gets pushed in. I am intrigued, because on that basis how on earth can any Government set a budget? Say you were trying to advise the Government about setting a budget—presumably you want to increase this programme—given you have so many different types of support and different ranges of expense. Your analysis shows that overall the balance is that people will be better off. How can a Government set a budget because, if you cannot get that right, how do you manage that budget? I was quite interested in what you just said about there being almost like a cap, and it is done through bureaucracy rather than it being a real cap. How would you think that budget—if you had worked out how you set it—could be sensibly administered? In a sense, rather than this bureaucracy for people who frankly only want 200 quid to fix whatever it is, should we be looking at, “Well, it costs £100,000 to support that person.”? Is that something that is relevant, given, as you said, it is taxpayers’ money? The first piece is really all about how you set the budget and how you manage it, because at the end of the day it is taxpayers’ money, but you do want the best option to help disabled people get into work.
Liz Sayce: It is tricky. When I did my review, which was published about three years ago, so obviously the figures may have changed, my recommendation was that the numbers using Access to Work should double within what was then the overall budgetary envelope for specialist disability employment programmes. I thought at the time that that was doable. It did presuppose money from other parts of the system going into Access to Work, and it presupposed the same average spend on Access to Work. Obviously, some people can have very high amounts, but some people have absolutely tiny amounts. So that would have meant doubling budget to around £200 million rather than £100 million. That has not happened. Actually, the budget went down because the numbers went down before coming up again. There is an interesting question, which maybe we will come to. I know the Government committed to putting in an extra £15 million, but against which baseline—which year? So £15 million has gone in clearly, but £15 million additional to what is a question worth asking.
The question was asked earlier about how many people might benefit from Access to Work. It is quite difficult to judge from the available research, although you might want to ask academics if they can come up with some figures on it. I think at least doubling the numbers is something that we should be looking to do. Now, that raises the question, do you want to cap what is available to particular individuals, so that you spread the money further? I think that was perhaps the implication of what you were saying.
I think it is right that the people judging what you are asking for can look at it in relation to, “Well, is this really going to support you to work long term?” I talked to someone who was getting quite considerable Access to Work support while she was setting up a business. At this point, the business is not making a huge amount of money, so the balance between what she is getting in and the Access to Work payment does not look like a very good ratio. However, all businesses go through start-up phases, and perhaps she should not be penalised for that if she has quite cost-intensive support needs because over a lifetime, if this business takes off, she will be paying a lot of tax and she will not be claiming a lot of benefits, so it will work out.
I would be cautious about putting an absolute cap on for everybody. Of course, there should be scrutiny of what kinds of costs are being incurred, and if people are asking for what seem very unreasonable things that perhaps could be done much more inexpensively, that should be queried, but preferably do not gear the whole system to doing that so that it ties people up in bureaucracy. I also think that the cost of some of these things could be driven down by market forces. One of the things that I recommended was a portal to achieve that. I still do not think we are there. Some of the kit and so on is too expensive and we need to drive the cost down.
Q28 Anne Marie Morris: I agree with you that a cap is a very blunt instrument, but what are the questions you ask when you have an individual who has a particular need and this is the amount they are going to earn by the result of that particular input: £100,000, doing a job for £30,000? But clearly also they are not going to be on benefit and also there is the whole benefit of the feeling of self-worth and being able to contribute to society; you cannot put a number of that. If it is not a cap, and I understand why you say that and I agree with you, what are the questions that you ask to begin to work out—given that in life there are always budgets—whether you give or do not give, and how much? What are the questions you ask?
Liz Sayce: I would just ask about the different ways of meeting this need and whether there are more inexpensive or cost-effective ways of doing it. The reason I say that is because it is very difficult, but I am not sure that we should be prioritising more cost-intensive support for people who are going to be managing directors than for people who are going to be nurses or in lower-paid roles. It just seems rather unfair to me to do that. The average cost is not high. People needing cost-intensive support are small in number, so, yes, let us ask questions about, “Is it really this expensive?” In particular, let’s try to drive down the cost. If you take something like the 30-hour thing—I know it has been suspended now—would it not be better to think about that market of interpreters and communication support and what can be done to grow that market and enable people to get the most cost-effective deal for interpreters and so on, so that, over time, perhaps this becomes less costly, rather than saying to the individual, “You’ve got to find a less costly way of doing this.”? For the individual, that might be quite difficult.
Q29 Anne Marie Morris: I understand what you are saying. The two are inevitably interrelated. So there is the budget and how you manage it. Then there is the piece about the money that goes in, and you rightly said that your expectation had been that, with the demise of Remploy, money would come in. Not as much has come in, etc. I think there was an AME/DEL switch suggestion. I think you are, as I understand it, a little bit frustrated that not all of that has happened, so I guess it would be useful to understand what you see as having successfully happened, and do you think there are other things that we might look at? That was your point with the executive working in the City of London: is it right that they get this help? At the moment, the system of contribution from employers: small ones, nothing. The bigger you get, there are these tranches. Should there be a situation where employers are actually asked to pay more that their £10,000 cap or whatever it is? Are there ways of looking at, first of all, where the Government should be looking to get that money that you need to double the numbers that can get the benefit? Do we have the right structure in terms of this contribution ratio arrangement between the employer and the employee, and are there more interesting, clever ways of looking at this and dealing with exactly the sort of point that you raise?
