Atos claim that 90% of people surveyed ‘are positive about their experience with us’. Yes, this is on WCA! The claim is apparently from their monthly survey of 2,500 people- odd then that an estimated 11, 000 people a week are going through this horrendous process =44,000 per month. They say:
Independent reviews have confirmed that we are providing a high standard of service in our WCA role and in our monthly survey of over 2,500 customers, 90% of those who respond are positive about their experience with us. We are the first to recognise that in a role as complex and challenging as this, it is also our day-to-day duty to look for ways to improve any aspect of our work.
It would be inappropriate for Atos Healthcare to comment on the government’s procurement process, but the company welcomes competition in the healthcare sector as with all other areas in which we operate.
 The survey is carried out by an external company and adheres to market research criteria.
Don’t let them get away with this rubbish! Fill in the #dpac short survey here
Employment and Support Allowance (ESA) is the benefit which is replacing Incapacity Benefit. ATOS healthcare are currently making £100 million a year processing both new claims and re-assessing those who are in receipt of Incapacity Benefit.
There are 2 types of ESA, one contributory ESA which disabled people are entitled to based on having paid National Insurance contributions and Income based ESA which is awarded to those on low incomes who are not in a partnership.
People claiming IB plus new claimants have to undergo a WCA (Work Capability Assessment) to claim ESA. There are 3 things that can happen from WCA
People can be found fit for work and have to claim JSA and register or work and meet lots of requirements about looking for work. If they don’t or they are late for appointments etc they are likely to have their benefits sanctioned ie stopped for 13-26 weeks. (This means that they only get an emergency payment of £30 pw to live on plus Housing and Council Tax benefit stop being paid automatically and if they don’t know that and don’t make new claim can end up with rent and CTB arrears.)
Second group of people get put in WRAG group ( Work Related Activity Group)
that is they get ESA( a lower rate) but this entitlement to Contribution based ESA for those placed in the WRAG has now been limited to 12 months and 700,000 claimants will be affected by this cut.
Disabled people in the WRAG have to jump through lots of hoops and make themselves work ready. Again if they don’t sanctions/ reduction of benefits will apply.
Third group is the support group- those disabled people who are considered unable to work due to their level of functional impairments.
Overall the Coalition plan to remove 1 million disabled people from being able to claim ESA and declare them fit for work and force them to claim JSA (Job Seekers Allowance instead) Financially this is a loss of about £30 a week, but as well as losing entitlement to Incapacity Benefit many are also losing entitlement to DLA ( both components so in total people may lose a further minimum £34 a week from an income which is there to meet the extra costs of being disabled).
WCA assessment has been criticised by CAB, many DPOs, disabled people, Cancer support groups, a GP
Paul Gregg who originally devised it but now says it isn’t working.
Basically measures physical functional ability so fails massively anyone with non-physical or fluctuating impairments. New WCA assessment is even worse then what was in place and eg someone with a visual impairment is likely to be found fit for work unless they need an actual person guiding them. Someone who has agoraphobia would be fit for work and the fact that they physically can’t get to a place of work is ignored.
Totally ignores any of the barriers disabled people face in the labour market i.e. attitudes, physical access, environmental access, the reduction in Access to Work funding.
At the moment 70% of those who fail the WCA with representation win at appeal and have benefit reinstated, 40% who don’t have representation win. Waiting time often up to 12 months due to backlog in Tribunal service.
Another problem is that if you win your appeal ATOS can just start all over again re-testing you which is what happened to one of our supporter’s uncles. When he got papers for 2nd tribunal hearing he killed himself as he couldn’t face going through it all again. ( he won 1st appeal then had to have a second WCA, and failed that again )
Debate was heated today as the House of Commons debated the Lords amendments to the Welfare Reform Bill with Ian Lavery, MP for Wansbeck, pointing to the similarity between the Tory party and the Nazis. Opposition MPs supported the Lords amendments while conceding the sad reality that the ConDems would likely carry the day. ConDem contributions to the debate exposed ignorance and failure to understand the day-to-day lives of disabled people and the barriers we face.
The Lords amendments rejected the 12-month limit for ESA claimants who are judged capable of working at some stage in the future, Peers voted down plans that would have meant some cancer patients receiving contributory ESA would have been means tested for the benefit after 12 months and they rejected moves to stop disabled young people who have never worked, due to illness or disability, from receiving contributory ESA. The Government was nevertheless determined to push these measures through.
