What’s wrong with ATOS

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Cross posted at Disabled People Against Cuts

In two weeks I have to undergo a Work Capability Assessment which will determine whether or not I will continue to receive Employment and Support Allowance while I am ill. I will be placed into one of two groups: the Support Group, who are judged sick enough to be left alone to receive ESA, or the Work Related Activity Group, who are thought able to attend several Work Focused Interviews and eventually to be able to work if pushed enough. If by some miracle I am suddenly cured, I could be declared fit to work and moved on to Job Seekers Allowance and classed as unemployed.

That all sounds OK, you might think. It sounds reasonable, we have to make sure that sick and disabled people receive support, and the the work shy are sent back to work. But there’s a problem. It isn’t my GP that will carrying out this assessment. Nor is it any hospital specialist. It’s not even the Department of Work and Pensions that will carry out this test, even though they requested it. No, instead of any of these, it is a French IT company called ATOS that will decide if I am fit to work or not. Specifically, a division of ATOS called ATOS Healthcare that has been contracted by the DWP to carry out these assessments and provide “medical advice” at a cost of £100 million a year. “That’s absurd!” you may say. What does an IT company know about health? Well, that doesn’t matter, according to ATOS. They have developed a computer system called LiMA that records the patients answers given in an interview, and makes the decision based on points. It’s all very straightforward. What could possibly go wrong?

Well obviously something has, because ATOS is the subject of strong protest. On twitter and on blogs anger against ATOS has been obvious, cropping up again and again. In the physical world campaigners have held extensive protests outside ATOS buildings, with signs and slogans like “ATOS kills” and “ATOS don’t give a toss.” ATOS recruitment fares have been targetted too. When sick and disabled people are scared and angry enough to picket a company, wheelchairs and crutches and all, there might just be something wrong. A commons select committee has been investigating the Migration from Incapacity Benefits to Employment Support Allowance, and while questioning senior executives from ATOS healthcare MP Stephen Lloyd said that Atos was “feared and loathed probably in equal terms” by the families and friends of disabled people. Lisa Coleman, a senior manager at ATOS, said that “fear and misunderstanding” could be blamed on claimants “not really understanding the role that Atos plays”.

So what is the problem with ATOS? Well, for a start, the computer can only work with what it is told. And what it is told is keywords. The examiner asks questions about things such as walking, reaching, communicating and controlling the bowels. The answers don’t really matter much, because the examiner stares fixedly at the computer screen and picks keywords and numbers from a list as they are mentioned and the computer assembles them into a sentence and fills in the gaps. This has often resulted in some absurd and misleading statements. Some genuine examples include “usually can do light gardening for 1 minutes” and “The client’s Amputation of Upper Limb is mild. They have seen a specialist for this problem.” Another claimant stated that she pottered about all day; it was recorded as “Customer does pottery all day.” After the questioning is complete there is usually a very short physical examination. The claimant may poked and prodded and instructed to stand up, raise their arms, pick something up, or make other movements. It is all very rushed and does not leave time or scope for much useful data to be gathered. In addition the examiner records observations about the patients ability to walk and talk while at the assessment.

This assessment is flawed for several reasons. Firstly, the data gathering process is inaccurate and rushed. Staff carrying out the assessment have strict targets and are expected to get through five assessments in a morning or afternoon session, which allows about 45 minutes per assessment at most. People that have been through the process complain that the examiner spent their time looking at the computer rather than paying attention to them.

Once the examination is over the examiner produces a report that may bear little resemblance to the patient’s actual condition. The reports often fail to take into account the variable nature of many illnesses. What the patient can do on one day is by no means representative of what they can do the next, and for someone who is chronically sick or disabled, each task in itself may be achievable but exhaustion and pain can often prevent repetition or moving on to the next task.

