‘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

Cool response to Harrington’s final review

The third annual review of the government’s “fitness for work” assessment process has received a cool response from disabled activists.

The report was the third carried out by Professor Malcolm Harrington – and his last before being replaced – and concluded that there had been “real progress” towards making the work capability assessment (WCA) more “humane, sensitive, accurate and efficient”.

Harrington accepted that “progress has been slower that hoped for”, but said he had “not seen or heard any compelling arguments or evidence that the whole system should be scrapped”.

He said there needed to be a period of “consolidation and monitoring”, although he called for the Department for Work and Pensions (DWP) to monitor “more closely” the performance of the much-criticised Atos Healthcare, which carries out the assessments, which test eligibility for out-of-work disability benefits.

Harrington said that implementation of his previous recommendations for improving the face-to-face assessments – the part of the WCA that has caused most anger among disabled campaigners – appeared to be “patchy”, while DWP staff frequently complained of “the variability in the quality of Atos performance”.

He noted that there had been frequent claims of “rude and unwelcoming healthcare professionals”, and reports showing “incorrect details” with “important points omitted”, and assumptions made about a claimant’s impairment.

Recent evidence-based reports by disabled activists have continued to find even more serious concerns about the WCA system.

Only last week, The People’s Review of the Work Capability Assessment found disabled people still experiencing humiliating and inappropriate treatment because of the failings embedded within the WCA.

And this week, a survey of more than 700 people by Disabled People Against Cuts (DPAC) reveals the “tricks, barriers and bullying tactics” being used to prevent disabled people having their WCAs recorded by Atos.

The DPAC report says that “a clear theme throughout was the tenacity of individuals who viewed the WCA assessments as a war-like situation for their survival”, with Atos scoring an average 1.99 out of 15 for its performance.

The disabled activist Sam Barnett-Cormack, who tweets at ‏@narco_sam, said that although Harrington had “declined to criticise the functioning of the WCA as much as it deserved, he still reported that people are suffering, and he still asked for important changes”.

He highlighted Harrington’s call for the DWP’s “decision-makers” to “actively consider the need to seek further documentary [medical] evidence in every claimant’s case”, and be forced to justify their decision if they choose not to do so.

Barnett-Cormack said that because the government had accepted this recommendation “provisionally”, if it could be done in a “cost effective fashion”, it was “vital” that they “don’t find some way to wriggle out of it”.

Another disabled activist, David Gillon, who tweets at @WTBDavidG, said he believed there had been a “noticeable change in tone” in how Harrington referred to criticisms of the assessment by disabled claimants, from “well, they would say that, wouldn’t they” in year one, to now saying the experiences of claimants were disturbing.

RNIB said it was “disappointed” with Harrington’s recommendations, which were “not specific enough to deal with the crux of the problems the assessment creates, not just for the people going through it but even for those who operate it”.

The charity also raised concerns about medical evidence and said there had been “no commitment by the government to cover the cost experienced by a claimant in obtaining a medical opinion from their GP or specialist consultant on their suitability for work”.

Stephen Timms MP, Labour’s shadow employment minister, accused the government of “dragging its feet” in implementing Harrington’s previous recommendations.

He said: “There clearly are very serious problems, particularly around [assessing people with] fluctuating conditions and mental health problems.

“Recommendations have been made by the charities about what should be done and there is just no real movement.”

The government welcomed Harrington’s report and said there was “no evidence to suggest that the system is fundamentally unsound”.

It added: “Equally we acknowledge that the WCA still attracts criticism, and although the system as a whole is on the right lines, too many individuals are finding the process more challenging than it should be, and that there is more hard work to be done to consolidate and strengthen the improvements that are emerging.”

22 November 2012

News provided by John Pring at www.disabilitynewsservice.com

People’s Review of WCA finds its way to Fry’s five million followers

Disabled people are still experiencing humiliating and inappropriate treatment because of the failings embedded within the government’s “fitness for work” assessment system, according to a new report researched and written by a disabled campaigner.

The People’s Review of the Work Capability Assessment is the fifth major research report into the impact of government cuts on disabled people by the WeAreSpartacus group of campaigners and researchers.

And its profile secured a huge boost when the actor and writer Stephen Fry – a Twitter superstar with more than five million followers – retweeted a link to the report this morning (15 November).

