‘Complacent’ DWP needs ‘major shake-up’ on work fitness tests

An influential committee of MPs has delivered a scathing account of the failure of the Department for Work and Pensions (DWP) to challenge the poor performance of its “fitness for work” contractor Atos Healthcare.

The public accounts committee says in its report, published today (Friday), that DWP is “getting far too many decisions wrong” through its much-criticised work capability assessment (WCA) system.

Margaret Hodge, the Labour chair of the committee, said DWP’s failures were creating “misery and hardship” for many claimants.

Her committee’s report says: “We are concerned that the department is unduly complacent regarding the quality of the decision-making process, particularly given the hardship which can be caused to individuals when the decision is wrong.”

It also accuses DWP of complacency over the number of successful appeals against being found fit for work, with nearly 40 per cent of appeals succeeding, and a third of these not as a result of any new evidence.

Hodge said the “standardised ‘tick-box’ approach” of the WCA “hits the most vulnerable claimants hardest”, while its “one-size-fits-all approach fails to account adequately for mental health conditions or those which are rare or fluctuating”.

She added: “While the department has started to improve, the process is still too inflexible and too often is so stressful for applicants that their health simply gets worse.”

DWP was unable to tell the committee the full cost of the WCA system across government, including knock-on costs to the NHS and Ministry of Justice.

The government has outsourced all of its medical assessments since 1998, with the contracts all carried out by one company, Atos – except when it has changed hands due to a company takeover – leaving DWP with “limited leverage to remedy poor performance”.

In 2011-12, DWP paid Atos £112.4 million to carry out 738,000 assessments, most of which were WCAs.

Atos will also assess about 440,000 claims a year for the new personal independence payment – the replacement for working-age disability living allowance – from April 2013.

The committee was scathing about DWP’s failure to manage its contract with Atos.

Hodge said DWP rarely checked that it was being charged correctly by Atos, failed to withhold payment for poor performance, and could not say whether Atos was making a “disproportionate” level of profit from the contract.

In a typical month, DWP only checked 0.1 per cent of the assessments it was invoiced for, the report says, and relied too much on information provided by Atos.

The report says the “lack of challenging targets for medical quality” allows Atos to conduct “thousands of poorly administered tests each year” without any financial sanction.

Hodge concluded: “There needs to be a substantial shake-up in how the department manages this contract and in its processes for improving the quality of decision-making.”

Liz Sayce, chief executive of Disability Rights UK, welcomed the report and “the fact that a cross-party committee of MPs agrees with what disabled people have been saying so strongly”.

She said: “Fear does not help job-seeking. People out of work for many years need encouragement and support to build confidence. We need personalised employment support, not tests causing anxiety and distress.

“We need a ‘real world’ test that takes account of barriers to work – whether employers make adjustments, whether people have the support they need to work.”

Meanwhile, the DWP has published its response to last November’s report by the work and pensions select committee on how universal credit will meet the needs of “vulnerable claimants”.

The universal credit reforms will be gradually introduced from April and will see key means-tested benefits and tax credits combined into a single payment.

The committee’s report called on the government to “reconsider” the loss of additional disability payments which are available under the current benefits system, particularly those affecting disabled children and disabled people with high support needs.

In its response, the government defended its changes, which it said would create a “simpler and fairer system” and would see disabled people “on average” gain by £8 a month, while it had “committed to a thorough process of evaluation for the effect of universal credit on disabled people”.

The disabled Labour MP Dame Anne Begg, who chairs the committee, said “significant concerns” remained about whether vulnerable people would receive the support they needed, although the government had shown “some movement in this direction” and had pledged to “monitor closely various aspects of the policy”.

8 February 2013

News provided by John Pring at www.disabilitynewsservice.com


Labour’s integration plans could see NHS take over social care

Leading disabled campaigners have welcomed Labour’s plans for “full integration” between the NHS and the social care system, but have raised concerns about putting the NHS in charge.

