Call for evidence on Work Capability Assessment: My submission

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Tell him about it: Dr Paul Litchfield is carrying out a review of the Work Capability Assessment and needs to know how you think the system could be improved. The Coalition government would like him to think that there is no need for any change at all; if you don’t tell him exactly what you think of it, he won’t know any different.

An article on this site earlier today publicised the DWP’s call for submissions to its independent review of the Work Capability Assessment and called for anyone with experience of the process to contribute by answering the four questions at this web address:

https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

As someone with direct experience of the assessment procedure, I made my own submission shortly after writing the piece, and I am reproducing it here. I threw as much information into the submission as I could, and I would like to take this opportunity to beg everybody who has also experienced a work capability assessment to do the same. It is weight of numbers that will carry any changes to this diabolical, unfit-for-work assessment system; if you have been affected, you cannot rely on other people to get it changed for you.

Here are the questions and my responses:

1. If you have undertaken a WCA yourself or represented somebody who has, what has been your/their experience of the face-to-face assessment and follow up contact with the DWP?

Before the assessment we were not provided all the information we needed, such as details of how to arrange to have the interview recorded. I went along with a Dictaphone, expecting this to be allowed, but the Atos employees made a huge fuss about it and it was clear that they were not prepared to go ahead with the interview if we insisted on recording it. This would not have been our fault or theirs, but the fault of the DWP for failing to make the situation clear. The DWP claims to have only 31 recorders available to it, but this seems ridiculous when every work capability assessment is carried out on a laptop computer which is perfectly capable of running audio recording programmes and burning the resulting files to disc. Fears that someone might tamper with the files (hardly likely between finishing the interview and creating the disc minutes later) can be allayed with a simple time-check at the beginning and end of the recording; the length of the recording should match the time expired between the start time-check and the stop time-check. Microphones are extremely cheap – even more so if ordered wholesale – so there is no reason not to provide them in order to ensure sound clarity. The assessment itself was inadequate – not fit for purpose. The problem is that the questions have been devised in order to shoehorn ESA claimants into particular categories – therefore the assessor needs straightforward “yes” or “no” answers about conditions that are NOT straightforward, and for which such answers would be inappropriate. I attended my partner’s WCA and, with almost every question, she was trying to explain how her situation affects her. This was of no interest to the person conducting the assessment. The problem lies in the fact that the whole system was originally devised by an American insurance company – Unum – in order to find ways of refusing payouts to customers whose policies had matured. Despite the fact that this strategy led to the company being successfully prosecuted in its home country, the UK government enthusiastically hired Unum to transform the assessment of disability/incapacity benefit claimants along the same lines. The implication is always that the claimant’s illness is in his or her mind, and in fact they are perfectly capable of doing a job. There is no effort to find out the claimant’s actual medical condition – all effort is devoted to finding which category they can most easily be put into. There’s more but I’m out of space!

2. On the basis of your experiences, can you suggest any changes to improve the face-to-face part of the WCA? Please give details of why you think these changes would help.

Scrap the work capability assessment as it currently exists; it is a waste of time and money. The interview should be a genuine fact-finding exercise in which a genuine medical doctor gathers all the evidence possible about a claimant’s case, including evidence from their GP and other experts involved with it, and makes an assessment without having to conform to any requirements imposed by the government (which has its own agenda). My partner has mental health issues but there was no attempt to address them. She also has fluctuating health conditions but these were not explored either. New guidelines on these may have been brought in after her assessment but she was not contacted about them afterwards.

3. Thinking about the overall WCA process from when you make a claim for ESA to when you receive a notification of a decision from the DWP, what changes do you think are needed? Please give details of why you think these changes would help.

The ESA50 form should be scrapped and re-thought. The questions in the ‘descriptor’ section are bizarrely-worded and unfit for use as any means to judge a person’s fitness for work. For example, section 8, ‘Getting around safely’, is said to be about visual problems, but the request is “please tick this box if you can get around safely on your own”. I had to write “This is a misleading question. She can’t, but not because of sight problems”. The form provides an opportunity to mislead assessors about the issues they will face at the assessment. The decision notification must be much more detailed. Claimants need to see not only what the decision was, but why it was made. They do not currently receive a copy of the assessment/assessor’s notes, and must instead request it after receiving the decision notice, if they intend to appeal. Why? What does the DWP/Atos/the individual assessor have to hide? Making the recording of assessments mandatory and providing all the documents used to make a decision along with the decision notice itself would hugely increase transparency in the process, helping to prevent costly mistakes.

