Educating Dr Litchfield – a few facts about the Work Capability Assessment

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allowance, benefit, benefits, committee, death, die, disability, disabled, Dr, employment, ESA, fatality, health, House of Commons, Incapacity Benefit, letter, Malcolm Harrington, Mike Sivier, mikesivier, Mo Stewart, Paul Litchfield, Pensions, people, politics, Prof, sick, social security, support, unum, Vox Political, WCA, welfare, work, work capability assessment

Dr Paul Litchfield.

Ignorance is most definitely not bliss for Dr Paul Litchfield.

The man was hand-picked by the Coalition government to review its hated Work Capability Assessment system of handling Employment and Support Allowance claims, amid rumours that previous incumbent Professor Malcolm Harrington had been unhappy with political decisions that ran against his findings. But he delivered a woeful performance to the House of Commons’ Work and Pensions committee last month.

He claimed to have no information about the staggering number of people who have died after going through the assessment system he is being paid to review, totalling 10,600 between January and November 2011 – that’s 220 per week or three every four hours. “I don’t have any information of that type; I haven’t seen numbers on that. Clearly every case would be a tragedy,” he said.

Clearly this expert has yet to gain access to some very important information!

Fortunately, help is at hand.

In advance of the fifth and final review of the WCA, lead researcher and disabled veteran Mo Stewart has written to offer him the benefit of four years’ detailed research evidence.

“The lacklustre 4th review of the WCA left a great deal to be desired,” she told Vox Political. “Now, with the news that Litchfield worked with Unum Insurance on the Technical and Consultative Working Group involved with the creation of the WCA, it can’t be too much of a surprise that Litchfield claims that the WCA had been designed ‘…with considerable rigour’.”

Mo Stewart’s lengthy letter to Litchfield has been distributed to a long list of distinguished experts and professionals, and it will be interesting to see if Dr Litchfield takes the time to respond and to react to the detailed research evidence Mo exposed – evidence that has been frequently quoted during welfare debates in the House of Lords and the House of Commons over the past three years.

You can read her letter for yourself, because Mo has sent Vox Political a copy. Just click on the link here.

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Tories and scandal (go together like a horse and carriage)

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abortion, bad, Behaviour, black book, blackmail, blue folder, Cecil Parkinson, Conservative, crime, date rape, David Mellor, drink, drug, Earl of Caithness, FOI, Freedom of Information, gay sex party, House of Commons, indiscretion, Mike Sivier, mikesivier, persuade, pregnant, scandal, seduce, seduction, sleaze, Sunday Mirror, Tim Yeo, Tories, Tory, Vox Political

Scene of the – er – indiscretions: The Light ApartHotel in Manchester. [Image: Sunday Mirror.]

The Party of Sleaze shoots itself in the foot yet again.

It seems the Conservative Party has been keeping documentary evidence of Tory MPs’ indiscretions, crimes and bad behaviour in a “black book” (actually a blue folder), but this has now been destroyed for fear that the Party might be forced to reveal its contents under the Freedom of Information Act.

The information in the “book”, which was destroyed a little more than four years ago as the Tories prepared for the 2010 general election, was used by party whips – its official title was “Whips’ Notes” – if they needed to persuade a colleague to support legislation they opposed, or a minister under fire.

Sources within the Conservative Party say this persuasion did not go as far as blackmail – although you are perfectly entitled to form your own opinion about this, dear reader.

The book’s existence was revealed by the Sunday Mirror, which also carried details of several more ‘sleaze’ scandals, including allegations that:

• Taxpayers indirectly funded a £2,500 suite in the Light ApartHotel, used for a gay sex party during the Conservative Party’s 2011 conference in Manchester.
• Senior Conservatives regularly tried to seduce male parliamentary workers after getting drunk at the House of Commons.
• MPs and peers used ‘date rape’ drugs on junior activists, and paid for abortions after getting their staff pregnant.

The claims are eerily reminiscent of sleaze scandals from the Conservative Parliaments of 1979-1997, in which Cecil Parkinson was forced to resign after impregnating his secretary; David Mellor’s extra-curricular sporting activities with Antonia de Sancha; and sex scandals involving Tim Yeo and the Earl of Caithness.

The headline of this article is based on a song and is intended to evoke comparisons between ‘love and marriage’ and ‘Tories and scandal’.

To close, let’s remember another well-known saying and conclude that if a leopard cannot change its spots, neither can a Tory resist sleaze.

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Mr ‘Political’ goes to Westminster, looking for justice

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assessment, Backbench Business, benefit, benefits, Coalition, committee, Conservative, cumulative, Democrat, Department, Department for Work and Pensions, disability, disabled, DWP, Employment and Support Allowance, ESA, evidence, government, Grahame Morris, health, House of Commons, Iain Duncan Smith, John McDonnell, joseph rowntree foundation, Labour, Liberal, Liberal Democrat, Mike Sivier, mikesivier, Monitoring Poverty, Mr Smith Goes To Washington, Parliament, Pensions, people, politics, Reform, sick, Social Exclusion, social security, statistic, Tories, Tory, unemployment, Vox Political, WCA, welfare, work, work capability, work capability assessment, wow petition

“I’m not licked. And I’m gonna stay right here and fight for this lost cause. Even if this room gets filled with lies.” – James Stewart as Jefferson Smith in Mr Smith Goes To Washington

Congratulations are due to Labour MPs John McDonnell and Grahame Morris, who have persuaded Parliament’s Backbench Business Committee to agree that a debate on the ‘WoW’ petition will take place in the House of Commons, early in the New Year.

Responsibility now falls back on the British people to make sure our elected representatives do not squander the opportunity, as the Commons Work and Pensions Committee squandered its chance to hold Iain Duncan Smith to account for his own, and his department’s, statisticial inaccuracies.

The petition, on the government’s website, passed its target of 100,000 signatures at the beginning of the month, meaning the Backbench Business committee had to consider whether a Commons debate should take place.

Those who oppose it will be trying to find any reason – no matter how small – to avoid having to consider the changes it demands, so its supporters need to go through it, line by line, making sure they can justify every claim and every demand with hard facts.