Andy Burnham, the shadow health secretary, said he wanted to see “whole person care”, with “one budget, one service co-ordinating all of one person’s needs: physical, mental and social”.

Burnham suggested that the exclusion of social care from the NHS explained why it had never been able to break out of its “medical model” mentality.

He said that giving the NHS responsibility for coordination of both health and social care would allow it to “raise the standards and horizons of social care, lifting it out of today’s cut-price, minimum wage business”.

Burnham pointed out in a speech announcing his proposals that £104 billion a year was spent on the NHS but only £15 billion on social care.

He also launched a major health and care policy review, under the shadow care services minister, Liz Kendall.

Professor Peter Beresford, who chairs the national user-led Shaping Our Lives network, welcomed Burnham’s recognition that calls for integration were “unlikely ever to work so long as they are separate competing organisations, based on different funding systems and fundamentally different principles for access and entitlement”.

He said integration could not come soon enough, because of the “national emergency” intensified by “rising numbers of older and disabled people”.

But he said he was worried that Burnham “seems to be turning to the NHS for the solution” to integration.

He said: “This won’t work. It’ll mean an unhelpful return to a medical model when we know that a social approach is crucial here.”

He added: “It’s time Andy started talking to service users, carers and their organisations. They’ll give him a really helpful steer for developing sustainable policy.”

Sue Bott, director of development for Disability Rights UK (DR UK), said she was pleased that a national politician was “really trying to get to grips with the crisis that there is in social care”, and said her organisation was “very much in favour” of integration.

But she said she was concerned that the culture in the NHS was “very different” to that in social services.

She said: “Although we often have issue with the attitudes that disabled people experience in social services, nevertheless we would say that there tends to be a much better, empowering culture in social services.”

She said integration would need to be a “genuine coming together”, and added: “If it is simply the NHS taking social services under its wing, then that really is not going to work for disabled people.”

Bott said DR UK would support Burnham’s “whole person” approach, and recognised that the difference between health and social care services was “very arbitrary” and meant disabled people often failed to receive the services they needed.

Burnham also talked in his speech at the King’s Fund in London about the key issue of social care funding reform, but focused on older people and said nothing about working-age disabled adults.

Disability News Service asked Burnham’s spokesman whether the shadow health secretary agreed with proposals from the Dilnot commission on funding reform that social care should be free for all people with “eligible” needs who become disabled before the age of 40.

He said: “Andy’s been clear he supports the Dilnot proposals as an important first step to addressing the crisis in all social care.”

But when asked to clarify exactly what he meant by this, he failed to comment further.

24 January 2013

News provided by John Pring at www.disabilitynewsservice.com

Winterbourne View: self-advocates say ‘acid test’ will be action on hospitals

Leading members of the self-advocacy movement have given a guarded response to the government’s report into the Winterbourne View abuse scandal.

They spoke out after the government pledged to move hundreds of people with learning difficulties and “challenging behaviour” out of hospitals and into new homes in the community, and promised that service-providers would be held accountable for abuse that takes place in their facilities.

The Department of Health’s final report into the abuse that took place at Winterbourne View, near Bristol, also promises improved access to advocacy, tougher inspections of hospitals and care homes, and new guidance on the use of physical “restraint” by staff.

Gavin Harding, co-chair of the National Forum of People with Learning Difficulties, said he believed the most important recommendation was to hold service-providers – and their directors and senior managers – accountable for the care their organisations provided.

He said he believed the report sent “very strong, powerful messages” and would “put the wind up these providers”, but that he also wanted to see social workers, nurses and social services directors legally “held to account” if they ignored abuse of adults with learning difficulties, as already happens if they fail to act on allegations of child abuse.

Harding also raised concerns about whether there would be enough funding to put the government’s plans into action, both in finding people new homes and in improving advocacy.

He said: “It is all right saying, ‘Close everything by 2014,’ but where is the budget going to come from? That worries me.”

Harding said he was concerned that some local authorities would now take people currently cared for in hospitals and move them to new placements in the community, but without the right support.

