No more repeat Work Capability Assessments until further notice

Some huge news has emerged today after a Freedom Of Information request by the Benefits and Work website.

It appears that the DWP have suspended all repeat Work Capability Assessments with Atos. This means that those who currently receive Employment Support Allowance and are in the Support Group or the Work-Related Activity Group will not be called back for repeat assessment unless the DWP are informed that their health has changed. This appears to be a move to clear the backlog of those in the Assessment Phase of ESA who are waiting for Atos to call them in for a WCA. It is unclear how this might affect the migration for those who still receive Incapacity Benefit. According to Benefits and Work the DWP memo states:

“The number of cases currently with Atos Healthcare has grown. A decision has therefore been taken to control the referral of repeat work capability assessments. Therefore, with effect from 20 January 2014, further routine repeat assessments referrals to Atos will be deferred until further notice.

“Controlling the volume of repeat Work Capability Assessments should help us to reduce delays for new claimants and those that have already been referred.”

Benefits and Work also claim that the DWP did not intend to inform either MPs or claimants. The uncertainty over the timing and outcome of the WCA is a huge problem for most people who rely on ESA and the knowledge that they will be left alone in the near future would be a great help so it is a further sign of cruelty that the DWP don’t care enough to inform anyone.

This decision to suspend repeat assessments sheds new light on the recent announcement by Atos that they are seeking to get out of the contract for WCAs early anyway and on the ongoing battle between Atos and the DWP to place the blame for the failure of the entire scheme.

Dr Greg Wood put some speculation into the thinking behind this decision on his blog in the form of a fictional memo – Work Test Whistleblower: A Note For The Minister?

Source: Benefits and Work: All repeat WCA medicals to be stopped

Related:

Atos want to end DWP Work Capability Assessment contract

The problem with the Work Capability Assessment goes far deeper than Atos

 

Atos want to end DWP Work Capability Assessment contract

According to a report in the Financial Times, (£) Atos are trying to bring an early end to their contract to carry out the Work Capability Assessment.

Atos, if you don’t know, are the French IT company that have the contract to assess every person that claims Employment Support Allowance and determine whether they really need support or should be told to get a job. They are notoriously bad at it, with vast numbers of decision overturned by appeal tribunals and many more who could not face the appeal abandoned without any income.

Crippen - Atos test

The Guardian reported on Monday that the Department of Work and Pensions were looking to commission other providers to take on some of the assessments but in a quote given to the Financial Times Atos said that they were already negotiating to leave the contract early. From the FT article:

The French IT company has been in discussions with the Department for Work and Pensions with a view to exiting the deal since October last year, because it views the tests as “outdated”.

“In its current form it is not working for claimants, for DWP or for Atos Healthcare,” Atos said. “For several months now we have been endeavouring to agree an early exit from the contract, which is due to expire in August 2015.”
“Despite these ongoing discussions, we will not walk away from a front-line service. Our total focus remains on delivering the services we are contracted to provide in a professional and compassionate way, until a new service begins.”

Of particular note is that in the article Atos are cited as saying that “the political environment has become untenable” and that the work capability assessment is “outdated”.

As I wrote earlier this week the replacement of Atos with another outsourcing company will not solve the problems with the Work Capability Assessment as those stem from government policy and the way in which the DWP enforce the contract so as to keep the numbers deemed eligible for help to a minimum. It is, however, satisfying to see a company which has been quite happy to play it’s part in the cruel and unnecessary suffering of thousands finally admit defeat.

Financial Times – Outsource group seeks exit from UK £500m benefits contract after death threats (£ – free registration to read 8 articles.)

Latent Existence – The problem with the Work Capability Assessment goes far deeper than Atos

The Guardian – Atos may lose fit-for-work tests contract as ministers line up rival firms

Whistleblower says Atos Work Capability Assessments are unfair

A doctor who worked for Atos carrying out Work Capability Assessments has resigned and has told the BBC that the assessments are unfair. He says that pressure was put on Atos staff to change the outcome of the reports.

But Dr Wood has criticised some of the tests which he says contain “dubious concepts and shaky reasoning”.

He claims assessors are told that if a claimant can walk from the kitchen to the sitting room, it proves they can walk 200m (650ft); and if a person can dress themselves once during the day that is proof they have enough concentration and motivation to hold down a job.

He insists these rules are not published in handbooks and guides, instead they are simply spoken about in training sessions.

Dr Wood, who was given special responsibility to champion mental health at Atos, said: “I was instructed to change my reports, to reduce the number of points that might be awarded to the claimants. I felt that was wrong professionally and ethically.

Watch the BBC Six O’Clock News report:

BBC News talked about this some more an hour later:

Tom Greatrex MP has written to David Cameron to urge him to order an investigation.

BBC News: Disability benefit assessments ‘unfair’, says ex-worker

The Guardian: Atos benefit claimants face biased medical assessments, doctor alleges

Benefit Scrounging Scum – Q: When is a target not a target? A: When its a statistical norm

Sue Marsh – What’s the state of ESA?

Letter to my MP on new ESA regulations #esaSOS

As promised, although a little late due to lack of spoons, here is the email that I sent to my MP regarding the new ESA regulations. Feel free to take any text from this for your own use.

