Third Harrington review of the Work Capability Assessment

Media-friendly Cancer

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!

 

Author: Latentexistence

The world is broken and I can't fix it because I am broken. I can, however, rant about it all and this is where I do that when I can get my thoughts together. Most of the time you'll find my words on Twitter rather than here though. I sometimes write for Where's The Benefit too.

13 thoughts on “Third Harrington review of the Work Capability Assessment”

  1. every time I read one of his reports,I feel like I don’t matter. This man is trying to hard not to offend the hand that feeds him.Also any government will just say its just teething problems, not that the game is rigged and there will only be one winner.

  2. I’m not brilliant at interpreting statistics as I glaze over, so please correct me if I’m wrong. According to the ad hoc analysis released for reasons why tribunal judges overturned ESA decisions, only 8.3% were because new documentary evidence had been produced.

    http://statistics.dwp.gov.uk/asd/asd1/adhoc_analysis/2012/sscs_appeals.pdf

    It suggests to me that decision makers generally already have all the written evidence they need, and Mark Hoban’s assertion that not enough info was being supplied with the ESA50 is simply wrong, or spin. I wouldn’t mind, but it’s hard trying to get a letter from a GP at the best of times, and you’ve only got four weeks to do this from start to finish.

    I have only read what’s been reproduced here of the Harrington report, and I’m furious. Of course representative parties who have been let down exceedlingly badly by this process are complaining! Going through the wca is life changing. It causes relentless worry and stress and financial insecurity for people who are really sick and already struggling to cope, and worse. I can’t face going through this year after year after year. I know my condition won’t suddenly be cured. There’s no magic pill here to make it all better within 12 months. What does he suggest? We shrug our shoulders and accept this mistreatment? If he’s pleased then thank goodness his opinion will no longer be called upon.

  3. This report, like many others is not easy reading and suffering from Fatigue as a result of multiple conditions, I’m aware it will probably take 4/5 readings of the report to attain a full perspective

    Having said that I agree with your review of the 3rd Harrington Report, and I also agree with the comment made earlier by Phil, regarding feeling ignored.

  4. Well what can I say, but that figures. I have gone from Fit to work, to the WRAG and am waiting to appeal that decision to. Wouldn’t it have been easier to read the 2 Medico Legal reports that both state “Mr Finch will never return to any meaningful remunerative employment and is classified as 60% disabled for life”. I end up disabled and labelled a scrounger and my ex boss (he made me redundant so he wouldn’t have to keep paying my private medical insurance) gets a slap on the wrist for breaking Health & safety and manual handling regulations and the Insurance company paid me less than 3 years wages for my disability. I thought this country respected the disabled but I was wrong!

  5. The “appropriate balance” recommendation seems to me to be advocating a loosening of targets in DWP ops – he’s saying that they currently focus on throughput rather than getting decisions right.

    It’s great that he’s saying the DWP should seek the evidence, rather than keep saying claimants should provide it, because (as I keep saying), getting evidence from your doctors *costs money*

  6. “The WCA continues to be portrayed in an extremely negative light, often fuelled by adverse media coverage,”

    Correct me if I am wrong, but didn’t Prof Harrington himself take part in the Panorama expose of the WCA and was not exactly complimentary about it himself?

    That was the same day he got the sack from carrying out the rest of his remaining reviews with the government saying they wanted a “fresh pair of eyes” to look at it.

    Harrington also says: “The Independent Reviewer has not seen or heard any compelling arguments or evidence that the whole system should be scrapped.”

    Strange. What about the BMA “DEMAND” that it should be stopped immediately. Or the LMC’s of GPs in England/Wales and seperately,Scotland LMC.

    What about Early Day Motion 295? Signed by 114 Mps. It “applauds” the BMA call to end the WCA immediately, It “welcomes the actions taken by disabled people…to end this brutality” and makes specific mention of the suicides attributed to it.
    What about the evidence from CABs etc?
    What about the survey from Rethink that shows 84% of GPs say they have patients suffering from some form of mental illness such as depression, stress or anxiety as a direct result of the WCA or that 6% of GPs say they have pateints who have attempted or committed suicide as a result of the WCA.
    Does the fact that doctors, MPs and chirtiable organisations think it should end with immediate effect not constitute any evidence he has seen that is “compelling”?.
    If so, he clearly hasn’t been looking. What an utter farce. and a BIG FAT LIE.

    1. Oh, plus Dame Anne Begg’s speech (The CHAIR of the Work and Pensions Committee) during the Parliamentary debate, which condemned both the test and the conduct of the contract with Atos, in absolute and undeniable terms.
      And the fact that a Judicial Review has been granted for the mental health descriptors for January. Plus the fact that disabled people in Britain, for God’s sake, like some third world dictatorship) have been forced to contact the UN Council for the Rights of Persons with Disabilities plus the International Criminal Court in the Hague, to beg for protection.
      How much evidence does this guy need?
      Or does the promise of a knighthood or summat make justice blind all of a sudden?

  7. My son – having suffered brain injury after a motorbike accident 15
    years ago – has now been recalled for Atos assessment for the third
    time in 3 years, 2009-12, although placed in the support group each time
    by both tribunals (three actually, one was adjourned for more
    evidence). I think they are repeating the exercise in the hope that
    eventually it will wear the judges down so that they give in (or the
    descriptors will change so that they can reject him even though his
    actual condition hasn’t changed). We are both desperate.

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