Publication - Consultation paper

Disability assistance in Scotland: consultation

Published: 5 Mar 2019

Seeks views on our proposed approach to delivery of devolved disability assistance in Scotland.

85 page PDF

622.3 kB

85 page PDF

622.3 kB

Contents
Disability assistance in Scotland: consultation
11. Section 7 - Partial Equality Impact Assessment

85 page PDF

622.3 kB

11. Section 7 - Partial Equality Impact Assessment

Title of policy

Disability Assistance for Children and Young People, Working Age people, and Older people.

Summary of aims and desired outcomes of policy

Devolving non-means tested Disability Assistance to Scotland for children and young people, working age people and older people.

Ensure that those who are entitled to Disability Assistance receive it based on the principle that it is a human right. Deliver such assistance with fairness, dignity and respect.

Provide assistance that works for the people of Scotland and focusses on the needs of those accessing the system.

Directorate: Division: Team

Social Security: Policy Division, Disability and Carer Benefits Policy Unit

Background

Policy Aims

1. The Social Security (Scotland) Act 2018 set out the legislative framework for the delivery of nine types of social security assistance in Scotland, including Disability Assistance. The Scottish Government is currently consulting on Disability Assistance, the three benefits that will become the Scottish replacements for Disability Living Allowance (child) (DLA Child), Attendance Allowance (AA) and Personal Independence Payments (PIP) currently administered by the Department for Work and Pensions (DWP).

2. The three new benefits currently proposed to replace the DWP administered benefits stated above are:

  • Disability Assistance for Children and Young People (DACYP)
  • Disability Assistance for Working Age People (DAWAP)
  • Disability Assistance for Older People (DAOP)

3. This Equalities Impact Assessment (EQIA) sets out the Scottish Government's analysis of the equalities impact of the policies described in the consultation document: 'Social Security: A Consultation on Disability Assistance in Scotland.'

Disability Assistance

4. The proposed approach to providing Disability Assistance was set out in the Scottish Government's consultation on Social Security in Scotland, which ran from 29 July 2016 to 28 October 2016.

5. As a result of this consultation, following extensive engagement with people who have a lived experience of accessing or attempting to access the DWP benefits system, the Cabinet Secretary for Social Security and Older People announced on 26 September 2018 that all assessments for Disability Assistance would be carried out by Social Security Scotland. At the same time the Cabinet Secretary set out a number of ways in which Scotland's social security system will work for the people of Scotland, providing a person centred service that treats people with fairness, dignity, and respect.

6. This policy will help deliver numerous Social Security Outcomes, it is closely aligned with the Healthier, Wealthier and Fairer Strategic Objectives, and contributes to the following National Outcomes:

  • We respect, protect and fulfil human rights and live free from discrimination;
  • We tackle poverty by sharing opportunities, wealth, and power more equally;
  • We live in communities that are inclusive, empowered, resilient and safe;
  • We grow up loved, safe and respected so that we realise our full potential.

7. Disability Assistance will be provided to individuals on account of their disability or health condition (which can be physical or mental). The Act also provides for Disability Assistance to be paid to people who are terminally ill. The eligibility requirement relating to disability means that the person's disability or health condition must have a significant adverse effect on their daily activities that is not short-term.

8. For those who are defined as terminally ill, this is not required. The rules for terminal illness state that a diagnosis by a registered medical practitioner, having regard to guidance that is produced by the Chief Medical Officer, will be sufficient evidence that a person qualifies for assistance.

9. In line with the principles of dignity, fairness and respect, the Scottish Government has sought the views of people with lived experience of engaging with the current benefit system to ensure that people's views and needs are embedded in both the policy and the operations of all aspects of social security. As part of this work the Scottish Government set up the Social Security Experience Panels. The Experience Panels are made up of over 2,400 people from across Scotland who have recent experience of claiming at least one of the benefits that will be devolved to Scotland. They are instrumental in shaping the policy and design of Disability Assistance in Scotland. The Scottish Government will continue to co-design the end to end process - from application to award- with them.

Who have we involved in our policy deliberations?