He said: “It is going to be harder to regulate in somebody’s home where they are out in the community. Who is going to regulate them? I am not saying it is not a good idea, it is, but you have to think about the impact.

“Some local authorities could be trusted, but trusting a local authority is like trusting Robert Maxwell with your pension.”

And he said he also had real concerns about people being “stigmatised” in the way they were during the “care in the community” resettlement programme of the 1980s.

Harding also called for the Care Quality Commission and local authorities to introduce new three-digit emergency numbers that people with learning difficulties could call to report abuse.

Wendy Perez, another leading self-advocate, who has her own training and consultancy company, See Me As Me, welcomed plans to move people out of the hospitals and into their local communities, but added: “They have been saying that for years and they have not done it yet.

“There have been reports and reports and they have not done it. They have just said it and no action.”

She added: “I think they should look at what people want and do what they want and not have so many people put into institutions and have more [living in] communities.”

Perez also welcomed plans to hold service-providers to account for abuse that happens within their services, and added: “They don’t listen to the people that use services. They try and cover things up.

“They try and say to families, ‘it’s fine, it’s fine,’ when the families know it’s not fine.”

Gary Bourlet, who founded Britain’s first People First organisation in London in 1984, said many of the recommendations in the government’s report were similar to those made in Labour’s Valuing People white paper in 2001.

And he pointed out that the kind of abuse seen at Winterbourne View was not restricted to hospitals, but also took place in residential homes, hostels and day centres.

He warned of the funding problems facing many self-advocacy organisations. “At the moment advocacy is not being funded very well and a lot of them are going under. It is a big concern to me because I have been doing advocacy for over 30 years.”

Andrew Lee, director of People First Self Advocacy, said he believed the “acid test” of the government’s report would be whether its recommendations were acted on.

He pointed out that similar reports had followed investigations into the abuse of patients with learning difficulties at Budock Hospital in Cornwall, in 2006, and at Orchard Hill, another of the last NHS long-stay hospitals, in 2007.

He added: “The same promises were made and yet Winterbourne View happened, so you can understand me being sceptical.”

13 December 2012

News provided by John Pring at www.disabilitynewsservice.com

Winterbourne View: Minister says action is ‘national imperative’

The government has pledged to move hundreds of people with learning difficulties out of hospitals and into new homes in the community, in the wake of the Winterbourne View abuse scandal.

It has also promised that companies that provide services to people with learning difficulties would be held accountable – possibly through the criminal courts – for abuse that takes place in their facilities.

Norman Lamb, the Liberal Democrat care services minister, said he wanted to send “a clear message to owners, directors and board members” that they should “expect to be held to account if abuse or neglect takes place”.

His pledge came as the Department of Health published its final report into the abuse that took place at Winterbourne View, near Bristol.

The report says there will also be efforts to improve access to advocacy, tougher inspections of hospitals and care homes for people with learning difficulties by the Care Quality Commission (CQC), and new guidance on the use of physical “restraint” by staff, which it says should only be used “as a last resort”.

And there will be a national audit of people with learning difficulties and challenging behaviour or mental health conditions, to see how many are in inappropriate, “out-of-area” placements in hospitals, many miles from their own home areas.

The government said that every one of the 3,400 people currently in NHS-funded inpatient beds for people with learning difficulties would have their placements reviewed by 1 June 2013, with all those “inappropriately” in hospital moved to community-based settings no later than 1 June 2014, with between £2 and £5 million from DH to support this improvement programme.

Many campaigners, including Disability News Service, have pointed out that successive governments have made similar pledges on emptying long-stay hospitals over the last 50 years.

But Lamb said it was a “national imperative” that people with learning difficulties who also have mental health conditions or challenging behaviour are “given the support and care they need in the community, near to family and friends”, rather than in hospitals.

The report says that, of the 48 patients living at Winterbourne View at the time it was closed, 14 had been referred by commissioners between 40 and 120 miles away from the hospital, with a further nine by commissioners more than 120 miles away.