There was much discussion about the arbitrary nature of the 12 month limit and Stephen Timms, Shadow Minister for Work and Pensions, reminded Libdem MPs that their party conference had voted against time-limiting ESA. ConDems defended their position by citing that a 2 year time limit was equally arbitrary. For every example given of individual circumstances where a person in need would potentially be thrown into poverty by the Government’s proposed measures, ConDems explained that such an individual would be placed in the support group of ESA and was therefore irrelevant to the debate on time-limiting for the work related group. Jenny Willott, MP for Cardiff Central, said that assessments were important for getting people into the right ESA groups. When Opposition MPs raised the issue of the notorious inaccuracy of the Work Capability Assessments, the Government Front Bench blamed the WCA system on New Labour, saying that the impact of the changes to the WCA following the Harrington review is not yet measurable and that the accuracy of the current WCA cannot be commented upon.
However we know that the aim of the time-limiting is to get people off benefits. We know that the application of a policy with such an aim is that people are found fit for work when they are not. For the Government to make the savings it wants there will continue to be cases of individuals who are in need and who are denied access to the ESA support group. Stephen Timms quoted figures to show that although 90% of people on contributory Job Seekers Allowance find work within 6 months, only 6% of those on ESA find work within 12 months. Inevitably therefore time-limiting will mean people being denied an income when their inability to find work is due to disability or ill health.
The question of the need to set the 12 month time limit in statute by an Act of Parliament was also questioned. Willott weakly defended this explaining that benefit claimants would welcome the stability to the benefits system that such an Act would ensure. In reality benefit claimants would be better reassured by such an arbitrary and unfair time-limit not being set in stone in legislation in this way. Willott did seek assurances from her front bench colleagues that those affected by the change to ESA would be among the first to be moved onto a universal credit system which aclnowledged that these measures will have a serious detrimental impact on high numbers of disabled people.
Anne Begg expressed exasperation at the inability of the ConDem benches to understand the fundamental difference between being out of work due to being unemployed and due to long term disability or ill health. As a Tory back-bencher cited his own past circumstance of being made redundant with no access to benefits to help him out, Begg explained that there is a clear difference when a person has no prospect of improving their financial circumstances themselves. She went on to have to explain to Jenny Willott what different benefits payments are for after the MP for Cardiff Central commented that an individual denied ESA would still have access to non means-tested benefits: Begg explained that housing benefit pays for rent, DLA pays for the extra costs that arise from being disabled and that still leaves no income, nothing for clothes or heating or the everyday things we take for granted. The Tories continued to fail to understand the barriers that disabled people face as David Nuttall got close to describing disabled people as benefit scroungers when he commented that his constituents are sick and tired of people making a lifestyle choice of being on benefits.
David Winnick, MP for Walsall North was vehement in his opposition to the Government proposals. He said: “This is indeed a grubby and obnoxious measure” and called on LibDem MPs to vote against the Government, as he would have done had his Government ever tried to introduce such a thing. Winnick quoted the Prime Minister, who said: “People who are sick, who are vulnerable, I want you to know we will always look after you. That is a sign of a civilised society. That is what I believe in”. The Welfare Reform Bill exposes this as a lie.
Baroness Meacher, an independent crossbencher, told BBC Radio 4’s Today programme: “The British public do not accept the idea that the banks screw up and very disabled people pay the bill.”
The Lords vote see the Government defeated by 234 to 186, a majority of 48, over a plan to limit to one year the time people can claim Employment Support Allowance.
Peers agreed a move to replace the one-year cap with the ability for the Government to specify a limit of no less than two years.
Lord Patel, an independent crossbench peer, said: “I am sympathetic to cutting the deficit, but I am highly sympathetic to sick and vulnerable people not being subjected to something that will make their lives even more miserable.”
The Government was also defeated when peers voted by 222 to 166, majority 56, to accept another amendment by Lord Patel removing the time limit on contributory ESA payments from people receiving treatment for cancer.
Employment minister Chris Grayling said the welfare state should be focused on supporting those with the most need quotes the BBC –DPAC agrees that it should too but we think Grayling is a bit confused over whose those might be – fortunately the Lords are not.
Labour said the coalition was defeated for trying to “cross the basic line of British decency”.
DPAC networks should congratulate themselves for the long months of protests and lobbying on Atos, WCA and on ESA since 2010- but the battle is not over yet. As responsible groups we know that the lobbying must continue when the amendments go to the House of Commons.
This is an important and urgent message from the Mental Health Resistance Network.
As you all know, members of the Mental Health Resistance Network have been working with a solicitor towards making a claim for a Judicial Review of the Work Capability Assessment (WCA) which is the assessment used to determine whether we will be granted Employment Support Allowance or sent back to work (if there is any work to be found!). We are just focussing on people who claim on mental health grounds.