10. As part of the Social Security Consultation in 2016 there were more than 200 responses to questions relating to disability benefits with an even split between responses from individuals and organisations. Respondents highreviewed the positive aspects of DLA, PIP, and AA, including that the approach was holistic and fair and that the benefits were non-means tested. They also identified a number of weaknesses in the current approach, which related mainly to the complex and stressful application and assessment processes - particularly for DLA and PIP, and also the perception that the eligibility criteria for DLA, PIP and AA discriminated against certain groups.

11. Overall respondents felt that the new Scottish social security system should be more flexible, accessible and person-centred. It was felt that applicants should be able to decide how to engage with the system, choosing from a range of options that suited them best, whether paper-based, online, by telephone, face to face or using other types of technology. Others underlined the importance of applicants being treated with dignity and respect throughout their dealings with the new Social Security Agency. There was support for better joint working and communication between relevant public agencies. In relation to data sharing there was some concern about potential breaches of security and respondents emphasised the importance of securing consent.

12. Policy changes have been co-designed by the Scottish Government, stakeholders, the Experience Panels and the wider public. The Disability and Carers Benefits Expert Advisory Group (DACBEAG) is independent of the Scottish Government and was formed to provide recommendations and advice to Scottish Ministers on the development of policy related to Disability Assistance. They have provided a range of advice to inform policies such as in relation to suitably qualified assessors, award duration, automatic entitlement and the Social Security Charter.

13. DACBEAG is comprised of experts from a range of professional backgrounds including the Convener of the Scottish Social Services Council, Chief Executive Officer of Inclusion Scotland and Associate Director for Scotland of Joseph Rowntree Foundation. The DACBEAG has significantly contributed to the development of policy related to Disability Assistance. To date the group has advised on:

  • automatic entitlement of Disability Assistance
  • duration of Disability Awards
  • the evidence base for policy decisions
  • suitably qualified assessors, Case Managers and relevant training

14. The Scottish Government has undertaken ongoing consultation with the Ill Health and Disability Benefits Stakeholder Reference Group. The Group was set up in March 2016 to inform and influence the development of policy options relating to devolved Disability Assistance. The group has advised on:

  • the evidence base for policy decisions
  • potential impact of policy decisions
  • user and stakeholder engagement; and
  • the interaction with other Scottish and UK social security benefits.

15. An exploratory process was undertaken for each form of assistance to gather the views of users through a range of user research and stakeholder engagement activity. These engagements supported the development of both the policy intent and the design of the administrative functions of each of the forms of assistance.

Who was involved in assessing the equalities impact?

16. Stakeholders and the wider public had the opportunity to express views about Disability Assistance during the consultation on Social Security, discussed above. In particular comments were invited on a partial Equality Impact Assessment which represented the Scottish Government's work on the impact of social security policy on people with protected characteristics up to the point of consultation. 521 formal written responses to the consultation were submitted. Of these, 241 were from organisations and 280 from individual respondents. Of the 241 organisations that responded to the consultation 81 were received from stakeholder groups relating to children/young people, equalities and human rights, disability and long term conditions and carers. The independent analysis of the responses along with the Scottish Government response were published on 22 February 2017[1]. In addition, the Equality Impact Assessment that was published alongside the Social Security (Scotland) Bill was used to inform this partial assessment. It can be found: https://www.gov.scot/publications/social-security-scotland-bill-equality-impact-assessment/

17. An initial framing exercise was carried out involving a range of internal Scottish Government stakeholders in order to inform this partial Equality Impact Assessment relating to Disability Assistance. In addition to highlighting a number of the positive impacts and potential barriers discussed above, the exercise enabled significant data gaps to be identified. Targeted consultation with stakeholders representing people with protected characteristics will be undertaken during the consultation period.

Data on Benefits Currently Paid

Attendance Allowance

18. As of May 2018, 125,501 individuals were in receipt of AA.

19. The AA caseload has gradually declined from a peak of 147,990 in November 2009.

20. 61 % of claimants were aged 80 or over. The peak age band for claims was 80-85 (31,875), though it is likely the incidence of claims increases with age, but subsequent age cohorts become smaller due to mortality.