We cannot rely on our MPs to do this. Even those who are sympathetic may not have the time or the resources to research the issues properly; and we have seen from the woeful Work and Pensions meeting on Monday that it is best not to leave Parliamentarians to phrase their own questions.

To use an angling metaphor – which seems appropriate – we must allow no opportunity for these worms to wriggle off the hook.

So, for example, the petition demands “a Cumulative Impact Assessment of Welfare Reform”. The government has denied that this is possible, saying it would be too complicated to carry out and that “external organisations have not produced this either”.

But the Joseph Rowntree Foundation’s report, Monitoring Poverty and Social Exclusion 2013, states: “There is a … growing number of people … in very deep poverty. They are being hit by … overlapping measures from welfare reform”. We can expect some Conservative MPs to demur over the differences between “cumulative” and “overlapping” (probably down to their respective spellings) but it seems clear that the Foundation not only has the evidence needed to provide a cumulative assessment, but has already carried it out.

It should also be noted that the Foundation has said the effects of this year’s changes cannot be quantified yet, and we must wait until next year to learn what further damage may have been caused; this is just the beginning.

The petition also calls for “a New Deal for sick and disabled people based on their needs, abilities and ambitions” – meaning evidence would need to be available to show that the Coalition system does not adequately cater for those needs, abilities and ambitions.

It demands an immediate end to the work capability assessment, and strong evidence will be required to show that this is necessary. Individual cases are fine on an anecdotal level – for example the single-question medical assessment (“Did you get here by bus?”) that led to the refusal of benefit for the poor lady from Kingswood who then took her own life; it seems clear that there was no attempt to understand the state of her mental health.

But these stories must be supported by the weight of numbers. We know that 3,500 people in the work-related activity group of ESA claimants died between January and November 2011. How many ESA claimants have died since then, and how many of them were in the group where they were expected to be working again within a year? We don’t know, because the statistics have been suppressed. Why have they been withheld? Is it because the number of deaths has risen to an even more horrifying level?

If the government wants to deny that this is the case, then it must provide proof. The Coalition has had more than a year to produce these figures; if it is unable – or unwilling – to do so then they must be damning indeed.

This article’s headline is based on the title of the film Mr Smith Goes To Washington (the ‘Political’ refers to the fact that some commenters, here and on Facebook, refer to me as if ‘Vox Political’ was my real name). It is a statement of my intent to go to London and watch the ‘WoW’ debate in person, just as Jefferson Smith attends the US Senate to seek justice in the film.

Of course I won’t be able to speak in the debate. If I could, though, I might pick a few words from that old movie, because they are just as relevant today:

“Take a look at this country if you really want to see something. You’ll see the whole parade of what Man’s carved out for himself, after centuries of fighting. Fighting for something better than just jungle law, fighting so’s he can stand on his own two feet, free and decent, like he was created, no matter what his race, colour, or creed. That’s what you’d see. There’s no place out there for graft, or greed, or lies, or compromise with human liberties.

“Great principles don’t get lost once they come to light. They’re right here; you just have to see them again! I wouldn’t give you two cents for all your fancy rules if, behind them, they didn’t have a little bit of plain, ordinary, everyday kindness and a little looking out for the other fella, too.”

Or how about this one? “I guess this is just another lost cause. All you people don’t know about lost causes. They were the only causes worth fighting for – for the only reason any man ever fights for them. Because of just one plain simple rule. Love thy neighbour. And in this world today of great hatred a man who knows that rule has a great trust. And you know that you fight harder for the lost causes than for any others. Yes you’d even die for them.”

People have died for this cause.

Those of us who remain have a duty not to lose it.

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Are landlord councillors resorting to illegal antics to enforce Bedroom Tax evictions?

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bedroom tax, benefit, benefits, block, Brecon, corrupt, council, county, dispensation, financial, general, House of Commons, housing, housing benefit, human right, Interest, Labour, landlord, Landlord Subsidy, library, Mike Sivier, mikesivier, motion, no eviction, particular, pecuniary, people, politics, Powys, Radnorshire, Raquel Rolnik, Shires Independent Group, social security, special, special rapporteur, Standards Committee, un, united nations, Vox Political, welfare

Taking no notice: Councillors appear to be breaking the law in order to enforce Bedroom Tax evictions. [Picture: The Guardian}

It seems the ruling group of Powys County Council, here in Mid Wales, has challenged the law in its attempts to block a ‘no-eviction’ motion on the Bedroom Tax.

The Labour motion was put forward at a meeting of the full council on October 24. It called on councillors to note the comments of Raquel Rolnik, the UN’s Special Rapporteur on Housing, who said that the Bedroom Tax policy could constitute a violation of the human right to adequate housing, and asked them to pledge that Powys will not evict tenants who fail to pay their rent because of it.

Councillors who are also private landlords were forbidden from speaking or voting on the motion. They have a financial (or pecuniary) interest in the matter as they stand to benefit if social housing tenants are forced to seek accommodation with them as a result of the policy. This meant around 30 councillors had to leave the chamber.

It seems that members of the ruling Shires Independent Group, realising that there was a real possibility that the motion would be carried, then called for any members who are themselves social housing tenants – or have friends or family who are social housing tenants – should also be barred from taking part.

This made it impossible to continue the debate. The matter has been passed to the council’s Standards Committee, whose members have been asked to judge whether landlord councillors should receive special dispensation in order to debate the motion.

It seems that this decision is wrong in law.

According to Essential Local Government, a journalistic textbook from the Vox Political vaults, “In some cases, the Secretary of State for the Environment or Secretary of State for Wales can issue either a general or particular dispensation entitling members with declared interests to take part in debates and to vote. An example of this is that councillors who are council tenants may take part in debates on, and vote on, matters relating to council housing.”

That book was published in 1993 but there is no reason to expect such a general dispensation to have been removed and therefore it seems that any call for councillors who are tenants – or who know tenants – not to be able to take part in a debate can have no basis in law.

