Tag Archive | ESA

The Telegraph, ESA and WCA

I wrote this post for Hardest Hit, and have simply cross-posted here.

 

Hardest Hit was pleased to see Isabel Hardman’s piece in the Telegraph on ESA. Ms Hardman wrote to explain that, “Disability testing isn’t working as it should – and Conservatives must have the courage to admit it.” This is an encouraging stance from a right-leaning newspaper and could become the start of increased accuracy in the debate around welfare.

When one knows most of the facts around an issue, it is easy to pick out the misleading from the less misleading newspaper articles. Newspapers don’t routinely cite the sources of their data, which can make fact-checking difficult. If one already knows the facts, this stage is automatically much easier. Knowing ESA as I do, it is refreshing to read an article that is not misleading in either direction.

The Work Capability Assessment for ESA has come under a lot of criticism. As we know, and Ms Hardman points out, 42% of appeals against ESA are successful.[1] Other information exists supporting the claim that the ESA assessment process is inaccurate. The Citizen’s Advice Bureau has reported high levels of inaccuracy in reports made by Atos assessors.[2] Tribunals report that most appeals are overturned due to new oral evidence presented to the tribunal – that is, evidence that would have been available to the Atos assessor had he or she asked the right question(s).[3] The independent Review, headed by Professor Harrington, has said that Decision Makers’ decisions vary in quality and consistency.[4]

The National Audit Office said that there are “serious questions about the quality of the overall decision-making process.”[5] A court judgement on Wednesday ruled that the current system is unreasonable to people with mental health conditions.

There are many reasons to believe that the ESA assessment process does not work; these are just some of the outcome data that suggest flaws in the decision-making process. As Ms Hardman says, the method of assessment is also unreliable. “It fails to assess, beyond someone’s ability to move a cardboard box in the test room, whether they are capable of doing a real job. The activities in the test are removed from workplace realities. … There are some simple changes that could improve the test, although they are unlikely to remedy the inherent flaw: the fact that it doesn’t realistically assess a person’s ability to do a day-to-day job.” Unfortunately, a real-world test – realistically assessing a person’s ability to do a day-to-day job – was the one thing that then Minister for Employment Chris Grayling was “absolutely unreservedly and implacably opposed to.”[6] Incorporating a real-world test has since been rejected on the grounds that there is a lack of “clear, evidence based advice” for what such a test might look like.[7] This “inherent flaw,” which most disabled organisations agree to be a flaw, appears set to remain.

Despite this, there are possibilities for improvement to the ESA assessment process. There could be more time for both the claimant and Atos to request and receive medical evidence; the questions asked of the claimant could be more relevant to the ability to work; the claimant could be provided with more space and time to fully explain the impact their condition(s) has. Other small, or less small, improvements could be made without first radically over-hauling ESA to include a real-world test.

There doesn’t have to be a public collapse of faith in these tests. Although Hardest Hit amongst others may feel that the collapse of faith should already have occurred, the fact that it hasn’t means there is still time for the Coalition government to get ESA right. It is vitally important: it is not just that this “distresses people who deserve better,” but that it drives into poverty and worsened health people who deserve full support. A catastrophe in the welfare reform may well “be enough to prevent any government looking at welfare reform for another generation,” so the Coalition must get this right.

There is potential for great harm, but there is also potential for great good. It is for us to ensure that everyone knows both what is wrong and what can be done right, to ensure justice for all the sick and disabled of this country.


[2] Right First Time, 2012, Citizen’s Advice Bureau

[3] Social Security and Child Support Tribunal hearings: Early analysis of appeals allowed from pilot data, Nov 2012, DWP

[4] Professor Harrington, An Independent Review of the Work Capability Assessment – year two, Nov 2011

[5] 23rd Report; Contract management of contract services, Feb 2013, National Audit Office

[6] Work and Pensions Committee hears from Chris Grayling on migration to employment and support allowance, June 2011

[7] Professor Harrington, An Independent Review of the Work Capability Assessment – year two, Nov 2011

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The Reality of Welfare Reform

When I first started on disability research, I just saw the numbers. I saw that 40% of ESA claimants told they are fit to work then appeal that decision, and most of them win. I saw that nurses under-award points for people with physical health conditions, and physiotherapists under-award points for people with mental health conditions. I saw that most assessments are carried out by either nurses or physiotherapists. I saw that decision makers are not consistent in the accuracy or quality of the decisions they make.