21. The largest number of cases are due to arthritis (39,694), followed by dementia (10,833) and heart disease (10,046). Learning disabilities tend to be more common for younger-age recipients.

Personal Independence Payments

22. 213,741 individuals received PIP in October 2018 in Scotland.

23. This number is increasing as DLA claimants are re-assessed onto PIP - 48 % of current PIP claimants have been re-assessed from DLA.

24. 66 % of claimants receive both daily living and mobility elements of PIP, and the most common types of main disabling condition are psychiatric disorders.

Disability Living Allowance

25. 38,488 children (aged 0-18) received Child DLA in May 2018 in Scotland.

26. 19% of claims for DLA overall were aged 0-17.

27. As a significant number of the working age and 65+ population receive DLA, the equality breakdown is still of interest when considering the assistance in those age groups. 41 % of DLA claimants are aged over 65. DWP do not publish breakdowns of DLA data for Scotland by religion, ethnicity or sexual orientation. In the UK, "White British" family units are the most likely to receive the care component of DLA (7 per cent) and "Chinese" the least (0 per cent). White British families are also most likely to receive the mobility component (6 per cent) and "Asian Other" and Chinese are the least likely on 1 per cent[2]. (DWP has not published similar data for PIP or AA).

28. DWP does not hold administrative data on gender re-assignment, marital status, religion or sexual orientation. Pregnancy data is only held where this is the main reason for incapacity.

Data Gaps

29. We are aware that there are significant gaps in our data particularly in relation to the gender of children and young people. This is due to the sensitivities and challenges in collecting data related to young children. In addition, there is no robust data relating to the proportion of people of any age in Scotland to whom the gender reassignment protected characteristic would apply. The available data in relation to religion and belief is also very limited: 48.7% Scots over 16 in 2016 identified as having "no religion" and 47.3 % were Christians (Church Scotland, Roman Catholic or "Other Christian"). Once age was taken into account difference in reported health tend to disappear, with only "lower than average" rates for "Roman Catholic" and "Other" Groups[3].

Impact of Disability Assistance on people with protected characteristics

30. This policy has the potential to have an overwhelmingly positive impact on people with protected characteristics. In reflecting the Scottish Government's approach to social security we intend to create a system of Disability Assistance that is person centred, meeting the specific needs of each individual. In combination with the ethos of fairness, dignity and respect this should bring about a marked improvement in the experience of people with disabilities, including those with other protected characteristics, in interacting with the social security system.

31. We have also identified a number of areas in which further development of the policy may be required to mitigate any potential barriers that people with certain protected characteristics may experience. We want to ensure that Disability Assistance meets the needs, as far as possible, of the people applying and receiving assistance.

32. The key positive impacts we envisage to specific protected groups are set out below followed by the potential barriers that have come to light and any proposed alternative approahes we have considered.

Positive Impacts

Sex

33. From the 2011 census we know that those reporting a long-term condition which limits their daily activities "a lot" rises with each age group for both men and women although women over 65 are still more likely to report a long-term condition. 8.3% of men and 10.2% of women reported that their day-to-day activities were limited "a lot". For those over 65 this rose to 25.6% and 29.2% for men and women respectively. For those over 85 this rose further to 48.1% of men and 56.% of women.

34. Women are proportionally more likely than men to have a limiting condition at older ages but also are more likely to live to those ages where frailty becomes an increasingly greater issue. Looking at a specific age band, 17% of women aged 65-69 find their activities limited a lot compared to 18.1 % of men, suggesting that disability has a similar incidence but that the numbers of women with a disability are likely to be higher because of a higher average life expectancy.

35. As boys account for 71% of those currently in receipt of Child Disability Living Allowance (DLA) it is predicted that the policy relating to Disability Assistance for children and young people will have a disproportionately positive impact on that group. One of the main causes of this disparity is the much more frequent diagnosis of boys with behavioural and learning disabilities compared to girls.

36. In contrast, women are currently more likely to be in receipt of PIP and AA than men, accounting for 55% and 64% of recipients of the respective benefits. This means that the benefits providing assistance relating to working age and older adults will have a disproportionately positive impact on women.