The report, which has so far been retweeted nearly 1,500 times, aims “to show the reality of going through the work capability assessment (WCA)”, which tests eligibility for out-of-work disability benefits.

It includes accounts of more than 70 people who have been assessed, and of welfare rights advisers and other professionals, the results of Freedom of Information requests, and summaries of parliamentary and government publications and media investigations.

It also details a string of cases involving ESA claimants who have killed themselves or otherwise died after being told they were “fit for work”, all of them in circumstances in which the WCA appears to have been a factor in their deaths.

And it comes as Professor Malcolm Harrington prepares to publish his third and final annual review of the WCA for the government, which is expected next week.

The author of The People’s Review, who has asked to remain anonymous because of the “culture of fear” that has built up around the assessment process, has taken a year to compile the report because of her health condition.

Jane Young, the coordinator of the WeAreSpartacus network, who edited the report, said she hoped its contents would be used by activists and MPs as a campaigning tool, particularly as a contrast to the expected conclusions of the Harrington report.

One disabled person who described experiencing the ESA system says in the report: “I am tired of fighting officials who seem to think they know more about my disabilities and needs than I do.

“It now makes me feel ashamed of who I am. I am being punished for being disabled and feel powerless.”

Many of those quoted describe their experiences at the hands of the healthcare professionals who are employed by Atos Healthcare to carry out the assessments.

A woman who accompanied her husband to his WCA says: “I can honestly say there are lies that go into that assessment. I do shorthand and I took down word for word my husband’s whole assessment. What actually came back was practically the opposite of everything he said.”

Another ESA claimant says: “I felt relief at getting ESA awarded, but three months later I’ve been sent a questionnaire to start the whole medical process again.

“Nothing’s changed in three months. I have a chronic condition, it’s not going to go away. Tipped me further into depression. Stress of the ESA makes my condition worse. I am worthless and a burden to society.”

And another disabled claimant says: “The assessor just sat behind a desk and barked questions at me, which caused me to have a panic attack, to which she told me to ‘stop messing about’.”

Professor Peter Beresford, who chairs the national user-led Shaping Our Lives network and is professor of social policy at Brunel University, says the research is particularly important because it reports “the direct voices of people at the sharp end” of the WCA.

He says in the report’s foreword: “This report lays bare the poverty of the WCA in theory and practice. And it does this by reporting its reality as experienced first-hand by disabled people.”

He says that evidence now shows the WCA to be “unreliable and unhelpful, as well as being arbitrary and cruel”, and adds: “It is an expensive, flawed and inefficient system that appears to cost more than it saves and is run by yet another multi-national corporation whose incompetence seems to go unpunished.”

News provided by John Pring at www.disabilitynewsservice.com

Disabled claimants feel ‘persecuted’ by WCA system, say MPs

A disabled Labour MP has delivered a passionate appeal for the government to fix the “fundamental” problems with its “fitness for work” assessment.

Dame Anne Begg, who chairs the Commons work and pensions committee, was speaking in a Commons debate for the first time since a serious injury in February that left her hospitalised.

She said that disabled people felt “persecuted” by the system that assesses their eligibility for employment and support allowance (ESA), the new out-of-work disability benefit.

Dame Anne told MPs in a debate on the performance of Atos Healthcare, the company that carries out these work capability assessments (WCAs) for the government, that there was “something fundamentally wrong” with the system, and the contract that had been awarded to Atos.

She said: “It is not enough for government to say that the genuine claimant has nothing to fear. In too many cases, genuine claimants are not scoring any points in their initial assessment.”

She pointed to the British Medical Association’s vote to scrap the WCA, and to the increased workload of GPs due to treating patients whose health has deteriorated because of their experience with their WCA.

Dame Anne said: “When my constituent, who has lost his job because he has motor neurone disease, scores zero on his WCA and is found fully fit for work, there is something wrong with the system.

“When that same constituent appears in front of a tribunal and in less than five minutes is awarded 15 points, there is something wrong with the system.

“When some people would rather do without the money to which they are absolutely entitled rather than submit to the stress of a WCA, there is something wrong with the system.”