Liz Sayce: First of all, although you are right in reflecting back that I feel a certain level of frustration, I do also acknowledge that some things have been done in relation to the recommendations that I made. Some of them create building blocks for things that could be very powerful going forward, like the extension to work experience and so on, so I am only partly frustrated, let us say. I think that the Access to Work Programme is not working well enough at the moment for people around the country, and we had a lot of people saying that to us as we did our written response to you.
I am not an economist, so on how exactly something like a DEL/AME switch would work on this I bow to others with more detailed experience. Intuitively, it makes sense that there is a benefit across Government financially, not only in terms of taxes paid and fewer benefits received—obviously you might still receive benefits while working—but also in terms of things like reduced hospitalisation rates. We know there is very strong evidence on that in mental health, for example. People who are working are significantly less likely to use hospital services and other health services. So if there is a way of spending on Access to Work against the savings that come—the essence of a DEL/AME switch, as I understand it—I really think that should be explored.
Obviously, that kind of switch was done in relation to the big payment-by-results programmes. That precise mechanism might not work here, but given that it is cost-effective when you look across Government, it seems a false economy to have a capped budget on it when there is such a consensus: we want more disabled people to be working, and this is going to be cost-effective for the Treasury, even if some people continue to have high individual packages through Access to Work—even without changing that. I am not sure I am quite answering your question.
Mike Adams: It is a really difficult question to answer, but we know that there were statistics that said that for every pound spent on Access to Work, £1.43 comes back to the Treasury. Everyone recognises that that figure needs review and rigour. If you were in a position where you could demonstrate that positive receipts were coming back from the spend in Access to Work, then as a Government that would be what you did in order to resolve a whole host of other issues around employment, self-worth, benefits, etc.
If you are asking me what to do, I would agree with Liz. You have got the specialist disability employment programme with a budget; Access to Work sits within that. It is generally recognised that Access to Work is effective and is efficient. There are things that need to be done, but I would be saying within that, “Let’s double it and use the money from the existing financial envelope. Let’s make tough decisions about that. This is about money going directly to disabled people to enable them to be employed and to work in the labour market.”
There are things the panel recommended. One of the things the panel did was say, “Okay, Sayce made these recommendations; how do we implement them particularly?” Then we looked at the wider issues that still exist. There are all sorts of areas in which Access to Work has made progress and can still make progress. We have seen in social care, and we are now seeing in health, the move to personal budgets and direct payments. That enables individuals to have the money and decide how it is best spent to meet the needs. It builds in levels of tolerance. We talk about sectors, and the example I use is the broadcasting industry, where people are on very short-term contracts and they move from one job to another job. Every time they move and they have something different they want that week, they have to go back and get permission to do it, whereas if you had a broadly agreed budget, and that was reviewed every three or six months, that individual would be much more mobile in terms of taking freelance offers, etc.
There are things that can be done to make the system more efficient. One of the things Liz has been saying, and I also said, is that we need to move to a position where Access to Work was accessed online. One of the panel members said to me that of everything they do in the world now, Access to Work is the only thing they cannot resolve online and has to go through paper. It seems untenable from where we are now.
The other area I would be focusing on, because I think it is really important, is pre-employment. I would be taking a very hard look at the value of Work Choice and the Work Programme and saying—I think it was issues around younger disabled people—“What is it? What are those factors that help you get a job and get a career?” Part of that is your experience in pre-employment. The panel recognised that the recommendations that it made had to sit within a financial envelope. Of course, if we could have sat there and said, “What should Access to Work do?”, I would have been saying Access to Work should be able to support an individual who wants to go and work Saturday mornings in Tesco to get voluntary experience. There is so much more that we can do to enable disabled people to have a CV that stacks up to employers—that exposes them to work experience and other kinds of activities that in the longer term enable them to maximise their potential.
Q30 Anne Marie Morris: In a way I think you are both saying you cannot look at this in a silo, and you should be looking at it across health, social services, and actually then you do the calculation about value for money, and you probably do it slightly differently, and then in terms of how you work out how you manage the budget, given the budget has got different bits from different departments, you would actually look at it in a different way. The challenge you have is to make it workable and simple, because without simplicity the whole thing falls on its face.
Can I, however, take you back to one of the final points that you made, which is about trying to drive down the cost of support? When you look at the things we are spending the money on, the most expensive thing is support workers. We have agreed that capping, rationing, whatever, does not really work, but how can we think clever? I think you came up with a couple of thoughts about web portals, etc. How do we think about reducing the cost, because clearly the less we spend delivering the same benefit, if you like, the further we can spread our budget overall. There are bits about the employment contract and the questions. The 30-hour piece was all about agency costs, etc. I would like your thoughts about the agency principle generally, because it is not just within the blind community or the deaf community that such a thing might be relevant, and how we might re-engineer or think about that, and then using the web and any other clever ideas as to how we can reduce the overall cost of the different bits so more people can benefit.