Dear Mr Luff,

I would like to apologise for the swearing incident which led you to block me on Twitter. As I am sure you must realise by now I suffer from mood swings and anger triggered by chronic pain and the painkillers which I take for it – something which will be inadmissible at my next Work Capability Assessment.

I have been shocked to read about new ESA regulations which will come into force on the 28th of January 2013 and I am writing to express my strong opposition to them. I appreciate that not much can be done at this late stage but this is in no small part due to the regulations coming into force less than six weeks after their announcement.

The new regulations allow a decision to be made about benefits based purely on the supposed difference that a suggested change, therapy, aid or medicine would make. This is already the case some of the time but will be much expanded in the new regulations. The new regulations do not require the Atos Health Care Professional (HCP) to discuss the suggested change with the benefit claimant before a decision is made by the DWP. It is of vital importance that any medicine, mobility aid or prosthetic or other change that an Atos HCP might feel would improve the claimant’s chances of working should be signed off by the patients own specialist doctors and by the claimant themselves before any decision. The Atos HCP is not the claimant’s doctor, (indeed, they are usually not a doctor at all) is not knowledgeable of the claimant’s condition, and the Work Capability Assessment, by the DWP’s own admission, is not a medical assessment.

There are numerous reasons why the change that the Atos HCP suggests might not be appropriate. It is quite possible that the change might not be available in that area or at all or might involve a very long waiting list. In Worcestershire, for example, wheelchairs are not available at all to people who can stagger around their own home. Prosthetic limbs are expensive everywhere. In many cases a person may be advised not to use a wheelchair, prosthetic limb or other aid because to do so will hasten the progression of their disease. A claimant may well have tried or considered a particular change but ruled it out because of negative side effects.

Even if the change were considered by doctors and the patient, there is the huge issue of consent. This change could compel people to take up a particular medical treatment through pressure from removal of their benefits and several legal experts have suggested that this could well breach their human rights. To push ahead with this could be extremely costly for the DWP when legal cases are brought.

Even worse than the above change, the new regulations will strictly separate the impact of mental health conditions and physical health conditions. This is an absurd change which ignores the reality of illness. Many medications for mental health problems cause physical problems, and many pain drugs cause cognitive problems. Impairments caused by a problem in the other category must be taken into account.

I do hope that you will agree with me that these regulations are a serious problem and will express your opposition to them.

Sincerely,

Steven Sumpter.

Johnny Needs More Than Chalk – why welfare reform needs a cumulative impact assessment

To do his schoolwork, the bare minimum Johnny needs is: paper, a pen, a teacher, a school, a chair to sit on, a desk to sit at, and a packed lunch.

If you take away just Johnny’s lunch, he will go hungry. It would be almost impossible for him to concentrate and do well in school. However, in theory, he could still do schoolwork.

If you just took away his desk, it would make it tricky to write, but Johnny could still do his schoolwork. It would just take longer and be less neat.

If you just took away his teacher, he could, in theory, go to libraries and museums to learn. In theory. Hypothetically, it’s still possible that he could teach himself something, so he could still do his schoolwork.

If you take away his paper and pen and school all at once, he can still sit on the floor and use chalk to write on the ground.

But if you take away Johnny’s paper, pen, teacher, school, chair, desk and lunch, all at once, Johnny is sitting on some ground with nothing, hungry, without a roof over his head. It’s hard to learn anything at all sitting alone, on the ground, with nothing but a piece of chalk.

Now imagine you have a disability or a long-term chronic illness. To manage it with a degree of dignity, you need a carer, a roof over your head, a bed, heating, food and transport. You rely on the carer, who comes in twice a day from social services, because she helps you to get up and get dressed and washed. Without her, you would have to spend all day, every day in bed. But at least you still have a bed.

Or maybe you rely on housing benefit to keep a roof over your head. You are forced to move to a smaller property on the 5th floor of a tower block when your housing benefit is cut. The lift doesn’t work. It means you have to move away from family and friends who help you out whenever they can. They cook meals perhaps, or help with all those jobs around the house you just can’t do.

But at least you still have somewhere to live.

Or maybe you rely on Disability Living Allowance (DLA) for transport. It means you can get a taxi to the hairdresser or social club. Without it, you would become isolated. It would be impossible to get to your GP or make hospital appointments.

But, in theory at least, you don’t actually need to go anywhere.

If, however, you cut Disability Living Allowance, housing benefits, social care, hospital budgets, the Independent Living Fund,  Employment and Support Allowance (ESA), income support and the Social Fund, then you are just lying in a bed, hungry and isolated, a prisoner in someone else’s home.

Governments must perform what is called an “impact assessment” on any new policy or law. This government has done the bare minimum to fulfil this commitment. Would it surprise you to know, for instance, that when considering the greatest cuts to disability support in living memory, they claim that they will have no impact on health, no impact on well-being, no impact on human rights, and no impact on the justice system?

The crucial flaw is that they have independently assessed each cut to the services disabled people rely on, as if it existed in a vacuum.

The government has refused to do an overall impact assessment. They have repeatedly refused to assess what thecombined impact of their cuts will be. First they said it would be too expensive, then they said it would be too difficult!

