Coroner: DWP ‘must act’ after it told severely ill patient to leave hospital to make claim
A coroner has called on the Department for Work and Pensions (DWP) to make urgent policy changes, after it ordered a disabled patient to leave hospital to visit a jobcentre despite being severely ill with a condition that later killed him.
The call for urgent action has come in a prevention of future deaths (PFD) report, the latest in a series of such letters to be sent to DWP by coroners over the last 12 years following the department’s repeated failure to ensure the safety of disabled benefit claimants.
Health professionals had told an inquest into the death of Terence Talbot that they had never heard of such a “severely ill inpatient” being told by DWP to leave hospital to make a benefit claim in person.
Talbot was being treated for drug hypersensitivity syndrome, while also being detained under the Mental Health Act, because of a rare reaction to medication that had been prescribed for his mental distress.
The severe allergic reaction had left him “very vulnerable to infection”, but DWP refused to allow him to submit a claim for benefits electronically.
Instead, he was told to leave hospital and attend his local jobcentre in person.
He later died in Maidstone Hospital, on 9 April 2020, aged 58, from multi-organ failure caused by the lung conditions pneumonia and empyema, which themselves were caused by drug hypersensitivity syndrome (also known as DRESS syndrome).
Sonia Hayes, assistant coroner for Mid Kent and Medway, wrote to work and pensions secretary Therese Coffey last month to warn her that other claimants could die if she did not make urgent changes to how DWP deals with such cases.
She told Coffey in the PFD letter – also known as a Regulation 28 report – that DWP had “required Terence Talbot to attend in person to make a claim for benefits rather than accept an electronic claim”.
The coroner said she had been told by “all the doctors and a senior nurse in this case” that they had “never experienced nor heard of a case” where such a “severely ill inpatient” was required by DWP to “leave hospital to attend its offices in person to make a claim for welfare benefits”.
She said Talbot had been experiencing mental distress and “an exceptionally rare and complex disease with a risk of death and suffering severe exfoliative dermatitis that rendered him very vulnerable to infection”.
Coffey has to respond to the coroner’s report by 28 January.
A DWP spokesperson told Disability News Service: “Our condolences are with Mr Talbot’s family.
“We are considering the report and will respond in due course.”
The coroner was also highly critical of Kent and Medway NHS and Social Care Partnership Trust (KMSCPT) – which provides mental health services across Kent and Medway – and Maidstone and Tunbridge Wells NHS Trust (MTW) for their failures.
She said there had been a failure to carry out regular reviews of Terence Talbot’s skin condition, and to apply moisturising treatments to his skin – they were recorded as “self-administered” even though he could not apply them effectively himself – while he experienced malnutrition because he did not receive the food, fluid and nutrition he needed.
The coroner said this “amounted to a gross failure to provide basic medical care that would have prolonged but probably would not have saved his life”.
She told KMSCPT that it had failed to subject all the decisions about Talbot’s care and treatment to formal Mental Capacity Act assessments at a time when he was “refusing medical interventions that were in his best interests”.
And she said MTW had failed to consider a specialist dermatology referral for his severe dermatitis, caused by the DRESS syndrome, and had failed to ensure regular input from a dietician to deal with his malnutrition.
Instead, she said, MTW had focused in meetings on problems relating to his discharge rather than the treatment he needed.
MTW had also failed to carry out mental capacity assessments of Talbot’s decisions on all the occasions it should have done, she said.
MTW is preparing a response to the PFD report.
But KMSCPT has already responded to the report, apologising for its failures, and telling the coroner that it had “identified a need for more joined up working with [MTW] particularly when it comes to accessing care for physical health for our in-patients at the Priority House site in Maidstone”.
The mental health trust said it also knew that it was “extremely important for us to thoroughly assess capacity and to document it when any of our patients are refusing to accept treatment for their physical health conditions”.
And it said it recognised “the importance of engaging with families and seeking their support with situations where the patient might appear to be refusing care and treatment for a deteriorating physical health condition”.
It described several measures it had taken to address the concerns raised by the coroner.