Liz Sayce: One of the things I recommended was this idea of a web portal. The concept was that this would be openly visible. It would be an open website, not something just available for Access to Work advisers or whatever. For example, if you were an employer, you could go on to this portal and look at voice-recognition software or adaptive chairs or whatever, and you could look at them and see how people had rated them and the respective costs. You might then think, “I can afford that anyway; I will just buy it.” Equally, if the person was eligible for Access to Work, in effect it could work that they had a voucher, if you like, to use on such a site. The idea is just that by having all this stuff there, and ratings and so on, the suppliers start to compete with each other. In effect you have a large number of people purchasing, rather than me going out and buying one specialist chair, and it might cost a bomb and it might have been recommended by an Access to Work assessor who recommends a company that is very specialist and niche but is actually very high priced. Some of the things that are sold to disabled people, from wheelchairs to specialist equipment, are really quite expensive, so as with any market we would like to see the cost start to come down. If it is always one individual purchaser, that is never going to happen. This is one recommendation that has not really moved forward.
I do not think the web portal necessarily has to be run by the Government. It could be done as a private sector partnership or something. That might have been one of the hesitancies of implementing it. One thing that happens with Access to Work sometimes is that people get recommended things and kit gets bought and then it does not get used. This goes back to the point about empowerment. We want the individual to be very fully involved, and the employer as needed, in what is going to work in this particular place of employment, not, “Here is the assessor.” “Oh, I think you need this, this and this.” Access to Work pays for it and then actually you do not even use it. That is a waste of money.
Q31 Anne Marie Morris: Should this also incorporate, dare I say, second-hand? I hear all sorts of stories of hospital equipment that is just chucked on the tip because nobody knows about some of the charities that have been set up to collect it. Is there a second-hand market for these things?
Mike Adams: There should be. For some reason around disability equipment, there is a level of mystique and level of premium. I agree with Liz. We just need to open up the supply side. I do not think it needs to be Government. There are businesses that can make margins on opening up the equipment market—a kind of Amazon for disabled people—and what that would then drive is a second-hand market as well. The panel recommended that cost share should be abolished across the board, not just for companies with under 50 people. On the basis that if your spend is £100 million, the cost share is worth about £1 million. One of the difficulties with the cost share, alongside the bureaucracy that goes with getting the £300 from the company, goes back to the point made earlier around, is it the line manager, is it the chief executive, is it HR? There is a huge bureaucracy around getting that money.
If you use a chair as an example, who then owns the chair? Is it the employer who has paid a contribution to it, or is it the disabled individual? I will use the banking industry just as an example. A disabled person works for NatWest. They have a chair they have used for 10 years because it meets their needs. They move to Barclays. What happens is the chair then stays at NatWest and probably is put in the store cupboard never to be seen again. The individual goes to Barclays, has another assessment and another chair exactly the same is then purchased. We were saying two things. First, that Access to Work should allow DHL to come and pick the chair up and take it from one to the other. Secondly, if you do not have cost share involved, then the responsibility for that piece of equipment goes with the disabled person. All sorts of things can be done within the framework of existing Access to Work that will enable a greater and better supply side, supplemented, in my view, by opening up that market to drive the cost of this equipment down.
Q32 Anne Marie Morris: I have a final question, if you will indulge me. The nuts and bolts, the widgets—the things—we have talked about. Then there is the challenge of people, because a lot of the support is people. Clearly, it is absolutely right that support workers get paid what they are worth, but if they come through agencies, there is the mark-up and various other challenges. Clearly, also, we live in a land of demand and supply, and there are not very many of them, so inevitably the price goes up. That is market economics. What can we do about some of these challenges about training more people and about trying to manage the costs so it is affordable?
Liz Sayce: Shall I start? I do not know if you have seen a report that was done by NDTi, the National Development Team for Inclusion, published earlier this year, which looked at commissioning of employment support, particularly for people with learning disabilities and people with mental health conditions, where it is human support, not kit, and they were looking at the support that was commissioned by local authorities, by the Health Service and so on. They found that one-third of it was evidence-based and likely to help people get and keep jobs. Two-thirds was not. If you looked across Government at the money that there is in enabling people to get work, it could be better spent. That is not to say we would not want there to be more money. Similarly, the vision that my organisation has is that what we want is maximum choice and control for the individual and maximum involvement of the employer as the key players here who have got to make it work.
I am really interested in the concept of personal budgets. We did a survey last year of about 500 disabled people, asking them, “What would you want in terms of employment support?” A lot of people were out of work; some were in work. People wanted much more say in the kind of support available. Predictably they were fed up with the standardised things they were being offered through the Work Programme, which they did not appreciate and did not think were any use. Also, about three-quarters said they would like to know exactly what funds and resources were available and then to have a say in what they could have that would work for them and would work for any employer once they got into work, or as they were getting into work.
Where we would like to get to is that you could have a personal budget, as you have now for your social care, personal health budget and employment support—and for your student support, so you could then seamlessly, hopefully, move from being a student or pupil to being in employment. Now, it is quite complicated to get to that point. There are people around who are offering support funded by local authorities and health and so on for employment, but some of them are not doing the right things, so there is a either a big re-recruitment or re-training approach.
One final thing, which I think is doable, is it is really powerful to deploy peer support and peer mentors. This has been done a bit in the field of disability; it has been done a lot with ex-offenders, where, classically, if you are coming out of prison, for example, you may be mentored by another ex-offender who is in employment. There is nothing quite as powerful as being surrounded by other disabled people who have made it out of unemployment. Rather than always thinking this has to be some sort of professionalised or semi-professionalised employment support worker giving you a unit of support, some of this can be done through peer support. Mike’s point about disabled people’s organisations is really important here. There is a lot that you can do through sharing stories, encouragement, sharing practical tips: “Oh yes, this is the kit that worked for me,” and, “This is how I manage my support worker.” We really need to grow that and invest in that.