The motion should have been debated by councillor-tenants and members with no interest, and a decision made on the day, nearly a month ago. The delay means social housing tenants in Powys (and VP knows of 686 affected households in the Brecon and Radnorshire constituency alone) may have been subjected to an unnecessary month of evictions or threats of eviction.

It has been suggested that the decision to block the motion may have been prompted by figures from the House of Commons library which suggest that as a result of the Bedroom Tax the amount of Housing Benefit paid to private landlords (remember, HB is a landlord subsidy and does not enrich tenants at all) will rise from £7.9 billion to £9.4 billion.

If the Standards Committee decides to allow them to debate the motion, it is likely that the decision will therefore be corrupt.

The matter went unreported by the local press because none of the newspapers had sent any reporters to cover the meeting.

How many other councils, across the UK, have voted on ‘no evictions’ motions under a false understanding of who can take part? VP knows that Bristol City Council has debated the matter with a controversial result.

Meanwhile, for tenants up and down the country, the agony goes on.

ESA audio recordings: Did Hoban answer and does it matter either way?

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adjournment debate, advance, Atos, audio, benefit, benefits, Coalition, committee, comprehensive, Conservative, Daily Telegraph, David Cameron, Democrat, Department, Department for Work and Pensions, disability, disabled, distort, DWP, Employment and Support Allowance, ESA, evidence, fact, falsehood, government, health, House of Commons, Iain Duncan Smith, information, Labour, liar, Liberal, lie, mark hoban, Mike Sivier, mikesivier, minister, notice, Parliament, people, politics, question, recording, Sheila Gilmore, sick, skew, social security, Tories, Tory, unemployment, Vox Political, WCA, welfare, work, work capability assessment

Audio anywhere: This image proves that Atos assessors can use their own laptop computers to create audio recordings of work capability assessments. They can then use onboard software to burn a CD of the interview and hand it to claimants on the spot. What’s the problem?

He did – and some of the responses were actually encouraging. Most were questionable – meaning, it seems, the government will continuing trying to obstruct attempts to make the assessment process more open.

Those of you who read yesterday’s article will know that the adjournment debate in the House of Commons yesterday was about the audio recording of work capability assessments, which are made as part of the claim process for Employment and Support Allowance.

The government has claimed that, when the service was offered in a pilot scheme, too few people requested it, and only one per cent of them wanted a copy of the recording that was made – but Sheila Gilmore MP, in her speech, pointed out that Atos, the company running the hated assessments, said enough requests had been made to make it desirable. She also pointed out that the procedure for getting a personal copy of the recording was extremely bureaucratic and off-putting.

She asked five questions about the issue and, in an unusual but welcome move, ensured that employment minister Mark Hoban had advance notice of them, thereby offering him no excuse for failure to answer.

In the main, he did. But… well, you’ll see.

Hoban prefaced his responses by affirming that the DWP considers the issue to be important, something that “we must get it right. It accords firmly with our commitment to improving the WCA process continuously”.

But he said: “While we accept that there has been an increase in demand for its use, we must be sure that we understand the evidence base, including that relating to the value to claimants… The evidence needs to be balanced against potential costs, and that is the process in which my officials are currently engaged.”

We’ll go into those extra costs in a moment, but the comment begs an obvious question: Wouldn’t the extra cost be offset by the savings made by having fewer ESA appeal tribunals?

Later he confirmed that a claimant has no legal right to an audio-recorded assessment, and neither the DWP nor Atos Healthcare has a legal obligation to provide an audio-recording service or equipment. “The unavailability of audio recording facilities does not mean that the WCA process can be delayed indefinitely. That could slow down the process unnecessarily.” But he added that, since the introduction of audio recording, only nine requests have been refused owing to the unavailability of equipment.

He said (but the statement is disputable): “All those having face-to-face assessments have been able to request that their sessions be recorded… Claimants can ask for their assessments to be recorded, either by means of the service offered by the Department for Work and Pensions and Atos Healthcare or through the use of their own recording equipment. Requests for an audio recording, whether through the use of Atos Healthcare’s equipment or through the use of equipment provided by a claimant, must be made in advance when a face-to-face assessment is arranged. The purpose of that is to provide adequate notice so that recording equipment can be made available and ready for use.”

This is not what I have found. Long-term readers will know that my partner, the long-suffering Mrs Mike, suffers from a long-term ailment and has undergone the work capability assessment. It took place in early July last year – remember the date. I went with her.

We were not informed of the procedure for requesting audio recordings in any way. I went along with my dictaphone, but when we announced our intention to use it, we were told that would not be acceptable and the assessment would not take place if we insisted on this condition.

Therefore it occurs to me (admittedly from anecdotal evidence) that Hoban’s figures must be skewed. How many claimants found themselves in the same position when they arrived for interview – ready to record – only to have the carpet pulled out from under them? For a disabled person, the only option then is to continue with the assessment because – for many of them, it is a very difficult and painful process simply to reach an assessment centre.

Let’s look at the questions. The first was this: Will the Minister now accept that the number of claimants requesting a copy of their recording is not an accurate reflection of demand, and that the number of people acquiescing to their assessment being recorded is a more appropriate metric to use?

Hoban’s response: “I do not think that it was that difficult to get hold of a copy. The recording might need to be held on a handheld device before it is transferred to a computer and a transcript is printed, but that does not stop people asking for a copy. I thought that was one point in the hon. Lady’s thoughtful speech that was not well substantiated.”

This is inaccurate. For those who have never attended a work capability assessment, the Atos assessors complete them using laptop computers – because the assessment is a tick-box test that demands simple ‘yes’ or ‘no’ answers. Laptops generally come with not only audio recording but also CD burning programs as part of the package, and even if they don’t, freeware recording software is widely available and CD-burning software is also available, if not for free, then for a reasonable price. If the onboard microphones aren’t adequate to the task, it is possible to buy them very cheaply – especially if buying in bulk.

In short, it should be entirely possible to record every single assessment at a reasonably high quality, burn it onto CD and hand it to claimants on the spot. For example, I have an audio copy of yesterday evening’s debate which I can burn off and hand to anybody who wants it for reference. There is no justification for the bureaucratic process through which the DWP currently demands claimants to navigate, which is – as Ms Gilmore noted – off-putting.