In all of this I saw the fear and the stress for ill people going through an assessment process that they knew to be inaccurate. I saw people calling for, and suggesting, improvements to the assessment process that could make it more accurate. I saw the government say that it accepts recommendations from the independent review, and then either not carry them out or carry them out so poorly that they brought little, if any, improvement.

With my head concentrating on figures I started to become numb to the reality. I forgot how shocking the statistics – the real ones – and the stories are. I told a friend that fraud in the disability benefits is less than half of a per cent, and was amazed at how surprised she was.

So then I started to read some stories. I read about people who cannot afford to put glass back into their broken windows and whose houses are falling into disrepair. I read about people being evicted from their homes. I read about people having cooked meals once every other day, eating bread in between. I read about people skipping medicine because it had to be taken with food and they didn’t any. I read about people having to fund-raise for equipment they need that their local authority won’t provide.

It made me think. I’m middle class so I haven’t seen much of the grinding effects of poverty before. I’ve spoken with people who think benefits are adequate and there isn’t a problem. But I’m seeing the problem now; I know people who are struggling; I’m seeing what happens when there isn’t enough money and there isn’t enough health. I’m seeing the despair.

I’m seeing the effects of the government deciding that people who may return to work from sickness benefits should receive benefit for only one year, even though the majority are still too ill to work at that point. I’m seeing the effects of the government deciding that people under 35 can live in shared accommodation, and thus reducing the housing benefit, without considering the health needs of these people. I’m seeing the effects of the government deciding that people should be charged for under-occupying, even though the under-occupation is this and past government’s fault for not building enough social housing.

And there are so many more cuts and changes. Benefits aren’t being uprated in line with inflation, wages, food or fuel. The Independent Living Fund has been closed. Council Tax Benefit is being reduced. Disability Living Allowance is being replaced with a benefit that ministers knew in advance would cut 20% off the money going to disabled people.

People have ended their lives. People are going without food and medicine. People are becoming homeless.

And this is because of the changes this government is making.

We need to realise what is going on. We need to get angry about what is being done, and let the government know this is not what we want. We need to start protecting those who are sick from extra poverty and stress, and stop listening to the unfounded scrounger rhetoric.

Don’t let the government get away with this. There is still time to make changes that will work, but the government needs to know that we want them. We can stop people dying of despair, losing their homes or becoming even more ill. But we need to let the government know.

Fact-checking FactCheck

Fact-checking fact-check

 

Firms get up to £13 720 for getting a person into a job.  Currently there is a small attachment fee of £400, which is to be phased out over the next few years as companies build up their success and therefore can afford to take people on at their own cost.  The biggest single payment is for a job outcome, paid when a person on JSA has been in employment for 6 months or a person on ESA has been in employment for 3 months.  However the money really starts coming in when people have stayed in jobs beyond the outcome period, as the companies then get between £117 and £370 every four weeks up to one or two years.  Presumably these people are no longer getting support from the Work Provider, so the Provider can just wait for the money to come in every four weeks.

Poor performance of the Work Programme has been linked to the state of the economy, which is worse than was expected when the WP started.  However CESI said the target of 5.5% should be revised down by only 15%, to just under 5%.  The headline figure of 3.4% getting a job is still too small.

However, whilst headline figures look poor, they mask the fact that with each month more people join the programme, without an equal number leaving because their allotted time (2 years) is up.  The appropriate figure is not the percentage with a job outcome out of all who have been referred, but the percentage with an outcome within a set period – not including people who have not been on the programme for that length of time.

So to know how well the programme is doing, we first need to decide how quickly we think they should find jobs for people attached to it.  Assuming that taking up to 12 months is acceptable, then the success rate is around 8.4%.