Lamb also spoke of his “shock, anger, dismay and deep regret” at the abuse that took place at Winterbourne View, which was only halted after the BBC screened footage filmed by an undercover reporter.

Six former employees were given prison terms ranging from six months to two years for their part in the abuse, but there was widespread anger that Castlebeck, the company that made huge profits from Winterbourne View, was not held accountable for its failings in court.

The report concludes that chances to spot “real problems” at Winterbourne View were “repeatedly missed” by managers, and agencies such as the Care Quality Commission (CQC), the police, the local hospital, local authorities and health trusts.

Andrew Lee, director of People First Self Advocacy, said he believed the “acid test” of the government’s report would be whether its recommendations were acted on.

He pointed out that similar reports had followed investigations into the abuse of patients with learning difficulties at Budock Hospital in Cornwall, in 2006, and at Orchard Hill, another of the last NHS long-stay hospitals, in 2007.

Gavin Harding, co-chair of the National Forum of People with Learning Difficulties, said he was concerned there might not be enough funding to put the government’s plans into action.

He said: “It is all right saying close everything by 2014, but where is the budget going to come from? That worries me.”

A DH spokesman said: “Hospital inpatient placements are very expensive. We think that in many cases it is possible to provide better services locally which meet the needs of people with learning disabilities better for the same amount of money and sometimes less.

“We are committing money to the joint improvement programme to spread best practice and provide advice to local areas on how to design services to meet the needs of people with learning disabilities.”

Alongside the report, more than 50 organisations, including the National Forum, the Local Government Association, the Association of Chief Police Officers, professional social work and health bodies, CQC, and organisations representing service-providers, signed an agreement with the government that they would push to “transform health and care services” for people with learning difficulties and mental health conditions or challenging behaviour.

13 December 2012

News provided by John Pring at www.disabilitynewsservice.com

UN’s international day sees awards, celebrations… and protests

Disabled people took part in protests, campaigns, awards, marches, conferences and celebrations as they found different ways to mark the UN’s international day of disabled people.

Many of the events used 3 December to continue the series of protests against government cuts to disability benefits and services, while others celebrated the achievements of organisations that have helped improve disabled people’s lives.

Breakthrough UK announced the winners of its National Independent Living Awards 2012, which included Harrow Asian Deaf Club, Norfolk Coalition of Disabled People, and retail giant Wilkinson.

In Guildford, Surrey, more than 350 people attended the first of a free, two-day sports festival organised by the British Paralympic Association, with more than 1,000 attending over the two days.

More than 20 Paralympians – including stars such as Jonnie Peacock, Sophie Christiansen, Ben Quilter and Mark Colbourne – were on hand to take part in the inaugural ParalympicsGB Sports Fest, which provided an opportunity for disabled people to try out different Paralympic sports and discover how to get involved in them.

In west London, members of Harrow Association of Disabled People took part in a 200-strong march to protest at disabled people being “hit the hardest by cuts to the benefits and services they need to live their lives”.

The march, which was joined by eight local councillors – seven Labour and one independent – and Labour MP Gareth Thomas, passed the Department for Work and Pensions’ Jobcentre Plus offices and ended at Harrow council’s Civic Centre headquarters, where Labour council leader Thaya Idaikkadar spoke to them about their concerns.

In Croydon, disabled people held a vigil inside the reception area of the building used by Atos Healthcare to test people’s eligibility for out-of-work disability benefits.

The vigil, organised by the Croydon and Bromley branch of Disabled People Against Cuts (DPAC), included a minute’s silence to remember the sick and disabled people who had “suffered as a result of the punitive regime of assessments” operated by Atos on behalf of the government.

They were refused permission to leave flowers in the building, so laid them instead at the local war memorial.

Protesters from Cardiff DPAC gathered beside the statue of Aneurin Bevan, founder of the NHS, for a candlelight vigil which featured about 1,200 candles spelling out the words “Atos Kills”, before continuing their own remembrance protest by blocking traffic for about 30 minutes.