We are now at a critical stage in this process as we are very close to being able to make the claim for Judicial Review. However, before we can do this, it would help if we could find stories that will show the court what sort of problems the WCA causes. So we are looking for people who have been through the process and would be able to tell us about their experience. If people wish, we can present their cases anonymously when we use their evidence. Although it would be very good if people were prepared for us to give their names to the DWP so that the DWP could check their stories, it is not essential.
There are two types of experience that we are particularly interested in (in the solicitor’s words):
(i) Cases where a person claims ESA without producing any medical evidence and is refused benefit, but then wins on appeal when medical evidence is obtained.
(ii) Cases where a person claims ESA without producing any medical evidence, is refused benefit, does not appeal (perhaps because they can’t face it), and then bad things happen (for example they go into work and become ill, or have a problem, or can’t get work, or whatever). Ideally, the case is recognised down the line as a problem because a CAB or law centre makes a new application with medical evidence and benefit is awarded.
In other words:
1) you have you claimed and been turned down for ESA but were successful on appeal when you produced additional medical evidence
2) were you turned down for ESA and did not appeal but reapplied with medical evidence, and were successful.
Atos are the French IT outsourcing company who’s Atos Healthcare arm have been running Work Capability Assessment for the Department of Work and Pensions.
Lots of people are unhappy about Employment Support Allowance, about the assessments, and about the way that Atos run them. There have been protests outside Atos offices using slogans such as “ATOS kills” to express their feelings. Lots of people have explained why they are unhappy with Atos in blogs, on social networks, and in support forums.
They have also shut down a support forum for carers, CarerWatch, by contacting their server host directly and having it taken down. This has removed a vital support network from many carers, presumably because of private discussions about Atos in members only parts of the forum. Apparently people are not even allowed to talk about Atos now, despite needing to do so to support each other when going through tests administered by Atos.
CarerWatch is an internet forum for sick and disabled people and their unpaid family carers. This is a private forum and only members are allowed to make/read posts.
We understand from the organisation that hosts our forum that they received a letter from your solicitors threatening to sue us for libel. The provider immediately closed our site down.
We have many members who are very fragile and the sudden disappearance of a support group has caused a lot of distress and fear. Some are ringing us in tears. We cannot get in contact with all of them though as we have lost their contact details through the closure.
All this distress could have been avoided if you had had the courtesy to contact us first and tell us what had been posted on our site that you considered libellous. Obviously if any post was possibly libellous we would have removed it and all this distress could have been avoided.
We imagine this distress is unintended and hope you will work with us in looking at the problem and finding a solution.
Please note that this letter, and any reply received from yourselves, will be posted on our website. It is the only means left to us to reach some members and keep them updated.
It is vital we have our forum up and running again to reach those that are isolated.
On behalf of CarerWatch members
Obviously, I don’t want my website taken down. I have been careful to state only known facts here. These are the facts that I know.
Atos Healthcare carries out Work Capability Assessments for the DWP.
The contract is worth approximately £100 million per year.
There has been a sharp rise in people found fit for work
There has been a sharp rise in people appealing that decision
40% of those that appeal, win, rising to 70% with legal representation.
Although the decision over “fit to work” lies with the DWP,a government review found that the DWP are institutionally incapable of overriding the Atos Health Care Professionals. The Atos recommendation is, in effect, the decision.
Atos employ Health Care Professionals to carry out the assessments. HCPs are a mix of doctors, physiotherapists and nurses. Only people with certain problems will definitely see doctors.
Atos use their own Lima computer system to record the patient’s answers. Lima has been widely criticised.
The HCP fills in Lima by choosing keywords and statements from a list and then justifying them.
An Atos recruiter said “We don’t call them patients . . . We call them claimants.”
In the end, although there is much to criticise with the way that Atos carry out ESA WCAs, they may really only be doing what the government expects of them. The descriptors that are used to make the decision of whether a person is fit for work or not are set out in the by the government. (See The Employment and Support Allowance (Limited Capability for Work and Limited Capability for Work-Related Activity) (Amendment) Regulations 2011) I personally question whether Atos accurately records if a patient fits the descriptors or not, and their ability to do so given the way that Lima Works or the staff that are used. Even if they do make an accurate record in line with the government’s descriptors, it is questionable whether the descriptors are an accurate description of being fit for work or not. Even then, it seems that decision makers at the DWP are “institutionally incapable” of taking into account all of the relevant information for the case as they are supposed to, instead simply rubber stamping the recommendation made by Atos. It would seem that the appeals tribunals are making a fairer judgement on this issue than Atos or the DWP.