Fact check does mention this, but not until near the end of the report.  By this time, there has been a lot of comparison of the 3.5% figure to the DWP target of 5.5% and suggestion that the WP is worse than nothing.  ESA figures were submitted to the same incorrect use of maths to get 1.5% finding work; the reality is that 4.1% of those who joined the programme in June-Aug 2011 had work a year later.

Fact check does not provide any data on whether the WP is worse than nothing.  To know this, we would need to know what percentage of jobseekers who had been out of work for 6 months prior to Jun-Jul 2011 and who were not placed on the WP got jobs within a year.

Keeping a job is not just about job outcomes, it is also about staying in work after that time.  For people from ESA, 2000 sustainment payments were paid out.  This works out as the average ESA referral not staying in work for more than six months (otherwise there would have been more sustainment payments).  I haven’t done the equivalent calculations for Jobseeker referrals, but the length of time people stay in work after reaching a job outcome is a crucial piece of information that the government has rather disappointingly not given us,

 

Cost wise, fact check has neglected sum important figures.

Until a person gets a job, Work Providers receive only £400 (attachment fee).  It is therefore not very expensive to have a lot of people on the programme, if being on the programme was all that mattered.  However the key thing is that for the Work Programme to be counted a success, people need to get into and stay in work.  This rapidly raises the costs.

At the lowest end, a Work Provider gets a £400 attachment fee, £1200 job outcome fee and 13 sets of sustainment payments at £170 each – a total of £3810.  At the highest end, the figures are £400, £3500 (all but ESA ex-IB claimants are £1200) and 26 sets of £370 – a total of £13720.

The first thing fact check has forgotten is that sustainment payments occur every four weeks for either 52, 80 or 104 weeks (1, 1 ½ and 2 years).  So most of the money that a Work Provider will get for getting a person into a job hasn’t been paid yet.

Secondly, so far only 8.4% of people got jobs within a year.  That’s approximately 9 people not getting a job to every 1 person that does.  The cost of that one person’s job includes the attachment fee for the other 9 who didn’t got jobs (although if people get jobs in their second year on the programme, the ratio of attachment fees to jobs will decrease; also this fee won’t continue to occur after the first few years of the WP).

All of this means that one job found this year costs between £7410 and £19120.

This means the WP is currently more expensive than the Flexible New Deal, Employment Zones, New Deal for Young People and New Deal for 25+.

 

So the key facts are:

WP success is 8.4%, not the 3.5% used by Fact-Check to compare to the 5.5% target

For ESA claimants, success is 4.1% not 1.2%

The WP is currently more expensive than the other programmes considered by Fact-Check

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

 

 


(Why We’re Not) Benefit Scroungers: Extract 2

The one thing I am absolutely unreservedly and implacably opposed to in all of this is a real world test.” – Chris Grayling, Minister of State, Department for Work and Pensions, 2011.

But the current, not-real-world test isn’t working.

It is not uncommon for a claimant to be signed off work by a GP, and yet be refused benefits.[1]  Nor is it unknown for an employer to consider an employee to be too ill to return to work, yet the employee is refused ESA.[2]  The DWP argue that this is because the ESA assessment considers the ability to carry out any job, not just the one the claimant was in before becoming ill.  However this still conflicts with the GP’s judgement, and the questions asked are so poor that it is often unclear what job the DWP has in mind when assessing a person as fit for work. …

When a system works well, appeals against decisions occur in marginal cases.  In terms of the WCA, the only people appealing should be those who received just under the required points.  After all, most people know whether or not they can walk 200m, dress themselves, prepare a meal, remember to take all their medicine etc.  They won’t appeal if they can appreciate that the decision was fair (n.b. fraud in DLA costs a mere 0.5% of DLA payments, less than the cost of official error.  Fraud in Incapacity Benefit is even lower at 0.3%.  ESA will not be assessed until 2013).  Yet up to February 2010, 60% of appeals overturned in favour of the claimant were for cases that had originally been awarded zero points.  A further 23% had been awarded between 3 and 6 points (there are no 1 or 2 point descriptors), leaving just 17% who had been awarded between 7 and 14 points.[3]  This is unacceptable.  A high percentage of claimants are failing to even come close to having a proper assessment of their health made. …