The trust said it was “sincerely sorry for the shortcomings in our care of Mr Talbot and are committed to ensuring that the improvements we have made are sustained”.
6 January 2022
Disabled woman wins go-ahead for high court review of ‘immoral’ DWP scheme
A disabled woman has won permission from the high court to challenge the legality of a Department for Work and Pensions (DWP) scheme that allows utility companies to “help themselves” from claimants’ benefits to pay off debts.
Helen Timson said she “cried like a baby” when deputy high court judge Peter Marquand granted her permission for a judicial review of DWP’s “third party deductions” scheme, which she described as a “gravy train”.
He had told a court hearing that the case was in the public interest, particularly in the light of rising fuel prices.
Timson said she hoped the court’s decision showed other disabled people and benefit claimants “that when we are walked over and treated like second-class citizens we don’t have to sit and take it”.
She has previously described the scheme as “immoral”.
The long-standing scheme allows DWP to take significant sums from a claimant’s means-tested benefits to pay off their gas, electricity, water and rent debts and current bills.
For those, like Timson, claiming employment and support allowance, DWP can deduct up to 25 per cent of their benefits without their agreement.
Timson says claimants are typically not given the opportunity to challenge the payments or discuss the financial problems they might cause with DWP before such deductions begin.
She said that as arrears can be deducted for different utilities, on top of their continuing usage charges, claimants can face significant and unmanageable deductions.
On one occasion, she had to pay a deduction of £80.80 a month after being charged too much because of a faulty electric meter.
Even though the electricity company knew the meter was faulty, it continued to take the same amount through the deductions scheme, even after she had changed supplier and no longer owed them anything.
She told Disability News Service (DNS): “This scheme is a gravy train for utility companies, who are allowed to help themselves from our frugal benefits without our consent.
“They and the DWP don’t bother to check if we are left with enough money for food or rent, as a county court would.
“Also, from my experience, utility companies also don’t seem terribly motivated to ensure they don’t take too much or don’t take money when nothing is owed or even that they pay our money into the correct account.”
Timson, from Leicester, believes the DWP deductions scheme means she is treated worse than those with utility debts who are not benefit claimants.
If she was not a benefit claimant, a court would have to decide whether she was liable for the debt and how much she should repay.
She told DNS last summer that she had even had to cancel a cancer scan because she could not afford the taxi fare, thanks to the deductions.
On other occasions, she has not been able to pay her rent.
She first had to ask DWP to stop making deductions for her water, electricity and gas debts in December 2014, because they were making it difficult for her to pay her rent.
But the department said the only way it would do so was if she secured permission from her creditors to stop the deductions.
Now she is again being faced with deductions from her employment and support allowance, this time amounting to more than £20 a week, to pay off fuel and water debts.
Even without the deductions, her total income is below the point which the benefit system says is an appropriate minimum level for someone in her circumstances.
She believes the deductions scheme is “immoral”, and that the scheme is putting thousands of disabled and non-disabled claimants under financial pressure.
She is receiving support from law firm Bindmans, including solicitor Emma Varley, and social security barristers Tom Royston and Jenni Richards, for the case against work and pensions secretary Therese Coffey.
She praised their work on the case and said: “I can’t thank my awesome legal team enough.”
Her lawyers argue that the DWP deductions scheme is a breach of two articles of the European Convention on Human Rights – on discrimination, and the right to “peaceful enjoyment of possessions” – and that the scheme means that DWP is acting beyond its legal powers (“ultra vires”).
A date has not yet been set for the hearing.
A DWP spokesperson said: “We cannot comment on active legal proceedings.”
However, DWP claims that its deductions policy strikes a fair balance between a claimant’s need to meet their financial obligations and their ability to ensure they can meet their day-to-day needs.
It also claims that its policy allows it to enforce the payment of court fines, ensure government debt is recovered and safeguard claimants from the potential impact of not repaying debts, such as homelessness or having utilities cut off.