They and many other activists believe the assessments, as carried out by Atos, are putting thousands of sick and disabled people under serious and unnecessary strain, forcing them further into poverty, and are even responsible for many deaths, including some people driven to suicide.

Norfolk Coalition of Disabled People marked the UN’s day by releasing a striking visual and audio representation of the Austerity War report it commissioned and published in September, which describes how the burden of the government’s cuts are falling unfairly on disabled people’s shoulders.

In contrast, the Department for Work and Pensions used the day to launch its Role Models: Inspire a Generation campaign, which will use video clips of young disabled role models talking about the barriers they have overcome to inspire other young disabled people to “help fulfil their potential and achieve their aspirations”.

The European Commission made its contribution to the day by publishing proposed legislation to ensure the accessibility of public sector websites.

But the proposed laws would cover only 12 public services – such as websites for benefits, applying for passports, car registration, birth and marriage certificates, enrolling in higher education, and communicating with the police.

The European Disability Forum welcomed the publication as “a first positive step” but said it would work with MEPs and the European Council to ensure the final legislation was “even more far-reaching”.

The European Blind Union said the proposal was “a missed opportunity” and was “simply not going to deliver the radical change that is needed” because it failed to cover all public sector websites and private sector sites that deliver “basic services to citizens”.

In Tower Hamlets, east London, the disabled people’s organisation Real joined other charities to host a free information event (on 4 December) and party, and celebrated both the international day and its own success in winning a new local authority contract to give disabled people more say over how services are run in the borough.

Meanwhile, Remploy ignored continuing anger over the closure of many of its remaining sheltered factories and released a video featuring pledges from employers – and disabled people such as Paralympic champion David Weir – to push for an improvement in the employment rate of disabled people.

Just three days later, Remploy announced that another 682 disabled people had been told they were at risk of redundancy because of its closure programme.

There were also many powerful blogs using 3 December to warn of the threat to disabled people’s rights posed by the government’s “austerity” policies.

Jane Young wrote that there was “little to celebrate” on 3 December, with the anticipated implementation of a “horrifying range of policies set to devastate the lives of hundreds of thousands of disabled Britons”, with the threat next year of “a tsunami of human need, the like of which we haven’t seen in Britain for many years”.

Kaliya Franklin wrote in her blog of a time when Britain “led the way in promoting rights and independence for disabled people”, while Neil Crowther said the government’s “perverse and illogical” assault on disabled people’s rights was “not only unjust, it is pure economic folly”.

5 December 2012

News provided by John Pring at www.disabilitynewsservice.com

Experts warn of PIP bombshell

Many thousands more disabled people than previously thought could lose their entitlement to disability benefits when the government introduces its new personal independence payment (PIP), according to a user-led information service.

The government has repeatedly stated that it aims to cut spending on working-age disability living allowance – and the number of claimants – by 20 per cent by 2015-16, through the introduction of PIP over the three years from 2013.

But welfare experts at Buckinghamshire Disability Service (BuDS) believe the reforms will lead to a far higher proportion of disabled people in the county – and maybe other parts of the country – losing their benefits and possibly being forced to rely on local authority and NHS services.

They have calculated that – based on the government’s current PIP award criteria – between 2,000 and 6,000 of approximately 7,500 working-age disabled people in Buckinghamshire who currently claim DLA may not be eligible for PIP.

Andrew Clark, BuDS’ chair of trustees, said their “working estimate” was that about 5,000 of the current claimants – or 70 per cent – may not be entitled to PIP.

The proportion losing their benefits in the county is likely to be higher than some other parts of the country because there is a higher proportion of working-age people receiving lower rates of DLA in Buckinghamshire, with the government stating that it wants to focus support on those with higher support needs.

Campaigners have been warning for months that disabled people who lose their DLA will be forced to seek more support from their local authorities and NHS services.

BuDS is so concerned that it has persuaded Buckinghamshire County Council to set up a working party to examine the figures and try to predict the impact on demand for council services caused by the benefit cuts.

Of about 90,000 disabled people in Buckinghamshire, only about 12,000 are currently eligible for social care support from the county council.