Hoban continued: “The results also provided little evidence that audio recording of face-to-face assessments improved the quality of assessments. There was only limited evidence of improvement in the customer experience for some individuals.”

SOME individuals? We must question these ministers’ use of language and that word is telling.

“Of those who took part, fewer than half the claimants thought that audio recording would be helpful to them.”

How were they to know? Did they expect to have to go to appeal and use it to persuade a tribunal? Were they even made aware that this could happen?

“Those are the key areas that Professor Harrington wanted to understand when he called for the original pilot. As a result the Department decided not to introduce audio recording of face-to-face assessments universally on the basis that a facility for all assessments would be extremely costly, with no apparent substantial benefit or improvement in the quality of assessments.”

Not true.

“Since the introduction of a limited audio recording facility in September 2011, fewer than 4,000 claimants have requested a recorded assessment. To date, Atos has conducted more than 2,000 audio-recorded assessments.”

So almost half those who requested a recording were refused it, despite that fact that using laptops to record assessments is cheap and easy?

“During that period almost 1.5 million face-to-face assessments for both ESA and incapacity benefit reassessments have been completed. Therefore, the proportion of recorded assessments is less than 0.2% of all assessments carried out during the period. We need to continue to monitor that take-up, but universal recording for such low numbers does not seem prudent and might not provide value for money.”

Not (provably) true.

We move on to the second question. I give you advance warning that the reply is scandalous: Can the Minister confirm whether any official DWP communications inform claimants that they can have their assessment recorded?

His response was to say that the DWP has recently provided more information about the audio-recording facility on the ‘Inside Government’ section of the gov.uk website. recently? Two years after the option was made available?

And he said: “I am pleased to say that we are … taking steps to boost awareness of audio recording. The Department and Atos are in the process of amending written communications to claimants by updating the WCA AL1C form. The document is sent to claimants when they need to arrange a face-to-face assessment and will provide more information on how to arrange an audio-recorded assessment. We expect the revised form to be sent out to claimants by the end of next month, once the necessary changes have been made and the form has been cleared for use.”

Sheila Gilmore rightly took issue with this, demanding: “Perhaps the Minister might be able to explain why it has taken nearly two years to make that amendment?”

Even if he was, he didn’t.

She also raised the issue of timing, which the DWP frequently uses to skew its statistics: “If I understood him correctly, he said that the evaluation of all this process was being extended to the end of the summer, so if the revised letter is not going out until the end of this month or the end of next month, there will be very little time to judge whether that has made any difference.”

Absolutely correct. This is how the DWP produces many of the figures it uses to hoodwink Parliament and the general public. If a procedure has been available for 24 months, but official documentation has publicised that to claimants for just two or three months, then the results are unreliable.

You will, undoubtedly, be on tenterhooks to know what Hoban had to say about this.

He said nothing.

Question three: Can he indicate how many audio recording devices Atos now have access to?

Yes he can. The total is a staggering 31 audio recording machines, three of which are currently being repaired – so 28 functioning machines. Atos also has access to 21 cassette machines which are on loan from the DWP.

“We constantly monitor the updating of audio recording assessments to ensure that the supply of the equipment meets demand,” said Hoban. Utterly ridiculous, for the reasons already outlined.

Question four: Can he confirm that what few recordings currently occur are part of a wider rollout or a mere further pilot?

This was the question he did not answer.

Finally: Will he accept Professor Harrington’s call for more work to be done on this? And will he rerun the pilot using the level of successful appeals as the key metric in determining whether or not audio recordings improve the quality of assessments?

It seems that he did! “we have decided to extend the evaluation period until the end of the summer to allow us to gather additional data on quality and potential take-up for a subsequent robust decision on any potential future audio-recording provision.

“We now have a benchmark for current take-up but, as has been rightly pointed out, we cannot get a true comparison until we routinely let people know about its availability.”

So what are we to make of these responses?

They’re a mixed bag. There is no excuse for failure to make recordings and hand them over to claimants on the day – that is glaringly obvious and the most scandalous part of this affair. Thanks to computer technology, it is cheap, easy and available. Considering the size of the DWP and the number of assessors employed by Atos, it is inconceivable that nobody was aware of this and therefore we must conclude that the failure to offer the service is an attempt to obstruct transparency by the DWP and its ministers.

There is also no excuse for the almost-two-year delay in revising DWP correspondence to make it clear that audio recording is available to anybody who wants to request it. In fact, because it should be possible to use assessors’ laptops to make those recordings, it is entirely possible to argue that they should offer it verbally at the start of the assessment procedure.

The extension of the evaluation period is to be welcomed – but the brevity of the extension is to be lamented and the “benchmark” data being used to judge the evaluation are entirely questionable.

As ever, with this Coalition government, any dialogue over its procedures is a war of attrition. This issue is not buried yet, and the debate was useful in teasing out the details.

The best we can say for the moment is that this is TO BE CONTINUED…

Nowhere to hide, Mr Hoban: With advance notice of questions there’s no excuse for failure to answer

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adjournment debate, advance, Atos, audio, benefit, benefits, Chris Grayling, Coalition, committee, comprehensive, Conservative, Daily Telegraph, David Cameron, Democrat, Department, Department for Work and Pensions, disability, disabled, distort, DWP, Employment and Support Allowance, ESA, evidence, fact, falsehood, George Osborne, government, Grant Shapps, health, House of Commons, Iain Duncan Smith, information, Labour, liar, Liberal, lie, mark hoban, Michael Gove, Mike Sivier, mikesivier, minister, notice, Parliament, Pensions, people, politics, Privileges, question, recording, Sheila Gilmore, sick, skew, social security, Speaker, spending review, standards, Tim Wigmore, Tories, Tory, unemployment, Vox Political, WCA, welfare, work, work capability assessment, Work Programme, Youth Contract

Now get out of that: Mark Hoban has been challenged to come clean with the facts. If he does, he’ll be the first DWP minister to do so since Labour left office.