There is high variability between decision makers [who are non-medical staff at the Department of Work and Pensions].   Professor Harrington, the head of the independent reviews into the ESA assessment, said that “consistency and quality of decision making appear to be key issues.”  This is particularly the case now that Harrington’s previous recommendations have led to an increased importance of the decision maker’s role, relative to the ATOS assessment. …

Professor Paul Gregg, before the WCA was rolled out nationally, reported that, “the test so far has caused a huge amount of anguish to the people who have gone through it. We need to have something that is working accurately before we apply it nationally. We shouldn’t roll this out until we have something that is working.”[4]  Gregg was involved in the design of the new system (ESA and WCA)and  has been described as “one of the most rigorous and high-impact social policy academics in the UK.”[5]


[1] Dryburgh, Unfit for Purpose, 2010, Citizen’s Advice Scotland. http://www.cas.org.uk/publications/unfit-purpose

[2] Dryburgh and Lancashire,The Work Capability Assessment, 2010, Citizen’s Advice Scotland http://www.cas.org.uk/publications/work-capability-assessment

[3] HC Deb, 28 June 2011, c662W

[4] New disability test “is a complete mess,” says expert. 22nd Feb 2011, The Guardian. http://www.guardian.co.uk/politics/2011/feb/22/new-disability-test-is-a-complete-mess

[5]Baumberg, September 27th 2012, Paul Gregg: new ideas for disability, employment and welfare reform. Inequalities. http://inequalitiesblog.wordpress.com/2012/09/27/paul-gregg-disability-employment-speech/

(Not) Coping with the ESA assessment process

This is a guest post from @IHaveaBoomstick, used with permission.

 

This morning two large envelopes from the ESA dropped through my door. One for me, one for my Mum. There they still sit, waiting for Mum to come home.  I am simply too stressed, too afraid, and too afraid of being stressed by them to open them until she gets home.  You see, I’m one of the many sufferers of a mental illness who’ve been somehow targeted by the government as part of their budget cutting process and put through the ATOS-led ESA assessment process.

From February to May this year I was filling out their poorly-designed forms, paying for GP support letters, being refused a letter from East Bristol Mental Health Trust because they stopped treating me in 2008 (referring me back to the GP as no more they could do) and reckoned “the GP can do it,” realising how flagrantly ill-equipped their ‘classification’ system is to cope with mental illness, trying to explain to numerous ESA advisors (or one with a rotating name) how WRAG is a joke and will create massive stress for people like me while serving no purpose, being put into WRAG, having them forget to review it, having them review it and stick by the decision while simultaneously sending me through their own assessors report clearly stating this person is unfit for work for at least 2 years if not more (alongside all the medical reports), chasing the Employment Service about my WRAG appointment, chasing legal aid people only to find out that the system in England is such a mess compared to Scotland that they won’t even represent you at an appeal tribunal …

… well, it’s fair to say that for someone with a chemical imbalance in the brain that fails to regulate stress and anxiety and suffers from major obsessive thinking, mental exhaustion, some depression, some paranoia and all the other things associated with an anxiety disorder it was not fun. Without the support of My Mum who organised and chased the case (herself a working pensioner) I would have utterly crumpled. As it was, it triggered an anxiety spell so major that I took months to fully recover from it. And, as someone who is also a diabetic, the stress dropped my resistance to illness so low that the GPs believe I became ill repeated times as a result.

Then, after sending the written appeal 5 months ago and the Employment Service backing off, it all went silent …

… until the envelopes dropped through my letter box. I’ve not even opened them. Yet, as someone whose disorder needs little to trigger it, they’ve pressed all the buttons anyway.

 

The following is what I tweeted this morning in response – it gets a little sweary and occasionally rambling. But it’s how I feel.  This has been edited to be more reader-friendly.  140 character restrictions make for jerky reading.