Mike Adams: Just on that, the panel made a set of recommendations in November 2012, one of which was to pilot some work around peer support in Access to Work, and we funded 10 programmes, which are now just coming to an end. What you are starting to see is the value to the disabled person from peer support, which will reduce over time that kind of specialist support that may be required, so it would be a different kind of contribution. That, alongside IT and other advancements, will start to change the nature of the spend.
It is important that, when we talk about support workers, we separate out those support workers who provide support and care while the person is in employment and those where it is more specialist, where there are issues. Certainly with the 30-hour rule and everything, you are talking about supply and demand. You are talking about a specialist market, which is driving up some of the prices.
Q33 Chair: Just as you are talking there, I am just wondering how inventive employers and, indeed, your organisations are in suggesting solutions that might be cheaper in terms of support workers. I think of my own support needs. I actually only need them at pinch points during the day. I do not need it the whole time. I need to get here in the morning, and I need someone to fetch and carry, but actually the doing of the job I can generally manage. However, you need the support worker, and that could be someone who is employed by the employer and then goes off and does another job. They have a job but are there as a peer support rather than as a support worker, driving the person to their work and getting them all set up for the day, but then leaving them alone to get on with their job while they go and do their own work. Is that something that disabled people would welcome, or do they think it would be too restrictive if their work support worker, if you like, is actually an employee of the employer as well? It would cut down the Access to Work payments part of their pay. It would be much smaller, because they actually have a job as well.
Mike Adams: I think disabled people would absolutely welcome the opportunity to have a bigger contribution to what support they best need. If you look in social care, for example, an increasing number of disabled people’s organisations are undertaking the support plan. It is decided on what the budget is, and in the way that that budget is then delivered in terms of support you are starting to see much more innovative and creative ways of meeting those needs, rather than the traditional, “Well, this is how we have always done it so this is what you need.”
Sitting behind me today is my support worker, who is employed by my organisation; I would not be here if I did not have that person. It is used very flexibly, and for me that works. Other people may want to employ them themselves; it may work on a Wednesday but not a Friday, or it may work on a Monday. Liz’s point around a personal budget is, you say, “Look, here is, overall, your spend over three years. We will want to see how you are spending it, but we expect you to have some underspend, some overspend, but over time this is what we want; go ahead and do it, and don’t keep coming back to us every week or every month when you want a variation for two hours.”
Q34 Chair: How many employers, like your organisation and indeed my organisation, are actually willing to pay for the support worker rather than it coming through Access to Work? The example was given where the employer pays two-thirds of the salary of the support worker, but a third of the salary comes from Access to Work. There is that kind of sharing, because they are getting two-thirds of this person. One-third of it is in the role as a support worker, but actually the rest of the day they are not a support worker at all.
Mike Adams: That is how it does work, but if you look at the numbers, the 31,000, and you look at the number of disabled people in employment, I imagine there will be a significant number of employers who do those kinds of arrangements on a regular basis in terms of enabling and putting on the payroll someone to provide additional support, some of which will come back from Access to Work.
Q35 Chair: The other thing that has occurred to me from talking about this is, should Access to Work really sit in the DWP? It is not social security and it is not a benefit. Should it not be in BIS, because it is about employment support, and other employment support—apprenticeships and all those kinds of thing—do not sit with the DWP; they sit in the Department for Business.
Liz Sayce: There is a bit of an issue. DWP is used to running big national programmes that are, as you say, mainly about benefits. This is very different. It is not just about whether you are entitled to something and, yes, you get it or, no, you do not. It is about investing in your potential and being able to do things, so it is slightly different.
With BIS, I do not know. It is definitely worth posing the question, but it is also worth posing the question, what would happen if you looked at a single modular assessment? We know that disabled people often feel assessed to death. Some programmes are national and some programmes are local. What about linking Access to Work to Jobcentre Plus? There are a number of ways that you could link it in more with how you are planning your own support needs at a local level in social care, in health, with your employment support. With the networks and organisations working together, as was said earlier, in a locality where it is so important that all the agencies work together. You could have a national framework and then devolve it in some way, so that it can be linked more effectively with other budget streams.
Chair: We have more questions from Nigel. I do not think that any of yours have been asked. Some of Graham’s have, but I do not think yours have.
Q36 Nigel Mills: We have briefly touched on mental health conditions. If this programme is the best-kept secret, it is certainly the best-kept secret for people suffering from mental health issues. What are your views on how we could increase the take-up of the scheme by people with those conditions?
Liz Sayce: First of all, it is a slight anomaly that there is one support service for people with mental health problems under Access to Work. In a way it was a good thing that it was given some attention, but there is an anomaly in the sense that everybody else can go to a whole variety of different suppliers—you can employ your own support worker or whatever—whereas if you have a mental health problem, “Here is the provider and off you go and use them.” It seems to suggest a lack of choice. That is probably a bit of a barrier.