She added: “When someone with a severe illness has to fight for a year through an appeal to get the correct benefit, only to be called in almost immediately for another assessment, there is something wrong with the system.

“When people feel so persecuted, there is something wrong with the system.”

Dame Anne also pointed to the high percentage rate of successful appeals against being found fit for work, and the lack of an incentive for Atos assessors to “get the assessment correct first time”.

She said: “It is time for the government to act, because there is something fundamentally wrong with the whole system.”

The debate was secured by her fellow Scottish Labour MP Tom Greatrex, who has asked scores of questions about the WCA and the performance of Atos over the last year.

Greatrex was deeply critical of the government’s management of the Atos contract and its failure to fine the company for the large number of successful appeals.

He said there was a need for a process that “works in the interests of taxpayers, and of individual claimants and applicants”, and that “helps people who can work and does not hound those who cannot”.

Several MPs – in a debate dominated by Labour members – gave examples of disabled constituents who had been found unfairly fit for work, and had been forced to appeal to claim the ESA they were entitled to and needed.

The Plaid Cymru MP Hywel Williams said there “can hardly be an MP who has not had a constituency case involving Atos and the work capability assessment”.

He said there were “persistent complaints that Atos is working to targets to fail people”, and that disabled people were facing “continual reassessments”.

Another Labour MP, John McDonnell, said that his early day motion calling for Atos’s contract to be withdrawn, and for the WCA to be replaced by a new system, had secured the signatures of 103 MPS.

He said: “Surely after that, and following debate after debate and the protests on the streets, the government must reassess the role of Atos, and establish a new system based… on reputable, fair and equitable criteria.”

He said he shared the “disgust” of many disabled people’s groups that Atos had been allowed to sponsor the London 2012 Olympic and Paralympic Games, and supported the week of protests against Atos – organised by the grassroots campaign group Disabled People Against Cuts – that took place last week.

In one of his final actions as employment minister, before his promotion to justice secretary, the Conservative MP Chris Grayling told MPs that the WCA system had been “created by Labour four years ago when they were in government, and it is a system that we have consistently tried to improve”.

He added: “It is really important to emphasise that the reassessment of people on incapacity benefit is not a financial exercise and that there are no financial targets attached to it.

“It is about finding the right number of people who can make a return to work. It is not an exact science – it never was and never could be – but it is all about trying to help people back into the workplace if they can possibly return to it.”

News provided by John Pring at www.disabilitynewsservice.com

MPs suggest minister ignored ‘fitness for work’ re-test concerns

Questions have been raised over a government minister’s failure to listen to serious concerns about the controversial “fitness for work” test.

The concerns emerged after the airing of two prime-time television documentaries this week, both focusing on the operation of the test used to assess eligibility for the new out-of-work disability benefit, employment and support allowance (ESA).

A Channel 4 investigation through its Dispatches strand on Monday evening was immediately followed by a Panorama expose on BBC Two, and both heavily criticised the work of Atos Healthcare, the company which carries out the work capability assessments (WCA) for the government.

Panorama interviewed several disabled people who had been found “fit for work” following WCAs carried out by Atos “health professionals”, despite serious health conditions.

Among those interviewed was the family of a man with a heart condition who was found fit for work, successfully appealed against that decision, but was then called in for another assessment.

His family told how, on learning that he had been found fit for work a second time, he had decided Atos must be right and had decided to vacuum his car, before collapsing and dying minutes later.

During the programme, Chris Grayling, the Conservative employment minister, said it had become clear “in the last few months” that the government had been “calling people back too regularly” for assessments, and so he had told civil servants to “make sure we leave a much more sensible interval”.

But Grayling’s admission has been called into serious question by two leading Labour MPs.

The disabled MP Dame Anne Begg said the work and pensions committee that she chairs told Grayling in the spring of 2011 of its concerns that people who had won appeals against being found fit for work were then almost immediately called in for another WCA.

She has recently received an email from a man with Huntington’s disease who had been called in for his third assessment in three years, was “absolutely feeling persecuted”, and has been told by Atos that if he fails to fill in the necessary form his ESA will be stopped.

The Labour and Co-op MP Tom Greatrex, who has led moves in the Commons to probe Atos’s performance through scores of written questions to ministers, said he had been raising concerns about repeat assessments since last year.

