Panorama’s “Disabled or Faking It?”, screened by the BBC, gives a graphic account of the problems millions of people in the UK face when trying to claim Employment and Support Allowance (ESA).
The programme was an exposé of the Work Capability Assessment (WCA) medical tests that are carried out by the private company Atos Healthcare. Since the introduction of the assessment process, up to a third of claimants have been found fit for work.
Atos have been contracted to carry out assessments for the Department for Work and Pensions (DWP) since the inception of the ESA in 2008, when this benefit was introduced under the then Labour government to replace Incapacity Benefit. Some 2.5 million people in the UK have already or will be forced to take a WCA test.
The claiming of ESA involves the claimant having to fill in a complex form, ESA50, and then in most cases to attend the medical examination carried out by a health care professional from Atos. A survey carried out by the DWP showed that nearly a third of those going through the WCA process were described as having “literacy problems”.
At the medical interview the questions asked are generated via a computer program run by a health care professional. The claimant answers specific questions about their condition and how it affects them.
The questions are restrictive and do not reflect the needs and requirements of people with complex physical and mental health problems. Claimants will often describe not being able to explain fully to the interviewer how their illness affects them, as the questions do not seem to take into account the problems they face.
WCA was heralded as a way of weeding out those who had been supposedly left for years languishing on sickness benefits. It was promoted as “enabling” those who could work to be able to get back into work. But the true aim was to further slash welfare spending.
On the basis of vastly exaggerated government claims, faithfully regurgitated by the media, that many people are fraudulently claiming sickness benefits, hundreds of thousands are being systematically removed from the welfare rolls. This is despite the fact that the DWP’s own statistics on fraud showed only 0.1 percent of cases were fraudulent, a minuscule figure.
In the four year period ending July since the WCA system began, more than 600,000 people have had to appeal against the outcome of their WCA interview.
The reality of what happens to claimants who turn up for these tests was also demonstrated by Panorama, with examples such as Steven Hill, who died of a heart attack 39 days after being found fit for work and being denied sickness benefits.
Between January and August last year, up to 32 people who the government had deemed fit enough to be able to go back into work in the medium-term died each week. According to information obtained in a Freedom of Information request by the Daily Mirror newspaper, between January and August 2011, 1,100 claimants died after they were put in the “work-related activity group”. People put into the “work-related activity group”, after a WCA, are given a lower rate of benefits and instructed to look for employment.
The real figure of how many fatalities have resulted from these policies is not known, but the death toll already acknowledged is very likely just the tip of the iceberg. As the Mirror said of its findings, “We don’t know how many people died after being found ‘fit to work’, the third group, as that information was ‘not available’. But we have also found that 1,600 people died before their assessment had been completed.”
The contract to Atos for its evaluations is worth £100 million a year. Since its inception there have been numerous critics that have seriously disputed the fairness and accuracy of the medical assessments, including the “Independent DWP advisor” Professor Malcolm Harrington.
Harrington told Panorama that the system was not currently fit, stating, “There will be people who, because we are in this interim period, will suffer. And I don’t like that”.
Professor Harrington had earlier concluded in an independent review of the WCA in 2010, “There is strong evidence that the system can be impersonal and mechanistic, that the process lacks transparency” and further, “evidence has consistently highlighted problems with each stage of the WCA process, which limits both the assessments fairness and effectiveness”.
The DWPs own statistics show that on appeal up to 30 percent of people win their cases at tribunals. However, Neil Bateman, an experienced welfare advisor who was featured in the Panorama documentary, believes that when people are given proper advice when appealing, this figure rises to a staggering 80-90 percent.
The process of appealing is expensive and time-consuming, with appeals against incorrect WCA decisions costing £50 million a year. This has led to a backlog of appeals, resulting in tribunals having to sit on Saturdays with an additional 30 percent increase in staff.
Many people who have successfully taken their cases to appeal and won are then called to another WCA in a short space of time following the decision.
A general practitioner (GP) interviewed felt that doctors had to pick up the pieces following their patients being found fit for work. They were regularly confronted with an increase in their workloads, due to patients trying to acquire further evidence to assist their appeal of these decisions. In May, the GPs’ annual conference voted unanimously in favour of scrapping the WCA. GPs backed a motion that the computer-based assessments were “inadequate” and “have little regard to the nature or complexity of the needs of long-term sick and disabled persons”.
In 2010, despite overwhelming evidence that the WCA was not working, with particular criticisms of the LiMA computer software system used when carrying out the assessment, Atos health care were awarded a further three year contract worth £300 million.
Panorama included an anonymous interview with a member of staff at Atos, who said there was pressure to see eight clients a day and complete the paperwork for each case as well. Some of Atos’s own employees have said the tests are too harsh.
Prospect, the trade union representing 135 Atos doctors, has stated that the target to see ten or more people a day is unrealistic and will lead to wrong assessments, especially in complex cases.
The Conservative/Liberal Democrat government’s employment minister, Chris Grayling, told the BBC that “there are no targets anywhere in the system”. Yet the government refused to allow Panorama to see the full contract it holds with Atos. Trying to obtain information from Atos as to the accusation of a target-driven culture was very difficult because they were covered by rules of commercial confidentiality.
Following the program, Professor Harrington was removed from his post as an independent advisor to the government.
A number of leading charities and 44,000 GPs have raised concerns that the government is not interested in criticisms of the WCA. Earlier this year Paul Farmer, chief executive of the mental health charity Mind, resigned from the Harrington Scrutiny Panel. The panel had been set up to oversee the work of the WCA Independent Review team. On his blog he gives reasons for his resignation and why he could not continue. Farmer states: “Meanwhile tens of thousands of people are being reassessed using a test which is still not fit for purpose. Around 50 percent of people are appealing against the decision, and a remarkable half of those appeals are being upheld, meaning that as many as one in four tests are wrong. The cost to the taxpayer of the tribunal system alone is £50m, around half of the £100m a year being spent on reassessment”.
Grayling has described the changes to the benefits system as “tough love”. It is nothing short of organised brutality, treating some of the most vulnerable and ill people in society with contempt and indifference to their fate after they are thrown off benefits.