Early calculations suggest that the number eligible for council support could double to 24,000 disabled people as a result of the cuts to disability benefits, at a time when the cash-strapped local authority is trying to reduce the number of people using its services.

Clark called on the government to carry out a “holistic” assessment of its benefit cuts and reforms on disabled people.

He added: “The actual saving through reducing incapacity benefits and DLA may well turn out to be negligible, or in fact turn out that it will cost the government money.”

He said that just one person visiting their GP because of anxiety or depression caused by losing their benefits, and being referred to the community mental health service, could cost the NHS as much as £500.

In April, Disability Rights UK (DR UK) published a report, Impact Assessing the Abolition of Working Age DLA, which warned that the knock-on effects of the government’s huge cuts to spending on DLA could wipe out every penny of its planned savings.

This week, Clark told a DR UK conference that there was a “fundamental misconception” at the heart of the government’s welfare reforms, because it was far more expensive to support a disabled person through NHS and local authority services than by giving them disability benefits.

He said: “If you take money away from disabled people and those disabled people become more dependent on the local authority and NHS services, the government are going to end up spending more money, except it will be through another budget.”

15 November 2012

News provided by John Pring at www.disabilitynewsservice.com

Activist secures high-profile backers for electoral assault on Corby

A disabled activist set to fight next month’s by-election in Corby has become the first candidate to be backed by a new political movement that wants to see non-career politicians elected to parliament.

Adam Lotun has become a leading figure in the disabled people’s anti-cuts movement and has been prominent in several direct action protests as a member of the grassroots campaigning organisation Disabled People Against Cuts.

He was asked by fellow disabled activists to stand in the Corby by-election on 15 November, and has secured more than £2,000 in donations to his campaign from across the UK in two weeks.

He is also receiving financial support from the government’s new access to elected office fund – to rent an electric wheelchair, and meet the costs of accessible taxis and personal assistants – which helps disabled people with the extra disability-related costs they face while campaigning.

Following his decision to fight the by-election, Lotun was persuaded to stand as the first candidate of the Democracy 2015 political movement, launched only last month by Andreas Whittam Smith, the founding editor of The Independent newspaper.

Democracy 2015 aims to encourage people from outside the political classes to stand for parliament, but for just one full term, so treating their position as a public service rather than a career.

The Corby seat was left vacant after the resignation of Conservative MP Louise Mensch, who won her seat in 2010 with a majority of less than 2,000 over Labour.

Lotun, who worked in the NHS and the IT industry before he became disabled, and later worked as a disability employment adviser in jobcentres, said he felt “immensely privileged” to be Democracy 2015’s first candidate.

He said: “All Democracy 2015 candidates will only be there for one term so you don’t end up with people who can be corrupted and people who see politics as a career.”

But despite the heavy odds against him as an independent candidate with no close links to Corby, he said he was “expecting to win”, and added: “Labour are going to be frightened of me.”

He pledges to stay in cheap bed and breakfasts in Corby if he is elected, rather than buying or renting a property in the constituency, and to use public transport wherever possible.

He said: “If I have to use a bus, I will use a bus. If they are not accessible they will be accessible pretty damn quick. If not, they will be facing legal challenges from me.”

Lotun will be campaigning for a fairer welfare system, against cuts to disability benefits, for the legalisation of cannabis use for medicinal purposes, and to scrap the government’s “fitness for work” assessment and remove Atos’s contract to carry out the controversial tests.

He has also secured backing from the Trade Unionist and Socialist Coalition, which was set up to enable trade union members, community campaigners and socialists to fight elections on an anti-austerity platform.

Whittam Smith said Democracy 2015 decided to back Lotun because he “exactly reflects our values, for he believes that there needs to be a change in the way of thinking of MPs, their work in their constituencies and also their work in parliament”.

He added: “British democracy is in crisis. The cause is a precipitous decline in respect for members of parliament and for the governments they form.”

11 October 2012

News provided by John Pring at www.disabilitynewsservice.com