An ATOS examiner might note that a person can sit at a computer, walk to the shops, cook a meal, and wash themselves. What they fail to note is that it might well only be possible to do one of those things on any given day! Being fit to work in an office, for example, involves a series of tasks – washing, dressing, commuting, sitting, talking, thinking, typing, holding the telephone, holding a pen, making decisions, defending those decisions, and much more. I could do any of those things, sometimes, maybe, but I could not do them all together, and I certainly could not make any guarantees about when I could do them or how long it would take, or even guarantee to do them at all. ATOS cares not. If you say that you can ever manage a task, it is assumed that you can do all of the tasks all of the time. They may well assume that because I could write and record this article, I could write for a living. They don’t see that it took me several days to write including many hours of frustration as my body left me in too much pain or fatigue to think or type.

Another flaw is that the ATOS assessment process can often be harmful in itself. For example, I could usually raise my arm above my head when asked. It would result in pain and fatigue which the examiner would not see. It would also be harder to do a second time, and after a few goes I would be unable to do it at all. The ATOS examiner would simply note that I could manage it the first time and would take no account of whether or not I could do it again or what price I paid for doing it.

More problems occur because at least a fifth of ATOS medical centres are not wheelchair accessible. Only one third of the centres have onsite parking, while visitors are required to walk from car parks several minutes away for other centres, and just one has a parking space for disabled people. 30 of the centres are not on the ground floor some don’t even have lifts! Considering that people only visit these buildings when they are sick or disabled and a huge number of them will be using walking sticks or wheelchairs, this is ridiculous.

For many people, just getting to the ATOS medical examination centre can be a major challenge. In a letter sent out to notify me of my impending assessment I was helpfully sent a suggested journey plan. It included bus, train and 17 minutes of walking. I do understand that the journey plan is a standard item sent out to all claimants, and this is why they have suggested that I walk despite them being fully aware that I cannot stay on my feet for more than a couple of minutes.  But I can’t be the only one that would have trouble with that journey. In fact, I would suggest that a majority of  people that claim ESA would find it difficult. Whether that be through inability to stand or walk, or pain, or fatigue, or because of a lack of accessible buses, or through mental health problems that get worse when around other people or attempting a task such as travelling. The problem is that many people will attempt and complete the journey at great cost to their own health, purely because they feel that they have to. Again, ATOS would merely note that the journey had been completed, and not what it cost in terms of pain, fatigue and recovery time.

It is not just the people subject to the tests that are unhappy with the situation. As I mentioned above, a commons select committee has been investigating the Migration from Incapacity Benefits to Employment Support Allowance.  In February, Dr Margaret McCartney attended a recruitment evening with ATOS Healthcare and reported back in the British Medical Journal. She noted that apart from doctors, ATOS also recruit nurses and physiotherapists for the same role, and that patients often would not be examined by anyone with knowledge of their health conditions. She reported that ATOS said “You are not in a typical caring role. This isn’t about diagnosing.” and “We don’t call them patients . . . We call them claimants.”  She said that “Throughput is a clear focus” and that “from the recruitment evening it was clear that the medical examination consisted of a computerised form to be filled in by choosing drop down statements and justifying them. For example, you could say “able to walk with ease” if you witnessed this or the patient told you this.” Even Professor Paul Gregg, who was involved in designing the test has said “The test is badly malfunctioning. The current assessment is a complete mess.

Since ATOS have taken over the assessments for ESA, both ESA and the contract with ATOS originating from our last government, by the way, the number of people being judged fit for work has risen substantially but high numbers of those go on to appeal with a 40% success rate at overturning the decision. That rises to 70% of cases overturned when representation is provided. This has caused alarm to a great many people with groups such as Citizens Advice Scotland reporting “Our evidence has highlighted the cases of many clients with serious health conditions who have been found fit for work, including those with Parkinson’s disease, multiple sclerosis, terminal cancer, bipolar disorder, heart failure, strokes, severe depression, and agoraphobia.” In fact there have been several recent cases where people have died soon after being judged fit for work and while waiting for their appeal. In one case the patient died IN the ATOS building after his assessment. On the day of the funeral his family received a letter notifying them that he had been declared fit for work.