Let’s get something straight from the outset: By Parliamentary convention, if a government minister lies to MPs – or is found to have told falsehoods and does not then correct the inaccuracies, that is a resignation matter.

Until the current Conservative/Liberal Democrat coalition came into power, this convention was observed by all parties. The fact that the current administration – which, let’s remember, did not win any elections to get into office – does not observe this convention is yet another indication that it is an outlaw government.

Iain Duncan Smith is a classic case of the Coalition attitude. He has told so many porkies to Parliament and the public that he is to be dragged before the Commons Work and Pensions committee to account for them. The trouble is, even if he is forced to admit knowingly misleading us all, there is no reason to expect him to do the decent thing and fall on his sword. He’ll damn our impertinence for having the cheek to question him.

Probably the best way forward with him would be for the Work and Pensions committee to take his case to the Speaker of the House of Commons, and the committee on Standards and Privileges, as this seems to be the correct route to take, in order to expel an MP.* If he won’t go willingly, he’ll have to be pushed.

Of course Mr… Smith might decide to claim he cannot answer some of the more involved questions, if he hasn’t had prior notice of them; he could say he hasn’t been able to put the facts together. Then, instead of admitting he is dishonest, he’ll just be admitting incompetence. No Coalition minister has yet been sacked for that.

One of his fellows who’ll have no such excuse is Mark Hoban, due to face questioning by Sheila Gilmore MP – who also sits on the Work and Pensions committee – in an adjournment debate on the audio recording of Atos work capability assessments at 7pm today (Wednesday, June 12).

Why not? Because she has sent him advance notice of all the questions she will be asking, in her speech, which she has published here for everyone to see.

Firstly, she attacks the government’s assertion – made by Hoban’s fellow truth-bender Chris Grayling, when he was in Hoban’s job – that there is a lack of demand for audio recording of assessments. He said a pilot scheme to test whether audio recording assessments improved their quality had produced a negative result: “We decided not to implement universal recording because, based on the trial experience, people did not want it.”

This is – to nobody’s surprise – untrue.

The Atos pilot concluded, “68% of customers agreed to the recording when contacted by telephone prior to the appointment.”

This total dropped to 46 per cent due to some claimants not taking the assessment. This is most likely caused by the phenomenon of ‘churn’, as discussed on this blog, and others, in previous articles – a fairly consistent number of claimants stop their claim before taking the assessment because they either get better, find a job that can accommodate their disability, or die.

As far as Atos were concerned, the result was beyond doubt: “Our recommendation would be that recording should become routine as it is in a call centre or for example – NHS direct.”

This is the recommendation of the company running the much-criticised assessment scheme, remember. Even Atos wants better accountability and an improved quality of assessment that this may bring.

Ms Gilmore goes on to attack the government’s claim that the number of claimants requesting a copy of their recording is just one per cent. This cannot be regarded as an accurate assessment of the number who would like a copy, for two reasons, she tells us.

Firstly, the assesssors used handheld devices to make their recordings, meaning they would have to be transferred to computer and burnt to CD afterwards, preventing claimants from taking recordings away with them on the day. Instead they had to make a further request – in writing. “Unsurprisingly this suppressed uptake,” Ms Gilmore’s speech states.

Secondly, claimants were warned off applying for copies by assessors who told them recordings would only be useful to them if they appealed. The report that stated only one per cent of claimants persisted in their request was completed only days after the pilot study ended, meaning most of those involved had not received a decision on their claim and therefore did not know whether they needed to appeal. Demand may well have been higher, had the measurement been taken after a reasonable time.

This is just one example of the DWP timing processes in order to get its way. We’ll return to that topic in a moment.

Chris Grayling also stated that the DWP would offer “everyone who wants it” the opportunity to have their assessment recorded. In practice, this seems an empty promise, as Atos had around 50 audio recording machines on May 22 this year, but undertakes more than 11,000 assessments every week.

Also, the option to request recordings is not offered in any official DWP communications to claimants. As Arthur Dent points out in The Hitch-Hiker’s Guide to the Galaxy, it’s not like they’ve gone out of their way, “like actually telling anyone or anything!”

What we’re seeing is a series of attempts to distort information and skew the facts, to create a story that supports DWP ministers’ intentions, rather than the evidence. That’s bad for the country, because it means decisions are taken on the basis of fantasy, diverting attention and effort away from where it is needed.

“Today I have taken the unusual step of emailing a copy of my speech for an upcoming debate to Mark Hoban, the Minister due to speak for the Government,” said Ms Gilmore. “Now he can have no excuse for not answering the important questions I intend to put to him…. I want to ensure the Minister can’t ignore these points, and that’s why I’ve take this action today.”

Whatever happens this evening, it seems unlikely that anything can be done about the DWP’s latest misuse of statistics – actually withholding performance data about the Work Programme (as reported previously in Vox Political) and the Youth Contract until the day after the government’s comprehensive spending review.

This means decisions are likely to be made on ministers’ recommendations, rather than on the basis of fact – and we now know that we cannot trust those recommendations at all.

The Telegraph, reporting the delay, stated that the figures – when they arrive – “are expected to be very disappointing.

“It is hardly unreasonable to say that the Government would sooner Labour did not have these to throw at it when George Osborne gives details of the Comprehensive Spending Review in Parliament on June 26.”

Columnist Tim Wigmore concludes – and this is in the Torygraph, remember: “The Government only has itself to blame if it’s getting harder to give it the benefit of the doubt.”

That time is long gone.

There must be no dishonesty in Parliament.

If Mark Hoban fails to give full and frank answers to the questions Sheila Gilmore has put to him, but resorts to distortions of the figures or outright falsehoods, then he must be expelled from his job, not just as a minister but as an MP.

That goes for his boss, Iain Duncan Smith. It goes for Grant Shapps, Michael Gove (mentioned in the Telegraph article) and, above all, it also goes for David Cameron.

Liars all.

*If any MP is reading this and able to provide details of the correct procedure, please get in touch.

Unum, Atos, the DWP and the WCA; Who gets the blame for the biopsychosocial saga?