For all new ESA claims from 27th October 2008 to 30th November 2010, the result of the initial WCA is as follows
Support Group – 7%
Work Related Activity Group – 17%
Fit for Work – 39%
Claim closed before assessment complete – 36%
Assessment still in progress – 1%
These figures are true, but lie by omission. First of all, the figures given are for ALL that start a claim for ESA. As stated, 36% of people that start a claim drop out before they even get to their Work Capability Assessment. Some of these people will drop out because they perhaps shouldn’t have applied in the first place. Some might even have been trying it on and then realised that they would be caught. Some recover enough to find work, some find work that fits around their disabilities. Some, however, drop out because they are so ill that they cannot face the application and testing process. We don’t know, as no records are kept of reasons for dropping out, but I contend that many more than we know drop out because they are too ill to finish the process. Given that 36% of claimants are not tested, we cannot include them in the ‘fit for work’ category. That 7% of claimants is actually 11% of claimants who complete the process.
11% is still a very small number. That still casts 89% of claimants as cheats, doesn’t it? Well no. No it doesn’t. Not unless you are a tabloid writer. You see, 17% of total claimantss – or 26.6% of claimants that finish the process – are put in the Work Related Activity Group. Being put in this group DOES NOT mean that the claimant is fit for work! It means that there may be some job, as yet unknown, that the claimant could possibly manage to do, if they push themselves hard enough,possibly at high cost to their health, IF they receive the right support in terms of information, equipment, services and grants. People in this group must attend six interviews at the Job Centre over the course of a few months to try and determine just what this possible job could be, and the support that would be needed to do it. People in this group STILL RECEIVE ESA.
Adding those two together and leaving out the people that dropped out, that means that 37.5% of people tested were not fit for work. That still leaves 61% that were receiving ESA who were found fit for work. Are they all cheats? No. Here’s why.
The Work Capability Assessment takes place at the end of the assessment phase of the claim. That means the test can take place up to 14 weeks after the person started to claim ESA. 14 weeks is a long time, and it should also be noted that people are often sick for a long time before they even apply for ESA, either on Statutory Sick Pay for 28 weeks, or just unaware that they can claim. Those people could easily have been sick for 9 months before being tested. 9 months is long enough for people to recover or start recovering from many health issues, and so these people would have been correctly being given ESA while unable to work. Health issues change, and finding these people fit for work now would be correct, but does not invalidate their claim in the previous months. I think if the WCA correctly finds someone capable of work after many months of illness but heading towards recovery, this is usually a good thing.
33% of people found fit for work between October 2008 and August 2009 appealed against that decision. 40% of those overturned that decision and were awarded ESA. That’s 27,500 people who were provably found fit for work when they were not. Many more people did not appeal, for many of the same reasons that may have caused people to drop out of the claims process.
5. Sections of the media routinely use pejorative language, such as “work-shy” or “scrounger”, when referring to incapacity benefit claimants. We strongly deprecate this and believe that it is irresponsible and inaccurate. The duty on the state to provide adequate support through the benefits system for people who are unable to work because of a serious health condition or illness is a fundamental principle of British society. Portraying the reassessment of incapacity benefit claimants as some sort of scheme to “weed out benefit cheats” shows a fundamental misunderstanding of the Government’s objectives. (Paragraph 40)
6. Whilst fully accepting that the Government, and this Committee, have no role in determining the nature and content of media coverage, we believe thatmore care is needed in the way the Government engages with the media and in particular the way in which it releases and provides its commentary on official statistics on the IB reassessment. In the end, the media will choose its own angle, but the Government should take great care with the language it itself uses and take all possible steps to ensure that context is provided when information about IB claimants found fit for work is released, so that unhelpful and inaccurate stories can be shown to have no basis. (Paragraph 41)
I disagree with part of this in that I think that consciously or not, Conservative ministers have an ideological motive to move people off of benefits, portraying them as cheats if necessary, with the help of special advisors. (SPADS.) I believe that ministers and SPADS have been feeding selected information to the press to create a national view that is biased against sick and disabled people that claim benefits, and the press have been only too happy to amplify this.
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.
Would you consider a person who became spontaneously unconscious once every five weeks fit for work? Would you employ them? Would you consider them fraudulent if they claimed that this condition was disabling? In the March 2011 version of training guidelines for the Atos Work Capability Assessment two of these options are valid. The Work Capability Assessment would rate such a person as fit for work and as a result a person who is neither sick or disabled.
The Work Capability Assessment is carried out for those migrating from Incapacity Benefit and for new claimants to Employment Support Allowance (ESA). It was put in place by New Labour in 2008. It is administered by the French/Dutch Company Atos at a cost of 300 million. Those going through the test can be put into one of three groups.
ESA Support Group not required to undertake work-related activity – but will be reassessed continuously
ESA Work Related Activity Group, for those deemed fit for work with support and preparation. Limited to just 12 months before ESA is stopped, also may be subject to reassessment in the 12 month period.