Clearly, the Work Capability Assessment needs a rethink. Actually, the whole system by which benefits are controlled needs a rethink. Government insist that GPs can be trusted to take over administration and budgeting of the NHS from Primary Care Trusts, and yet they do not trust GPs and specialists to say whether or not their patient is capable of work or needs to rest at home.  The current arrangement for ATOS to assess patients does not and cannot provide for accurate assessment and proper care.

 

Related Links

Margret McCartney reports for the BMJ: Well enough to work?

The Guardian: New disability test ‘is a complete mess’, says expert

ESA and how the Lima computer system says “NO”

The Guardian: ‘The medical was an absolute joke’

MP asks Atos bosses why their company is ‘feared and loathed’

Disability activists demonstrate against Atos Origin – London

3 more assessed “fit for work” by ATOS die

BBC Ouch: ATOS assessment centres not accessible

Commons Select Committee: Migration from Incapacity Benefits to Employment Support Allowance

Disabled People Against Cuts: Atos don’t give a toss!

DPAC – Debbie Jolly: The Billion Pound Welfare Reform Fraud: fit for work?

 PCS – Welfare: an alternative vision [PDF]

 

 

 

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.

20 thoughts on “What’s wrong with ATOS”

  1. Good piece! Though I’d say the real prob is the descriptors & Atos conveniently taking flak so less blame real culprit, DWP

  2. I agree that it is the DWP who have a huge part in the area of blame but Atos is also responsible for a major part of the heartache caused.

    If the Atos HCPs did their job in an honest and transparent way, and that there were truly independent checks on what they were doing, the size of the problem would be much smaller.

     http://atosregisterofshame.yolasite.com/

  3. I actually have my own ATOS assessment this afternoon and I am confident that I will fail it. My disability is NEAD (non epileptic attack disorder) which means when I get upset/stressed/uneasy I go into seizures ranging from zoning out to full blown fits – it took SEVEN YEARS for my own doctor to diagnose me and realize I had a mental disability, how the hell will I manage with a stranger staring at a computer screen asking me if I can do the washing up? Yes I can but if I DO have a seizure I could cut my hand open with a knife/drop glasses/get scalded by hot water and will have to stay sat down during the entire thing in case I do have a fit and fall on the tiled floor. If I tell them this they will just note “Can do washing up”.

    I really do worry about this government D:

  4. Another good piece; I just wish we could get a wider audience for this sort of quality writing. Feels like the vast majority of people that read these sort of things are already in agreement. We need a wider audience. No idea how to get it. Vast majority of the media seem against us. When I say ‘us’, I mean of course those with long term illnesses and disabilities.

  5. I have been at the hands of ATOS for some time now.  I had my appeal to be placed in the Support Group last Friday. I was unsuccessful.  I am now trying to go to a Tier 2 tribunal. Wondering why I think/know I should be in the Support Group?  Here’s a list of my medical conditions;

    Diabetes (40 Years)
    Diabetic Autonomic Neuropathy (Gastric, causing unpredictable and severe bouts of vomiting and diarrhoea)
    Diabetic Retinopathy
    Partially-Sighted (Loss of peripheral vision in both eyes and some central vision in left eye)
    Chronic Kidney Disease- Egfr – 16 (Being placed on list for Kidney/Pancreas Transplant)
    Vitamin B12 Deficiency
    Anaemia (Currently undergoing Iron Infusion Treatment)
    Increased Heartbeat (Due to Autonomic Neuropathy)
    High Blood Pressure
    High Cholesterol
    Underactive thyroid
    Chronic tiredness due to combination of multiple medical conditions
    All this and being turned away from the Jobcentre when I had an initial Pathways to Work interview, being told by the assessor.  “You are too ill to work, there is nothing we can do for you.  You should not have even been called in. I am sorry, you need to go home” and my ATOS assessor telling me “You should be in the Support Group, if the decision from this medical doesn’t come back as this, appeal it, and you will win”, I did this and it made no difference, I still lost. 