Why might it be too difficult? Because they know, as we know, that, metaphorically speaking, the result will be little Johnny sitting on the floor with nothing but a piece of chalk, hungry, without a roof over his head.

The combined impact of removing someone’s DLA so they can no longer afford care or transport, heating or food, cutting their ESA so that they must look for work with cancer or multiple sclerosis, cutting their local care support so that they cannot clean themselves or feed themselves, cutting their housing support so that they risk homelessness and, to cap it all, scrapping the Social Fund so that there is no safety net when all else fails, is a strategy so risky that it ought to be criminalised.

We call upon the government to immediately carry out an overall impact assessment of all the cuts to the support that sick and disabled people rely on to live. I’ll say it again – to live. And they must do it now, before it’s too late. Because it’s hard to survive, sitting in the dirt with nothing but a piece of chalk.

First posted by The Occupied Times.

Please sign WOW Petition calling for a cumulative impact assessment.

What’s the state of ESA?

This won’t be a short post, but it is a crucially important one.
I have never written about something on this blog that I couldn’t prove to be true. If I didn’t have evidence that I could show you online, I didn’t write about it.
I’ve had many conversations with Labour MPs or peers or journalists or managing directors or trade unions  that I couldn’t share, but each one added to my overall understanding of ESA (Employment Support Allowance)
Today though, I think it’s important that I try to lay out very clearly what I feel I “know” about ESA, WCAs, Atos, the DWP and the current political situation.
I’ve dismissed those I judged to be fools along the way, the way we all do every day as we decide to trust someone or not, to believe something or not. I’ve made my judgements from meeting people, from talking to them. I like to “see the whites of their eyes” when I can. I research people, I try to “know” them and what makes them tick.
I’ve judged evidence and analysis along the way and tried always to get as close to a truth I could prove as possible.
I’ve dug into the history of welfare reform where I could. I’ve tried to find out what was going on with Labour at the time, when were Atos brought in? What was Unum’s involvement, who designed ESA? Which DPOs and charities were involved?
At every stage, with every decision, every   speech, every article, I’ve tried to think of the people who read my blog. I’ve tried to ask what we need to change and why. How to change it. Who are the real enemies? Why? What methods of demanding change are effective?
 Of course, my judgements may not have been yours. I have absolutely no way of actually “knowing” if I was right or wrong, too naïve or too cynical, biased or balanced but the following summary is where I feel we are in my heart from everything I’ve read and everyone I’ve met.
There are so many things that so urgently need changing about ESA, forgive me if I forget any here. For every bullet point, the section in italics is my opinion on where we currently stand.
  •       Medical evidence from own GP or consultant rarely taken into account
One of the most shocking statistics disclosed about WCAs was that DWP decision makers only refer to medical evidence as well as the Atos decisions in 2% of cases. Harrington recommended that medical evidence should always be considered and there has been progress- 8% of decisions are now overturned by DWP decision makers, suggesting they are referring to medical evidence much more. This has not yet been rolled out everywhere, so we might hope to see the figures improve further. However, the ideal solution would be for decisions to be taken by an independent doctor, based on all the evidence available.
  •     Descriptors used to assess fitness to work are far too narrow and not based on real life. They discriminate against those with mental illness, long term chronic illness, learning difficulties and more.
No assessment can ever be fair or functional if the descriptors are wrong. ESA descriptors are so wrong, they need totally fundamental reform. I got the impression that something shifted in the early part of this year. Government suddenly decided to go ahead with a trial of alternative descriptors (you can see them here) that were much fairer and broader and more rooted in a real life test. Though far from perfect, I believe they would give much more realistic results and provide much more opportunity for HCPs to make informed decisions.

The timescales to test these new descriptors is very quick for government. They will be trialled alongside a panel of expert decision makers to see how accurate they are. This process will be run by civil servants and if they are a notable improvement on the current descriptors, government do say that they will be implemented. 

We can help make sure the new descriptors are fairly trialled and the results accurately reported by keeping an eye on the trial, communicating with the charities responsible for writing the new descriptors and making sure that this isn’t somehow quietly shelved while we’re not looking. However, if all went well, we might be looking at the introduction of the new descriptors by 2014.
  •          Disability assessment centres are not all accessible to disabled people, often with no parking (!?!)
This is something that Atos has pledged to change as soon as they can. Whether might choose to be sceptical, but they have said on their blog and elsewhere that they are committed to quickly making all centres fully accessible. 

We can make sure they do this by writing to them and saying how important it is, urging them not to delay and telling them your own stories of trying to access an inaccessible centre.
  •          The Support group is too narrow and far too difficult to get into.
Support group numbers have been steadily rising. Last year the government had to find an extra £1 billion due to paying more people than they had predicted going into the support group. The figures are still rising and suggest they will continue to rise as the Harrington changes are rolled out. Grayling has said that they are “intensely relaxed” about this rise in Support Group numbers if it means those in genuine need are getting help and certainly, there doesn’t seem to be any evidence of this rise being suppressed or restricted. 

Once the latest figures are adjusted to take account of appeal decisions, around 35% will end up in the Support Group, around  42% in the WRAG and 23% fit for work. This is a huge improvement on the shocking days of  new-claim only  ESA stats, where just 6% were going into the support group, 18% into the WRAG and a full 77% of claims not resulting in any award of ESA. 