Fit for Work not entitled to ESA but transferred to lower amount on Jobseeker’s Allowance
One estimate claims that up to 500,000 people have been wrongly denied Incapacity status. In a 2011 February piece in the Guardian Amelia Gentlemen argues:
Since its preliminary rollout in 2008, people with terminal cancer have been found fit to work, people with mental health problems have complained their condition is not taken seriously, people with complex illnesses report that the tick-box system is not able to cope with the nuances of their problems.
Citizens Advice Scotland reported that under incapacity benefits 37% were found ‘fit for work’ under Work Capacity Assessment, the figure had soaredto 66%
Between October 2010 and Spring 2014 those who receive Incapacity Benefit, Severe Disablement Allowance and Income Support paid on the grounds of illness or disability will be assessed for Employment and Support Allowance. Pilots in Aberdeen and Burnley have raised more criticisms of the process adding to the raft of criticisms from the British Medical Association, the originator of the software that Atos uses, GPs, Citizens Advice Bureaus (CABs), Members of Parliament and disability organisations.
The Work Capability Assessment replaced the Personal Capability Assessment. Yet, as long ago as 2006 the Green Paper: A New Deal for Welfare: Empowering People to Work, stated ‘the current Personal Capability Assessment process (is) already recognised by the OECD as being one of the toughest in the world’.
Case studies have shown the inhumanity of a system based on government targets and the pain and misery of the increasing stringency of these tests. One example from the 2010 report from the Citizens Advice Bureau’s report on ESA and testing procedures highlights the experiences that someone considered ‘fit for work’ by WCA might endure:
A Yorkshire bureau saw a woman in her forties who was working full-time and was enthusiastically looking forward to starting a new job, when she became ill. At first it was thought she had a viral illness, but she was subsequently diagnosed with lupus erythematosus and transverse myelitis. She was in a great deal of pain in her muscles and joints and had extreme fatigue. At times her balance was affected and she could not walk without someone to support her. Sometimes she lost sensation in her legs, and on her worst days she could not walk at all. Any exertion such as walking 40 or 50 metres led to days in bed. She had had a bad reaction to some of the treatment and an ECG showed her heart muscle had been damaged. Her husband had to come home from work each lunchtime to help her. Her immune system was weakened, so she had to be careful when mixing with others. She claimed ESA but was given six points in the Work Capability Assessment (WCA) and found capable of work. Her doctor supported her claim and she is currently appealing, but under Incapacity Benefit she would probably have been exempt and would have avoided this process
The WCA does not take into account GP assessments of an individual’s impairment or long term condition, this is ignored in favour of an, or average, 15-45 minute set of questions administered through the LiMAS software developed by Atos. LiMAS asks a set of questions for which the applicant can, but increasingly can’t, score up to 15 points which would put them in the ESA support group. As GPs who may have known applicants for all of their lives with an understanding of the medical, social and emotional impacts are ignored, a new set of individuals come into play called ‘health care professionals’. These individuals are trained by Atos for four to 16 weeks to understand targets and the all powerful LiMAS software; they are given time limits for each assessment and told that the more people they get through the better. They consist of physiotherapists, nurses and doctors usually with a general practice background or from overseas due to the notorious low pay of the multi- million pound profit Company Atos.
In 2008 The Department of Work and Pensions and Atos were severely criticised by Robert Martin the president of the appeals Tribunal Panel, a position now abolished:
Criticism was made of ATOS Healthcare medical practitioners who did not appear to pay sufficient attention to the appellant at the medical examination and who produced findings in medical reports based on observations that were inconsistent, or recorded in the medical report findings that were contradictory’
In 2010 an independent review of the WCA tests by Professor Harrington concluded
There is strong evidence that the system can be impersonal and mechanistic, that the process lacks transparency and that a lack of communication between the various parties involved contributes to poor decision making and a high rate of appeals.” and that “evidence has consistently and regularly highlighted problems with each stage of the WCA process, which limit both the assessment’s fairness and effectiveness.
In a government report, Atos’s own staff said the assessments are too harsh. Prospect, the trade union who represents 135 Atos doctors, has stated that the target of seeing ten or more people a day is unrealistic and will lead to wrong assessments, especially in complex cases.
Despite the overwhelming evidence that WCA was not working Atos were awarded a further contract by the Department of Work and Pensions in 2010.
Figures not Identified in the Media
The figures of those considered ‘fit for work’ by Atos testing systems regularly make headlines in newspapers such as the Daily Mail, the Express, and most recently the Guardian, but little investigative journalism has been exercised in examining this apparent miracle of ‘curing of the sick and ‘the disabled’, nor looking at process, outcomes or the ways that these figures are produced.