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Mansel Aylward, former chief medical officer at the Department of Work and Pensions, now director of the (UnumProvident) Centre for Psychosocial and Disability Research at Cardiff University: Architect of misery?

If we know anything at all about the Work Capability Assessment for sickness and disability benefits, we know that it doesn’t work. In fact, it kills. There is a wealth of evidence proving this, and if any readers are in doubt, please take a look at the other article I am publishing today, MPs tell their own Atos horror stories.

Much has been made of this fact, without properly – in my opinion – addressing why it doesn’t work. The apparent intention is an honourable one – to help people who have been ‘parked’ on disability benefits back into work, if it is now possible for them to take employment again, and to provide support for those who cannot work at all. What went wrong?

Let’s start at the beginning. The WCA is, at least nominally, based on the biopsychosocial model developed by George Engel. He wanted to broaden the way people think about illness, taking into account not only biological factors but psychological and social influences as well. He contended that these non-biological influences may interfere with a patient’s healing process.

The idea has been developed to suggest that, once identified, the non-biological factors inhibiting healing would be neutralised via a variety of support methods. Stressful events in a person’s life or environmental factors are acknowledged as having real effects on their illness, and it can be seen that this confers a certain amount of legitimacy on symptoms that are not currently explainable by medicine.

Engel stated, in 1961, “Many illnesses are largely subjective – at least until we as observers discover the parameters and framework within which we can also make objective observations. Hyperparathyroidism… was a purely subjective experience for many patients until we discovered what to look for and which instruments to use in the search.” He also warned that people engaged in research should “see what everyone else has seen and think what nobody else has thought” – as long as they don’t automatically assume that their new thought must be correct.

The Engels theory forms the basis of the system of insurance claims management adopted by US giant Unum when its bosses realised that their profits were being threatened by falling interest rates – meaning the company’s investments were losing value – and a rise in claims for “subjective illnesses” which had no clear biological markers – Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), Fibromyalgia, Chronic Pain, Multiple Sclerosis, Lyme Disease, even Irritable Bowel Syndrome (IBS).

As I wrote on Wednesday, Unum adapted the biopsychosocial model into a new medical examination that stripped it of its ‘bio’ and ‘social’ aspects in order to concentrate on the ‘psycho’ – with a relentless emphasis on an individual claimant’s beliefs and attitudes.

The new test aggressively disputed whether the claimant was ill, questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims.   The thinking behind it was: Sickness is temporary. Illness is a behaviour – all the things that people say and do that express and communicate their feelings of being unwell. The degree of this behaviour is dependent on the attitudes and beliefs of the individual, as well as the social context and culture. Illness is a personal choice. In other words: “It’s all in the mind; these people are fit to work.” (as I mentioned in When big business dabbles with welfare; a cautionary tale)

Already we can see that this is a perversion of Professor Engel’s theory, using it to call an individual’s illness into question, not to treat it. Yet this is the model that was put forward to the Department of Social Security (later the Department of Work and Pensions) by its then-chief medical officer, Mansel Aylward, in tandem with Unum’s then-second vice president, John LoCascio.

Together they devised a new ‘All Work Test’ that would not actually focus on whether an individual could do their job; instead it would assess their general capacity to work through a series of ‘descriptors’. Decisions on eligibility for benefit would be made by non-medical adjudication officers within the government department, advised by doctors trained by Mr LoCascio. Claimants’ own doctors would be marginalised.

When New Labour came to power, Mansel Aylward was asked to change the test to reduce the flow of claimants with mental health problems. In came the ‘Personal Capability Assessment’, which again focused on what a person was able to do and how they could be supported back into work.

It is at this point that US IT corporation Atos Origin (now Atos Healthcare in the UK) became involved. The task of administrating the PCA was contracted out to a company which was taken over by Atos, meaning its employees – who had no medical training – could now assess claims for sickness and disability benefits, using the company’s Logical Integrated Medical Assessment tick-box computer system. These evaluations proved unreliable and the number of successful appeals against decisions skyrocketed.

So in 2003 the DWP introduced ‘Pathways to Work’, in which claimants – now labelled ‘customers’ – had to undertake a work-focused interview with a personal advisor. If they weren’t screened out by the interview, they would go on to mandatory monthly interviews where they would be encouraged to return to work and discuss work-focused activity. I can assure readers, from personal experience with Mrs Mike, that this activity remains a prominent part of the DWP’s sickness and disability benefit policy.

Mansel Aylward is no longer at the DWP, though. In 2004 he was appointed director of the UnumProvident Centre for Psychosocial and Disability Research at Cardiff University (it has since dropped the company title from its name). Was this as a reward for services rendered in getting Unum and its practices into the heart of the UK government?

Let’s have a look at some of the ‘descriptors’ that are being used to determine a claimant’s – sorry, customer’s – fitness for work in what is now called the ‘Work Capability Assessment’. I am grateful to Helen Goodman, Labour MP for Bishop Auckland, who provided this information during yesterday’s debate on the Atos WCA in the House of Commons. She said a person who…

“Cannot mount or descend two steps unaided by another person even with the support of a handrail”;

“Cannot, for the majority of the time, remain at a work station, either…standing unassisted by another person…or…sitting…for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion”

“Cannot pick up and move a one litre carton full of liquid”;

“Cannot use a pencil or pen to make a meaningful mark”;

“Cannot use a suitable keyboard or mouse”;

“Is unable to navigate around unfamiliar surrounding, without being accompanied by another person, due to sensory impairment”;

“Is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, not able to reach a toilet quickly”;

“At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration”;

“Has an epileptic fit once a fortnight”;

“Cannot learn anything beyond a simple task, such as setting an alarm clock”;

“Has reduced awareness of everyday hazards leading to a significant risk of…injury to self or others; or…damage to property or possessions such that they frequently require supervision”;

“Cannot cope with minor planned change” such as a change to lunchtime;

“Is unable to get to a specified place with which they are familiar, without being accompanied by another person”

… is “fit for work”.

A person in the following category is also deemed fit for work, if: “Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual.”