There’s still a long way to go. I would argue that the support group should be bigger than the WRAG and that 23% is too many being found fit for work, but there really has been great improvement.
  •          Sanctions of any kind, but particularly time limiting bad health to one year, are inappropriate for people with serious illnesses or disabilities.
Sanctions and penalties are most beloved by this government despite no evidence at all, anywhere in the world that they work. They have totally refused to listen or compromise at all over this and I can’t see that they will. The public are currently very supportive of sanctions and mostly believe they should actually be tougher.

However, workfare, work providers and some of the reality of sanctions have taken a hit this year thanks to the work of people like Johnny Void and Boycott Workfare, with big companies experiencing a strong public backlash leading them and charities to pull out of workfare and other failing schemes. 

More to the point, the way the government has set up the “payment by results” scheme, means that small providers who tend to get good results are going to the wall while less targeted, less successful large companies are unable to hit the targets set. The reality is, most sanctions will either never be used, or will be quietly abandoned as the government realise they either cause too much embarrassment or the scheme collapses totally because none of the providers are getting paid.
  •          Decisions take far too long. Appealing a wrong decision can take well over a year.
This is only getting worse with backlogs growing, targets for re-assessment falling further behind and tribunals taking longer. Soon, as the government realise that it is, in fact, impossible to actually assess 2 million people and keep on assessing them indefinitely. They cannot achieve accurate assessment rates assessing 11,000 people a week. There simply aren’t the HCPs to do the job. 

Assessment rates need to fall by around half and government must accept that the whole process will take longer then they predicted. When assessment rates DO fall, the appeal rate also falls drastically as shown in Kettering who have implemented all of the Harrington changes enthusiastically. Getting the decision right first time, by taking the necessary time with each claimant saves the taxpayer millions and the person being assessed trauma and unnecessary waits for tribunals etc.

There is strong anecdotal evidence that Atos and the DWP are now pre-assessing many as unable to work without calling them for assessment. This is exactly what we always said they would have to do. It is how the original IB system worked and though the government are clinging on to the rhetoric, they are realising we were right all along and there really IS no point in assessing people who will never get better and who clearly will never work. This is a big win, but you’re unlikely to hear about it.·         Healthcare professionals (HCPs) used by Atos to assess disability do not have to be doctors and do not need to have any specialism or prior understanding of the condition the claimant suffers from to make a decision.

Atos have pledged “mental health champions”, up and down the country, claiming that they will make the assessments fairer for those suffering from mental illness. This is welcome, but unless the assessor has some knowledge of the conditions they are assessing they cannot possibly make an accurate decision. Atos might consider other teams of expert assessor for other conditions. Though it might mean claimants travelling further to be assessed, if specialist teams were more accurate it would be a small price to pay. All HCPs should have a working knowledge of either general medicine or the speciality of the person they are assessing.
  •         Reports written by HCPs are inaccurate; often bearing no resemblance to what the claimant reports was actually said.
This still seems to be shockingly common. The DWP have said in principle that all assessments can be recorded, but in reality are blocking the process. Until someone being assessed for ESA is afforded the same basic rights as a criminal, and assessments are recorded, claimants cannot make sure this doesn’t happen. 

As both Atos and the DWP have said that assessments can be recorded and have pledged to get working recording machines into assessment centres, we can make sure people get accurate HCP reports by keeping the pressure on the DWP to provide these machines in every centre. This is one area that I know is under great pressure legally too. Having the law on our side can only help.
  •          Questions are misleading, seemingly designed to “catch people out”
A longer assessment using the improved descriptors, should make this less likely, but there is a culture of suspicion between state and claimant that must be talked from the roots up. All the time ESA is only designed to catch the cheats, it will never serve those in genuine need.
  •         Mail containing highly personal and sensitive information on forms is opened and sorted by a third party.
Mails used to be opened by the Royal Mail, sorted and only then sent on to Atos. Once the DWP finally accepted that the practise was commonplace, they have now pledged to stop it. We can make sure they do by keeping the pressure on.
  •          Correspondence sent to the claimant is threatening and frightening.
This is one area where Atos have seemed very keen to make improvements. They have redesigned their website to make information more easily available, less frightening and more sensitive. They now have a patient charter and say that they will work hard to make the whole claimant experience more customer focussed and compassionate. 

They would like people to advise them on how to do that, what we would like to change etc. Of course, we can refuse to make things better right at the point where Atos are asking how to, but that feels a bit like a four year old having a tantrum. We’re grown ups and we can’t change things if we don’t explain what needs to change and why.
  •         Language used by politicians and press to discuss those claiming ESA is derogatory and demeaning. Scroungers, skivers, feckless, festering – we are called all these things. Journalism is often lazy and full of inaccuracies.
For some time now, we haven’t been unheard. Just two years ago, no-one was writing about ESA at all, other than to remind the public that we were all scroungers who could be working. Now, the Guardian, the Mirror, the Independent, Private eye, Political Scrapbook, Left wing blogs and even the Spectator are running regular stories about the failures of ESA and the WCA. Channel  4 have run some fantastic sections on the failures of ESA and even the Daily Mail have allowed blogs about ESA written by the indomitable Sonia Poulton. 