DWP says there are safeguards to ensure deductions are manageable and claimants can contact the department to discuss a possible reduction in their rate of repayment if they are in financial hardship.
6 January 2022
Peer ‘makes new bid for assisted suicide legalisation’ through health and care bill
The crossbench peer leading parliamentary efforts to end the ban on assisted suicide appears to be trying to use the government’s health and care bill to make a parallel bid to introduce legalisation.
Baroness Meacher’s assisted dying bill is awaiting its committee stage in the House of Lords, following a debate that appeared to show peers split on the issue of legalisation.
Disabled people opposed to her bill have described it as “dangerous” and “incoherent” and have called on parliament to focus on ensuring disabled people have a right to live independently, before even considering legalisation of assisted suicide, while warning that the bill adds to the “distorted view” that many have of disabled people’s lives.
But Baroness Meacher has now lodged an amendment to the government’s health and care bill in what appears to be a second, separate attempt to secure legalisation.
Her amendment states that regulations in the health and care bill on patient choice must also apply to those with a diagnosis of terminal illness, or to “another relevant person” if the terminally-ill person lacks capacity for such a conversation.
The amendment also states that NHS and other “relevant” bodies “must have regard to the needs and preferences recorded in such conversations” when making decisions on whether to provide them with services.
Baroness Meacher had told fellow peers in a debate on the health and care bill on 7 December: “Crucial to high-quality palliative care is the patient’s right to choose at the very end of life, and the bill needs to play its part in this area – we cannot afford not to.”
Soon afterwards, she lodged her proposed amendment to the bill.
Some commentators have suggested that this amendment would allow the legalisation of assisted suicide, even if her assisted dying bill fails to become law.
Baroness Meacher, a former social worker, is chair of the campaigning organisation Dignity in Dying, formerly known as the Voluntary Euthanasia Society, which is leading the campaign for legalisation.
When Disability News Service (DNS) asked her to clarify her intentions this week, she failed to rule out the possibility that her amendment would have the effect of legalising assisted suicide, if it became law.
When DNS asked if it was her intention that her amendment to the health and care bill would allow the introduction of legalised assisted suicide, she replied by email: “It is a fundamental human right to ensure people don’t suffer torture or degrading treatment.
“Patient choice is vital in all contexts but particularly at the end of life.”
DNS asked on Tuesday for further clarification of whether she intended that her amendment would secure legalisation, but she had not responded by noon today (Thursday).
6 January 2022
Minister offers transport industry latest ‘ludicrous’ exemptions from access laws
A minister has agreed to offer transport providers yet another series of “ludicrous” exemptions from transport access laws, two years after the regulations were supposed to have come into force.
The government has told senior figures in the rail, bus and coach industry that they will be allowed to continue to evade the regulations after their existing exemptions run out this summer.
The exemptions relate to buses and coaches used as rail replacement (RR) vehicles when train services are disrupted, and those used to provide home-to-school (HTS) services for disabled students.
The Public Services Vehicle Accessibility Regulations (PSVAR), introduced more than two decades ago, mean that all such vehicles should have complied with the regulations by 31 December 2019.
But because of the industry’s failure to prepare for that date in advance by ensuring sufficient provision of accessible vehicles, ministers have already handed providers four sets of temporary exemptions.
This means that train operating companies are still allowed to use older buses and coaches for rail replacement purposes, even if those vehicles do not comply with PSVAR.
Other exemptions have been offered to those providing home-to-school services, including local councils and schools.
In a letter to rail, bus and coach bosses, transport minister Baroness Vere admits that disabled people “have waited too long to be able to travel on services subject to the Regulations as easily as non-disabled passengers”.
But she says she still intends to offer further “medium-term” exemptions to providers that will “ensure that essential HTS and RR services can continue operating, helping passengers to make the journeys important to them whilst operators step up their efforts to comply with existing legal obligations”.
The government has promised to review PSVAR by the end of next year as part of its national bus strategy.
Baroness Vere says in the letter: “This letter explains our plan to bridge the gap between the current HTS and RR exemptions ending, and any post review changes to the Regulations coming into force.”