    The appeal was a harrowing and difficult situation with a doctor that seemed to ask innappropriate and irrelevant questions to why I was appealing.  And was in essence, a bit of a git.  I am now finding myself increasingly stressed and pressured by the situation I am now in.

    I wish all people who are going through these things the best of luck. But, be prepared to battle, and battle hard for what you know is rightfully yours.

  6. In my view the whole point of the ATOS testing is that it facilitates the transfer of hundreds of millions of pounds from the public purse to the private sector where it may be divvied up by the crooked businessmen and corrupt politicians (of all parties) involved. That’s all it is, just a scam. The tests have no medical merit and no practical application other than that above. The people being declared fit to work are in reality unemployable. The testing ignores any difficulty they are likely to have in actually getting to and from any place of work and they as they can’t take care of themselves someone would in many cases have to be employed to take them to the toilet and feed them as necessary. The fact is that by any reasonable assessment these people are unemployable and so clearly entitled to the financial support the government is taking way from them. The whole scheme is a get-rich-quick scam, nothing more. In my view, Chris Grayling should be answering questions about this in the dock, not in the media.

    BB

  7. Anyone who attends a assessment by Atos please get the name of the person doing your assessment and If possible what qualifications they hold (GP,NURSE,OT,Physiotherapist) etc, I’m trying to build a register up of names.

    I’m hoping that when it’s published and passed about those Atos HCPs will realise they cannot hide in the shadows anymore.
    Please use my website to contact me.

     http://atosregisterofshame.yol …

  8. Firstly, congratulations on such a well written article and for the stamina it must have required to complete it. I know we have to weed out the work shy and just downright lazy people who claim benefits for an easy life – but why, oh why, do they have to therefore make it so difficult, traumatic and almost impossible for those of us with genuine conditions!
    I feel it is the policy makers – whoever they may be – who are at fault here. I almost (I said almost) admire the consultants such as ATOS who can make a healthy (no pun intended) income from effectively mechanising such an intangible process.
    Luckily I seem to have bypassed this daunting process myself – but would be terrified if I had to go through it, and feel I would undoubtedly fail. I can do all the actions and pass all the criteria mentioned here – except probably actually manage to attend the assessment in the first place!
    I applaud your passion and stance on this subject, and thank you for bringing it to a wider audience – sadly though I am afraid that those who are lucky enough not be in our position will not begin to comprehend. However I will do my bit and spread the word… x 

  9. My husband attained 9 points for not waling, and 9 points for standing, atos person took no notice of the other illnesses that he had, all atos did was look at his computer.  Job centre sent my husband home in his electric chair, I am disgusted.  DWP still have compasssion for the disabled but atos are money making machines.

  10. I’m so glad I found this article.  It is some comfort to know someone feels like me (I have ME). we are made to feel like frauds.  The system is so unfair. The money to live is important but so is being believed. Our government doesn’t care about us. We are only pawns in a bigger game.

  11. The fish stinks from the head down! Its pretty obvious what both the previous and the present government want to do, they want to totally get rid of the benefits system by making out that all claimants are false. A lot of non claimants go along with this because they hope they’ll pay less taxes. I suspect there’s a well thumbed copy of “Mein Kampf” sitting in the bedside cabinet of number 10!

  12. I have been informed that I must attend an Assessment Centre.  However, the nearest one is only accessible by taking three modes of transport from my house.  The only way I can get there is to take a taxi to get me to train stations at both ends, but this means that I will have to pay for this and the train fare.  One of my main problems is anxiety regarding travel and an inability to find new places without difficulty.  This makes the whole thing a farce!

  13. A very well written article. I think you should perhaps consider submitting it, or something very similar, to the Nursing Times as the BMJ readership has already been given a “heads up”. They (ATOS) appear to be currently recruiting via a company called SJB Medical these days. I’m not sure how closely SJB and ATOS are related or exactly why they decided to make the switch. I think that eventuallythey are going to exhaust the pool of suitable nurses who are prepared to work for them. Judging by how frequently they seem to be recruiting I think they may have some staff retention issues. Once again – good article.

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