Instead of doing that, I would look at working very closely with mental health service providers to promote Access to Work as being available. There has been a long-standing issue that people who work in mental health and people who themselves experience mental health conditions do not view themselves as disabled people and do not think of disability programmes as having any relevance to them. Access to Work is viewed as being all about technical kit, if people have heard about it all: “What use is it to someone with a mental health condition?” It would be a good idea to work with all the main mental health professional bodies and with the mental health voluntary sector organisations to specify what it can deliver and what it can support people with. I would like to extend what it can support people with, so it can be much more individualised.
Q37 Nigel Mills: I think the service you referred to is the Remploy Workplace Mental Health Support Service, which is, from memory, one where you have to be in work and in danger of dropping out of work. I am not sure referrals to it are very easy to come across or understand. I think you have to self-refer and have to ring up and say, “I am mentally ill and I am in danger of falling out of work,” or something. It strikes me as being an unlikely scenario and unlikely to work. I guess that is a service that is important, but are you saying there should be something on top of that to help people who are not in work get into work in the first place?
Liz Sayce: I was just going to say one more thing, which is that the model of support workers and peer support for employment can work very well in relation to mental health problems. Perhaps people with mental health problems in some respects lack power in the system. Things have been provided for people through the Health Service or through social services rather than this being part of something over which people with mental health problems themselves can have some say.
I think personal budgets work really well for people with mental health problems. In health, for example, it was found that people with mental health problems were among those who benefited the most and were most satisfied with them. There is nothing wrong with the Remploy service being there as one of the things that you can have, but we need to promote the concept that the same sorts of things that are useful to people with physical impairments are also useful: support workers, peer support, additional mentoring—that kind of thing. Very often what people with mental health problems need at work actually is very low cost. It is things like being able to phone somebody when in a very anxious state or having some support before work. Sometimes Access to Work can really help with that. I just think we need to promote it much better with some good examples and make the eligibility exactly the same as for everybody else.
Mike Adams: If I could just come back on that, in terms of the Workplace Mental Health Support Service, they were just going to be evaluated at the time we had to submit the report to the Minister, so I am not sure what the evaluation said. However, I agree with your point. It seemed fairly narrow in terms of its remit. It only provided support to people who were already in work and who self-referred themselves.
What we wanted to see as a panel was whether or not, with a bit of shaping, having a focus on a particular kind of impairment might be valuable. We talked earlier about areas where there is under-representation. Might this be a short-term measure in terms of stimulating understanding and knowledge around learning disabilities, for example? In terms of long-term health conditions, I certainly know I was lobbied very hard when doing the report around supporting people with cancer. I do not know what the evaluation said. I agree with you and I agree with Liz that what we want to do is enable people to have choice and control over where they get their support, and ensure it is timely. It must be, for example, in mental health; those conversations and those discussions around entering employment are absolutely critical. You need to be able to access services at that point as well; in effect, you can only access support when you are in crisis.
Q38 Nigel Mills: One of the issues that springs to mind is stress-related conditions, which are a big issue for various employers and, I guess, helping an employee through that and getting them back to work. It strikes me that there is a role here for this service to stop people dropping out of work in that situation and the relationship with their employer breaking down. Is that something you see as being a useful use for this?
Mike Adams: I certainly do. There is a real issue around people who acquire an impairment and what then happens. Certainly, the clear recommendation from the Health and Work Assessment and Advisory Service that has been set up is that they should understand Access to Work and they should be proactively supporting that through their networks.
From my point of view, interestingly, we have done some work with local employers, and when you say to them, “What are your issues around disability?” they will, nine times out of 10, go, and have gone, “Mental health.” That is an issue they are facing on the front line every day, and how you address that. Certainly, what people are saying is that, if an individual is getting to a position of not necessarily mental health but an acquired impairment, the mechanisms in place sometimes go against getting an appropriate resolution with occupational health and stuff. People are saying you are in a stand-off position where the individual is making demands through occupational health they do not really understand. The employer is trying to make as many reasonable adjustments as they can. All of that is happening without any kind of knowledge or understanding of Access to Work at all.
If we are going to look at Access to Work, we need to make sure that Access to Work works for people who are already in work and acquire an impairment, as well as people who are wanting to move into work.
Liz Sayce: Could I add one point? One of the things I recommended in my review, which has not been done, and was also recommended in the Perkins review of mental health and employment that was commissioned by the last Government, was that Access to Work should be extended to be able to be used for temporary cover for somebody with a fluctuating condition. The Perkins review was only about mental health and a particular extended use for people with mental health problems, but it could apply to other fluctuating conditions. On the same basis that an employer might be reluctant about taking you on because you need some equipment or an interpreter, and Access to Work removes that disincentive, the same thing might apply. Say you have bipolar disorder and perhaps every couple of years typically you take two months out because of ill health. Let’s say that is your pattern. The employer is going to look at that sickness record and feel anxious.
I am not talking about Access to Work covering every sickness or anything. I have certainly worked with and line-managed people who have that kind of recurrent, episodic impairment. It is quite difficult in a small organisation when somebody goes off for, say, two months. Supposing they were in an administrative role or something, if you knew that Access to Work could be used to cover a temp for that period—there would be a cap on it, with an agreed sum for the year or something—it would remove a big disincentive, because if you have a poor sickness record for purely impairment-related reasons, employers do not want to take you on. It is very understandable. Actually, this has been recommended to governments of different persuasions and they have never acted on it. I would just like to put it back on the agenda, because I think it could make a real difference.