My mum and I both had two big letters from DWP drop through the door. Probably another ESA appeal failure. Not going to open it. Already stressing me.

It’s been months and months so I am guessing it’s the written appeal verdict.  Mum took over dealing with it as I pretty much blew a mental fuse.  All one massive disorder trigger. They couldn’t seem to ‘get’ that going there once a month and being judged unfit for at least two years was still both a pointless verdict and actually stressful. I can’t tell WHAT I’m going to be like day-to-day, without having a monthly appointment to stress me

Two big envelopes, one for me and one for Mum.  I’m tensing up now and I haven’t even looked at it yet.  It has just made me immediately mentally tense up so I have no choice but to avoid it and let Mum check it later.

It was the attitude of one of them on the phone saying “what’s the problem, you’re in the same category as cancer patients,” that really upset me.  They’re not quite getting that their whole category system is fucked and cancer patients with no chance of recovery should no more be expected to turn up to monthly appointments which have no purpose whatever then me. They don’t get that a disorder fuelled by having a chemical imbalance which means my stress regulation is f*cked means putting me in a situation like that on a monthly basis is not only likely to kick me off but also damaging in general.  It makes me very angry.   This is a joke system.  Let alone people far worse off and less functional then me still being expected to do it. It isn’t just those people being deemed fit being screwed over by this ridiculous assessment system, but the people further down the ladder being screwed over with pointless stress and discomfort as well, given needless hoops to jump through even when the system acknowledges they’re ill!

 

Ok, let’s treat you to some comedy from the Government. There are 3 benefit groups with ESA – first is “Limited Capability to work.” At the other end of the spectrum is the ‘Support’ group for those people for whom getting back to work probably is never going to happen AND SUPPOSEDLY for if “it is decided that you have a limited capability for work-related activity.” Now here comes the middle group: the “work-related activity group.” This is for all those deemed not well enough to do some work but not fucked enough to count as having “a limited capability for work-related activity.” Said activity being appointments where a back-to-work plan is figured out and you have monthly appointments with an adviser.

Unfortunately EVERYONE is being put in that middle group. Getting into the support group? Impossible.  Suffering from a progressive disease and consequently your death can reasonably be expected within six months – work-related activity group.  So if you’re probably going to die within 6 months? – you’re still expected to attend appointments planning to get you a job. Have a mental disability where you can’t cope for days/weeks at a time, is random when it hits, random when it goes and the NHS have TOLD  you that there’s nothing the psychiatrists can do and medication is barely effective and it ain’t getting better? – work-related activity group.

Now the WRA group says: You cannot be required, as part of a work related activity, to apply for a job, undertake paid work or voluntary work, or undergo medical treatment.  And then it has a “personal adviser who will try to help you back into work.” So, no pressure apart from this member of staff whose job description is to pressure. And, according to many, the whole scheme has incentives for employees to get bonuses by getting people back to work. Which doesn’t encourage pressure at all, I’m sure.

The Jobcentre staff themselves? Not their fault whatsoever. The Government, DWP and ATOS have made a glaring fuck-up of contradictory terms in the categories for people, making the support category too hard to be placed into EVEN FOR THE TERMINALLY ILL!!! And thousands of people who, like me, have serious mental illness, physical illness or disabilities fall between the cracks and get screwed.  Thousands of people who aren’t utterly fucked but are not likely to be work-fit functional indefinitely/forever are hounded, harassed and frankly f*cking TERRIFIED that they’ll be forced back into situations that caused some of them to become ill and/or lose control of their disability to begin with

My life is now about balance and routine, trying to avoid stress, input, any mental stimulation that’ll trigger me off. It’s not great and even with that control it doesn’t work well and I regularly have ‘events’ that pretty much consign me to my room for days/wks. But I’ve fought to get that level of stability. I’m unable to work because of it, rarely go out because of it, rarely socialise due to it.  I have gone through the GPs, psychiatrists, psychologists, meds etc. and after all of it have found this equilibrium for managing day to day.  So when the DWP and ATOS try to fuck that over and give me ½ a page of A4 to respond while ignoring ALL medical evidence, including that of their own f*cking assessor? That, my friends, is a system that is utterly, utterly screwed and will get no better atm. Rant over.