Slowly but surely, things are changing. Bit by bit we are [persuading those that matter to persuade the public that we are right and the government are wrong. 

It is frustratingly slow. The public have to read things many times over before they accept them and we still have a long way to go. But things are totally different now to two years ago and momentum is building in our favour.
  •          ESA had cross party support. There was almost total political consensus that it was good policy.
From my own point of view, this is what I most wanted to change and the thing I’ve worked hardest on. All the time we still have a Labour party blind to the suffering of sick and disabled people, they are not a Labour party. It has been achingly slow with disappointments and faux-pas at every stage. It pains me that I have had to drag Labour to every concession kicking and screaming, that some in the party still think ESA is right. It hurts me to remember some of the judgemental speeches and thoughtless, unfounded coalition policies they originally supported. 

But as I wrote here Labour have made real steps in the past year to put the mistakes of ESA behind them. They are now saying they are listening and travelling the country discussing sickness and disability policy with those actually affected. They have laid out a set of “rights” they believe sick and disabled people should be able to rely on and they have admitted ESA is a mess and isn’t working . Byrne’s Beveridge 2 speech was a turning point in which Labour started to dare to say the word disability again. I DO believe Labour are listening. They realise that we face very grave threats, that we are not just the usual suspects making a fuss. It’s up to us to tell them what we need. We can’t sit at our keyboards complaining then refuse to say what we want. 

The EDM raised by John McDonnell was signed by 114 MPs and became the 3rd most signed EDM Every day a new Labour MP or even a Lib Dem or Conservative join the growing chorus of MPs opposed to WCAs. Again, it’s slow and it’s frustrating, but we’re getting there. 

It is also now Lib Dem policy to oppose WCAs despite their actions. This might not help now, but could come in very handy in the event of a future Lib/Lab coalition,

Once the political consensus is broken, it gets much harder for the government to get away with leaving ESA a shambles. 

Jon Cruddas, the head of Labour’s policy review, has promised to make sure anything we send to Liam Byrne and Anne MacGuire goes to the very heart of discussions over future policy. I believe him because he’s a good guy who’s written articles about sickness and disability that sound just like mine. He is a politician who really understands our issues. 

I honestly believe we have a chance if we just make sure we tell Labour what they have to do and keep the pressure on them to do it. 

But we have to tell them.
  •          It’s pointless expensive and unnecessarily distressing to constantly re-assess those with disabilities so severe and profound that they will never work.
(Dealt with under delays and appeals above)
  •          The help & support politicians say people with serious illnesses and disabilities will get to find work is totally inappropriate and ineffective. It conflates disability benefits with JSA (Jobseekers Allowance) Most people who lose ESA have not found work.
As I’ve argued here and here it is no good sorting out all of the problems above if there is no work sick and disabled people can actually get or do. The work provision is woefully inadequate, the system is not going to make work pay for us and we need to totally re-design the help and support government provide. If you can take part, please leave your comments below the articles and let politicians know what you need to work and what that work should be
  •          The public were unaware of all these faults and generally thought ESA was a good policy.
Sadly, this is the area where we still have the most work to do. Most people still don’t know what’s happening and disability is not an issue they think about often or that interests them much. If we are sitting around waiting for people to wake up and say “Oh, this is terrible, we have to stop it!” they aren’t going to do that any time soon. Think how long it took for Tom Watson to expose phone hacking?  It took years to spill over into genuine public outrage. There isn’t going to be a revolution.
All we can do is chip away, every day, telling more and more people, getting them to tell even more people. Slowly but surely, opinion will change.
If you look at all I’ve written above, we’re well on the way to winning most of the points above. If we haven’t won, we’re at least at the place where we’ve won a seat around the table. We’ve made massive progress since 2010 and the truth is that with new descriptors, accessible centres staffed by respectful courteous experienced staff, more paper assessments taking place, higher support group and WRAG numbers a commitment from Labour to make rights a reality for disabled people and to really listen to what we need we have all the ingredients of success. With Atos claiming that they are willing to improve assessments  implement the Harrington changes and allow assessments to be recorded we’ve come a huge way in two years.
Of course we still have a long way to go, of course it isn’t enough but I think it shows for itself how successful a strategy of engagement and lobbying can be. We would have achieved none of this without sustained and often boring small changes, bit by bit, day by day, chipping away at everything that is warped and wrong with ESA. The government become more and more isolated by the day as the BMA, every main charity, Atos, the press and the opposition parties edge further and further away from supporting ESA.
This might not be the way everyone would do business but I don’t care about saving face or an ultimate glorious win that may never come.
I want to ACTUALLY win and that means compromise, boring detail, hard work and disappointments.
The proof of the pudding will be ESA in 2015. Tragically that will be too late for many, but better to win slowly but surely than to never win at all.
First published at Diary Of A Benefit Scrounger.

Iain Duncan Smith is proud of getting people off benefits

IDS - "We've heard enough of you"
“We’ve heard enough from you.”

Owen Jones confronted Iain Duncan Smith with the names of two people who have died as a result of the work capability assessment. He did not react well. I urge you to watch this video of the last part of Question Time, particularly the last minute if you want to see what IDS is really like.