Q39 Nigel Mills: Would it be simpler to say it should cover the sick pay of that person with an impairment-related absence, rather than trying to cover the temp costs?
Liz Sayce: There are different policy ways of doing it, but the key point is that it needs to be addressed, because at the moment it does act as a disincentive.
Mike Adams: Certainly the panel recommendation was that DWP should commission a short and time-bound further piece of research to determine how Access to Work can better support those individuals with fluctuating conditions in employment. We, as a panel, looked at the different mechanisms and explored the different ways that could happen using Access to Work. Again, it was felt that it just needed some further thinking through of how that works so it could be implemented. I am not sure that has been taken forward.
Q40 Nigel Mills: Neither of you have any ongoing role in this, do you? It was one-off advice, thanks very much, and the Government thinks about it?
Liz Sayce: Obviously, we have informal relationships, but I do not have a formal ongoing role in relation to it, no.
Q41 Sheila Gilmore: For many people, particularly with either new or ongoing mental health problems, one of their main sources of contact for advice of any kind is their GP initially, and that becomes a very medical approach, where the GP is trying to find somebody therapy or counselling or something, which is often in quite short supply. What knowledge do you think GPs have about the potential of getting people help through Access to Work? Are you aware of any connections in that respect? It is not just about basic information; it is maybe a bit about mindsets. Doctors are thinking medically rather than necessarily in terms of employment.
Liz Sayce: I agree completely with you. I think that is right. There are some very good examples where GP surgeries or health centres have people actually based in the surgery who can offer advice on a range of social issues, including debt, housing and employment. That is really good, because in a sense we do not need GPs to know all this stuff, but timing is often very crucial. If you have just had a significant diagnosis of MS or something, you can very easily just give up your job at that point because you do not yet know what it means, whereas the right advice and information quickly will stop you falling out of work. Sometimes the medical profession—not only GPs but also hospital clinicians—will see you when you are at your worst, in a way, and think, “Oh well, I will be helpful and write them the fit note,” which it is called now. This happens in mental health as well.
Sheila Gilmore: It happens a lot, yes.
Liz Sayce: Let us say you are seen by a community mental health team and you are in a crisis; they will of course say you are not able to work. In one way, of course, that is helpful, because at least you get the benefits and so forth. On the other hand, they do not see you when you are coping and a very highly functional person, so people can very easily underestimate what you might be able to do. There has been some very good work in mental health where vocational workers are placed within community mental health teams, and that has been shown to create a significant increase in people keeping their jobs, getting jobs or getting into further education. It is linking health services to people who can really focus and understand, know what employers think, understand employers and provide some hands-on support.
Mike Adams: We saw some success in the Right to Control pilots, where, first—Liz mentioned it earlier—disabled people only have to tell their story once, and secondly, there was much better integration between health, social care and employment in terms of not quite creating the one budget, but just a greater appreciation that the journey of an individual does not stop at the GP surgery, and that part of the rehabilitation recovery moving forward does involve employment.
Q42 Chair: Something else that occurred to me is, what about job shares? Is that something that is pushed quite a lot with disabled people, or to get Access to Work do you have to work a certain number of hours a week in order to qualify? We were talking about the mental health thing. We think of job shares for people with caring responsibilities. Is it something we should be thinking about for some disabled people?
Liz Sayce: There are examples of disabled people doing job shares and also of people working collaboratively. I have met with a group of people with Parkinson’s, for example, who are working together as freelancers, and they cover each other’s work if one of them is not well enough to fulfil a contract.
Q43 Chair: So there are examples, but there are no restrictions on Access to Work in that situation, are there? There is no hourly rule or anything on Access to Work?
Liz Sayce: You can get Access to Work for part-time work as well as full-time work. The same applies, I think.
Chair: Graham, I think some of your questions have been asked. We touched on some of the things about the Work Programme anyway, but I think you may want to dig a bit deeper.
Q44 Graham Evans: To what extent would the Work Choice programme improve employment outcomes for disabled people if it were to be substantially expanded?
Liz Sayce: When I did my review, the employment outcomes for Work Choice were not all that great. They have improved a bit in the last couple of years. The only caution I would place on that is that, in effect, Work Choice providers, one way or another, can select who they take on. They are looking for people who they think are going to be able to get a job within six months, because that is what they are measured on. I have a concern in the back of mind over how many of those individuals might have got a job anyway.
Also, Work Choice is a curate’s egg. There are some very good examples of work done under Work Choice, but there is also some old-fashioned, more sheltered work-type activity that goes on under Work Choice. The idea of sheltered work has always been that it leads to open employment. It gives you some work skills and then you go and get open employment, but all the evidence suggests that that does not happen. People actually just stay in the sheltered work. That might be better than no activity at all, but it is not achieving employment outcomes as you might recognise the term, if you see what I mean. I would have some caution.