 

If it wasn’t for the fact that I live back at home with Mum and she was supporting me, I’d have been in real trouble I think.  DWP has been quiet for 3-5 months and just that one unopened letter this morning has pressed the buttons. Thing is, they don’t get the complexity of mental illnesses. Due to the nature of mine, I spent years massively damaging my health pushing myself through university and then working for 7yrs because not only didn’t I understand it but I’d got into the mind-set of “it’s all in my head” and used that as a real obsessive trigger. So whenever this kicks off with places like them, I immediately start questioning myself: “is it that bad?,” “you worked with it before” etc. etc. despite EVERYTHING I’ve been through medically with the psychiatrists & GPs since. It’s a mental illness and they just trigger it with their actions even more. I think people in general don’t realise how much many of us manage to f*ck ourselves up mentally before we get diagnosed

 

Ironically that rant will/is probably going to contribute to a spell kicking off and me needing to step away for a bit. 100% worth it.  It took me months to recover from the stress of all this at the start of the year, and one unopened letter is enough to spin me out again.  This is why a lot of people don’t fight it. It is exhausting. Without my parent supporting me, I’d just have meekly let it go.  Whole system is screwed.  Irony is I could open the envelope and it’ll say “appeal won, yay” but I’m just too stressed to do it.

 

The telephone advisor’s words are a bit more difficult to post, though my mum and I were so surprised by their attitude that we felt like recording future conversations just to be sure we didn’t imagine it!

 

I have no problems with clamping down on people cheating the system but the way the categories are judged is purely to deny people access to the support group and I would guess to massage the figures hugely.

The whole process is a rushed job. And a money-maker for the government. They may pay ATOS but they changed regulations so you don’t officially need a GP letter of support. Which means the Government don’t have to pay for one as in the past but, if you don’t get one yourself, they won’t check any details with your GP or hospital etc. it seems. And given the amount of panic there is about being assessed and the knowledge now that the system is so terrible, people being assessed feel getting a letter of support is essential. So you pay the £15+ for it. Which goes back into the NHS coffers no doubt, and then seems to be completely disregarded anyway.

 

So my mum is home, and the envelopes are opened. It’s the appeal papers and the answers DWP/ATOS are giving at it. I’m letting Mum read it first as it’s liable to send me off the deep end again but her initial glance through suggests that, yet again, they’re rigidly sticking by their point-based system whilst completely ignoring medical evidence and what was actually written down. Sad thing is, don’t think we can easily get someone to represent me at the tribunal. Unlike Scotland, legal aid here only gives you brief phone advice on if you have a case but won’t represent you.

 

Ok, I’ve read through their ‘side’ of the case. Basically they’re saying, “by our descriptors, we’ve done nothing wrong” and they’re heavily quoting legal cases. Very much seems as though they’re so intent on going by their points-based descriptor system that they ignore what the person is TELLING them. Joke.

I am not very confident at all to be honest. We’re a working-class family.  We don’t know the legal system and someone who does is unavailable/unaffordable here.  Also humorous how they’re quite happy to find their own medical report from 8 years ago but not pay for one from my GP or psychiatry team. This has moved beyond equal, fair treatment now. To me, this just looks like they want to enforce their system regardless of the person.

No allowance for the fact that “your descriptors are f*cked.”  And actually state a legal case in their appeal to make a point that “in this case, something MIGHT happen isn’t good enough.”  Um, your monthly appointments blowing my stress levels through the roof? That WILL happen. But my testimony due to 15+ years of experience as a sufferer clearly isn’t enough as evidence. Tbh, if all this doesn’t work out, I’d imagine the first person I see for this WRAG thing is going to throw their hands up in despair. And now I’m wound up again.

I can only pray that the tribunal actually takes the time to read everything. But I doubt they will. No-one else on that side has so far.  Sorry for all this ranting folks – it’s just that it feels like all the stress from April that was put on hold has come back.  It is just so depressing. Attending monthly WRAG meetings is both pointless given my future diagnosis and is likely to actively aggravate my disorder. How is that so difficult for them to see and allow for?

