The People’s Review of the WCA: a summary

Yesterday a report was released about the Work Capability Assessment for Employment and Support Allowance.  It contains many stories of poor assessments and inappropriate decisions that a person is fit for work.  Here I have made a summary of some of the problems that the WCA faces.  The full report is well worth reading and can be found at http://wearespartacus.org.uk/wca-peoples-review/

 

The ESA is surrounded by secrecy:

  • Atos Health Care Professionals (HCPs) have to sign the Official Secrets Act
  • The DWP has refused to release details of the contract between the DWP and Atos
  • Details of the Independent Tier that monitors Atos have not been released
  • Data on Quality Assurance checks are not available to the public
  • The report on improved Mental Health descriptors developed by Professor Harrington with Mind, Mencap and the National Autistic Society has not been released to the public
  • recordings of assessments are ‘only provided for the customer’s own personal use’ and will not be routinely used in appeals or as evidence of inaccuracy in the WCA
  • Data on the use of free text boxes during the WCA are not released to the public

 

Evidence suggests the ESA is not working well:

  • 41% of people found fit for work appeal this decision
  • Of this 41%, 38% win the appeal.  This rises to 70% if the claimant has a representative; some representatives claim a 100% appeal success rate
  • 72% of claimants found fit for work are still out of work 12-18 months later[1]
  • anecdotal reports from Jobcentre staff show multiple people are sent to look for work who are demonstrably too ill to work
  • appeals cost £60 million a year; the Atos contract is worth £100 million a year[2]
  • A large backlog of appeals means that the tribunal service has had to:[3]
    • recruit more judges and medical panel members
    • increase administrative resources
    • secure additional estate
    •  increase the number of cases listed in each session
    • run double shifts in its largest processing centre
    • run Saturday sittings in some of the busiest venues
    • set up a customer contact centre to deal with telephone inquiries

 

Atos HCPs are not well trained:

  • reports on training vary, but appear to be measured in days or a small number of weeks[4]
  • HCPs are not required to have a Diploma in Disability Assessment Medicine[5]
  • any training received by Atos HCPs is not recognised by the European Qualifications Regulations 2007[6]
  • The Royal College of Nurses has refused to accredit the training of Atos Nurse assessors[7]

 

WCAs are not well checked for accuracy and quality:

  • Checks are internal and are not open to the public
  • The checks are run by a company chosen and paid for by Atos
  • Professor Harrington recommended unannounced visits to assessment centres, but this has not occurred
  • the National Audit Office said that, “The current target of no more than 5 per cent of reports being graded as ‘unsatisfactory’ is not sufficiently challenging and allows the contractor to deliver a significant number of assessments before financial penalties become due.”[8]

 

WCAs have been criticised by multiple bodies and experts:

  • GPs called for an end to the WCA with immediate effect
  • The British Medical Association called for an end to the WCA with immediate effect[9]
  • The RCN has refused to accredit Atos nurses[10]
  • The Liberal Democrat Party voted unanimously for a Motion calling for the WCA to be changed
  • The High Court has granted a Judicial Review against the Secretary of State for Work and Pensions, on the basis that medical evidence for claimants with mental health issues should be obtained early in the assessment process
  • the National Audit Office criticised the DWP for not seeking financial redress for delays
  • The NAO noted “uncertainty of roles and responsibilities, poor record-keeping and irregular sitting of the Executive Management Board.”

 

Recording of WCAs is variable:

  • no information about the right to have WCA recorded, or how to request this, is provided on either the DWP or the Atos website
  • the Jobcentre said that, “There is no real need for customers to request and use the recording of their assessment.  The recording is only provided for the customer’s own personal use and must not be put into the public domain… If the customer is insistent on the recording being taken into account as evidence, these will be handled on an individual basis and the customer will need to provide consent for Atos Healthcare to share this information with Jobcentre Plus.”

 

Professor Harrington’s recommendations have not all been implemented:

  • work with Mind, Mencap and the National Autistic Society to develop better mental health descriptors has not been used by the DWP
  • Professor Harrington recommended unannounced visits to assessment centres, but this has not occurred[11]
  • there is no requirement for a claimant’s doctors to submit medical evidence
  • there is strong opposition to incorporating a real world test into the ESA assessment process
  • Atos is not required to provide data on the use of free text boxes during the WCA[12]

 

There is risk of breaching human rights:

  • a judge ruled that not requesting data from a claimant’s doctors may breach the Equality Act requirement for reasonable adjustment for claimants with mental health problems
  • the Welfare Reform Bill was not accompanied by a human rights memorandum, and there has not been any detailed analysis of the compatibility of the Bill with human rights obligations
  • conditionality and sanctions could lead to destitution, which would be inhumane or degrading treatment This is particularly problematic where disabled people are judged capable of work when in practice they cannot work; they may therefore struggle to comply with the requirements put on them.
  • The decision to time-limit contribution based ESA to 12 months has not been taken on the basis of any evidence that twelve months is a reasonable time frame in which to expect chronically ill or disabled people to have recovered and/or found work

 

Customer satisfaction with WCAs is low.  Problems include:

  • poor format of the assessment process:
    • irrelevant questions
    • lateral questions
    • lack of consideration from the claimant’s doctors
    • tick-box approach
    • increase in severity and prevalence of mental health problems as a result of the assessment[13]
    • doctors have noted that suicidal tendencies and self-harm are occurring in patients where the WCA is cited as a contributing factor
    • nearly 1000 complaints have been made against Atos so far this year
    • Citizen’s Advice Scotland has received 24 000 complaints about Atos and the WCA[14]
    • investigations have been started into 35 Atos HCPs

 

 


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