I would advocate putting resources together, from Access to Work and Work Choice, and the money freed up from the Remploy programme, and having a menu of more individualised support. That is certainly what disabled people tell us they want. It also in a way fits the evidence, because for somebody who has slightly more complex support needs—like somebody with a mental health condition, for example—continuity can be really important. Rather than having one programme for people who are in work and then another programme for the people who are trying to get work and so on, why can you not have a gateway? We all think we need a gateway, so the right people are getting the more specialist support. It is clear at the moment that Work Choice supports some people who do not face very complex barriers, let us put it that way. Why not have a proper gateway and then say, “Okay, this is the resource allocation, and some of what you are going to use this budget for might be stuff we are calling Access to Work at the moment; some of it might be some more ongoing support to get into employment,” and then have support as you go through. You could develop that menu in a variety of ways. In other words, I do not think Work Choice is a panacea.
Q45 Graham Evans: Is there a case for making Access to Work funding available to disabled jobseekers during their search for work, rather than only once they have secured a job or an interview?
Liz Sayce: It is really important, as we have talked about before, for all sorts of work experience, internships, traineeships—all of those things—and that this really happens. That is being developed in principle, but the numbers are very low, so it is really important that gets promoted. There are so many young people feeling they are at a real disadvantage in relation to their peers because there are certain opportunities that they could take up that they cannot get Access to Work for, or they could not until very recently.
The one thing about disability that was in the original Coalition agreement was about the idea that you should be able to have an indicative entitlement to Access to Work that you knew while you were job seeking. The idea of that is that you can go to an interview, and perhaps you have an obvious impairment—perhaps you are blind, let’s say—and you can say to the employer, “I know that I am likely to get Access to Work and what it would mean. As a small employer, it would not be a cost to you.” You can actively reassure, and it gives confidence to both the employee and employer.
The letter that has been developed that you can download from the website does part of that, but it does not quite go the whole way, because it is a bit too standardised. It asks you a couple of questions and then you can download a letter, but it does not actually say that you know that you personally are likely to get Access to Work and can explain to the employer what it will mean. We could go a little bit further with it.
Other job-seeking activity: yes, you might need Access to Work support for other types of activities while you are job searching. You need to specify what those are. I suppose in my vision of putting Work Choice and Access to Work money together, it would all become fairly seamless.
Q46 Graham Evans: It is interesting. In some of the evidence you have given, you talked about youth unemployment and, therefore, disabled youth unemployment, and structural issues that have been there for quite a long while. My experience is blind people seem to get jobs and indeed qualify. For example, my wife worked in a building society and there were analysts who were blind. They had guide dogs and they were fine. There are certain jobs and qualifications that disabled people can do—they do not need much help as they seem to get the jobs anyway—yet the country is short of certain skills. I do not see why disabled people cannot learn those skills. Have you looked at science-based or engineering-type professions that disabled people perhaps have not considered in the past and there is no reason why they could not pursue those? When you talk about structural, if young people were going into those skills that are very much needed by the country, it is really almost irrelevant that you are disabled because you still have that science or technical qualification.
Liz Sayce: One of the things we have done is produced a guide called “Into Apprenticeships”, which is directed at young disabled people. It is about the kinds of opportunities they might pursue. We also tried to draw on things like LMI For All—sort of labour market information—to alert advisers that, as for any young person, I suppose, you need to know what the opportunities in the labour market are, and not just suggest routes into employment that may actually be fairly sparse, and not to think, “ Oh, well, you are a disabled person, so perhaps you will cope with this kind of job,” when actually you might be able to do something else with a few adjustments in a booming area of the economy. What you say is really important, and we have done a bit towards it with things like that guide, which I am happy to leave you.
Q47 Graham Evans: That is very interesting, because it gets on to the other point, and the question is the integrated specialist employment support, because in many ways the hardest to reach are those with mental conditions. In my experience, paraplegics have got employment in Cheshire because of all the support they have managed to get. You made a very interesting point about the public sector. It used to take a lot of disabled people in, and they are not in a position to do that now, so therefore the private sector has to take that slack. We mentioned earlier, and you just mentioned it again, which industries and which sectors are growth and therefore would have those vacancies that the public sector would have done. When we are talking about integrated specialist employment support, would it be possible to analyse the region or the area’s growth sectors that require the skills you have identified there and you could put into it? That is the point I made earlier about Essex and Cheshire and so on. It will vary within the regions. What are the growth industries within the given area? It is not the same one hat that fits all. It varies around the country, but the point is there are opportunities for young people. There are skills that are needed, whether you are disabled or not, so there is no discrimination there. It is identifying those skills that are required, and marrying them up with where you may need help and support with your application to get in there. We end up with a very happy situation where the work-type provision is there, the money is available and the people know that that is available. The Jobcentre or whoever is helping to place these people knows it. Everybody knows it is available, and the employers are saying, “We are very much interested in these disabled people.”
Mike Adams: I absolutely agree with you. If you take the example of where I used to be, Coventry University, the community was based on the car industry and high tech. The local strategy would be to develop the skills of the population in order to do those kinds of growth industries. If you took that in terms of disabled people, the strategy has to be that Access to Work enables, in effect, your specialist disability employment funding to follow the individual. Therefore, in that area you want to attract people through the university, through the businesses, into developing careers in those kinds of specific industries.