“Hang on a second, we’ve heard a lot from you. Let me tell you something. I didn’t hear you screaming about two and a half million people who are parked, nobody saw them for over ten years, not working, with no hope, no aspiration, we are changing their lives, I am proud of doing that, getting them off benefit is what we are going to do.”

Iain Duncan Smith is proud of getting people off benefits. Never mind that there is no work for them to go to even if they can, and that the way lives are being changed is by sending people further into poverty and homelessness. Not only that, but he thinks that being “parked on benefits” and left alone is a bad thing. Well those of us on permanent sickness and disability benefits do have hopes and aspirations. We hope to not have too much pain today and we aspire to getting the care that we need so that we can undertake something entertaining that isn’t lying in bed waiting to die. We probably don’t aspire to being a rich Tory, which is probably similar to being dead in the head of Iain Duncan Smith. As for nobody seeing sick people, now they are being reassessed so frequently that they are committing suicide. Winning an appeal at tribunal often leads to an immediate call to another assessment.

https://twitter.com/crazybladeuk/status/271197324594786305

Dead people don't get benefits
Dead people don’t get benefits – cartoon by @dochackenbush

Further Reading

Brian Mcardle: Atos benefits bullies killed my sick dad, says devastated Kieran, 13

Karen Sherlock: How many more disabled people will die frightened that their benefits will be taken away?

Karen’s Story – RIP Karen Sherlock, Disability Rights Campaigner – Died June 8th 2012

Hundreds more: The People’s Review of the Work Capability Assessment

 

Third Harrington review of the Work Capability Assessment

The third independent review of the Work Capability Assessment [PDF] by Professor Harrington has been released today. I am not particularly impressed with it, particularly Harrington’s criticism of those who have campaigned against the current welfare reform.

The WCA continues to be portrayed in an extremely negative light, often fuelled by adverse media coverage, representative groups and political points scoring. Whilst the Review continues to hear examples of individuals who have been poorly treated by the WCA process, DWP can be reasonably pleased with what they have achieved. Some recognition of the considerable work to date would give a more balanced picture and DWP needs to be more proactive in communicating this. [Emphasis mine.]

I don’t know what world Harrington inhabits but that “adverse media coverage” was brought about by relentless campaigning from those who are directly affected in horrendous ways – “representative groups” and the only “political points scoring” we’ve made has been nearly universally against all three main parties. We have had a very hard time getting people within those parties to see the problem at all. Calling for the DWP to get better PR is not the solution.
Right in the foreward I was struck by his comments about tribunal judges.

Recommendations on the training of professionals in DWP Operations, Atos Healthcare and the Tribunals have produced some limited progress. In particular, it is regrettable that the First-tier Tribunal has effectively distanced itself from the rest of the WCA. Feedback from the Judges to the Decision Makers has, at last, started in a rudimentary way. However, much, much more is needed if we are to see a real dialogue between the Judges and the Decision Makers. This must happen on cases where there is a difference of opinion on what category is appropriate for that case based on the same set of evidence. For the First-tier Tribunal to suggest that the WCA Independent Review has no remit to consider the appeal stage of the process is illogical and untenable in my view. [Emphasis mine.]

Harrington is calling for feedback from tribunal judges to the Atos assessors and the DWP decision makers over why they reached different decisions to those made by the DWP. However the comments that Robert Devereux DWP private secretary made before the Public Accounts Committee on the 19th appear to be directly quoting the paragraph above out of context and instead criticised the tribunal judges for reaching a different decision. His thought appears to be that if looking at the same evidence then the decision should also be the same, without considering that the original decision makers might have been wrong. What Devereux and Harrington both seem to have missed is that Atos and the DWP have often failed to look at the evidence at all and the face-to-face assessment is not likely to find anything that strays from the Lima computer system’s checklist. There have been many cases where Atos and DWP staff have refused to look at evidence from healthcare professionals or refused to wait for evidence, and many more cases where evidence has been lost in the system somewhere between health care professional and decision maker.

One of Harrington’s conclusions stood out to me:

The Work Capability Assessment (WCA) remains a valid concept for assessing benefit claimants’ eligibility for Employment and Support Allowance (ESA). Whilst the WCA continues to garner considerable – and sometimes, but not always, justifiable – criticism the Independent Reviewer has not seen or heard any compelling arguments or evidence that the whole system should be scrapped. Instead it needs to be made fairer and more effective by improving both the process and the technical descriptors used to assess eligibility.

I know a lot of people would disagree with that, but I think this is a lost battle and the public will continue to support assessments in this way. I took a little more hope from his recognition that we do need change.

A number of the major charities in this year’s call for evidence say that although they have seen some change for the better, it is disappointingly incomplete in coverage and depth. I agree with them. Changing such a large and complex process and such a controversial assessment takes time – it is happening.

So far as the descriptors are concerned, progress has been positive but slow. We are close to a new and much improved set of provisions for cancer treatment. For the mental, intellectual and cognitive conditions descriptors and for the fluctuating condition descriptors, work is underway for a formal review of new proposals from a number of charities to compare them with the existing descriptors. This work will continue into 2013 and I have been asked to chair the expert independent steering group overseeing the quality and validity of the evidence-based review. It is important to wait for the results of this before rushing to conclusions about how to change the descriptors.

