Tuesday, July 31, 2012

Sick and disabled being pushed off benefits at any costs

As Panorama showed, the pressure on medical assessors to declare sickness benefits claimants fit for work is immense

Chris Grayling
Employment minister Chris Grayling told the BBC 'there are no targets anywhere in the system'.
 
guardian.co.uk,

Viewers of last night's Panorama programme, Disabled or Faking it?, may have been shocked by the story of Stephen Hill, the man who died of a heart attack 39 days after he was declared fit to work by a government contractor and subsequently denied sickness benefits by the Department for Work and Pensions (DWP). But for those of us who have been voicing serious concerns about the government's changes to employment support allowance (ESA), the story was met with both exasperation and frustrating familiarity.

A parliamentary question found that 31 people have died in the three years to last October while appealing against decisions that they were able to work. Panorama also revealed that between January and August last year, on average 32 people died every week who the government had declared could be helped back into work in the medium term.

To receive ESA, the new incapacity benefit, the vast majority of claimants have to pass a working capability assessment (WCA) – a short medical test carried out by government contractor Atos Healthcare. The WCA is so consistently failing to recognise those who are in dire need of support that it is hard to understand why society is not in uproar. The cost to the government alone is staggering. Appeals against incorrect WCA decisions are costing £50m a year, with tribunals having to sit on Saturdays and increase staff by 30% to deal with the backlog. Appeals find in favour of the claimant in at least 30% of cases, according to the government's own statistics – although Neil Bateman, a welfare adviser featured on Panorama, believes this rises to a staggering 80-90% if the appellant seeks the help of an experienced adviser.

With such high costs to the taxpayer to manage the assessment and appeal process plus the health implications to those British citizens left abandoned by the government when they are most in need of help, the coalition must find a commonsense approach to the ESA.

Firstly, it needs to be open about the allegation that the government and/or Atos have been set targets to minimise the number of people that can be found incapable of work. The DWP and Atos Healthcare both gave firm rebuttals to this allegation by both Panorama and Dispatches, which also aired a programme last night looking into the same issue of sickness benefit. The employment minister, Chris Grayling, told the BBC that "there are no targets anywhere in the system", although the government refused to allow the broadcaster to see the full contract it holds with Atos.

But both programmes uncovered a system in which assessors would be put on "targeted audit" if they were found to put too many people into the "support group" of ESA, with Dispatches uncovering that only about 12-13% of people should be found unable to do any work at all. Steve Bick, the doctor working undercover in Atos for Dispatches, said that of the eight cases he dealt with before resigning, he was asked by Atos hierarchy to review his decision on four of them. As one assessor put it in Panorama, such a system "creates a feeling there are indeed targets". If we are to believe the government's statement that targets are not set, then something is clearly going wrong between the instructions given to Atos by the DWP and the spirit with which they are implemented by assessors on the ground.

Moreover, with Atos's government contract valued at £100m a year, it is reasonable to expect it to have some financial accountability for the high rate of successful appeals. However, Dispatches revealed this isn't the case. As one Atos trainer states: "The thing for us is, even if you made the wrong decision … you never go to the tribunal. So, sort of, you won't be blamed."

The medical test in its current form isn't fit for purpose, and the government's contract with Atos Healthcare isn't providing the value for money that taxpayers deserve. It is reasonable that the government suspends its relentless reassessment of 11,000 sickness benefits claimants every week until practical changes can be made to the medical test that protect the genuinely sick and disabled.

Yet, in a worrying development, professor Malcolm Harrington, shown criticising the WCA in last night's Panorama programme, was removed from his post yesterday as an independent adviser to the government on the WCA. He insists he hasn't been sacked, but the move will add to concerns by leading charities and 44,000 GPs that the government has little interest in listening to critics of the WCA. Perhaps the greatest concern raised by the two programmes is how committed the government is to making changes to a system that Grayling believes is providing "tough love". In research released last week by the Institute for Employment Studies, carried out on behalf of the DWP, 25% of ESA claimants that had been found fit to work are neither back in employment nor receiving benefits – a statistic the DWP seems unconcerned by.

It is this government's laissez faire attitude to whether those thrown off sickness benefits are able to move into the workplace that makes campaigners believe that underlying the harshness of this medical test is a desire to reduce the welfare bill at any cost. No wonder sick and disabled people throughout the country live in real fear of when the next brown envelope from the DWP will drop through their door.

Guardian