Kate Green, Labour MP for Stretford and Urmston, added: “My constituents told me categorically last week that they believe that the whole system was deliberately designed and operated to trick them — to make them incriminate themselves and to catch them out.

“They firmly believe that the system is deliberately designed, not to assess and then help them into work if they are fit for it, but simply to stop paying benefits wherever possible.

“There are far too many instances of trickery and misleading people and of distorting what they have done, said and reported and drawing conclusions from that. That is happening far too often.

“It is an absolute disgrace that we should run a public assessment process in such a discredited way.”

It seems to be a result of Professor Aylward’s work that the main influence on government welfare reform has been a perversion of a perversion of a theory that has not been shown to work. Authentic evidence is disregarded by those in power, who clearly continue to persecute the sick while feeding the profits of private concerns.

I wonder what he would have to say, if he were to be confronted by the evidence of what his policies have done to the sick and disabled of this country – as spelled out, in the House of Commons, by MPs from many parties.

Afterthought: It should be noted that Professor Aylward is on record as having expressed doubts about the Work Capability Assessment and the current system, as run by the government, with the caveat that he has not been involved for several years.

He told the Black Triangle Campaign: “I will make myself aware … but I think that I’m a man of integrity … and if I think that the Work Capability Assessment … test or whatever … is not proper … I will speak out against it.”

In the light of what happened while he was at the DWP, I leave it to readers to judge whether he will.

Success for one disability campaign – but another needs your help

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Atos, benefit, benefits, Coalition, Conservative, Department for Work and Pensions, disability, disabled, doctor, DWP, Employment and Support Allowance, ESA, government, GP, health, House of Commons, human rights, Labour, Liam Byrne, Mandatory Work Activity, Mike Sivier, mikesivier, opposition day debate, Parliament, pat onions, pat's petition, people, politics, Samuel Miller, sick, united nations, Vox Political, WCA, welfare, work capability assessment, Work Programme, work-related activity group, Workfare, WRA, WRAG

Don’t let the despair go on – join the debate and put an end to the suffering.

You may remember an irate column on this blog a few weeks ago, berating the British public for failing to provide the required 100,000 signatures for Pat’s Petition.

The petition, calling on the government to “stop and review the cuts to benefits and services which are falling disproportionately on disabled people, their carers and families”, totalled more than 62,600 signatures when it closed, fair short of the required amount of support.

I am delighted, therefore, to report that there will be an Opposition Day debate in the House of Commons, bsed around the petition.

The Labour Party agreed to the debate after campaigners sent an open letter to Liam Byrne, the shadow Work and Pensions Secretary.

The petition’s creator, Pat Onions, wrote: “The debate will probably take place some time in January and we will only have a week’s notice, so the important thing now is to get ready for the debate and make sure all the issues we have been campaigning on get attention.

“The theme of the motion for the debate will be the Pat’s Petition demand that the government stop and review the cuts to benefits and services which are falling disproportionately on disabled people, their carers and families, and a demand for a cumulative impact assessment. It’s a very wide brief so if you want to focus on a particular issue that’s fine.

“We will need lots of help from you all to make sure that, after all your effort, this debate gets real results. We will also need help to ask MPs from all parties to speak in this debate.”

Contact your MP via this link.

This is all very encouraging.

But securing a debate does not mean any battles are won, and another aspect of the fight against those disproportionate cuts to benefits and services is the appeal to the United Nations by Samuel Miller – another matter which has been well-reported on this site.

Mr Miller is calling for people who are sick or disabled, and in the work-related activity group for Employment and Support Allowance, to send him scans of letters from their GP that state, explicitly, that they are not fit for work.

“This information is needed for the filing of United Nations complaints against the United Kingdom of Great Britain and Northern Ireland,” he wrote.   “It is my opinion that the British government’s mandatory Work Programme for sick and/or disabled persons is in violation of the International Covenant on Economic, Social and Cultural Rights, which it signed on September 16, 1968 and ratified on May 20, 1976. (See http://www2.ohchr.org/english/law/pdf/cescr.pdf and http://www2.ohchr.org/english/law/cescr-ratify.htm)   “Further, it is my opinion the British government is violating the Convention on the Rights of Persons with Disabilities and Optional Protocol.” (See http://www.un.org/disabilities/documents/convention/convoptprot-e.pdf and http://www.un.org/disabilities/countries.asp?navid=12&pid=166)

I strongly urge anyone who is able to help Mr Miller to send him copies of these documents. The more information he is able to collect, the easier it will be to persuade the United Nations that the British Government is knowingly and deliberately causing serious harm to sick and disabled people across the UK.

The email address, as ever, is disabilityinliterature@gmail.com

Cabinet reshuffle: Does Cameron think he’s the Joker?

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One person who didn’t leave the government in the Cabinet reshuffle was David Cameron himself – despite appeals from a multitude of sources (including this blog’s readers) for him to do so.

Today’s blog entry will be relatively short. I had an operation on my leg yesterday (September 4) and it seems to be affecting my ability to think.

… And if you think that’s bizarre and illogical, let’s have a look at the decisions made by David Cameron in yesterday’s Cabinet reshuffle!

Firstly, the really shocking news: George Osborne is remaining as Chancellor of the Exchequer. Not really news, I know, but at the outset it makes a mockery of a process that is supposed to be about improving the government of the UK. Osborne’s policies are a disaster; he has sent British industry nosediving while increasing borrowing by £9.3 billion in the last four months. He was booed when he got up to give out medals at the Paralympics and he was booed at Prime Minister’s Questions today. But he remains in the Number Two government job.

Also remaining in post are Home Secretary Theresa May and Foreign Secretary William Hague; Education Secretary Michael Gove surprisingly keeps his brief, despite having proved by his activities that he is not up to the intellectual challenge (see previous Vox articles).

And Iain Duncan Smith will remain at Work and Pensions – oh yes he will! – despite having been offered Justice by David Cameron. This shows the weakness of the Prime Minister. As LabourList’s Mark Ferguson put it: “Cameron tried to move IDS. IDS said no. Cameron said ‘ah…um…ok’. Weak, weak, weak.”