We know from earlier this year that the DWP have been testing new descriptors and I hope that there will be progress on these so that serious conditions affecting ability to function which are currently missed will be noted in future. Also note in the paragraph above that Harrington is to continue working with the DWP on this aspect.

Media-friendly Cancer

I am concerned that cancer treatment has been singled out as needing special attention once again. Cancer is very bad and unpleasant and everyone knows someone who has had it, that’s why it is politically dangerous to send patients on chemotherapy to work. However many other conditions are equally serious and yet not so media-friendly and are therefore treated differently. The Work Capability Assessment is supposed to be about assessing the impact of the condition on ability to function, not what treatment is being received.

Recommendations

Harrington made a number of recommendations to the DWP. I am pleased that the first is for decision makers to consider the need for further documentary evidence. Whether they will do this or not is another question but as I said before the gathering of evidence is a big problem.

It is essential that all relevant medical and allied evidence about the claimant is available to the DWP Decision Maker at the earliest possible stage in the assessment process. If this can be achieved then Tribunals will be based on Judges and Medical Members considering the same body of evidence as the Decision Maker did.

Less pleasing is his second recommendation:

DWP Operations need to find an appropriate balance between better quality decisions that are carefully considered and ‘right first time’ and the achievement of appropriate benchmarks at a local level.

Now I could be wrong here, but that looks very much like a target.

The third recommendation is that the DWP should try to get more feedback from tribunals as to why decisions are overturned. This seems reasonable as it could affect change in the decisions made to start with. The fourth recommendation is that the DWP must highlight improvements, and be open about problems. As I said before, better PR for the DWP is not the answer. I’m open to hearing about improvements made but not if they are used to distract from problems that remain unsolved.

As an antidote to this review I recommend that you look at The People’s Review of the Work Capability Assessment from We Are Spartacus. Also note that DWP statistics released yesterday [PDF] show that 53% of the people placed in the Support Group for ESA are put there without a Work Capability Assessment.

I’ll leave you with this comment from Harrington.

Considerable disquiet remains, and this cannot be ignored

You’re damn right it can’t!

 

The Co-operative group and Atos

Welfare campaigners have recently come across this July 2009 announcement on the Atos website.

The Co-operative Group and the Co-operative Financial Services choose Atos Healthcare

London, 22 July 2009
Atos Healthcare, the number one occupational health provider in the UK1 and a business division of Atos Origin, today announced that it has won a contract with the Co-operative Group (tCG) and Cooperative Financial Services (CFS).

Under the new contract, Atos Healthcare will provide occupational healthcare services for the 82,000 employees who serve around 10 million customers a week through food, pharmacy, travel, funeral care, motor dealerships, legal and financial services. Atos Healthcare will provide pre-employment referrals and absence management including physiotherapy and workstation assessments to help improve employee wellbeing and reduce absence.

Atos Healthcare are the company that carry out Work Capability Assessments for the government to determine whether people are too sick to work and will receive benefits (Employment Support Allowance) or will be told that they are fit to work and abandoned on Job Seekers Allowance at a time when we are desperately short of jobs. People claiming Job Seekers Allowance and people receiving Employment Support Allowance but considered able to return to work in the near future are sent to work placements and flagship government schemes like The Work Programme. Assessments are wrong much of the time and people are dying because of them. More recently Atos Healthcare have also been awarded the contract to assess people for the new Personal Independence Payments which will replace DLA. As a result Atos have been the subject of much protest.

Many companies who use forced work from unpaid workers who receive JSA and ESA have been subject to boycotts by people revolted by what they see. At the same time we are in the midst of a global financial meltdown caused by international banks and so banks too are despised. The Co-operative Group touts itself as ethical and has been seen as one of the best alternatives for banking and grocery shopping and other services. Like many people, I shop and bank with The Co-op for these reasons and so I am disapointed to find that some of the money I spend with Co-op goes to Atos.

When asked via Twitter about their connection with Atos The Co-op replied:

https://twitter.com/TheCooperative/status/247987535287033856

https://twitter.com/TheCooperative/status/247988019800461312

https://twitter.com/TheCooperative/status/247988179829932032

https://twitter.com/TheCooperative/status/247988423254736896

I personally will stick with the Co-op for now but as a member I will try my best to put pressure on them to dump Atos. If that doesn’t work I will boycott them too. However, another worrying thing has emerged today. This morning a former Co-op bank employee told me that:

At the bank they stressed they weren’t ethical but a bank with an ethical investment policy, an entirely different proposition.

This raises whole new problems which I will investigate urgently.

What’s the difference between 1930s Germany and modern-day Britain?

Before we start I would like to point out that I am not a historian and I am not a sociologist and as such I have done my best to present the information here as I understand it. With that out of the way, I’ll start with an overview of how disabled people were treated in Germany during WWII.

1930s Germany

Nazi Euthanasia Propaganda
A poster about how expensive disabled people are.