4. Please give us any further information and evidence about the effectiveness of the WCA, particularly thinking about the effect on claimants, that you consider to be helpful.

My partner was put in the work-related activity group of ESA and told she would be contacted about what she would be required to do. She had to wait FOUR MONTHS (out of a 12-month benefit period) before anybody got in touch. After an interview at the Job Centre, a work programme provider contacted her and established, within half an hour of telephone conversation, that there was nothing they could do with her. She was advised to request reassessment, which she did. That was six months ago and we have heard nothing. As her benefit period is coming to an end, she is currently undergoing reassessment anyway, but this does not excuse the DWP from its tardiness. You can see from this that the WCA, in my partner’s case, produced an inaccurate response. She is not the only one – statistics from the tribunals service show the number of appeals against WCA decisions between January and March have more than doubled, compared with the same period last year, and findings for the claimant have risen to almost half of cases (43%). The work programme has failed most WRAG members – as it failed my partner. Only 10% of them have found work, according to the DWP – around 1.7% of all ESA claimants. This conforms with the view that the rest have been misplaced and are too sick or disabled to work. Of course, the WCA has had a devastating effect on many claimants – statistics last year showed dozens were dying every week, while going through the process, while appealing, or after having been found ‘fit for work’. The DWP is refusing to release current figures, which implies that they have not improved. This proves that the system does not work and should be scrapped. The fact that claimants have DIED while going through this process, and ministers have done nothing about it, implies corporate manslaughter and I would certainly recommend that criminal investigations take place on this basis. Hopefully others will provide details of some of the deceased; otherwise I should be able to provide contact details.

That was my submission.

The web page is at https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

Over to you.

Work Capability Assessment: Time to make your experience count

Tags

activity, annual, appeal, Atos, benefit, benefits, Coalition, Conservative, Department for Work and Pensions, descriptor, disability, disabled, doctor, Dr, DWP, Employment and Support Allowance, ESA, ESA50, fluctuating, form, fourth, government, Group, health, Iain Duncan Smith, Incapacity Benefit, Independent, interview, Job Centre Plus, Liberal, Liberal Democrat, Malcolm Harrington, mark hoban, mental, Mike Sivier, mikesivier, Paul Litchfield, people, politics, poll, Prof, Professor, provider, re-assessment, record, recording, review, sick, social security, Tories, Tory, tribunal, unum, voodoo, Vox Political, WCA, welfare, work capability assessment, Work Programme, work-related

What we’re fighting: Not only are work capability assessments leading to many deaths every week (we don’t know how many because the DWP won’t release the numbers), but administrative idiocy has led to at least one of the deceased being harassed AFTER DEATH, for failing to attend an interview. And Mark Hoban says no significant reforms are required. Dream on…

The Coalition government is launching a call for evidence to help with its fourth annual independent review into the Work Capability Assessment process – and I, for one, will be delighted to be part of it.

The review will be carried out by Dr Paul Litchfield, a senior occupational physician replacing Professor Malcolm Harrington, who ran the review process for the previous three years.

According to the Department for Work and Pensions’ press release, it “will continue the process of monitoring whether the assessment is effective in identifying people who could be helped back to work, while ensuring financial support goes to those who are too sick or disabled to seek employment”.

We all know that the WCA is a total failure in those terms. Recent Work Programme and appeal tribunal statistics are unequivocal in making that clear.

Now – if you have had the same experience of the assessment process as I, and Mrs Mike, have – it is time for you to have your say.

If you are an individual or a member of an organisation with information on how the Work Capability Assessment is operating and further changes that may be needed to improve the process, then you can submit it using the online form on this web page:

https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

It also includes links to more information about the reviews, large print and Easy Read documents. Audio and BSL versions “will be made available on this page shortly”.

The DWP press release has a lot to say about how well they have performed in changing the system so far. It is worth quoting here, just to show you the importance of the need to challenge this attitude. It states:

“In launching the call for evidence, Dr Litchfield will be considering both how the suggested improvements from previous reviews are working, and what further refinements can be made. Dr Litchfield is particularly interested in hearing how the WCA works for people with mental health conditions.

“Dr Paul Litchfield said: ‘This fourth review is an appropriate time to review the impact of the changes that have been made to the WCA in recent years, including those recommended by my predecessor Professor Malcolm Harrington. I will also be considering if more can be done to ensure that the assessment process is both effective and perceived as being objective by all stakeholders.