Disability

37. Our consultation and engagement with stakeholders in relation to current disability benefit provision has shown that individuals with fluctuating conditions, mental health conditions and learning disabilities have faced particular difficulty in applying for and receiving Personal Independence Payment (PIP). It is estimated that they account for over 50% of people currently in reciept of PIP, with the most common disabling condition among PIP claimants being psychiatric disorders. The aspects of the policy that will improve the application and assessment process, particularly the proposed approach to the provision of suitably qualified assessors, are likely to have an even greater positive impact on people with fluctuating conditions, mental health conditions and learning disabilities.

38. In addition to our proposals for the ways in which existing PIP rules should be dealt with in Scotland, Scottish Disability Assistance will further positively impact on people with mental health conditions and fluctuating conditions. Examples of this are the "50% rule" (which determines that for a fluctuating condition you must require support at least 50% of the time) and the "20m rule" (which determines that to recieve the higher mobility rate you must be able to walk less than 20m.

39. We are committed to delivering Disability Assistance in a way that reflects our responsibility to provide inclusive communication. We know, for example, that 12,533 people in Scotland use BSL (British Sign Language) as the main language spoken at home. The variety of ways in which individuals will be able to apply for assistance - on-line, on the phone, by e-mail and in person - and the provision of application forms in accessible formats is part of this commitment. This will reduce the barriers to access which may otherwise be experienced by people whose illness or disability impacts the ways in which they communicate.

40. In addition, when building our Disability Assistance system the Scottish Government will continue to adhere to the Digital First Service Standards. These criteria include requirements relating to accessibility, ensuring that systems can be used by individuals with a range of communication needs. In order to progress to each new stage of development the system must pass a Digital First Assessment.

Age

41. The 2017 mid-year population estimates reported that there were 3.38 million people aged 18-64, 1.01 million people aged 65 and over, and 1.03 million under 18 year olds in Scotland[4].

42. The ethos underpinning Scotland's system of social security - fairness, dignity and respect - ensures that a person centred approach, whatever the individual's age, is embedded within delivery of Disability Assistance.

43. The Scottish Health Survey 2016 (published 2017) found that around 7% of young people in Scotland (under the age of 16) had a limiting long-term physical or mental health condition. Boys were much more likely to have a long-term limiting condition at 9% of the population of boys under 16, compared to 6% of girls under 16.

44. If an individual is regarded as terminally ill, their claim for Disability Assistance will be processed under 'special rules' for terminal illness as laid out in the Social Security (Scotland) Act 2018. These rules will do four things:

No qualifying period for the benefit will apply. This means that an individual will not be required to have the progressive disease for any period of time in order to be eligible for assistance.

There will be no assessment by Social Security Scotland. All that will be needed is verification that an individual has been diagnosed by a registered medical practitioner as being terminally ill for the purposes of entitlement to Disability Assistance.

Awards will be calculated, at the latest, from the date of application. This approach allows awards to be made based on an earlier date than when the application is made, namely the date on which an individual is verified by a registered medical practitioner as being terminally ill.

At present, individuals regarded as terminally ill get the highest rate for the care component but the mobility component of an award is not automatic. We are changing this approach to ensure that individuals regarded as terminally ill will be fast-tracked to both highest rate care and mobility components for Disability Assistance.

45. As part of the implementation of DACYP we are intending to increase eligibility from age 16 to 18 for young people in receipt of DACYP prior to their 16th birthday. This will ensure that young people and their families do not have to undergo a stressful and anxiety provoking reassessment process at age 16, a time when many young people undergo a transition to adult services. This policy measure is likely to have a broadly positive impact and is supported by stakeholders as a desirable permanent change to the eligibility rules for the benefit.

46. It should be noted that at age 16, under the current UK administration of Child DLA, 22% of DLA applicants to UK PIP are unsuccessful[5]. This policy measure intends to mitigate this issue by ensuring that there is an extended award to 18.

Sexual Orientation

Young people are more likely to identify as "Lesbian, Gay, Bisexual or Other" at 4.5 %.[6] Individuals reporting themselves as "LGB & Other" are less likely to report "good" or "very good" general health than the rest of the population (65.6% compared to 74.5% of the general population). It is therefore predicted that this group will benefit from policy related to new Disability Assistance.