For example, newspapers do not tell us that there has been a 56% increase in ESA appeals with figures up from 25,700 in the second quarter of 2009/2010 to 52,000 in the same quarter of 2010/2011. Almost half of cases are overturned at appeal.Nor are we told that figures from the Department for Work and Pensions show that of those declared ‘fit for work’ by the WCA system, just 13% are in employment, 27% temporarily sick and 28% classed as permanently sick. The ‘fit for work’ myth does not convert into any form of reality.
Nor is the context of the claims ever provided, a representative survey carried out by Ipsos MORI and reported in Employment and Support Allowance: findings from a face to face Survey commissioned by the Department of Work Pensions found that nearly a third of those going through the ESA process were described as having ‘literacy problems’. A further six per cent ‘problems speaking English’ and 11% had ‘numeracy problems’. Twenty two percent were described as in one or more disadvantaged groups including those with mental health issues, ex-offenders, and those with perceived learning difficulties.
An overwhelming 69% of those going through the WCA process had ‘multiple health conditions’. Those in the support group and in the ‘fit for work’ group both had the same number of ‘health conditions’ at 31.
In all groups 81% of people were receiving medical treatment for their condition, with 38% waiting for treatment or additionaltreatmentThese statistics do not present us with a set of fraudsters pretending to be sick or disabled, nor a set of individuals who have been languishing on incapacity benefits for years, in fact 71% of applicants to ESA were new claimants making their first ever claim.
Newspaper headlines have also made much of the incomplete claims and those that ‘drop out’ of the testing system. This rhetorical demonising does not examine the process of WCA claims nor take into account the medical treatment. The first form that individuals will receive from Atos is an ESA50 form, of those surveyed almost half 46% said they found the form ‘difficult’ or that they were ‘unable to complete it’. An initial point for non-completion, others could be knocked off the system if Job Centre Plus decide that they have missed an appointment, or not responded to a letter without ‘good reason’. This would seem to complement the new punitive sanctions for universal credit and welfare reform first expressed in the Welfare Reform Bill.
The costs of tribunals, Atos contracts and the extra strain on the health service amount to a million pound fraud by successive governments. This does not count the human anxiety, misery or stress of the test, nor the suicides that have resulted because of it. Remarkably, Chris Grayling minister for employment (note minister for employment, not health or disability) said the government was making “almost constant improvements” to the WCA, but that he was “always willing to talk to the charities”, not disability organisations run and controlled by disabled then. He said “if we do something that does not prove to be the right thing, we will be happy to change it”. The new set of training guidelines proves that changes have been made. However, these changes make the WCA more not less stringent, maybe the percentages of those declared ‘fit for work’ did not satisfy the existing regime.
New Training Guidelines for Atos ‘Health Care Professionals’ 2011
The training guidelines for the work capability assessment have made a number of changes which came into force in March 2011to be incorporated into a revised Work Capability Assessment. The text below is copied from the Department of Work and Pensions Training & Development Revised WCA Handbook ESA (LCW/LCWRA) Amendment Regulations 2011 version 2. The introduction states:
This handbook has been written to support Health Care Professionals (HCPs) trained in the principles of Disability Analysis; in their training and in performing medical assessments in relation to the Employment and Support Allowance Limited Capability for Work / Limited Capability for Work Related Activity (LCW/LCWRA) Amendment Regulations 2011. The amendment regulations of 2011 may also be referred to as “The Revised Work Capability Assessment” (Revised WCA).
Page 9 amazingly states: ‘The analysis of the data established that the WCA (ESA regulations 2008) was accurately identifying a person’s capability for work’.
However, an internal review produced the following recommendations. Text below is copied from pages 9-10 outlining the recommendations. Sections in bold are my own ‘disability analysis’.
Lower Limb Function
In this area, it was felt that the 2008 activities did not accurately reflect the level of function required for the modern workplace. As a result “walking” has been changed to “mobilising” to reflect the functionality of wheelchair users. It was also felt that considering standing and sitting abilities as separate entities was not relevant in the modern workplace and the new activity relates to the ability to remain at a workstation. In the 2008 descriptors, bending and kneeling were considered, however the ability to bend or kneel are no longer considered critical in the modern workplace, so this activity has been removed.
If you cannot stand, have difficulty sitting or cannot walk its OK because you have the ability to ‘remain at a workstation’ how you get to this ‘workstation’ is another matter. ‘fit for work’
Upper Limb Function
The review group felt that unilateral upper limb restriction would not significantly impact on an individual’s ability to work and therefore all descriptors now relate to bilateral restriction. As bilateral restriction is a significant issue, the manual dexterity scores have been revised to reflect this issue.