The Aktion T4 programme ran in Germany from 1939 to 1945. In the 1920s  Alfred Hoche and Karl Binding, part of an extreme eugenics movement, advocated killing those who were judged to have “life unworthy of life.”  In the 1930s there were huge cuts to state institutions causing overcrowding and Nazi propaganda emphasised the cost of caring for mentally ill and disabled people. In 1939 parents of disabled child Gerhard Kretschmar wrote to Hitler to ask him to permit their child to be killed. Hitler agreed and immediately set up a committee whose job was to organise more such murders – Aktion T4. When the war started parents were told that their mentally ill and physically disabled children were being sent to special treatments centres. In fact they were murdered without the knowledge of the parents. The programme was soon extended to adults, starting in Poland then in Germany. Throughout the programme Hitler knew that there would be huge opposition to such killing and so he never put his orders in writing. The one exception was a secret letter written to authorise the formation of the Aktion T4 programme, mainly because his justice minister would not cooperate without one. The programme operated in secrecy until it was too late for most people. Under the programme at least 200,000 disabled people were murdered over six years, either through lethal medication, starvation or gas chambers.

Modern Britain

Now we jump forward to Britain today. The events I describe in the paragraph above are unthinkable. No government minister, no tabloid newspaper, no man in the street would advocate such things, right?

That’s not quite true though. Most of the pieces are in place. We have propaganda pushing the idea that sick and disabled people are scroungers, workshy, lazy. This propaganda is coming from government ministers, their special advisers, and tabloids like the Daily Express, The Sun, the Daily Mail. Even broadsheets like the Times and the Telegraph have contributed. Such propaganda has even been raised by MPs in the Work and Pensions Select Committee and ministers told to stop. The propaganda is working too, with hate crimes against disabled people up in vast numbers.

We have many people fighting to legalise assisted suicide, inadvertently promoting the idea that life for some people is not worth living. Sure, we’re only asking for voluntary euthanasia, but what other factors might be in play? Pressure to stop being a burden, financial problems, cuts to care all contribute to a desire for death. If euthanasia becomes legal what is to stop people from being pushed to kill themselves? It may be overt or it may be through suggestion and through making their lives hell. (This is more my fear of how it could go wrong than any judgement on my part for or against euthanasia.)

We have cuts to local authority care budgets, starting in Worcestershire, that mean anyone whose care costs more than sending them to an institution will lose some care. The politicians argue that it’s a choice because people can choose to move to a care home or to cut some of their care provision. But what to cut? Eating? Washing? Dressing? Using a toilet? We have already seen people lose in court after fighting to not have to wear a nappy. Adults are expected to soil themselves rather than get help to use a toilet. We have also seen the loss of the independent living fund. The net result is loss of care or institutionalising people. Most care homes are run by private companies and neglect does not seem uncommon. I think more abuse and neglect is likely especially when companies are cutting costs because they have underquoted better homes.

We have sick and disabled people being  judged as fit to work and told to claim job seeker’s allowance and look for work, and we have even more seriously sick and disabled people being placed in the Work Related Activity Group. Both groups are subject to The Work Programme where they are expected to undertake unpaid work experience for large companies, and government plans are to make such work placements of unlimited duration. Work makes you free.

Under these plans anyone who is seen to not be cooperating with The Work Programme and other work related activities will see their benefit income slashed. Those on Job Seeker’s Allowance can have their entire allowance removed entirely for weeks, even six months. Those on Employment Support Allowance (e.g. too sick to work) will see three quarters of their allowance removed. Of course anyone who has been judged as fit to work or has been placed in the WRAG is expected to be capable of going on work placements even if their assessment was wrong and they are waiting a year for an appeal, and even if people are seriously harmed by trying to work. The result is that those who don’t destroy themselves trying to find jobs that don’t exist or going to endless work placements will instead not be able to afford food, clothes, fuel bills, rent and more. Many will be able to use food banks but some will not be physically able to get to them and food banks rely on charity from other people who are struggling too.

The result

Is it such a large step for disabled people to be dying? No. It’s already  happening. Reports in April claimed that 1,100 people had already died after being placed in the work related activity group. That’s more than thirty people a week. This is what Chris Grayling calls “Tough love.”

Some government ministers make policy decisions without thinking about the consequences of what will happen in practice. Others are fully aware of what will happen and just don’t care. Either way, they are often covered by claiming that their policy in itself does not harm people, even though the flaws with implementation allow people to fall through the net and come to harm. Government ignore evidence. They dismiss statistics, they blame the previous government, they claim that processes are being sorted out now, they claim that any harm is the fault of the sick or disabled or unemployed individual. The Government are hiding behind Atos and A4e who are “just carrying out orders” but they way they carry out those orders makes things even worse. Government ministers have the same attitude as many other people in power – they can say “make it happen” and the minions do the dirty work.

In 1930s Germany the government themselves ordered the rounding up and the killing of disabled people. In modern-day Britain the government can claim that it is not their fault, even that it should not happen, but private companies and the chasm of bureaucracy between various government departments are what kill people. Starvation, homelessness and neglect are what will kill people. The implementation is different and the scale is different but the attitude and the outcome are the same.

 

Further Reading

Godwin’s law must die [A Latent Existence]

Action T4 [Wikipedia]

Disabled benefits claimants face £71 a week fines for breaching work plan [The Guardian]

32 die a week after failing test for new incapacity benefit [Mirror]

Early day motion 295 [Parliament]

Work-or-starve plans for seriously ill welfare claimants might backfire [Eklesia]

Past Caring? [We are Spartacus]