“‘I am keen to hear from people who have constructive and evidence-based ideas for improvement. The WCA touches many lives and it is in the interest of all of us to try and make it as good as we can.’

“Employment Minister Mark Hoban said: ‘Helping people who can work into a job, while giving financial support to people who need it, is one of my top priorities. That is why it is so important that the Work Capability Assessment is as effective as possible.

“‘Following the previous independent reviews we have already made considerable improvements to the assessment process, so this new review is a great opportunity to build on that progress.’

“This is the fourth in a series of 5 annual independent reviews into the Work Capability Assessment. The previous reviewer, Professor Harrington, made a number of recommendations, and in his third review found that – as improvements were starting to have an impact – no fundamental reforms were needed to the current WCA. Over 40 recommendations have been, or are being, implemented including:

• Better communication with claimants, including phone calls from decision-makers to ensure all medical evidence has been provided
• Introducing 60 mental health champions into assessment centres to provide advice to Atos healthcare professionals
• Working with charities to test out new descriptors covering mental function and fluctuating conditions
• Simplifying the process for people undergoing treatment for cancer – reducing the need for face-to-face assessments and ensuring more are placed in the Support Group.”

If “no fundamental reforms are needed”, then why is the DWP refusing to provide details of the number of people who are dying while going through the assessment process, appealing against its decision, or after having been thrown off-benefit? Clearly it seems to have something to hide and until we find out what that is, such claims should be considered to be wild fantasies with no basis in reality.

You’ll notice the possibility of having the Work Capability Assessment recorded is not mentioned, even though there was a debate within the last month. Does Hoban really think our memories are so short?

A submission from myself and Mrs Mike would include information on the run-up to the assessment, including the fact that we were not told we had to announce in advance our desire to have the interview recorded. When I arrived, dictaphone in hand, the Atos employees kicked up a fuss about it that could have stopped the interview taking place at all. That would not have been our fault but theirs, for failing to make the situation clear. We would also point out that claims by the DWP to have only 31 recorders are in error, as the tick-box assessment they use is carried out on laptop computers that can easily – and probably do – carry recording and CD-burning software. It would be simplicity itself to provide simple microphones for both assessor and assessee to use, to make questions and responses clear, and concerns over tampering with recordings may be addressed by a time-check at the start and finish.

I would raise issue with the ESA50 form, that includes ‘descriptors’ that are said to be intended to help describe a claimant’s condition. In fact they do no such thing. They are there to help Atos assessors fit you into the categories laid out by Unum when it originally devised the process as a way to avoid making payments to customers whose insurance policies had matured. It would be far better to allow claimants to describe their symptoms and provide medical evidence from their doctors; the fact that this would require the DWP staff reviewing the forms to use their brains in consideration of the individual situation, rather than slavishly follow instructions that try to shoehorn people into pre-defined groups, is of no concern to the claimant.

I would raise issue with the Work Capability Assessment itself, which also attempts to bypass explanations of the issues in order to shoehorn claimants into providing “yes” or “no” answers to its questions. We have seen from the Conservative Party’s own ‘voodoo’ polling that, if a question is framed in a particular way, the questioner will get the answer they want, and this would not necessarily be productive.

Mrs Mike has mental health issues. There was no concession to those issues during her assessment and I do not recall them being explored at all.

Mrs Mike has fluctuating health conditions. There was no inquiry into how those changes affect her daily life.

Changes for both of the above may have been brought in after the assessment, but they are still relevant to my partner. However, no attempt has been made to contact her or explore her situation in the light of these developments. That is a grave omission.

She was put in the work-related activity group and asked to visit her local Job Centre Plus for interviews. After doing so, and being passed on to a Work Programme Provider, it took just one half-hour telephone conversation to establish that this organisation could do nothing for her, and she was advised to seek re-assessment. This was six months into her one-year period on ESA (remember, those in the work-related activity group get benefit for one year only). Nobody had contacted her during the first four months she was on the benefit.

Mrs Mike did ask for reassessment but nothing was done about it. She is, in fact, going through the assessment process again, but this is because a year has passed since her initial assessment and it is therefore time for her to go through the whole torturous process again. The form went off in mid-May and we have yet to hear back from the DWP.

From our point of view, the whole situation has been a farce.

If you have been through the process, how did you find it?

https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

Don’t just tell us – tell the independent assessor.