If you cannot move your arms, or hands presumably to type at your workstation ‘fit for work’ if you have no function in your legs but can mobilize 50 metres ‘fit for work’
In the 2008 regulations, the activities in this area reflected impairment. Adaptation had not been taken into account in these areas. The review group felt that an individual’s ability to adapt must be taken into account and therefore the activity of vision has changed to the concept of being able to safely navigate. The activities of hearing and speech have been changed to the more functional concept of being able to receive communication and communicate with others.
If you are blind, deaf, Deaf or unable to speak you are ‘fit for work’ It’s about being able to safely navigate and receive communication and communicate with others, presumably with unavailable space age communication aids.
This made the assessment overly complex and thus the descriptors have been amended to reflect any loss of continence. The loss of dignity associated with incontinence has been reflected in the scoring of the descriptors.
Incontinence is too complex for the WCA but the loss of dignity is reflected in the new scoring ‘fit for work’
In this area, it was felt that infrequent loss of consciousness would not substantially impact on a person’s ability to work and therefore only those experiencing weekly or monthly episodes of loss of consciousness will be awarded scoring descriptors.
If you spontaneously lose consciousness once every five weeks ‘fit for work’
In understanding and focus, it was felt that the 2008 descriptors were complex and difficult to interpret. These have therefore been simplified. In the area of learning tasks, how an individual learns is no longer considered to be the crucial factor – it is their ability to learn that is considered. In awareness of hazard the review group felt the important issue in the workplace was to assess the level of risk for the person and others. The activity of personal action has been amended to reflect a person’s ability to prioritise and complete tasks.
In adapting to change, the highest descriptor reflects a total inability to cope with any change and is now a Support Group. In getting about, it was considered that the familiarity of a place was more important in functional terms rather than the frequency of ability to get to places.
In the area of social interaction, the review group felt the previous descriptors were rather negative in their wording and the new descriptors relate to ability to engage in social contact an individual’s ability to behave in an appropriate manner with others.
Mental functioning is too complex for the WCA it’s no longer about learning simple tasks, but an ability to learn. If you are familiar with a place (?) this is considered more important than your ability to get to that place or any place with which you are unfamiliar with (?) ‘fit for work’. If you are unable to deal with social contact that’s OK as long as you behave in an appropriate manner with others ‘fit for work’
The Decline of Welfare: the rise of private profit
Neither the PCA or the WCA were ever really centred on assessing peoples’ fitness for work; they were always part of a mutual linking between successive Government’s will to cut social claims on the state, insurance companies such as the discredited UnumProvident (now renamed Unum Group) in the early days, and private companies such as Atos’ willingness to meet targets while increasing profit.
The entire process is likely to cost the hallowed taxpayer more than the original benefits bill did, the cost of Atos contracts, the cost of tribunals, and the cost of addition health care caused by the misery of the WCA add to the higher long term costs. Yet, it’s all done under the guise of state efficiency and the market economy.
The WCA is about exploiting aspects of the social model to develop a badly mutated individualistic ‘can do’ attitude merged with a culture of blame for ‘can’t do’ aspects of bodies and minds in an increasingly disabling welfare reformist climate.
It is a publically sanctioned fraud that misrepresents and bastardises its claims to support people while simultaneously undermining the logic, and the economic and social realities of any reasonable employment criteria. In 2007 Rutherford argued:
Welfare reform exemplifies the transformation of the old style nation state into a new kind of ‘enabling’ market state. Instead of providing social protection, the market state offers ‘opportunities’ and ‘choice’ to ‘customers’, who in return must shoulder a greater degree of responsibility for their individual predicament… But the compact between the state and an individual whose life has been disrupted by disability or sickness is not an equal one… The history of the British welfare system has always been one of grudging, paternalistic and sometimes punitive forms of social protection. But even measured against its own limited ambitions, the future of welfare looks bleak.
Debbie Jolly is on twitter : @redjolly1
Revised WCA Training & Development Revised WCA Handbook ESA (LCW/LCWRA) Amendment Regulations 2011 March 2011
 Quarterly Statistics for the Tribunals Service, 2ndquarter 2010-11 Ministry of Justice and Tribunals service 13th January 2011.
 Three- Quarters of Sickness Benefit Claims Fit to Work says DWP Helen Mulholland, Guardian 28th April 2011 http://www.guardian.co.uk/society/2011/apr/28/three-quarters-sickness-benefit-claimants-fit-work
 Employment and Support Allowance: findings from a face to face survey, Helen Barnes, Paul Sissons and Helen Stevens DWP research report no 707 2010
Thursday 14th April is the next day of action against welfare cuts. In Islington there will be a protest at 8.30am to 9.30am outside the Atos Healthcare assessment centre at 1 Elthorne Road, just off Holloway Road, 2 minutes walk south from Archway tube.