Other Protected Characteristics

47. The policy measures described are anticipated to have a broadly positive impact across all individuals. However we have not identified any specific positive impacts of this policy in relation to the following protected characteristics: race, religion or belief, marriage and civil partnership, gender reasignment, pregnancy and maternity.

Potential barriers

Age

48. 9.6% of all working age and older people described having a condition which limited their day-to-day activities "a lot". We know that the older population is more likely to be affected by disabling conditions: 7% of those aged 16-64 describe having a condition which limits their day-to-day activities but this rose to 27.6% of those aged 65 and above.

49. People currently in receipt of the higher rate of mobility component of DLA or the enhanced rate mobility component of PIP are able to transfer either the whole or part of their mobility component to lease a new car, scooter or powered wheelchair through the Motability Scheme.

50. Due to the lack of mobility component AA recipients cannot access the motability scheme although we know that the largest number of AA cases are due to mobility-limiting conditions: for example, 32% of all claims are due to arthritis. Respondents to the 2016 Consultation on Social Security in Scotland argued this lack of mobility component for older people represented discriminatory policy making.

51. We intend to carry out some exploratory work to assess how we can better meet the mobility needs of older people who are not currently eligible for mobility elements of benefits and will be in receipt of Disability Assistance in the future.

52. It should be noted that under the current DWP administered system, children in receipt of DLA are required to apply for PIP at age 16, of which 22% are unsuccessful. Increasing the transition age intends to mitigate this issue by ensuring that there is an extended award to 18. Further scoping is being undertaken to ascertain any negative impact of this change. PIP clients receive on average awards that are 32% higher than DLA awards, meaning that some clients may be in receipt of a lower award as a result of this policy measure.

Race

The total share of minority ethnic groups in 2015 was 3.7 %. In terms of general health, respondents with Pakistani heritage (in 2008-2011) were least likely to report good health, albeit this was not significantly different to the national average. People describing themselves as having Chinese heritage were most likely to report good health although not by a significant margin. In 2014 those identifying as "White, other British" and "White other" had reported significantly better health than those who reported "White-Scottish" as their ethnicity.[7]

Non-white ethnicities made up 3.7 % of those with a reported learning disability or developmental disorder compared to 4.0 % of the total population according to the 2011 census. The 2011 census showed that 9.6 % of the population reported that their day-to-day activities were limited "a lot". This was 9.7 % for "white" people, 5.6 % for those who identified as "Caribbean or Black", 4.1 % for "Asian, Asian Scottish or Asian British". The smallest incidence was 2.2 % for those who reported their ethnicity as "African". White and Caribbean or Black groups show the joint highest: 5.5 % of 24-49 year-olds described their day-to-day activity as limited. Among 50-64 year-olds those describing themselves as "mixed of multiple ethnic groups" had the highest incidence of those who describe their day-to-day activities as "limited a lot": 13% compared to a whole-population share of 12.8 % and 8.1 % who described themselves as "African".

53. As with the general population, incidence of disability amongst those who reported that their day-to-day activities were limited "a lot" tends to rise with age. 27.6% of white people aged 65+ had conditions which limited their day-to-day activity "a lot", 29.5 % "mixed or multiple ethnic groups" and 21.7% of who described themselves as "African".

54. Our commitment to accessible communication includes making sure that we do not create lanaguage barriers for people who communicate in languages other than English, who make up 7% of the Scottish population. We intend to undertake additional engagement with stakeholders to fully understand the needs of such individuals and explore the measures we can take to ensure equal access to all the application channels for Disability Assistance.

55. In order to promote uptake of Disability Assistance amongst people with disabilities from ethnic minorities a communication and engagement strategy will be required. We understand that some ethnic minority communities feel less able to engage with universal services because the services don't reach out appropriately. It is crucial that we work with stakeholders to identify an effective strategy. In promoting engagement with Social Security Scotland, individuals can be linked up with additional assistance and services, both within the Agency and more widely.