Fellow Tweeter Carl Maxim added: “Iain Duncan Smith was offered a job at Justice but refused to take it. Therefore his benefits should be cut.”

And a fellow called ‘Woodo’ tweeted: “Gove and Duncan-Smith to stay in roles to ‘get the job done’. ‘The job’ being making educating poor kids harder and killing off the disabled.”

Biggest winner in the reshuffle has to be former Culture moron – I mean secretary – Jeremy Hunt, who has been moved up to take the Health brief. This has been seen as a reward for his work on the phone hacking controversy that led to the departure of former News of the World editor Andy Coulson from the Downing Street press office, and to the Leveson Inquiry into the behaviour of the media.

This seems a nonsensical move. Leveson has ordered not only Cameron, but Cameron’s friends Coulson, Rebekah Brooks (who now faces criminal charges for her part in phone hacking), and Hunt himself to give evidence in hearings that were highly embarrassing for those under scrutiny.

Hunt’s own close connections with Rupert Murdoch, whose News Corporation owns the papers that were mainly responsible for the crimes, is well-documented, and led to this tweet from James Lyons: “BREAKING – Rupert Murdoch to buy the NHS.”

This may not be far from the truth. Hunt co-authored a book dealing with the NHS at length, with Daniel Hannon MEP who called the NHS a 60 year mistake. The book states: “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain“.

He reportedly tried to remove the NHS tribute from the Olympic Games opening ceremony and his record in government is as dodgy: he voted to halve the time allowed for an abortion from 24 weeks to 12. His support of homeopathy has also attracted ridicule from some quarters.

Hunt’s arrival at Health follows the ejection of Andrew Lansley, the man who worked for eight long years on his Health and Social Care Bill, that effectively privatised health care in England. This work constituted the biggest lie this government ever sold to the public – that the Conservatives would safeguard the well-loved 64-year-old national institution. His reward? Demotion to become Leader of the House of Commons.

Former employment minister Chris Grayling, a man who believes bed and breakfast owners should be allowed to ban gay couples, has been promoted to the Justice brief. In response, one tweeter asked if Cameron will be building more prisons.

This means the oldest Cabinet member, Kenneth Clarke, has been ejected from Justice. David Cameron reportedly tried to sack him outright, along with departing Conservative co-chair Baroness Warsi, but ended up compounding his weakness by creating new roles for them instead. Clarke will be a minister without portfolio (although it is believed he’ll be sticking his oar into Osborne’s business at the Treasury), and Warsi will be minister for faith and communities.

Nick Parry tweeted: “Now ‘Baroness’ Warsi really knows what it’s like to be Northern and working-class – she’s been made redundant by the Tories.”

And Rory Macqueen asked: “Who has replaced Warsi in the <issue off-the-shelf statement about “Labour’s union baron paymasters”> role? It looks really challenging.”

That would be tireless self-promoter and foot-in-mouth artist Grant Shapps.

Scraping the bottom of the barrel… The new Transport secretary, Patrick McLoughlin, is afraid of flying.

And the former minister for the disabled, Maria ‘Killer’ Miller, is the new Equalities minister. She’ll be victimising women, gays and ethnic minorities as well, from now on. If you think that’s harsh, bear in mind that she voted for a (heavily defeated) proposal to stop abortion providers like Marie Stopes counselling women, and is on record as being in favour of defining homophobia, racial hatred and prejudice as ‘freedom of speech’.

Beyond that, we’re into comedy territory. For example, Mid Wales Labour member Ryan Myles said: “Apparently David Cameron was planning on moving Eric Pickles but couldn’t afford the crane.”

All in all, it’s been a wholesale replacement of anybody with talent, by idiots. The tweeter who identifies himself with Yes Minister lead character Rt Hon Jim Hacker MP summed it up perfectly: “Expected a night of the long knives, may just be a morning of insignificant pricks!“

Mr Lansley’s UNclean Bill of health

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Listening exercise: It must be hard for Mr Lansley to hear our concerns with his ear-warmers on.

I have trust issues when it comes to Andrew Lansley and his Health and Social Care Bill.

Mr Lansley swears blind that introducing competition will not only bring in better patient care, but will drive costs down as well.

The problem is, so much of the medical profession opposes it – including huge numbers of GPs, the people who are meant to benefit the most – that one has to be sceptical.

Also, if his Bill is so healthy, why is he – even now – refusing to publish the Department of Health’s risk report? This is the document that the Information Commissioner ordered him to release last November; according to the law (as I understand it) he is committing a criminal act by failing to publish.

I read today on the Green Benches blog that the report contains a very serious warning that Lansley’s changes will spark a surge in healthcare costs and that the NHS will become unaffordable as private profiteers siphon off money for their own benefit.

It may also warn specifically that GPs have no experience or skills to manage costs effectively.

This is a very serious matter. It means Mr Lansley – who has already criminalised himself over this, let’s not forget – could be attempting to mislead Parliament.

But let’s not get carried away. This is all speculation.

So, let’s make a constructive suggestion.

If Mr Lansley is so adamant that his Bill is going to be good for both patient care and the nation’s finances, let’s see him build a few safeguards into it.

Isn’t it time we asked what mechanism is built into the Bill to ensure that, if costs skyrocket and the quality of patient care plummets, Mr Lansley’s changes will be reversed, and the system brought back under control?

Isn’t it time we asked what penalties Mr Lansley himself will face, if the report is published after the Bill is passed and (as many fear) reveals exactly what the Green Benches blog mentions?

Isn’t it time the Tories made an effort to suggest they can be trusted to do the right thing for a change, instead of merely doing what’s right-wing?

There is also an Early Day Motion here which states “That this House expects the Government to respect the ruling by the Information Commissioner and to publish the risk register associated with the Health and Social Care Bill reforms in advance of Report Stage in the House of Lords in order to ensure that it informs that debate.”

Early Day Motions are formal motions submitted for debate in the House of Commons, but very few are actually debated. EDMs allow MPs to draw attention to an event or cause. MPs register their support by signing individual motions and I shall be calling on my own MP to support this one.

If you agree, go thou and do likewise.