This private company gets paid millions to carry out dubious medical assessments for Employment and Support Allowance (ESA), which is replacing Incapacity Benefit.
Atos Healthcare has been awarded a £300 million contract by the government to carry out ‘work capability assessments’.
It’s claimed that assessments are to test what people can do rather than what they can’t. The real purpose is to strip benefits from as many people as possible.
This testing system has already led to people with terminal illnesses and severe medical conditions being declared fit for work and having benefits cut. GPs are ignored in favour of decisions made by Atos’s computer.
Plans announced for the scrapping of Disability Living Allowance mean this intrusive testing is likely to be extended to everyone on some form of disability or health related benefit.
Meeting @ Leeds Train Station 10am before moving to picket ATOS from 10:30 for an hour then move onto A4e/BEST for a couple of hours. The last picket was a great success and we hope to have another good day. Bring banners, flags etc.
The Work and Pensions Committee have launched an inquiry into the migration from Incapacity Benefits to Employment and Support Allowance, including the Work Capability Assessment.
ESA replaced incapacity benefits for people making new claims from October 2008. To be eligible for ESA, a person must usually undergo a Work Capability Assessment (WCA).
The introduction of ESA in 2008 was initially limited to new claimants. Existing incapacity benefit claimants are now being reassessed under the Work Capability Assessment. The process will last until 2014 with around 1.5 million people being reassessed.
Reassessment commenced on 11 October 2010 with a trial in Aberdeen and Burnley. At the end of February, Jobcentre Plus began a limited introductory phase, and will move to full national reassessment of incapacity benefit claimants from April 2011.
Short submissions (no more than 3,000 words) are invited from interested organisations and individuals.
The deadline for submitting evidence is 14 April 2011.
The 3rd National Day of Protest Against Benefit Cuts has been called for April 14th 2011.
Millions are set to be affected by savage cuts to housing, disability, sickness and welfare benefits. People with disabilities, illness, the unemployed, single parents, carers the low waged, part time students, volunteers, homeless people and college students are all likely to see a devastating drop in disposable income with many slipping even further below the poverty line.
The poorest and most vulnerable are being asked to pay for the mistakes and extravagances of the richest. Meanwhile poverty pimps like Atos Origin and A4e are set to rake in hundreds of millions on government contracts to bully and intimidate people from claiming the pittance handed out in benefit payments. Many disabled people have threatened suicide if these cuts are allowed to continue. Some have tragically already carried out that threat.
The first two days of protest against benefit cuts have seen demonstrations, meetings, unemployed discos, public pantomimes and occupations in cities across the UK. Atos Origin have been forced to close offices, protesters have gathered inside and outside workfare sharks A4e and demonstrations have taken place from Downing Street to local town centres such as Lydney and Crawley.
This time we have two months to organise for the biggest day yet. We call on all claimants, as groups or individuals, to organise and take action around the country on April 14th.
You can also send details to firstname.lastname@example.org
If you would like to see action locally, set up a group, event page or ask below. We will do out best to promote and co-ordinate all activity.
We are fighting for our homes, our livelihoods, our very survival. It’s time to show these public school parasites and their poverty pimp collaborators we mean business.
Actions/events are being discussed and organised in Edinburgh, London, Birmingham and Nottingham so far.
UPDATE: First to call, the fine folk of Leeds
Thursday, April 14 · 10:30am – 2:00pm
Meeting @ Leeds Train Station 10am before moving to picket ATOS from 10:30 for an hour then move onto A4e/BEST for a couple of hours. The last picket was a great success and we hope to have another good day. Bring banners, flags etc.
o Black Triangle Anti-Defamation Campaign
o Brighton Benefits Campaign
o Cardiff’s Unemployed Daytime Disco
o Carer Watch
o Carer Watch fb page
o Crippen – Disabled Cartoonist
o Diary of a Benefit Scrounger
o Disabled People Against Cuts
o Dundee Unemployed Workers
o Free London Listings
o Goldsmiths in Occupation
o Haringey Solidarity Group
o Ipswich Unemployed Action
o Kilburn Unemployed Workers Group
o Lancaster and Morecambe Against the Cuts
o London Coalition Against Poverty (LCAP)
o Mad Pride
o Norfolk Community Action Group
o Nottingham Claimants’ Union
o Nuneaton Against Benefit Cuts
o Oxford Save Our Services
o Tyneside Claimants Union
o Welfare Action Hackney
o Welfare Rights 4 u (UK)
o Work Programme & Flexible New Deal Scandal
o World Homeless Day