56. Our proposed residence requirements are:

  • Ordinarily resident in Scotland.
  • Have been present in Great Britain for a period of, or periods amounting in aggregate to, not less than 104 weeks out of the last 156 weeks (i.e. 2 out of the last 3 years);
  • Be habitually resident in the United Kingdom, Republic of Ireland, Isle of Man or the Channel Islands (i.e. the Common Travel Area (CTA)).
  • Not be subject to immigration control.

57. We are aware that when people are newly able to meet the residence requirements we may need to consider evidence requirements so they do not continue to experience barriers to applying for Disability Assistance. For example, this may include broadening the documentation that can be used to prove residence. In addition, we understand that gypsy/travellers in particular, may not have easy access to the forms of evidence usually required to meet residence requirements and so this factor will be included when evidence requirements are considered.

Sex

58. Our policy is that Disability Assistance for adults who are detained in custody will have their payment suspended after 28 days. This indirectly discriminates against men as they account for a signifiantly higher proportion of the prison population than women, with men comprising 95% and women 5% of the average daily prison population[8]. We intend to undertake analysis to consider whether there is anything we can do as part of the policy development to mitigate this issue.

Sexual orientation

59. Potential barriers may deter lesbian, gay and bisexual (LGB) people from accessing Disability Assistance relating to language, both with regards to written communication and interactions with Agency staff. During the development of the Disability Assistance system we will ensure that the need for language to be inclusive of LGB people - for example by using parent as opposed to mother or father, and partner as opposed to husband or wife - is fully understood and implemented. It will also be important that all Agency staff undergo LGB awareness training and avoid making assumptions, for example that two women are sisters as opposed to married.

60. We understand that there are likely to be other factors which although not a consequence of the policy itself may impact on uptake by LGB people. This may include a fear of experiencing homophobia when interacting with a government Agency. We will engage with stakeholders during the consultation to more fully understand potential issues and, if necessary, explore what can be done to overcome them.

Gender reassignment

61. One of the main potential barriers to trans people accessing Disability Assistance is a requirement for individuals to provide their gender when making an application. Non-binary people in particular will be excluded if individuals are asked to tick a box to indicate their gender and the only options available are male and female. The issues discussed above impacting LGB people relating to inclusive language, staff awareness, and fear of experiencing discrimination also apply to trans people.

Other Protected Characteristics

62. We have not yet identified any particular barriers resulting from our policy approach which may affect people with the following protected characteristics: religion or belief, marriage and civil partnership, and pregnancy and maternity.

Monitoring and review

63. Monitoring the impact of Disability Assistance on people with protected characteristics will be a continuous process. If and when any unintended consequences are identified steps will be taken to rectify them. The Scottish Government will put in place a monitoring and evaluation plan prior to the implementation of Disability Assistance which takes account of the issues identified within the final EQIA. On-going stakeholder engagement will be an important part of this plan monitoring. The Charter reflects the requirements set out in the Act that the Scottish social security system advances equality and non-discrimination.

Extent / Level of EQIA required

64. While we have identified that the devolution of Disability Assistance will have some positive and negative impacts on the groupings outlined above, we are keen to seek out opportunities to promote better equality of opportunity. This consultation therefore seeks the views of stakeholders, the public and a wide range of equality groups (see Annex A) on any potential equality issues.

The consultation specifically asks consultees to consider:

Do you think the partial Equality Impact Assessment has correctly identified the impact of our proposals on those with protected characteristics? What would you add or change?

In 2014-17, the poverty rate after housing costs for families with a disabled person was 24%. This compares with 16% of people in a family without a disabled person who were in poverty.

How do you think the devolution of Disability Assistance might impact upon disabled households? Particularly people on low incomes, people living in deprived areas, people in material deprivation, or people with no / or low wealth and people from different socio-economic backgrounds?

Responses to these and the other questions will inform the development of the EQIA that will accompany the draft regulations for Disability Assistance and help us to duly consider its impact for equality groups within the context of the public sector equality duty to:

  • eliminate unlawful discrimination, harassment and victimisation,
  • better promote equality of opportunity and
  • foster good relations

Contact

Email: ross.trotter@gov.scot