Only hope is reading that the tribunal is independent of DWP.  I hate Mum getting stressed about going there but not sure I’d be much use tbh. And if I went there and was present? Can guarantee that the stress would retroactively trigger a spell that’d floor me for weeks. Can’t bloody win.

WCA and the fear it brings

With greatest respect and sorrow for everyone who has attempted or completed suicide.

“84% of GPs say they have patients who have presented with mental health problems such as stress, anxiety or depression as a result of undergoing, or fear of undergoing, the Work Capability Assessment.  21% of GPs say they have patients who have had suicidal thoughts as a result of undergoing, or fear of undergoing, the Work Capability Assessment.”[1]  As Stephen Lloyd, MP, said, Atos is “feared and loathed probably in equal terms.”  Many find the WCA both stressful and upsetting, and Citizens’ Advice Scotland concluded, “It is fair to say that claimants always feel the process is making every condition worse.”[2]

Patients do not only experience suicidal feelings, brought on or exacerbated by the ESA assessment process; they also act on them.  14% of GPs have patients who have self-harmed as a consequence of the distress brought by the ESA assessment, and 6% have patients who have attempted, and in some cases completed, suicide.  This is something that is scaring people so much that they take it out on their body.  It is scaring them so much that sometimes they literally cannot live through it.

As Rethink Mental Illness concluded, WCAs are pushing vulnerable and unwell people “to the edge.”[3]  And sometimes over it.

 

This is not acceptable.  This is supposed to be a test that assesses people’s ability to work, not one that makes their health worse.  It is supposed to separate the unwell from the very unwell, not drive the unwell into the very unwell category.  Of course when I say unwell, I am talking largely about people who are ill enough to have been out of work for 28 weeks; otherwise they would still have been on Statutory Sick Pay or gone back to work before their SSP ran out.  So it’s not like these are people who are just a bit peaky, to quote Rod Liddle’s definition of ME and Fibromyalgia. (The Sun, 27/1/12)

Genuinely sick people are terrified that they won’t get the support they need.  They know they are too ill to work, but also know they are likely to be found fit for work.  Their fears are not based on rumours.  ESA has been in place for four years, so the people living in fear now have been through the system and know what it is like for themselves.  In that time, appeals have led to 38% of initial refusals being overturned, 60% of which were originally assigned 0 points; if a representative such as a CAB volunteer is present, then appeal overturn rates can reach 100%.  Report after report has highlighted the errors, inaccuracies and falsehoods that are leading to very ill people being found fit for work.  Labour has called for a review; the British medical Association has called for the WCA to be scrapped immediately.

These people are not basing their fear on hearsay.  It’s based on fact and personal experience.  These people are scared because they know the system, they know it doesn’t work, and they know their money is being stolen.  They have a right to it legally – appeals are judged according to the law – but their payments are being stopped.

 

The government and the public need to know this is happening.  They need to know that there are people so ill that, when they are found fit for work, death is a more viable option than an attempt to go on Jobseeker’s Allowance with its attendant interviews.  They need to know that people who weren’t mentally ill are becoming so; people who were mentally ill are becoming suicidal.

“These figures demonstrate how urgent it is that the Government overhauls the test. It is putting a strain on individuals, families and the NHS. The human and economic costs are too great for the Government to continue with it. We urge the Government to halt the system now – it could be the difference between life and death for some of the most vulnerable people in our society.”[4]

As Tom Greatrex, MP, said, “There is clearly a problem when an assessment that is designed to help people back into work ends up having the opposite effect.”


[1] Rethink Mental Illness: New GP survey shows Government welfare test is pushing vulnerable people to the brink. http://www.rethink.org/how_we_can_help/news_and_media/national_press_releases/new_gp_survey_shows.html

[2] Dryburgh, K. and Lancashire, M., September 2010 The WCA: A response from Citizens’ Advice Scotland. CAS

[3] Rethink Mental Illness

[4] Rethink Mental Illness