Greatrex said:  “It is wrong for Chris Grayling to claim he is only now being made aware of this problem.

“I met him last year [on 7 December], along with Parkinson’s UK, to highlight concerns that people were being trapped in a seemingly never-ending cycle of assessment-appeal-reassessment.

“For many people with progressive incurable conditions they are never going to get better.

“The continuous reassessment is a waste of their time and energy, as well as a waste of taxpayer money.”

A Department for Work and Pensions (DWP) spokeswoman said: “We are aware that very shortly after appeal, some individuals are being asked to attend a reassessment.

“We have strengthened guidance to ‘decision makers’ to ensure claimants are recalled after appropriate periods of time and are working to get better feedback from the Tribunals Services on their reasons for overturning decisions.”

But DWP has so far been unable to say why Grayling has taken so long to respond to the concerns.

The Dispatches programme, which was watched by 1.3 million people, followed a GP as he trained to become an assessor for Atos.

His Atos trainer was shown admitting that the WCA was “toxic” and “very, very tough”.

She then warned the GP that any assessor who allowed too many disabled people to join the ESA support group – for those not expected to carry out any work-related activity – would be told this rate was “too high”.

Campaigners pointed to the admission as proof that Atos had been given targets for the number of disabled people it should find “fit for work”, a claim the Department for Work and Pensions continues to deny strenuously, although it says Atos has “contractual arrangements they need to adhere to in terms of quantity and quality”.

Dame Anne said she was “shocked” by some of the statements made by the Atos trainer and her apparent “harsh interpretation” of the WCA rules.

She said: “It gives the lie to the assertion that those who are most disabled are protected and have nothing to fear.”

She said DWP must investigate the training being given to new Atos assessors to find out “whether it is so harsh and unforgiving and unbending as it appeared in Dispatches”.

Atos this week refused to answer a series of questions from Disability News Service (DNS) about the two documentaries, declining to say which key facts and conclusions it disputed.

An Atos spokeswoman instead emailed a statement, which claimed the company spends “a great deal of time and resource in training and reviewing the work of our medical professionals to ensure that those assessed are treated both professionally and sympathetically”.

She said: “It is important to underline that the assessment forms an important but single part of the information used by the DWP when it makes its decisions on benefits.”

She refused to say whether Atos was investigating any of the issues raised by the two programmes.

News provided by John Pring at www.disabilitynewsservice.com

Government says ‘no guarantees’ over recording of ‘fit for work’ tests

The Department for Work and Pensions (DWP) has admitted that it cannot guarantee that disabled people who want to have their “fitness for work” tests recorded will be able to do so.

Ministers introduced a new right last year for claimants to have their work capability assessment (WCA) recorded – if a request was made in advance – but only paid for 11 specialist, dual-CD interview recorders to cover the entire country.

The concession was introduced because of complaints that “healthcare professionals” working for Atos Healthcare, the company that carries out the tests for the government, were failing to record accurately the evidence they were given.

But there has been mounting confusion over whether claimants have the right to postpone their WCA if Atos tells them there will be no recording equipment available.

One disabled woman has twice been told by Atos staff that all 11 of the interview recorders were “broken” and that Atos had decided it would no longer offer a recording option.

The Conservative employment minister Chris Grayling promised MPs in February that Atos would “offer everyone who wants it the opportunity to have their session recorded”.

But Atos says on its website that it “cannot postpone an assessment on the basis of audio-recording”.

Grayling increased confusion by telling MPs last week that if recording equipment was not available “clients will be told in advance that their request cannot be accommodated and offered a later date”.

Despite this answer, a DWP spokeswoman has now confirmed to Disability News Service that “although we continue to make reasonable endeavours to accommodate requests for recording assessments, we believe it would be unreasonable to delay the assessment indefinitely for this purpose”.

She said only a “very few people” would not be able to have their WCA recorded, and added: “Atos will make every effort to get your assessment recorded but for a very few people that situation cannot go on indefinitely.

“If there is a particular problem [with arranging the recording equipment] then it may be that you have to proceed with the assessment without recording.”

She said Atos had ordered some new recorders – but could not say how many – and would also borrow equipment usually used by DWP to record interviews in cases of suspected benefit fraud.