This suggests that providers will continue to be offered PSVAR exemptions until any changes suggested by the review come into force, which is almost certain to stretch into 2024 and probably even 2025 or 2026.
The letter suggests that larger operators taking advantage of exemptions will have to make quicker progress towards compliance than smaller ones.
The minister also suggests in the letter that all non-compliant vehicles may be offered a further six-month exemption this summer, but beyond that period providers will have to meet “increasing levels of compliance over the lifetime of the exemption”.
Disabled campaigner Doug Paulley, who has played a key role in holding the industry and ministers to account over PSVAR, said: “When ministers first issued PSVAR exemptions for rail replacement back at the end of 2019, the minister would only issue an initial one-month exemption.
“Since then, we’ve had a continual set of piecemeal extensions in both home to school and rail replacement bus provisions.
“These have happened through industry lobbying against application of the legislation.
“I wonder why accessibility is treated differently from emissions standards, drivers’ hours and tax law changes; perhaps if they ask nicely the government might like to give them exemptions from those too?
“This legislation has been in place for 22 years now. Why are we still pandering to the CPT [which represents the bus and coach sector] and RDG [which represents the rail industry] and diddling around with further special authorisations 20 years on?
“It is ludicrous and a disgrace, and makes a mockery of disabled people’s rights to access to public transport.”
The Department for Transport (DfT) had refused by noon today (Thursday) to clarify when it believed the exemptions would end; how ministers justified the industry’s continuing failure to comply with the regulations; and what their message was to disabled users of public transport, who should have been able to rely on an accessible service from January 2020.
But a DfT spokesperson said: “Safe and convenient home-to-school transport plays a vital role for many families, which is why we will be offering qualified medium-term exemptions.
“Authorities and transport operators can therefore invest in providing vehicles compliant with the Public Service Vehicles Accessibility Regulations.
“We welcome the continued support of the bus and coach industry as we work together towards delivering a fully inclusive transport system.”
DfT also pointed out that, by 2020, 99 per cent of vehicles providing local services were compliant with PSVAR. so it was disappointing that similar levels of accessibility had not yet been achieved in home-to-school and rail replacement sectors.
6 January 2022
Government’s failure on job support for disabled people is ‘unacceptable’, MPs hear
The government’s failure to spend enough money on specialist employment support for disabled people is unacceptable, MPs have been told by policy and research experts.
Members of the Commons work and pensions committee were told the government was “not doing enough” to support more disabled people into jobs.
Tony Wilson, director of the Institute for Employment Studies, told the committee yesterday (Wednesday) that the government spent less last year on specialist employment support for disabled people in the whole year than it did on the mainstream COVID-19 furlough scheme in a single week.
Responding to a question from Labour’s Neil Coyle (watch from 14.27 onwards), Wilson said: “This is something where money does talk. We simply don’t spend enough money on specialist employment support for disabled people.
“I don’t think it is acceptable given that disabled people are two-and-half times more likely to be out of work than non-disabled people.”
He said the UK was “among the best performers in Europe and in the world” on mainstream employment support but was “distinctly mid-table on employment for disabled people”.
Sam Avanzo Windett, deputy director of the Learning and Work Institute, said she “completely” agreed with Wilson.
She said it was a concern that the disability employment gap – the difference between the proportion of disabled and non-disabled people in work – had widened during the pandemic.
Avanzo Windett said the government’s Plan for Jobs, created to deal with the economic impact of the pandemic, “was about policies for the majority, not the overlooked groups”, such as disabled people.
And she questioned whether the government’s Work and Health Programme, launched in 2017, was receiving enough funding.
She said that many disabled people were working in the gig economy and in self-employment, both sectors that were under pressure, and were also more at risk of losing jobs to automation than any other group.
She told the committee: “Is the department planning ahead for that, is there enough support into those jobs that are at risk of automation or with self-employment decreasing, are we doing enough planning and support around that?
“I would counter no, at the moment.”
6 January 2022
News provided by John Pring at www.disabilitynewsservice.com