As part of that strategy, you would want to include attracting disabled people. This is why I think you can enable these things to happen with something like Access to Work if Access to Work follows the individual, so it is not structurally attached to particular industries or particular sectors. I am interested in the Access to Work recommendations being extended to sector-based work academies. I would be interested to see in different areas—whether it is Cheshire or Essex—what those growth industries are; how the sector-based work academies are working; do they understand about Access to Work; are they marketing and promoting to disabled communities in those areas; and do they then understand how Access to Work can support those individuals?
Liz Sayce: I can give one other example. I was talking with somebody recently from Hartlepool, and they had a team supporting people with learning disabilities into employment, which was originally part of their social services area of work. At a certain point they moved it into their economic regeneration work, such that the work with people with learning disabilities was then completely linked to everything they were doing with local employers and the chambers of commerce. They knew what the industries were and what the jobs were likely to be and, as a result, they have significantly increased the employment rates of people with learning disabilities.
There is something about—going back to this not-working-in-silos issue—people like LEPs: what is going on in terms of economic development at local level and labour market development. Again, I am going back to the point that Government has certain levers here to work with employers, LEPs and local government and so on, and to stimulate—just including disabled people in that mix and making sure that careers advice also directs people towards where the job opportunities are.
Graham Evans: Governments down here are a long way from home, as it were. You mention LEPs, the chambers of commerce and the Federation of Small Businesses. They can fine-tune what the Government wants, but at a local level to take account of the local needs. I really like this sort of thinking, Chair.
Chair: I was just thinking that; therefore, you are saying the right things.
Q48 Teresa Pearce: First, apologies for being late. I believe that Access to Work is available to people who have set up in self-employment. Self-employment can be quite attractive to someone with a disability, because they can flex it around their disability. Does that work and is there anything we should be looking at regarding the self-employed and Access to Work? Do you know?
Mike Adams: Certainly, the panel recommended that we have to make it easier for disabled entrepreneurs and self-employed disabled people to access Access to Work. There was a whole range of initiatives around business start-up and the New Enterprise Allowance scheme, for example, which was going to be extended to Access to Work.
Teresa Pearce: Right.
Mike Adams: There certainly was a focus and an assumption that disabled people start up businesses and are self-employed, and Access to Work should work equally well for them as if they were employed by another organisation.
Teresa Pearce: Thank you.
Liz Sayce: Going back to what we were talking about earlier—I am not sure if you were here then—there are some difficulties in how the actual processes work, and some of that seems to be driven by an attempt to contain costs by the people administering Access to Work on the ground. This seems to be impacting on people who are self-employed. This is just from things our members are telling us; I do not have data on it, but it seems that if you are self-employed and you are claiming Access to Work, you seem to be subject to more questioning about how real the business is and so on. Of course, questions are legitimate, but we are getting concerns and complaints.
Teresa Pearce: It should not be a barrier.
Liz Sayce: Exactly.
Q49 Chair: The DWP published a Disability and Health Employment Strategy discussion paper in December 2013, but so far no action plan has come out of that. Do you know anything about when that is likely to happen or do you have any insight as to what they might conclude from it?
Liz Sayce: We are expecting a delivery plan before long, but I do not know when. Just to go back to the issue about the amount of money that there is for specialist disability employment programmes within DWP—and obviously there is other money, as we talked about earlier, such as local budgets and so on—it would be really useful for there to be a clear vision of how that money can best be spent.
Q50 Chair: Do you think that should be outside the Work Programme? You were quite critical of the Work Programme for not delivering for disabled people. Do you think it is unrecoverable for disabled people and that this specialist provision really needs to sit outside the Work Programme if it is going to have any success?
Liz Sayce: Obviously, there are lots and lots of disabled people who are on Jobseeker’s Allowance. There are lots of disabled people who will be using the Work Programme as things currently stand. For disabled people who need something quite bespoke in terms of support, equipment or travel arrangements, it does make sense, and that support might be support to get into employment in the first place, as is currently done through Work Choice, and then be supported through that early period. It seems to me that some people have more specific requirements, and it makes more sense to integrate those with how they are managing their social care and health care budgets. There is a wider question about the Work Programme and how it is working for everybody and how it is working for those disabled people using it.
Q51 Chair: That group of people you have just described are getting lost in the Work Programme. There are effectively the ones who have been parked. There is money attached to them individually; it is just their providers are not going to spend that money at the moment because there is not an award. However, if that money was out of the Work Programme and into more specialist provision, then you start to have quite good packages that can be used holistically to get someone into work.
Liz Sayce: It is a question of where the threshold is, is it not? Are you talking all disabled people, which is very large numbers, or are you talking about perhaps people on the ESA work-related activity group? Taking some money out of the Work Programme would be helpful, because then you could augment the £350 million that is in the current package, although some of that includes some money in the Work Programme, I think. I think some clarity about what that £350 million is currently projected to be spent on would be really helpful, plus how it can be augmented so that more disabled people can have really personalised support that they can control if they wish to and we can make it much more bespoke. I think the chances of the Work Programme getting fine-tuned and personalised enough for people with quite complex lives is rather slim.
Chair: Right, we are exhausted. The bell is ringing; the House is sitting. There are Scottish questions. Have you got anything that you came along and you thought, “I must say that,” and we have not given you an opportunity to say? No. That’s good. Can I thank you very much for coming along today? We really do appreciate it and it has got our inquiry off to a really good start as well, so thank you very much.
Oral evidence: Employment support for disabled people: Access to Work HC 481 38