She added: “We initially purchased 11 as there were very small numbers who requested recording and on the basis of [a pilot project] the solution seemed reasonable. 

“We are now putting in a revised solution but must balance the still very small number of requests with appropriate use of public money which we will continue to evaluate.”

Debbie Jolly, a member of the grassroots campaigning organisation Disabled People Against Cuts (DPAC), said that despite the “Chinese whispers” taking place between DWP, Atos and MPs, they all insist that a “very small number” of people request recordings of their WCA.

But she said that early results from a survey launched this week by DPAC and fellow campaigning groups Black Triangle and Social Welfare Union cast huge doubt on this conclusion, with 98 per cent of people who have taken part saying they would like their WCA recorded.

Of those refused a recording, she said, most were not given a reason or an alternative appointment, but were told instead that they would be classed as a “no show” if they didn’t take the original appointment.

They launched the survey because of fears that the government will try to remove the option of recording WCAs completely by claiming there is a lack of demand.

News provided by John Pring at www.disabilitynewsservice.com

Victory in first stage of ‘fitness for work’ court case

Two disabled people have won the first stage of their legal bid to force the government to improve the much-criticised “fitness for work” test.

The high court this week granted permission for them to bring a claim for judicial review against Iain Duncan Smith, the Conservative work and pensions secretary.

The two disabled people, both supported by the Mental Health Resistance Network (MHRN), claim that the work capability assessment (WCA) discriminates against people with mental health conditions.

The WCA was introduced by the Labour government in 2008 but is now a centrepiece of the coalition’s welfare reforms, and is used to determine eligibility for employment and support allowance (ESA), the replacement for incapacity benefit (IB).

Lawyers for MM and DM – who have been granted anonymity by the court – say many ESA claims are decided through assessments by healthcare professionals who are not mental health specialists.

They argue that the WCA fails to make reasonable adjustments under the Equality Act for people with mental health conditions, and are calling on the Department for Work and Pensions (DWP) and Atos Healthcare – the private company which carries out the tests – to seek medical evidence at the beginning of each claim.

Mr Justice Edwards-Stuart, granting permission for a judicial review, said that it was “reasonably arguable” that “early obtaining” of independent medical evidence was a reasonable adjustment under the Equality Act for claimant with mental health conditions and “that this has not been done, or at least not done on a sufficiently widespread basis”.

A judicial review victory will not lead to the WCA being scrapped, but could make it fairer and less stressful for those with mental health problems, while some could be exempted from having to undergo a face-to-face assessment.

Ravi Low-Beer, MM and DM’s solicitor, from the Public Law Project, said: “The present system results in many thousands of unnecessary appeals at great public expense, with a high success rate.

“What is not counted is the cost in human misery for those people who should never have had to go through the appeals process in the first place.

“This could be avoided if doctors were involved in the assessments at the outset. The government’s policy of bypassing doctors is inefficient, unfair and inhumane.

“We gain heart from the court’s findings that as a matter of law, it is arguable that something has to change.”

He said he hoped the judicial review hearing would take place later this year.

Dave Skull, an MHRN member, also welcomed the court’s decision, and said: “A number of people have been wrongly assessed and misrepresented by the current situation. It is vital that there is some sort of review.”

He said many people with mental health conditions were in a “vulnerable position” and were experiencing “incredible anxiety” because of the WCA’s flaws, and added: “I am supporting a lot of people who are feeling suicidal about the situation with their WCA.”  

The MHRN was formed in 2010 by people claiming IB on mental health grounds, who were concerned about the proposed programme to reassess all those on the benefit for their eligibility for ESA.

Many of the network’s members have had relapses, episodes of self-harm and suicide attempts, and have needed higher levels of medication and even hospitalisation in the lead-up to their reassessment.

Thousands of people with mental distress have been found unfairly fit for work following their WCA, and while many go on to win an appeal against this decision, some are unable to cope with an appeal, or experience a relapse in their health as a result of the process.

A DWP spokeswoman said: “Government welfare reforms have a long history of being taken to judicial review so this is little surprise and we will be challenging this claim vigorously.

“We have worked hard to ensure people with mental health problems are treated fairly.”

News provided by John Pring at www.disabilitynewsservice.com